EUTF Open Enrollment

EUTF Open Enrollment *** In the interest of full disclosure, I am employed by HMSA and the following post will be biased toward my employer. HMSA has not paid or asked me to write this post. The above chart is from the Open Enrollment Reference Guide. The Employer-Union Health Benefit Trust Fund (EUTF) will offer Open Enrollment (OE) for health plans to all active State of Hawaii employees starting in November 2009. Open Enrollment is the time of year when employees can make a choice of what health plan they wish to have for the coming year. This is an annual process. Most of the time (and I am an example of this) when you first get hired your company will lay out its benefits choices and you setup which plan you want to go with and forget about it. Each year you are told if you don't do anything at Open Enrollment, you will rollover to your current existing plan. This is all about to change with the 65,000 active State of Hawaii workers. As described in the first option, if you currently have HMSA 90/10 PPO and you do nothing, you will get converted to HMA 90/10 PPO. HMA is a Mainland company, part of the family of I/MX family of companies based in Tempe, Arizona. If you want to stay with HMSA you will need to fill out the EC-1 form, specifically selecting HMSA.  This is very different from previous years. Action needs to be taken to stay with HMSA. I won't get into details as to why this is being handled this way. A lot of it has to do with price. Plans are different and in this OE period HMSA is offering an 80/20 PPO plan. HMSA will outline the different plans and benefits in forthcoming news releases. My intent here is to make people aware of this change. At the end of the day, each State of Hawaii employee will need to make their own decision regarding health plans based on their finances and the value their plan choice provides. I only hope that people make informed decisions and not placed in a plan because they were unaware of the change. If you have any questions please feel free to post comments here and I will personally track down the answers. If you read this post please pass it on to a fellow State employee. Mahalo!

21 thoughts on “EUTF Open Enrollment”

  1. Well, leave it to a bunch of state workers to screw everything up and then get paid overtime in their attempt to fix the mess they started. To avoid defaulting to the HMA, I filed my EUTF paperwork early. Had my dependants approved and received confirmation. Low and behold, the EUTF office cancelled my wife from my HMSA. It appears to be an error, because everything was filled correctly and on time. The problem is, they are not answering their phones. I’ve been trying to fix this since February 2nd and have yet to get someone on the phone. They will not see you at their office. I’m fed up!!!

  2. What i would like to know is who authorized a AUTOMATIC DEFAULT TO HMA IF YOU DONT COMPLETE THE FORM ON TIME???
    Who did HMA pay off? Why isnt the unions tring to stop this corruption? Why are they forcing us to get our medication through the mail?
    WHO GAVE HGEA PERMISSION TO LET THEM SWITCH TO EUTF IN THE FIRST PLACE?

  3. Ola, where did you find a list of HMA providers? If mine are on there I’m switching also. I think I can get rid of Informed then. They are unprofessional, unimformed and downright incompentent people. I do not want to trust my meds with them. Any ideas on how to stay insured with HMSA or HMA without Informed? My many years with HMSA have been great. No complaints at all.

  4. I go to the doctor when I’m sick, period. EUTF is giving their top tier option to HMA. You tell me why, I have no idea. What’s the reasoning?

  5. Ola
    TheEUTF is a self -insured plan. That means the EUTF determines the rates/premiums that are charged. HMSA administers their plan with customer support and the wide range of other benefits offered by HMSA. HMSA only gets an administrative fee from the EUTF. So it comes down to which adminstrator (HMSA or HMA) offers you more value beyond just processing your claims. Larger physician network, local company, local customer service, health & wellness programs, healthy lifestyle discounts, and much more are provided by HMSA. Do some research on how HMA (thru its subsidiares NevadaCare and Iowa Health Solutions) has serviced its members in Iowa, Illinois and Nevada. Oops, sorry I forgot they pulled out of all of those states because of reported substandard service. In Iowa’s case, they had to surrender their license and promise not to do business in that state for 5 years.

  6. Actually I can’t choose an experience I already know. There is no HMSA 90/10 plan. They choose to raise their rates above the already increased interim ones, to a level I’m assuming the state felt wasn’t worth keeping even with their long standing relationship. Otherwise why not offer a 90/10 HMSA plan to compete. I’m actually confused as to why the state didn’t just drop HMSA completely. I would think HMA could offer a cheaper 80/20 plan as well. I’m sure there’s a whole lot of politics involved.

    Anyway I went to my doctor today and they didn’t seem to have anything bad to say about HMA. They just said I might have a little lower copay.

  7. Ola, good question. You might look at it this way. If you have not had the necessity to interact with HMSA over the years, that might mean HMSA was able to process your benefit claims without incident. If all works well HMSA is pretty transparent. HMSA does provide various services which might go unnoticed, like health screenings, flu shots and wellness programs. If you move over to HMA your experience will be determine by the degree you may need to interact with them. Right now it is to early to tell what that will be. In making your decision, you can choose HMSA which is an experience you already know, or go with HMA and find out what their customer service is like. If you have any questions you can check out the HMSA site at http://www.hmsa.com/eutf or call HMSA at 808-948-6499.

  8. I currently have HMSA 90/10. I checked the HMA site, and all the doctors I’ve been to also accept HMA. I currently have HMSA 90/10. Why would I want to switch to a 80/20 plan to save a couple bucks a month? I have never interacted personally with HMSA itself, just with doctors and hospitals who appear to work with both HMA and HMSA.

    Having to avoid one-time paperwork with my doctor to switch to HMA(re-register) doesn’t seem like that big a deal. Same amount of effort to do the paperwork to keep HMSA during open enrollment.

    I am trying to figure what to do. I just would like to find out what would be a negative of defaulting to HMA, other than the not local thing. I’m sure they will have local office with local staff that I will never personally interact with just like HMSA.

  9. Where can I find/get a listing of all physicians/medical specialist that will accept HMA? And do I need to re-register or get new doctors as Eric indicated?

  10. sorry… my previous comment has an old Employee/ Employer Contribution Form. apparently the 2010 form is not available yet.

  11. thank you for this information!
    my family is burdened by the high cost of HMSA and are looking for a comparable plan and your blog has helped. we love HMSA and our doctors but we are forced to make a switch to a more affordable plan. while we are in a position to make a switch we need to know what the implications are and what plan will be right for us.
    i recently visited the EUTF website and could not find the Open Enrollment Reference Guide, thank you for providing that. i noticed the Reference Guide did not provide the Employee/ Employer Contribution Form here it is:
    http://www.eutf.hawaii.gov/OE_2009/Interim_Rates_eff_7-1-09_to_12-31-09_County_Employees.pdf

    aloha,
    amy

  12. Admin, you are right. HMSA offers the 80/20 plan, HMA the 90/10 plan.

    Although I’d prefer to have a 90/10 plan, HMSA is the provider I’ll be writing down. I don’t want to get new doctors, I like the ones I already have. Too much hassle, and the HMSA plan is cheaper.

  13. Aloha Keola, as far as I can tell the 80/20 plan is what HMSA is offering. I can double check at the office but Kalani sounds like he figured it out.

  14. Being on my wife’s HSTA-provided plan, we got automatically switched from HMSA to HMA in July. What a mess that was, having to re-register with all our physicians and pharmacies. We switched back to HMSA just as soon as HSTA would let us.

  15. Keola, you got to switch to pick the 80/20 plan. I was confused about it too, but figured it out eventually. I’m the same way, want to stay with HMSA no matter what. I want my health care to be handled by a local company that I trust.

  16. Burt, I got my EUTF newsletter today and I’m kind of confused. If we want to stay with HMSA do we have to pick the 80/20 plan or can we stay with the 90/10 HMSA plan? The way it looks if we want the 90/10 we have to switch to HMA, maybe I’m reading it wrong. I want to stick with HMSA no matter what. Mahalo for this post.

  17. Thanks for the info. I do not want to lose HMSA, and had already planned on selecting to stay with HMSA. You are right though, most state workers probably aren’t thinking about this right now, with layoffs and all.

    Rowena, we should do our part and spread the word to our coworkers.

    Big mahalos

  18. hey burt — thanks for the info — most of us state employees are so caught up in the layoffs and bumping, that this will probably NOT be on anyone’s mind. Considering how much ruckus was caused by EUTF going with InformedRX, I’m sure state employees won’t know that they have to pick HMSA if they want to stay with HMSA.

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