2003 Benefit Conference

The 2003 Delphi/GM IUE-CWA Joint Benefit Conference
by Jim Martin
(printed in the 2003 June/July Newsletter)

The benefit staff, on May 8th and 9th, attended the annual joint benefit plans conference in Las Vegas Nevada. The benefit and pesnion presentatives have been attending these training conferences annualy for the last decade, and they always provide practical education. It's a great forum to vent our compaints and get problems resolved. Most of the presentations are very educational. We also get to meet face to face with the people that we talk with every day on the phone and establish relationships that always come in handy down the road. It's a nice treat to do something work related and at the same time go somewhere nice. It's a great incidental perk the comes with the job, and I always come home with more knowledge than I left with. The benefit conference is one of many nationally negotiated benefits, and it's paid for with Delphi joint training funds. Below is a summary of the information that was provided at the training conference.

Department of Labor Regulations

The department of labor DOL recently implememted changes to the health care plans and appeal process. These changes basically give health care carriers such as Anthem and U.H.C. strict time limits to make claim determinations and respond to appeal letters. The health plan carrier has thirty days to make a determination on a claim once received. Appeals: (for example) Anthem BC/BS utilizes a one step process and must respond to an appeal witin 60 days. There are several other regulations that we learned about such as regulations pertaining to "urgent claims," which is a pre-service claim that is submitted to get authorization for a procedure that if delayed, could jeopardize a person's health or life. An ordinary (non-urgent) pre-service determination might come into play if you are considering services such as gastric bypass surgery or schlero therapy.

H.I.P.A.A GUIDELINES

Health Information Portability and Accountability Act

The HIPAA privacy rules were a big part of the conference this year. There's a lot of sensitive personal information that is exchanged between doctors and insurance companies. This Act just lays down the law for the purpose of protecting this information and making sure that it doesn't meet the eyes of anyone that isn't supposed to see it. There are serious finacial penalties in place for any person or professional institution that violates the act. This wil impact the benefit staff, because in the past we could call int insurance companies and bring back information to you and specifically explain why your claim was denied. We have also been able to , when necessary, call collection agencies to have claims submitted or put holds on accounts. We will not be permitted to do this anymore according the these HIPPA rules. A benefit rep is not recognized as a "service employee" like a claim reviewer or doctor's assistant is, but we have already recognized the impact of HIPPA in how our local medical providers are interpreting the guidelines. We hope to have an authorization form readily available for some situations when we need to get medical information.

SUB

Our Vice President, Kevin Hartill, asked a Delphi SUB administrator to take some action and communicate with the state employment agencies to speed up the time it takes to get T.E.U.C. determinations processed. Many of our members have exhausted their unemployment benefits and SUB won't send out a check until the unemployment office mails out the temporary monetary determination. This process takes way too long. I was able to exchange email addresses with many of the higher level benefit people at Delphi and have been talking with Michelle Trimble regarding the four-six weeks that it takes to get your initial monetary determination letter. There's got to be a quicker way. I think SUB should just pay us in good gaith and then if they don't get the determination within a certain time grame, take the money back. They're really experienced at taking money back out of our checks. I don't think it would be a problem. I think it's also ridiculous that some of us have to fax our determination and others don't If you get your letter on a Tuesday or Wednesday, most likely you woh't get it faxed in before the cut-off on Wednesday night.

PSP

Delphi presented pie charts and examples of employees that have never touched their PSP and have hundreds of thousands of dollars saved. Money makes money. It's interesting to see all of the scenarious and look at the money that some people have accumulated. There was also talk about another investment workshop. I'd like to see us host another one at our hall. Stay tuned..

(some wording changed to make the article more reader friendly)

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