Court lifts stay on state worker HMO contracts

Sep 23, 2011

The following article was published in The Florida Current on September 23, 2011:

Court lifts stay on state worker HMO contracts

By Gray Rohrer

Florida’s 1st District Court of Appeal has lifted the stay on health maintenance organization (HMO) contracts for Florida state workers and a date for open enrollment to begin has been set.

Minutes after the decision ending the multimillion dollar legal tussle was rendered on Friday, the Department of Management Services said open enrollment in the health plans for state employees would begin Nov. 7 and runs through Nov. 18. The health plans take effect in January, and
DMS will host benefit fairs across the state, beginning today in Tallahassee, to provide information to state employees about he health plan changes.

The first fair is set for today at the Betty Easley Center at 4075 Esplanade Way in Tallahasee.

This summer, Gov. Rick Scott and DMS wanted to limit state workers to one HMO for each county. HMOs fought that proposal and last week DMS settled with five of the six HMOs contracting with the state.

After Friday’s decision, the last holdout, UnitedHealthcare, signed a contract to be the sole health care provider for state workers in 18 counties (Bay, Charlotte, Collier, DeSoto, Glades, Gulf, Holmes, Jackson, Lafayette, Lee, Monroe, Okaloosa, Okeechobee, Putnam, Sarasota, Taylor, Walton and Washington).

An administrative judge ruled this month that UnitedHealthcare did not post a bond in the appropriate time to file suit, but the company carried on its legal challenge.

The state touted $400 million in savings over the next two years with the new plans, but the HMOs initially claimed those savings were overblown.

Under the settlement with DMS, state workers in six counties – Broward, Flagler, Miami-Dade, Palm Beach, St. Lucie and Volusia – will be able to choose between two HMOs for plans that begin in January. State workers also  will be able to choose a health plan from a preferred provider organization (PPO) provided by Blue Cross and Blue Shield of Florida.

“We are pleased that eligible state employees and retirees in all 67 Florida counties will have the option of both HMO and PPO plans to choose from during Open Enrollment. The procurement process and awards made by DMS were sound and appropriate and achieve significant value for the State,” DMS Secretary John Miles said  in a released statement.

AvMed, the largest health care provider to state workers in Florida, will serve 37 counties next year. The changes mean about 23,000 workers across the state will have to sign up with a different HMO, but AvMed President and COO Ed Hannum said he will work with state employees to “minimize disruption.”

“Choosing a health care plan is an important decision. We will work closely with the DMS to help employees make the decision that is best for them and their family.  Our priority is to make this a smooth transition with minimal disruption,” Hannum said.

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