Survivor Insurance: The 3 Fixes Are In

I am happy to announce that we (think we) have a solution to the improper cancellation of survivor health insurance under the retiree health plan. When I last registered to speak to the Regents at their retreat, that request triggered an inquiry from the Regents' office to UCOP which in turn set in motion a process, including a Zoom consultation with administrators of the plan. What emerged was a three-part solution:

A longer-term fix;

An interim fix;

An interim-interim fix.

To understand the various fixes, we need to start with the current workings of the system, as it was presented to us during the Zoom call. The various insurance carriers are given what can be viewed as operating documents telling them what to do on behalf of UC. As they are written, these documents assume modern operating procedures at UC, such as those that exist at other public plans that, as we have noted in the past, don't have a survivor cancellation problem. 

When a retiree dies, an eligible survivor converts from dependent status to survivor status. The documents assume that, thanks to computers and computer records, this conversion happens quickly. In effect, the computer "knows" in advance who is eligible for survivor coverage. So, upon the death of the retiree, there is a one-month grace period in which dependent coverage continues. That coverage is then seamlessly cancelled and survivor coverage begins with no interruption of coverage.

The longer-term fix is to make UC's computer and administrative system operate as described above. And the current problem is that it doesn't.

UC's computer system doesn't "know" prior to the death of the retiree who is an eligible survivor of that retiree. As a result, manual processing is set in motion when a death report comes in. If the manual processing takes longer than the one-month grace period, the eligible dependent-survivor is cancelled as a dependent but is not picked up as a survivor. The survivor goes into a no-coverage limbo and is effectively cancelled. That is the root of the current problem. The manual processing takes too long.

So, the interim fix is to have the one-month grace period extended to two months. That extension, we were assured, will allow the current slow manual processing to occur. We have been told that the extension of the grace period to two months can happen as early as November 1 but not later than December 1.

Assuming the interim fix is put in place some time in November, there might still be some survivors who are cancelled between now and then. 

The interim-interim fix is to create a temporary arrangement so that any survivor who finds his/her insurance has been cancelled and who calls to complain will immediately default to restored coverage. The manual processing of their case will then proceed. But the default will be that any survivor who complains of cancellation will get immediate coverage until the interim fix is implemented.

Yours truly will make a brief public comment to the Regents later this week. He will thank them and everyone else involved for their assistance, and will give an abridged description of the three fixes above. Assuming everything goes as plans, he will not need to revisit the Regents on this matter thereafter.