New rates to improve GHLIP’s financial status

An estimated $2.9 million additional revenue from the newly-implemented premium rate of Group Health and Life Insurance subscribers will pump up the needed financial assistance of the NMI Retirement Fund for the immediate implementation of an off-island review firm.

In an interview with reporters, NMIRF Board Chair Vicente Camacho disclosed that the GHLI Branch will be able to source out the much needed $1 million revolving fund for the hiring of an off-island utilization review board with the new rate implemented last month.

The revenue will be utilized if the Legislature fails to appropriate supplemental budget necessary to get the service of Honolulu-based HMAA. With the firm’s extensive experience on hospital and medical activities, Mr. Camacho is optimistic that overblown medical charges won’t likely to happen in the future.

This, following the multi-million medical charges billed by Hawaii-based Queen’s Medical Center to GHLI last year. The hospital administration asked GHLI to settle over $4 million in hospital bills incurred by off-island providers for the past years.

He explained the new rate will infuse the needed capital this year with over $2 million additional funds. The present active employee’s contribution amounts to more than $6.7 million per year.

To set up the URB, NMIRF needs a $1 million revolving fund.

GHLIP manager Dolores Moore in an earlier interview said at least 659 retired government employees will be affected by the hike. From the present $13.48 contributions for retirees of 1993 and $60.30 in 1995, new rates was pegged at $93.03 semi-monthly for high option plan.

Aside from premium increase, NMIRF officials disclosed that another option is being looked into by the Fund to level the amount of health claims and the collections generated from its subscribers.

Officials are likewise weighing the possibility of reducing the medical services the GHLIP offers to its subscribers and to streamline its over endearing generosity.

The GHLIP’s operation solely depends on the revenues it generates from the premium collections, though he added, there has been no plans in the past to increase the premium charges but overblown health claims prodded Fund officials to look into various options that they need to undertake.

“The premium has to go up, there is a disparity on the premium collections and the health claims, its is either that or we streamline the services that the premium can cover,” Fund Administrator Juan S. Torres said.

Last year, NMIRF increased the premium rates by more than 50 percent to cover its operational cost but hundreds of retired employees were not included in the said increase. The error committed had somewhat overblown health claim problems that the GHLIP is currently experiencing.

NMIRF also disclosed the hiring of short-term reviewer last month to audit GHLI’s medical referral claims even way back in 1996.

The firm approved to get the services of Liz Torres-Untalan to process 1996-2000 bills forwarded by various health service providers and to re-check medical services and treatments accorded to subscribers.

Rep. Malua Peter and the Office of Public Auditor both recommended to GHLIB the hiring of a reviewer to correct billing discrepancies of several hospitals and service providers.

Last week, the Department of Public Health said the agreement with Queen’s will be severed should billing discrepancies continue despite persistent efforts on the part of the Commonwealth to settle hospital bills incurred through the years.

Once the DPH cut its agreement with Queen’s, treatments of patients with advanced cancer are likely to be jeopardized since the hospital is the only center with complete facilities to treat cancer patients. (EGA)