Tuesday, December 12, 2017
Business

Universal Health Care's liquidation hits some members with surprise out-of-pocket expenses

ST. PETERSBURG — The fast-track liquidation of Universal Health Care is leading to unexpected out-of-pocket expenses for thousands of Medicare enrollees.

Instead of placing members of the insolvent St. Petersburg-based insurer with another Medicare Advantage Plan run by a private company, enrollees are being shifted by default into original, government-run Medicare.

That means effective Monday, they will have to start paying the 20 percent co-insurance charged by original Medicare for most services.

"This just isn't fair. This is insane," said Richard Jones, an insurance agent in North Carolina who has about 150 clients he had placed with Universal. "These poor people will be back on (original) Medicare for a period of time and have to pay the copay, and they haven't even gotten a letter yet" telling them about Universal's liquidation.

The Florida Department of Financial Services has been appointed as receiver overseeing Universal's dismantling. A spokeswoman for the department acknowledged "a lot of confusion" regarding Medicare options, but deferred any questions about the transition to the Centers for Medicare & Medicaid Services.

CMS indicated that impacted Universal customers are initially being placed in original Medicare and "a comparable prescription drug plan." Members are being notified that they're allowed to change their coverage to a privately run Medicare Advantage plan from now until May 31, but the onus is on individual members to make the move.

The hitch is that any change in coverage won't become effective until the first day of the month after the request is received. So if enrollees wait until next week to pick a new private plan, they will have to wait until May 1 for it to become effective — and shell out a copay in the meantime.

Effective April 1, the state is liquidating two related Universal Health Care companies with nearly 140,000 members combined: Universal Health Care Insurance, which has about 37,500 Medicare policyholders, and Universal Health Care Inc., an HMO with about 60,000 Medicaid members and 40,000 Medicare members.

Most of the insurer's roughly 800 employees are losing their jobs this week. The bulk of them work out of its downtown St. Petersburg headquarters.

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