Police and Fire Health Plan Update

The Insurance and Benefits Trust of PORAC Health Plan completed its first quarter under the new Anthem Blue Cross Joint Administrative Agreement (JAA) and is continuing to process claims in-house with no delays.

Under the JAA arrangement, all claims processing is now being done in-house, as of January 1. Processing claims in-house will ensure a higher level of customer service with added savings to the plan and will allow us to further control administrative costs.

As with all big undertakings and system conversions, there were some unfortunate technical difficulties that were encountered with the plan conversion, and we greatly regret the inconvenience it caused our participants. For this, we certainly apologize as we are committed to resolving all plan and system issues immediately as they arise and providing our participants with quality customer service.

Staff worked diligently with Anthem Blue Cross to resolve these issues, and we are happy to say that we have worked through all issues and have resolved over 98% of all coverage discrepancies.

As of January 1, all participants have been provided with information regarding the health plan conversion to a JAA, a questionnaire regarding the Coordination of Benefits (COB), as well as information on COVID-19 home test kits, which went into effect on January 15.

We are still continuing to see the COB questionnaires coming in, and we thank our participants for their diligent responses, as this information will assist in expediting claims.

As of March 28, the health plan claims inventory contains less than seven days of claims, with approximately 3,000 claims in the queue.

The health plan is also developing an online portal, I-Site, for participants to view their benefits and track the status of their claims. Once the portal is finalized, we will advise all participants of the available access.

In addition to processing claims, our fully staffed health plan department continues to assist all participants with enrollment and coverage issues and is available to answer your questions and assist with your plan coverage.

The 2022 CalPERS Open Enrollment period will run from September 19, 2022 to October 14, 2022.

The Board of Trustees will be meeting in the coming months to establish rates for the 2023 coverage year. Please look for more information in the coming months to stay informed on the 2023 rates.

The IBT is committed to serving its participants and we look forward to serving you and your family’s insurance needs now and into the future.

As always, the IBT thanks PORAC members and its participants for supporting the IBT’s benefits.

Featured in the June 2022 issue of PORAC Law Enforcement News.