State workers face challenges amid choices

Health insurance enrollment runs through Nov. 30

LORRINE THOMPSON, THE OLYMPIAN

Originally published October 26, 2001

THURSTON COUNTY -- With nearly a quarter of the county's population affected by open health insurance enrollment for state workers, officials have one primary piece of advice:

State workers should check with their doctors' offices to ensure which health plans the doctors work with.

The health care marketplace is still somewhat "shaky," and changes among physician offices and health plans can happen at any time, said Dave Wasser, spokesman for the Health Care Authority, which oversees health insurance coverage for state employees.

"We find ourselves sending out last-minute letters" to state employees, Wasser said.

Open enrollment for state employee health insurance starts this week and runs through Nov. 30.

More than 18,000 active state workers and their dependents and about 4,500 retired state workers and their dependents -- totaling about 49,000 people in Thurston County -- can choose new insurance plans or remain with the plans they have, Wasser said.

"Thurston is obviously one of our bigger counties," he said of the population of state government workers here.

To help state workers with information, benefit fairs are scheduled around South Sound for the next three weeks.

The fairs may help workers with questions about physician shortages and other concerns about the health care marketplace, Wasser said.

Thurston County was hit hard with the loss of family practitioners, internists and other primary-care physicians over the last 18 months, many leaving when Memorial Clinic closed its operations this year.

The 50-year-old Olympia clinic had more than 90 doctors at one time.

"What we're hearing from the plans is that they feel they have adequate (physician) coverage in Thurston County," Wasser said.

"We are hopeful that that's true," he said.

The nonprofit Thurston-Mason Medical Society still gets "tons" of calls from people looking for primary-care doctors, said director Susan Peterson.

"We got 16 calls on Monday," she said. "It comes and goes in waves."

The majority of calls are not from state workers or other employees, she said. The calls mainly come from patients with Medicare and Medicaid insurance, who can't find doctors to accept their insurance.

One of the insurance companies hardest hit when Memorial Clinic closed was PacifiCare, which has 3,450 members in Thurston County.

Many PacifiCare customers lost their family doctors when the doctors left or chose not to work with PacifiCare after leaving Memorial Clinic.

"They have that stabilized now. They've gotten all the members matched up with primary-care physicians," PacifiCare spokesman Mark Funk said.

After the clinic's closure, PacifiCare negotiated new contracts with physicians, in some cases increasing the reimbursement fees, Funk said. The company also searched out doctors that had not previously worked with PacifiCare.

"It took a variety of different things," he said.

Rising health care costs, mergers of health insurance companies and physician dissatisfaction with insurance payments and paperwork have combined to make the health-care market less than stable, Wasser said.

"I remember eight years ago when we had 15 plans to work with," he said. "Now there are some counties that only have a couple of plans to choose from, and that's upsetting to people."

Five insurance plans operate in Thurston County for state workers.

"We can't force doctors to contract with the plans, and we can't force the plans to contract with us," Wasser said.

In addition to the upcoming benefit fairs, the state operates a Web site with new information, a new way to compare the plans based on different needs and new options for switching plans online, he said.

Lorrine Thompson covers Thurston County and health for The Olympian. She can be reached at 360-754-5431.

To learn more

Benefit fairs for state employees in Thurston County are set for the following days:

- Monday: 10 a.m. to 4 p.m. at St. Martin's College's Worthington Center, 5300 Pacific Ave. S.E., Lacey.

- Nov. 6: 10 a.m. to 4 p.m. in the Transportation Building lobby, 310 Maple St., Olympia.

- Nov. 16: 10 a.m. to 2 p.m. in the Labor and Industries auditorium, 7273 Linderson Way, Tumwater.

Information about health plan changes and options for state workers, as well as a new "compare-a-plan" service, are available at www.wa.gov/hca. Click on "Public Employees Benefits Board." Information by phone is available at 800-700-1555.

The Olympian Copyright 2001

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