Some state workers’ families caught in middle of insurance audit

“How can it be anything else but fraud?” a political wonk posted on Twitter yesterday after MPR’s Tom Scheck broke the story that 3,100 family members of state workers have been removed from state health insurance coverage because they are ineligible.

Catherine McDonnell-Forney of Minneapolis can easily answer the question.

McDonnel-Forney, whose husband has worked for the Department of Vehicle Services since 2007, is eligible for health care coverage. But she only found out she’d been dropped when she went to the pharmacy earlier this month.

“We did not find out until I went to fill a prescription after the first of August and was told I had no insurance and would have to play the full price,” she told me today. “We still didn’t receive notice until about a week after the first of the month.”

How did she end up in this situation?

“Employees were asked to have paperwork submitted by the middle of June. Employees were sent an email and then four reminder correspondence to their homes. We were asked to submit our wedding certificate, our daughter’s birth certificate and a utility bill. The paperwork was sent before the deadline,” she said.

Her husband turned in the documentation on time, she says, but the outside consulting firm that the state employed to conduct the audit says it didn’t receive the paperwork. Scheck’s story indicated 770 families reportedly didn’t turn in the documentation.

“I work for a small nonprofit with only six employees and we are not offered health insurance, so my daughter and I are dependent upon my husband’s health insurance policy,” Ms. McDonnel-Forney said in her e-mail to me. “Because we weren’t notified until after the beginning on the month, I was not able to get any health insurance for the month of August. We will hopefully be able to be covered from September 1st through January 1st when we can be added back on to my husband’s policy and hopefully won’t need to go to the doctor or the emergency room for any reason.”

She says they appealed the decision that tossed them off health care, but it was rejected.

“We got a letter saying that we failed to qualify and that we were eligible for COBRA, which we are not taking because it’s obscenely expensive,” she said.

Instead, she’ll pay $175 a month for a Blue Cross policy with a $9,000 deductible that will cover routine care.

“I’m mostly anxious not being covered for the next 2 1/2 weeks. You don’t plan accidents, ” she said.

“What makes me so mad is the shabby manner in which a dedicated employee is being treated and I’m sure that the public reaction is that we were defrauding the state and stealing tax dollars.”

  • http://www.farces.com/ Michael Fraase

    // Her husband turned in the documentation on time, she says, but the outside consulting firm that the state employed to conduct the audit says it didn’t receive the paperwork.

    Bingo.

  • Kris A

    I am more inclined to believe the family with the kid than I am a consulting firm. Having no insurance, especially with a child is terrifying. Ultimately no matter who you believe, if they DO qualify, and HAVE been on the insurance for the last 5 years they should just be put back on. No one is being cheated here except the family and ESPECIALLY the child.

    I have my fingers crossed for you Catherine and your daughter, stay healthy.

  • Kassie

    Part of the problem all along was there was no way to confirm if they received your paperwork. I know of some people who submitted it multiple times, multiple ways to make sure. Also, some of the paperwork they were asking for was difficult or expensive to get, like marriage licenses from foreign countries.

  • nt

    This law was an especially vivid piece of douchebaggery. Birth certificates required for every child, poor feedback from the consulting firm, poor notice that documentation was complete/incomplete, questionable security practices with private data, etc. It was a total waste of tax dollars. The law essentially read like the republican leg. majority giving public unions the bird.

  • Kassie

    Of course, the Republicans backed off a bit when they realized that they too were covered under the law. I’d like to see a breakdown of which branch the employees who lost coverage for family members work in and which level of work they do (AFSCME, MAPE, Management, Etc).

    I do find it hard to believe that there isn’t an appeal process. Forcing people to wait until open enrollment is cruel. Generally if there is a “qualifying event” we can add other family members before open enrollment. One such qualifying event is “significant cost or coverage changes (including coverage curtailment and the addition of a benefit package).” Seems they should fall under that and be able to sign family member up again immediately.

  • Jamie

    I know one person who wasn’t able to get all the paperwork she needed, and I heard about others. I wonder how much of that $10 million they’re saying will be saved comes from situations like that.

    Of course the Republican bullies are using this as another way to demonize public employees.

  • BJ

    My wife’s work did this about 2 or 3 years ago. Very similar results. Total number of employees was around 3000, and around 300-400 dependents were removed as not eligible. I think they said around $500,000 in savings per year to the company.

  • Joanna

    Isn’t this something the Attorney General can look into? It seems to be a case of a company hired by the state that has perpetuated fraud and deprived state employees of their benefits.

  • Christin

    This is ridiculous & I feel for all the families impacted. What a debacle.

    This situation seems like a crash course in what it is like to be poor everyday. Loads of bureaucracy and paperwork to get basic needs (such as healthcare) and lack of insurance for your kid in the meantime. Maybe all state legislators and congressmembers should experience this as a part of job training.

  • allie

    I’m a state employee. The insurance verification was a stupid, stupid process, and made me feel like a fraud, despite the fact that we turned in our paperwork on time and knew my husband easily qualified for his coverage under me. Ah, such is life when you’re a state worker. It’s hoop-jumping central up in here.

    The majority of my co-workers greeted the whole thing with an exasperated sigh and an eyeroll–they’ve been around for longer than I have, and have seen worse measures come and go from the legislature.

    Just for once, could the legislators trust us to do our damn jobs and not assume we’re all loafers and criminals?