Insurance Provider

Q

Almost weekly I've noticed a serious article in the newspaper regarding
PacifiCare. In almost every case the information includes some large
medical organization dropping PacifiCare from its list of insurance
providers. The service that PacifiCare provides to patients seems to be
going downhill as well. My question, Has the UCAR benefits administrator
started looking at replacing PacifiCare as our primary insurer? If the
answer is no, then may I suggest it's time we did.

Answered on April 19, 2001

A

The past year has been a rocky one for PacifiCare, especially in the area
of EPO/HMO [Exclusive Provider Organization/Health Maintenance
Organization] networks and service. In particular, the unexpected loss of
the Boulder Medical Center in November threw us all for a loop. The PPO
[Preferred Provider Option] still remains strong with its network affiliations.

We have heard your concerns from others over the past couple of years and
will review our course of action for the plan year 2002.

Here are some points we will consider as we evaluate our options:

(1) Though not all employees are unhappy with the current PacifiCare EPO or
PPO products, we have heard from those of you who are not pleased-the
majority expressing concern and frustration with the dwindling EPO networks
and with customer service.

(2) Changing medical plans for 1,100 active participants (not including
dependents) while continuing to meet everyone's needs is a serious move
that involves a great deal of planning and about six months of
behind-the-scenes preparation and roll-out.

If a move is made to another insurance company, HR's job is to ensure a
smooth transition and implement a slate of coverage similar to the current
design so as not to reduce or interfere with current treatment plans for
short- or long-term medical conditions.

(3) HR's review will include a comparison of PacifiCare's current network
providers (EPO and PPO) with a potential new carrier's network providers.
We want to ensure that the physicians available through another medical
carrier are the same as, if not better than, PacifiCare's current EPO/HMO
network.

As we begin this review for 2002, we invite staff to continue to tell us
your comments and suggestions. Please contact Cyd Perrone, ext. 8710, or
Laurie Carr, ext. 8702.

-Laurie Carr, Benefits/Compensation Manager, Human Resources