Most Faculty are using the Priority Health HMO option for their health insurance this year. Since January 2016 we have been alerted to many problems experienced by Faculty with this provider. Issues with a poor website interface, difficulties with obtaining the full enhanced 100% coverage level, difficulty with PH customer service.
One benefit of our Faculty Association is the ability to get feedback from many people simply by asking through our organization. Based on feedback since January, and response to a request for feedback emailed last week, we had a hunch that many problems experienced by faculty with PH are a result of the following problems. All are fixable.
Scott Barns and myself met last Friday with the PH director of accounts and the PH account manager assigned to Oakland's PH plan. Ron Watson and Kevin Venet of OU Benefits office were there too and I would like to thank them for arranging this meeting.
We started the meeting by providing examples (unidentified) of feedback from many of you who emailed to myself and Scott Barns regarding your Priority Health experiences. I had some positive feedback, which took up one page. I also shared SEVEN pages of what would be negative experiences and comments. Over 30 Faculty shared with me and Scott their problems with Priority Health within 48 hours of my email request for feedback. Thanks to all of you who took the time to do so.
Based on comments and feedback, one trend was clear. Those of us who are basically happy with Priority Health have generally healthy adult partners and no ongoing health management issues. Especially none that involve the metrics required for Priority Health's annual health qualification. However, that is not the case for many OU Faculty.
After our discussions at this meeting, it was clear that many problems exist because of disorganization on the part of Priority Health. We did receive several apologies. The AAUP communicated at this meeting that fixing several problems will be to PH's benefit as we approach the next open enrollment period. Several of you who provided feedback had indicated you are planning to change away from PH at the next open enrollment because of your bad experiences.
I have summarized what we (AAUP) took from this meeting and the same points listed below I have already emailed to everyone who attended the meeting Friday.
1. Inability to access information that is relevant to the OU specific P-health plan. This is because of an incompletely executed migration of the Priority Health client web-portal at the most critical time of year, Jan to March. In retrospect, a third party website should have been completely migrated and tested before swapping it for the old PH website, and that should have been done AFTER the critical months required for subscribers to do online assessments. Those of us who used the previous PH website last year, found it was basically functional. As of Friday evening (June 3), we really still have an incompletely migrated website as we are passing the halfway point in the current account year. To our knowledge, OU was not offered an extension of the qualification period by PH, but in retrospect that would have been useful. Apparently PH did that for some other client groups this year because of website issues.
2. Faculty experiencing inconsistent customer service when they attempt to get help from PH.
Inconsistent in at least two ways.
First, some calls get customer service representatives that can help solve a certain situation, while the very same situation for a different OU faculty member is concluded differently and/or incorrectly. Of course the subscriber calling has no way to realize they have a wrong result, because the the problems created by problem 1.) above.
Secondly, there is inconsistency in how subscribers are treated on the phone.
We (OU-AAUP) are getting reports from our members of condescending treatment in telephone conversations. This is quite annoying, as you might imagine, if we find later that the position of PH toward the member was also incorrect. It is clear from our member feedback, and from our meeting Friday, that PH customer service representatives sometimes provide the WRONG information to OU-subscribers and the customer service representatives may or may not be aware themselves that they do not understand the OU plan.
(For example, if you are on the lower 80% coverage tier, and your doctor resets your data to meet a current metric you can immediately be changed up to 100% coverage. Some faculty were told incorrectly that they have to wait til next year.
IF YOU are unhappy still with your situation, DO contact Kevin Venet in our benefits office. He can confirm what is correct or incorrect for you with account managers at Priority Health.)
3. PH does not provide printed documents to subscribers, relying on PDFs and a website, and so it is beholding on Priority Health to get this information to clients.
As of 11:52 PM Friday June 3rd: I (Ken Mitton) logged into my "My Health" and find that links to my coverage documents led back to the old PH website. There I find a link to a page of many documents for many plans. I must guess the right one to click on. With all due respect to PH, it is long past the time get the website fixed, or carry out some work around.
Many of us (Faculty) have maintained and designed fairly sophisticated web-sites for our own scholarly and research activities since the 90's, and we know that not having a simple link to a member handbook PDF is simply a matter of a website programmer NOT taking ten minutes to add a line of code to the shared template seen by all of PH's Oakland University subscribers. Our (AAUP) friendly advice to PH Accounts managers: If your IT people are dragging on this issue, tell them you know better that they can fix it now.
4. Faculty Concern: Travel for vacation and for the Required duties of academic faculty (research and scholarship)
I myself have had personal experience with health insurance in Alberta (AltaHealth), Ontario (OHIP), Virginia (BC/BS), Maryland (BC/BS), and Michigan (MCare, BCN, HAP, PH). MCare was at UMich. BCN, HAP and PH at Oakland University. This is my second year with a Family of five in Priority Health.
I must say that finding information on how to use my PH health insurance while outside my service area is the most difficult I have experienced of all the providers I have had experience with. Usually this information is pro-actively sent to us. All previous insurance providers had a simple phone number contact system to services that assist not only in locating medical care but in communicating with the distant care provider. It is not clear to many of our faculty members if such service exists with PH, as the website has a generic description of Assist America stating that "most" PH plans include Assist America. Again, not being able to find a specific member handbook for our particular OU-plan makes this yet another puzzle to solve or another reason for Faculty call PH customer service.
Beyond travel for vacations, Academics MUST travel for their own careers to national and international meetings in their fields to keep current and to build reputations. Most OU Faculty pay substantial out of pocket costs for this "work related" travel already, because University does not fully cover such travel for all Faculty. So faculty have have ZERO patience for anything else that makes travel difficult or stressful. While that is not Priority Health's fault, it is a reality that affects Faculty perception when choosing a provider during open enrollment.
We (AAUP) recommend that clear, concise information on how to access and use Assist America for medical coverage with PH outside our service area is prepared and placed on the Priority Health member website. Again this is just modifying the single shared menu and link template that the My Health web-server generates for every OU client login. This is not a big deal for website managers. I am not a website manager. I am a full time biomedical research scientist but I regularly update my own personal website over a cup of coffee, sometimes from my phone.
ONE LAST POINT: Your coverage tier. Just my personal free advice.
It is apparently true that whatever target your doctor thinks is alright for you at this time under their care is a target that your doctor can set to qualify you to full coverage status. I specifically asked about this, and this was not refuted by PH at this meeting. If you feel you are following your doctor's plans and they are not helping you get qualified now, then seriously consider finding another doctor that will work with you.
We (AAUP) have provided the above feedback to Priority Health and OU Benefits Office. We do thank everyone for meeting with Scott and I about the issues faculty have with their PH health insurance management. We appreciate that OU Benefits set up this meeting and I hope the result is better service for Faculty relying on Priority Health. I have also provided this meeting information summary to Academic Affairs (Cathy Rush).
President OU chapter of the AAUP
Several items of current interest for our members:
Minutes from the November 11, 2015 General Membership Meeting.
This past Monday morning, December 7th, several members of your OU-AAUP Executive Committee met with trustee Mark Schlussel (our BOT Chair), President Hynd and Provost Lentini. While this was not a meeting with the Board of Trustees, it was a meeting offered by Trustee Schlussel and accepted by me and other members of your chapter's Executive Committee.
Of course, we talked about the recent Chief Operating Officer (COO) hire. Trustee Schlussel and President Hynd continue to assert that this hiring decision was wise and represents no conflict of interest violations. Those from the Executive Committee reaffirmed that the faculty overwhelmingly feel that due diligence required that the Board first define the position and explain its need, and then conduct an open search. Furthermore, Oakland University's faculty do not understand the need to compress the COO search process merely to provide a hasty outcome.
The absence of an open search has been particularly troubling in light of the fact that our new COO was drawn from the Board of Trustees. In several public forums, faculty members have raised questions whether it is appropriate for Board members to accept high-salaried administrative positions with the university. Many are not assuaged by the Board's insistence that its own conflict of interest policy was not violated. We noted again that the perception of conflict of interest can be as damaging to the university's reputation as a confirmed conflict of interest. Faculty overwhelmingly hold this opinion because we are a public institution of higher education, and we have a mandate to rigorously follow open hiring practices and refrain from any actions that could be perceived as cronyism.
We also took the time at the meeting to contextualize the hiring of the COO from the faculty's perspective. The faculty's experience with the previous president had undermined both trust and cooperation. While we welcomed the establishment of a new presidential administration that touted its support for the faculty and professed its desire to improve the working environment, the experience of negotiating the current faculty contract revealed little change from previous negotiations. This disconnect between the assertion of support and the administration's stance during bargaining left many faculty disenfranchised even before the appointment of the COO.
Trustee Schlussel, Provost Lentini and President Hynd emphasized their desire is to improve the focus on academics at Oakland University and stated that they consider the support of the faculty to be essential to this goal. They hope that faculty would work with them to move the university forward in this new direction. We in turn, indicated that the faculty are fully dedicated to improving the educational experience for our students.
So, what can we do moving forward? We acknowledge that the faculty cannot force the Board to hire transparently; the Board is responsible for enforcing its own policies. We can be skeptical about the stated intentions of our Board and the administration. We can, at the same time, follow Trustee Schlussel's request to "have an open mind" as we observe the actions of the new COO. Regardless of these choices, we have the duty to object when we think things have been done badly and applaud the good actions of our university. At this juncture in President Hynd's term of office, very skeptical faculty members are still waiting for actions that match the rhetoric. This point was also communicated at this Monday's meeting.
As the president of the OU-AAUP, I will continue to read emails from faculty, respond to questions from journalists, discuss with my colleagues, and talk with our students to develop an understanding of the community's attitudes. I will pass on pertinent information to the administration so that they may act in a more informed manner. I will continue to identify those issues that we can affect and will use the contract to defend the interests of our membership.
Oakland University AAUP Chapter President
An important and hard-won decision was recently reached in an AAUP/Oakland arbitration, a decision that has significant impact on every Oakland faculty member. The grievance concerned a faculty member who, on the basis of a student’s recording of the faculty member’s remarks in class, was issued an order of persona non grata and summarily removed from campus on Sept. 27, 2013. On the basis of the student’s recording alone, without interviewing any other member of the class or the faculty member, the administration judged the faculty member to be a threat to the safety of others on campus. The persona non grata order, issued by the OU Police Department, also mandated that the faculty member undergo certain medical and psychological exams.
Understandably, the AAUP grieved this action. Not only did the administration's action violate contract provisions that are specifically designed to deal with such a situation, but the claim of an immediate threat to the campus community, followed by rapid removal from campus, seemed a clear violation of principles of due process and fairness.
The Arbitrator, agreeing with the AAUP's reading of the contract, found that the administration violated Agreement Article IX, 66 c. and d. by failing to give notice to the faculty member and the Association prior to effecting the action, and by failing to state in writing (to the faculty member and the Association) the reasons for the action.
The Arbitrator also found that the administration violated Article XXXIII, 216 by failing to disclose relevant information "within a reasonable time after receiving a request."
The issue of a hearing is not directly addressed in the Agreement, but was based on Oakland University ordinance 9.04. This ordinance reads as follows:
Any individual who violates these ordinances and whose actions pose a threat to the health and/or safety of the university community, or to university property, or whose actions constitute trespass may also be referred to the university administrator designated by the president for a hearing which may result in an order denying the offending individual access to the campus for a specified period of time.
On this issue the Arbitrator found that use of the word "may" indicates that a hearing is not necessary, and therefore found for the administration.
The Arbitrator's ruling marked the conclusion of a lengthy grievance and arbitration, extended in part by the administration's delays in turning over information and in scheduling arbitration dates. The Arbitrator's finding on behalf of the Association regarding the timely disclosure of information is therefore particularly gratifying and encouraging.
The other part of the Arbitrator's decision in favor of the AAUP is an important one, as it supports the Association's understanding of the plain language of Article IX. Significantly, the Arbitrator found that the faculty member did not, in fact, pose a health or safety threat to anyone on campus and therefore the administration needed to adhere to the advance notification requirements of 66 c. and d.
Had the administration's actions been upheld in this case, our protections against extreme disciplinary actions would have been significantly eroded.
The Association is pleased to report the outcome of this grievance, particularly as current labor laws tend to favor management positions. We also want to acknowledge the hard work on this case of both our Grievance Officer, Kevin Murphy, and our attorney, Robert Fetter.
Kevin T. Grimm