CalPERS Reports Record 2003 Health Program Enrollment.

Business Editors

SACRAMENTO, Calif.--(BUSINESS WIRE)--Dec. 3, 2002

The California Public Employees' Retirement System (CalPERS) today reported that approximately 170,000 beneficiary families have been enrolled in new plans for health care coverage, beginning January 1, 2003.

That preliminary total of plan switches doubled the previous record of 85,000 for the 2002 calendar year. It stemmed from the CalPERS decision in April 2002 to partner with fewer plans in providing coverage for its enrollees for 2003.

Anticipated spending for 1.2 million active and retired state and public agency employees and their dependents will be an estimated $3.4 billion in 2003, compared with $2.7 billion in 2002.

During the annual enrollment period, September 3 through October 18, members could choose between Blue Shield of California and Kaiser Permanente for health maintenance organization (HMO) coverage, and two self-funded preferred provider organizations (PPOs), PERSCare and PERS Choice. Western Health Advantage, a small regional HMO, continued in the program but was not open to new members in 2003.

Public safety officers could obtain coverage through their associations.

Since Health Net, Health Plan of the Redwoods, PacifiCare and Universal Care were not retained in the CalPERS lineup for 2003, members with those HMOs had to choose another plan.

About 49,000 of those 170,000 member/families made choices for themselves and their dependents during open enrollment. The others allowed CalPERS to automatically enroll them in Blue Shield.

Almost 90 percent of all members of discontinued HMOs chose Blue Shield. Most were able to stay with their primary care physicians.

"It was a very smooth campaign given the historic volumes dealt with this year," said Allen Feezor, Health Benefits Administrator for CalPERS.

The transition effort led by HMO Contracts Manager Lisa Tanaka substantially reduced telephone traffic for CalPERS, which processed some 162,000 calls. Staff might have received as many as 300,000 calls had CalPERS not partnered with Blue Shield's Customer Service Center. More than 140 Blue Shield agents processed 110,000 calls.

"Without their support, our goal of handling member calls in a timely way would have been greatly impacted," said Ron Kraft, Chief, CalPERS Customer Call Center. "This truly was a team effort between business partners that translated into quality customer service by both organizations."

CalPERS staff was able to transfer calls directly to Blue Shield without requiring the member to make another call.

Some 40,000 Call Center contacts came through the new Interactive Voice Response (IVR) system. Its telephone speech recognition technology allowed members to get what they needed without having to speak to an operator.

The system's customer response design, project management and implementation was developed by Stealth Network Communications in less than five months.

The IVR system produced a 30 percent closure rate, or double what had been anticipated, Kraft said.

Tanaka said staff was optimistic that members would receive their new identification cards by mid-December with accurate information. All members who didn't provide Blue Shield with a primary physician would have one assigned to them.

CalPERS is the nation's second largest purchaser of public employee health care after the federal government. For more information on CalPERS, please visit the System's Web site at www.calpers.ca.gov.