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Panhandle workers unhappy with PEIA

January 30, 2001

Panhandle workers unhappy with PEIA



By DAVE McMILLION / Staff Writer, Charles Town


MARTINSBURG, W.Va. - Public employees in the Eastern Panhandle are complaining about problems with their health insurance, including slow processing of claims, confusion over which providers are covered by the insurance and complicated policies.

Many of the complaints have been directed at Acordia National, a Charleston-based company that was hired by the Public Employees Insurance Agency to process claims for the insurance service.

PEIA director Tom Susman said Acordia National has done a "very bad job" helping public employees understand which medical providers are included under the insurance plan.

Susman warned Tuesday that if Acordia National's service does not soon improve, he will find another company to do the job.

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"This is not going to be tolerated for any length of period," Susman said.

State Sen. John Unger, D-Berkeley, said he has received numerous complaints from local state workers including teachers, correctional officers, Division of Highways employees, Department of Health and Human Resources workers and state police about the insurance coverage.

Many local state workers have doctors in nearby Virginia or Maryland, but it has been difficult for them to determine whether the health care providers are included under the insurance plan, said Unger.

Employees who call Acordia National in an attempt to find out what kind of service they have must use a telephone menu system that is confusing, and the policies under the plan are complex, Unger said.

"You almost have to be a Philadelphia lawyer to figure it out. They call me to complain and I try to figure it out for them," Unger said.

An Acordia National executive said Tuesday the company is working on improving the insurance service, but he said serving the 12,000 public employees who work in the Eastern Panhandle area is a difficult job.

"Unfortunately, all the people aren't going to be happy all the time," said Jennings Hart, senior vice-president for Acordia National.

Hart said Acordia National is offering coverage for about 90 percent of the medical providers in the Winchester, Va., area. In Washington County, Md., and other Western Maryland counties, Acordia National is providing coverage for about 65 percent of the providers there, he said.

"We're looking to increase the Maryland concentration," Hart said.

The problems come at a time when public employees are preparing to shell out more money for premiums. For a salary between $32,000 and $34,000, premiums for a single person will go up by $5.25 a month, and increase by $15.89 a month for an employee paying for family coverage. Another $5 will be added to the single rate and another $10 will be added to the family rate to offset health care for smokers, said Bob Morgenstern, lobbyist for the West Virginia Education Association.

The added fees for smokers can be taken off the premium if workers prove they do not smoke, Morgenstern said.

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