University Employees Dealing With Frozen Medical Claims

Union officials at the University of Illinois are grappling with the recent news that a number of state employee health insurance claims will not be processed amid a state budget stalemate.

U of I employees were told in a mass e-mail this week that those with self-insured health plans -- Health Link OAP, Quality Care, and Coventry OAP - as well as Delta Dental, should call ahead of upcoming appointments to see if they must pay in advance and get reimbursed later.

Ricky Baldwin with SEIU Local 73, representing building and food service workers, said some members live paycheck to paycheck, and can’t afford to pay up-front.

Meanwhile, Non-Tenure Faculty Coalition Local 6546 President Shawn Gilmore, which represents about 500 U of I faculty members, said his members are having trouble with routine prescription renewals, and planning doctor visits.

He cites one colleague who requires them each week.

“Because he’s diabetic," Gilmore said.  "He’s in the unit, and he said that he’s very concerned, because this is a weekly sort of thing because he has to go in for something related to his condition.  He’s not quite sure what to do at the moment.”

Gilmore, an English lecuturer at the U of I, said he questions whether asking employees to pay up-front is a violation of contracts that just started with the beginning of the academic year.

"This caught a lot of us really off guard," he said Thursday.  "I literally had no idea a day and a half ago that this was a standing issue."

Claudia Lennhoff, Executive Director of Champaign County Health Care Consumers, also urges U of I employees and other workers under those health plans to check in with the health care provider ahead of appointments.

"I know some of the health care providers are willing to work things out, and let things go forward," she said.  "So I definitely would recommend that people do not cancel appointments or cancel procedures.  It's too soon to be doing anything like that.  I would also say don't panic, but stay tuned and stay informed."

But at least one health care provider, Carle, said it’s still accepting patients in both self-funded and fully insured plans. 

Spokesperson Jennifer Hendricks-Kaufman issued a statement, saying they’ll be required to pay only their portion of the bill, such as a copayment.

"It often takes considerable time to receive State of Illinois reimbursements," she said. 

In the interest of disclosure, employees of WILL are state employees, covered by various state health plans.