TVA Survey Narrative
The following information is a narrative of the results of a survey of NRLN TVA Retirees Chapter members to gain their input related to their experiences with OneExchange (now Via Benefits) to acquire Medigap coverage after TVA terminated its healthcare plan for retirees in 2016.
The NRLN has shared the survey narrative with members of Congress and the Center for Medicare and Medicaid Services (CMS) in Washington, D.C. in an effort to gain a Special Enrollment Period for retirees who where given inaccurate and misleading information on the availability and cost of Medigap plans.
If you are a TVA retiree who purchased your Medigap plan from OneExchange and would like to add your input to the survey, send your name and email address to firstname.lastname@example.org. If enough are interested, we will reopen the survey and send you the link to the survey.
The report is a narrative of the results of a survey of NRLN TVA Retirees Chapter Members.
You may have read the June 9 NRLN President Bill Kadereit Forum message that announce the completion a new NRLN whitepaper on Medicare Advantage (MA). To access the whitepaper, click on the Legislative Agenda tab on the NRLN home page, select whitepapers and scroll down to MEDICARE ADVANTAGE QUALITY BONUS PLAN IS A HOUSE OF CARDS.
The NRLN’s primary concern has always been for its members and all seniors who see the TV commercials about MA plans and good deals that are “FREE.” Implying that Medicare Part A & B premiums and benefits are free is misleading since whether you stay with original Medicare Part A & B or buy a private MA plan to get A & B benefits we get all Part A benefits as we have prepaid the 1.45% premium tax on wages over our lifetime and we all must pay the Medicare Part B premium of $145.60 a month. Nothing free here!
Regrettably, our income tax dollars subsidize private MA insurance companies with bonuses and rebates that fund reduced deductibles, copays, costs in excess of out-of-pocket maximums and may pay for drug, dental and vision plans and for Silver Sneakers memberships. These rebates amount to $126 a month for every MA plan enrollee. In 2020, cost sharing and chronic benefit costs will be $35 billion and MA plan cost per enrollee will be higher than in original Medicare!
The 44 million in original Medicare and all others paying income taxes also pay for MA plan new “chronic” benefits for the 26 million MA enrollees that are denied to the other 44 million original Medicare beneficiaries. The NRLN is advocating this is unfair, discriminatory. All Medicare enrollees should be eligible for approved original Medicare plan benefits.
The NRLN fully supports competition from private healthcare plans and understands the financial challenges ahead for Medicare and the federal budget. However, the NRLN lobbies against legislated subsidies and restrictions placed on original Medicare Fee-for-Service (FFS) just to preserve the notion that private insurance plans are more effective. Sooner or later these subsidies will dry up, causing insurers to abandon MA plans. The NRLN’s proposal includes “grandfathering” protection for those in MA HMO plans should this happen.
When talking with Bill, I told him about the research I had been doing into the way premiums are often increased for Medigap, which are original Medicare supplement plans intended to pay the 20 percent that Medicare does not pay for Medicare Part A and Part B. My concern is that a Medigap policy begins with a stated premium but the premium can be raised at any time. This often happens with months after the Medigap policy is issued. I know a number of TVA members have experienced this.
I want to let you know that Bill requested that I continue my research and develop a proposal for the NRLN Board’s consideration to take a position on this issue.
If you have a Medigap plan and experienced premium increases within a few months of acquiring your plan, I would like to hear from you. Let me know the provider of your Medigap plan, when you began paying the premium and how soon the premium was increased.
Dan Pitts, President
NRLN TVA Retirees Chapter
To: TVA Retirees Chapter Members
July 9, 2021
The TVA Chapter of the National Retirees Legislative Network (NRLN) has been investigating what we believe is an injustice to TVA retirees. When TVA terminated your Medicare supplemental plan back in the fall of 2016, it appears that retirees were given misleading/false information about which Medicare plans were available to them for purchase and the rates of those plans. It appears this caused thousands of TVA retirees to purchase plans with very high rates, but no additional benefits.
With your help, we may be able to correct these injustices and avoid these types of abuses in the future. Your input in this survey is vital for seeking Congressional support and we will be in a better position to lobby Congress on your behalf.
We are continuing to assess the damage done to retirees. The following is an update on our findings and then we have some survey questions for you.
- TVA retirees were falsely informed that they “must” enroll in the plans offered through OneExchange (OE). Medicare laws specifically and clearly granted TVA retirees “guaranteed issue” status and the right to purchase Medigap plans from any of the 30 plus+ insurers offered in retirees’ areas. The statement that retirees “must” enroll through OE was simply false.
- TVA retirees were falsely informed that OE’s plan rates were “competitive”. In addition, they were told that OE’s plans could not be purchased at a lower rate anywhere else. However, we obtained rate information from CSG Actuarial, a firm that provides plan data to the State Health Insurance Assistance Program (SHIP), that showed OE’s plan rates were, in some cases, 67% higher than the same Medigap plans (Plan G, Plan N. etc.) available through local agents or brokers.
In fairness, some of OE’s plans (Medigap Plan F) were competitively priced. However, rates for the most popular plan, Medigap Plan G, were 35% to 67% higher than buying directly from the insurers. In addition, there were many other “A rated” insurers available to retirees – OE’s rates, in some cases, were around 100% higher.
- TVA retirees were not, as specifically required by law, notified of their “guaranteed issue” rights and protections. It appears that retirees were informed that they had guaranteed-issue status, but they were never notified of the specific rights and protections they were entitled to. Without knowledge of those rights and protections, retirees were not equipped to make a prudent and fully-informed decision about their insurance.
According to the law, the employer (TVA) and its plan administrator (Blue Cross Blue Shield) were both required to provide notices to TVA retirees of their guaranteed-issue rights and protections. Both failed to do so.
Special Enrollment Period: Under Medicare laws, if an enrollee is presented with misleading or false information while selecting their Medigap plan, they may be eligible for a “do-over” known as a special enrollment period (SEP). With the SEP, retirees would regain their ”guaranteed issue” status, which would provide them a new opportunity to buy a fairly priced plan without being denied because of pre-existing health conditions.
To better assess the extent of the false/misleading information provided TVA retirees, we continue to gather input about retirees’ experience during transition to the new plans. We realize a substantial period of time has passed since enrollment. However, anything you remember could be helpful.
Our goal is to get members of Congress and/or Center for Medicare and Medicaid Services (CMS) to offer a new special enrollment period (SEP) to provide affected TVA retirees a new opportunity to make a well-informed decision on acquiring a Medigap plan with their guaranteed issue rights.
NOTE: This survey is for those TVA retirees who were in the old TVA Medicare supplemental plan in 2016 and bought a new Medigap plan through One Exchange(OE) effective January 1, 2017.
You will see that the survey does not request your name or contact information, only your city, state and zip code. However, if you are willing to be contacted for more information that could be used with Medicare officials or members of Congress, please answer “Yes” to the last questions on the survey and provide your name, email address and phone number.
I appreciate your taking the time to participate in this important survey. Please share the NRLN with other TVA retirees on your email list. They can sign up to receive emails from the TVA Chapter and the NRLN by clicking here.
Dan Pitts, President
NRLN TVA Retirees Chapter