State Universities Annuitants Association
Mini Briefing
August 28, 2009

This issue is dedicated to the Policy Change for Group Dental Insurance

Because of the over-whelming number of telephone calls and emails received by the SUAA office, (not-to-mention the number received by SURS, CMS, AFSCME and the Governor’s Office) it has been determined that more information needs to be provided. Even this attempt might not cover all of the questions that have been put forth, but it is at least a beginning to explain the recent occurrence that caused a change of policy for Dental Insurance.

Beginning Monday, August 17^th, letters to retirees and survivors of the State Employees’ Group Insurance Program were mailed or at least delivered to the mail service in charge of sending out the information. Do to the vast number of retirees and survivors it has taken at least a full week for the recipients to receive this notification. As of today, some still have not been formally informed. If you have not as yet received your letter, please visit:

http://provider.healthcare.cigna.com/soi.html or http://suaa.org/assets/doc/Dental%20Policy%20Change%208.09.htm

This policy change does not in any way affect the Community College retirees or survivors. The Community Colleges have a different health plan – the College Insurance Plan (CIP).

It is important to know that University retirees and survivors are not being discriminated against as has been suggested. Community College retirees and survivors have always paid and will continue to pay a premium for their dental care plus health care benefits, eye care, behavioral health and pharmaceuticals.

Again, to be stated:

This policy change was not a result of an end to a contract.

ASFCME did file a grievance with the CMS Labor Relations Department. There will be a response from CMS Labor Relations Department. The next step would most likely be arbitration, but it could take a while to progress.

The decision to charge a premium for Dental Care was made by CMS, Group Insurance Division, Bureau of Benefits and Health Care and Family Services. Although legislators did not seem to be aware (nor were the unions or any other affiliated organizations), it is most likely the Governor was informed and supportive of this change. Individuals behind the scenes are unknown. But it is no secret that the State is in a financial crisis and is continuing to find ways to cut costs.

It seems that the Dental Insurance has always been a separate insurance, but possibly not realized once a person is retired or becomes a survivor. All current employees do pay for this insurance. The cost can be found on their payroll slip. For those who are retired and are having health insurance premiums deducted from their pension checks (due to not enough qualified years for health coverage or for a spouse), the Dental Insurance had always been provided to these pension members without charge. In other words, this population of retirees have benefited from Dental Insurance along with all other retirees and survivors without a cost to them.

During open enrollment consideration of a policy change for Group Dental Insurance was not conveyed or even suggested. Accordingly, a Policy Change within the department does not need to be conveyed because the decisions made by the retirees and survivors during open enrollment would have no bearing on the coverage of the insurance. All members receive the same coverage. There are no choices.

What was not and is not realized - Dental Insurance is separate from Health Insurance. Health Insurance has and does only cover health, behavioral health and pharmaceuticals. Eye Care is considered a bonus within the health insurance package or better known as “bundled” coverage.

Could Eye Care ever be removed from the bundled coverage? Yes, because as stated, it is a bonus at this time. The next time the Health Insurance coverage is negotiated it could be omitted. At this time, there are no plans to change the Eye Care coverage, but again, it would be a part of the negotiations between CMS and the health insurance company which at this time is CIGNA. Coverage would still be available, but possibly considered as Dental Insurance is – a separate insurance.

In looking at the CIGNA website ( http://www.cigna.com/our_plans/dental/for_you.html ), it can be noted that Dental Care is separated from the Health Care Insurance Policies. The Benefit Choice books supplied to all enrollees also convey this message. The assumption seems to be that because Dental Insurance is listed in the book, it is considered part of the package or bundled benefits. It can’t be said enough, Dental Insurance is a separate group insurance.

Is the cost of Dental Insurance a good deal? The Dental Insurance benefits have definitely increased during its availability. In the beginning, the coverage was minimal - general cleanings and tooth fillings, but it has evolved into much more than those in the private sector are able to have covered at such a low premium. What Dental Insurance now covers can be found on the CMS website, the SUAA website and in the Benefits Choice books. Each individual should make their own determination of Dental Insurance being a good deal for them.

It needs to be noted that Benefit Choice books need to be read and kept. Comparisons of the coverage can be made by keeping those books from one year to the next. Assumptions can be detrimental to your decisions. As with private sector health insurance, coverage does change from year to year, as does the deductible or lifetime limits.

If you choose not to continue the Dental Insurance at this time, you can re-enroll during open enrollment next year or during any open enrollment period in the future.

Spouses who have both retired and are receiving pensions from any of the pension systems cannot elect to discontinue the Dental Insurance and be covered by the other spouse at this time. The reason - this is not an open enrollment period, it is only a policy change within CMS. Policy can change at any time.

Public Act 91-0395 has been reference many times this past week. It amends the State employees Group Insurance Act of 1971 by changing Sections 3 and 10. By reading through this act, it will be found that:

Section 3 (m) states “Optional coverages or benefits” means those coverages or benefits available to the member on his or her voluntary election, and at his or her own expense.

(n) “Program” means the group life insurance, health benefits and other employee benefits designed and contracted for by the Director under this Act.

(o) “Health plan” means a self-insured health insurance program offered by the State of Illinois for the purposes of benefiting employees by means of providing, among others, wellness programs, utilization reviews, second opinions and medical fee reviews, as well as for paying for hospital and medical care up to the maximum coverage provided by the plan, to its members and their dependents.

The paragraphs above are worth noting. To continue:

Section 10. Payments by State; premiums.

(a) The State shall pay the cost of basic non-contributory group life insurance and, subject to member paid contributions set by the Department or required by this Section, the basic program of group health benefits on each eligible member, . . .

The concern for the policy change at CMS is most likely due to notification not being made. Or, the method in which the change came about. Many are wondering if this is just the beginning of other benefits being chipped away over time.

There is no crystal ball to guide us. The State is financially strapped. It is in a financial crisis. In fact, in such a crisis that CMS did not have the money to send notices to each and every person affected by the change in policy for the Dental Insurance. Should the unions and other organizations been notified – most likely the answer is yes because the word could have been spread, but there doesn’t seem to be forward thinking or even critical thinking about outcomes to the decisions that have been made or are being made.

Good decisions need to be made going forward; past actions from the legislators and the Governor’s office are hitting hard. It is definitely time for all of us to become more knowledgeable.

The money received from the paid premiums will most likely become a part of the General Fund. It would make more sense for this money to be paid towards the dental claims that are currently in arrears. Payments for dental claims are now being held 105 days.

If you are currently involved in dental procedures or your dentist is requiring payments to be paid before any type of treatment, please talk to your dentist about this situation. Find out what the lowest payment might be in order for you to receive care. Paying the premium for Dental Insurance is most likely the choice you need to make under these circumstances.

The best place to send your concerns is to the Governor’s Office:

The Honorable Patrick Quinn
The Governor of Illinois

Springfield Office: 207 Statehouse, Springfield, IL 62706
Chicago Office: James R. Thompson Center, Suite 16-100; 100 West Randolph,
Chicago, IL 60601-3220

You may also continue to call or email the SUAA office of your concerns.

217.585.2370 or suaa@suaa.org or linda@suaa.org