The wife of one Bayou la Batre employee recently took her son to see an urgent care doctor, but when she got her bill, she was shocked to learn her family didn’t have the health insurance she thought they did.
Though the outage was only temporary, this employee’s family wasn’t alone after Bayou la Batre officials failed to make the city’s monthly insurance payment to Blue Cross and Blue Shield of Alabama — resulting in a near six-week lapse in coverage for all current and retired employees.
The woman, who wished to remain anonymous to protect her husband, said she had no idea coverage had been canceled because the payroll deductions for health insurance continued throughout the three-check period coverage had been suspended.
“They’re wanting to charge me $500 for the visit to urgent care, whenever I was told that we had insurance,” she said. “I called Blue Cross Blue Shield, and all they could tell me is that it had been canceled as of Nov. 1, 2014, but we paid for this insurance the whole month of November and the first two weeks of December.”
Records provided by other city employees show that from Nov. 1 to at least Dec. 10, coverage was not being provided, and pay stubs acquired by Lagniappe show the city had indeed deducted payments for health insurance during the same time.
According to city officials, the funds were still removed because they too were unaware the coverage had been canceled by BCBS until employees contacting them with concerns last week.
“We did have a situation, but it has been corrected,” said Wanda Overstreet, assistant to Mayor Brett Dungan. “It was an oversight in our administrative office here, but just an error. I know it did impact a lot of people, but it has been corrected and everything is back on track.”
Overstreet said the issue arose from an invoice that was thought to have been paid but wasn’t, which she said could be the result making manual payments. The city is planning to move to an electronic billing system for BCBS, pending approval from the City Council — something Overstreet said they could take up as early as Dec. 18.
Still, some employees have been asking whether the money removed from their three checks would be reimbursed for the six-week period when services were lost.
Ken Smith, an attorney with the Alabama League of Municipalities, said it may not be that simple. According to Smith, there isn’t any specific law that would require such a refund, and said these issues typically vary on a case-by-case basis.
“There’s not any law on this that I’m aware of,” Smith said. “The employees, the city and the insurance providers are going to have to work that out between themselves.”
Overstreet didn’t say the city had any plans to reimburse the deductions that were removed, and said there had been no lapse in coverage to be reimbursed since the issues had been resolved with BCBS.
“Again, the services are still paid for — we were just late paying them,” she said. “If (their doctor wasn’t paid), it just goes back to the insurance company, and they’ll reimburse them. Coverage was reinstated, so that means complete coverage back to the day they canceled it. If there’s a problem, they can call their doctor and ask them to resubmit everything to the insurance company.”
When city officials spoke with Lagniappe Dec. 10, the issue was said to have been resolved, but, according to multiple employees, BCBS was still refusing to reimburse doctors for some employees’ medical bills as of Dec. 15.
In conversations between city employees and BCBS, it was revealed the failure to reimburse those costs was the result of late payment for month of December, which hadn’t been received from Bayou la Batre as of Dec. 15 — though the date would still fall within the 30-day grace period.
Questions about the December payment were sent via email to Dungan and city attorney Bill Wasden, but were still unanswered at deadline.
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