LACERS BOARD UPDATE
By Michael R. Wilkinson, LACERS Commissioner
lACERS has released the results of a survey of the more than 4,000 members who are currently enrolled in the Anthem Medicare Advantage PPO. The purpose of the survey was to measure the satisfaction of our members with the new Medicare Advantage plan that replaced the Anthem Medicare Supplement Plan in January 2021. Medicare is the primary payer in a Medicare Supplement Plan and the plan is the secondary payer for benefits. In a Medicare Advantage plan, everything is provided by the plan.
The survey was conducted over 10 weeks, covered 15 questions and included an open-ended section to provide comments. The results were based on 275 members who responded to the survey. The survey was sent by email or mail and received a response rate 35 percent higher than industry standards, per Anthem.
Results from the responses received showed 66 percent of the members were satisfied or very satisfied with the PPO Advantage plan and 68 percent were satisfied or very satisfied with the medical benefits offered. This is slightly better than the 65 percent average satisfaction rate of other Anthem clients. On the negative side, 12 percent were very unsatisfied, 10 percent unsatisfied and 10 percent neutral.
One of the survey questions was about Anthem’s customer service. 53 percent replied satisfied or very satisfied, 14 percent neutral and 17 percent unsatisfied or very unsatisfied and 16 percent not applicable.
Another question on the survey asked about the enhanced benefits offered under the Advantage Plan that were not offered on the supplement plan. 47 percent of the respondents answered that it was not applicable which Anthem believes was due to members either not using or not aware of the services. 19 percent answered satisfied or very satisfied with the enhanced benefits. 25 percent were neutral and 9 percent unsatisfied or very unsatisfied.
The survey also asked an open-ended question about what could be done to improve the plan. The top five responses were: 1) satisfied with the plan; 2) go back to Medicare Supplement Plan; 3) add more benefits to the plan; 4) issues with preauthorization; and 5) providers not accepting the plan. Only six percent of those responding to the survey asked to return to the old plan.
During a recent LACERS Benefits Administration Committee that I chair, I questioned the Anthem representatives closely on two of those issues, preauthorizations and problems with doctors not accepting the plan. I asked about at least one situation brought to my attention by a member where the doctor would accept the Anthem Medicare Supplement plan, but not the Anthem Medicare Advantage plan. The Anthem representative promised to work with our members to solve problems with both issues.
I am aware that LACERS health staff has contacted Anthem and resolved most of the difficulties with the new plan.
Finally, a few members have contacted me and are not happy with the Medicare Advantage Plan. They would like the former plan back. I have been contacted by other members who love the new plan and the free services, zero copay and zero deductibles for most services.
LACERS is in the process of evaluating the responses to the RFP for health plans starting in 2024 and is asking for a Medicare Supplement proposal as well as a Medicare Advantage proposal. Eight responses have been received, but it is not clear how many proposals are for a Medicare Supplement. I will follow this process closely as it is reviewed by staff and the Benefits Administration Committee.