New state health insurance takes effect - WALB.com, Albany News, Weather, Sports

January 2, 2006

Albany - Teachers, state employees and retirees have begun the new year under a new State Health Benefit Plan. Tonight, there's still old debate over whether that plan was the best choice. 

After statewide concern over higher out-of-pocket costs with limited doctors and services, United Healthcare now insures thousands of Georgians.  

In November, hundreds of state employees packed Albany High School to voice their concerns.

 "To talk about how scared they are. That got my attention," says Peggy Nielson, a member of the State Board of Education.

Nielsen has heard hundreds of concerns from the start.

Although there's been some progress with added providers and coverage, the questions continue.

"I have continued to get e-mails, calls, and letters from both educators, state employees, retirees and even providers," says Nielson.

And although many providers have signed up, many state employees worry they still won't be covered because their physician's credentials haven't been cleared by United Healthcare.

"Some of them have called because they are to go into the hospital this week and their providers whether it be the hospital or the physician are not listed on the provider list. This may have to do with credentialing," says Nielson.

Which may add up to substantial out-of-pocket expenses. The credentialing process also troubles providers.

"There's one group in Albany that sent their entire credentialing package in in June of 2005, 32 providers and of this very day, only 11 have been credentialed," says Nielson.

Nielson feels that in order for the rest of the contract with United to be successful, some work needs to be done quickly.

"This is something that the Governor needs to address and United Healthcare needs to address. They need to clarify the issues," says Nielson.

If the issues aren't clarified, many state employees want an immediate change.

"If United Healthcare does not faithfully execute this contract, they want it terminated," says Nielson.

But the basic issue comes down to employees simply wanting a benefit plan that serves them.

"Does United Healthcare have the capacity to do that?  You bet they do. They are one of the richest companies on the New York Stock Exchange," says Nielson.

Many are watching closely to make sure that plan is carried out.