Civil servants' dental insurance coverage is listed as 'inactive'
John Wight, President & CEO of BF&M, made the following announcement this morning: “BF&M considers matters between our company and our clients to be confidential, and thus it is the
company's standard policy not to comment through the media on such matters. Having spoken with our
client regarding the disinformation in the media, we would like to put to rest any concerns that
Government Employees have about their dental insurance coverage. GEHI premiums are paid up to
date, and all Government employees have been, and will continue to be, fully covered for dental
treatment provided under the policy.”
The One Bermuda Alliance yesterday provided documents appearing to indicate civil servants lost their dental insurance coverage, as it stood by its claim Government has fallen into arrears with premium payments.
Lists from the BF&M portal, printed off yesterday, show many patients' status on the Government Employees Health Insurance plan is described as “inactive — customer must contact their employer”.
According to the Opposition, this means the patients' coverage has been suspended and dentists are entitled to ask them to pay their fee at the time of service.
Under normal circumstances, dentists would only ask GEHI patients to pay the uninsured portion of the bill, known as the co-pay; but Shadow Health Minister Michael Dunkley claims employees are facing the consequences of Government's failure to pay the premium.
Premier Paula Cox yesterday dismissed Sen Dunkley's allegations as untrue and reprehensible, insisting coverage has not been suspended, while union boss Kevin Grant said he had received no complaints from members.
BF&M CEO John Wight was off the Island yesterday, and executive assistant Karen Stroeder said the company was unable to respond in his absence.
One dentist told The Royal Gazette he did not charge patients the full fee because he understood the problem was temporary and did not want to penalise customers.
That dentist, put in touch with this newspaper by the OBA and speaking on the condition of anonymity, said: “My practice's administrator drew to my attention that any GEHI patients whose coverage she was checking are listed on the portal as 'inactive — customer must contact the employer'.
"My practice's administrator contacted BF&M to ask what was happening. She was told if the Upfront Payments Act had gone into effect that we would be able to demand full payment from GEHI patients without penalty.
"We would be well within our rights to demand the patient pay the full amount and then wait for the payment to come from BF&M. But we have been helping our patients even though we don't have to.”
The documents leaked to The Royal Gazette provide status information on the health plans of a sample of more than 80 individuals on the BF&M portal, dated July 9, 2012.
Almost half of those patients, whose identities are withheld, have an “inactive” status. The documents, which will be posted on this newspaper's website, show those people have basic dental coverage, restorative coverage at 80 percent or orthodontics coverage which, according to an OBA spokesman, indicates they are on the GEHI plan.
Finance Minister Ms Cox has strenuously denied the OBA's suggestions and, when challenged at a press conference on another matter yesterday, replied: “It's allegations. Nothing has been suspended. The service provider is BF&M and the work continues to be done.”
She added later: "It's not true. It's scurrilous, it's untrue, it's unfair and it's reprehensible.”
The Ministry of Finance has said it has a respectable relationship with the insurer and received no communication that dental coverage has been discontinued.
In a further statement yesterday morning, the Ministry said: “This morning the Ministry of Finance addressed concerns stemming from the rumoured suspension of Government's dental coverage.
“The Ministry of Finance moved to reassure Government employees covered by the insurance plan that coverage has not been suspended nor cancelled.
“And the Ministry took the opportunity this morning to refute any commentary to the contrary — calling it “regrettable and baseless”.
Asked if members had raised any concerns, Bermuda Public Services Union president Kevin Grant told this newspaper: “No members have come to the BPSU with this concern. I have also spoken to a senior Government officer who has confirmed that no civil servants have lost their dental coverage.”
Sen Dunkley said he stood by his claims despite Government's denial.
He said: “We decided to alert employees under GEHI because the insurer changed the status of dental insurance coverage to 'inactive' from 'active'. This meant that they could no longer expect dentists to automatically accept their GEHI coverage.
“It meant their coverage was 'inactive', pending a discussion between the employee and the employer — presumably to get the employee to pressure the employer to pay the premium.
“The insurer's instruction to dentists that the 'customer must contact their employer' is pretty extraordinary, especially given that these Government employees had already paid their part of the premium through automatic pay cheque deductions.
“This issue developed because GEHI has been notoriously late in making premium payments and clearly the insurer — or perhaps its reinsurer — felt a message needed to be sent that continuing late payments are not acceptable.
“The situation was clearly unfair to Government employees and that is why we decided to act.
“This is just one more example of the Government not managing the people's business in a responsible manner.”