NC restores SHIIP for seniors who choose health insurance plans

By Thomas Goldsmith

The state is popular NC Senior Health Insurance Information Program, or SHIIP, decided on Monday to put state-compiled health insurance information back online that, until a change this year, consumers used to choose from different Medigap plans.

This is a reversal of a decision taken earlier this year when the state insurance department, which manages SHIIP, switched to a database created by a commercial vendor with a potential financial interest. in the valuable health data that older people enter into the system.

SHIIP is a national program administered by each state to help Medicare beneficiaries navigate the confusing world of benefits, co-payments, and insurance plans in addition to federally-supported insurance. It’s a program that has become increasingly complicated over the past decade and a half, as prescription drug benefits, Medicare Advantage commercial options and a “donut hole” created by the Affordable Care Act. were superimposed on the original cover.

For years in North Carolina, SHIIP staff and county volunteers have been trained to help seniors navigate their way through several options. This often involves consulting the state-established Database of Choices for Critical Medicare Supplement coverage, or Medigap.

But at the start of the year, the Insurance Department opted for a database made up of Actuarial CSG, a Nebraska-based health insurance data compiler. The change would have meant that SHIIP consumers would rely solely on a new database from an external vendor, accessible only through the connection of a SHIIP employee or volunteer.

SHIIP management said on Monday that the new database had definite benefits and would create efficiencies, in part by taking DOI workers who had previously compiled the data and freeing them up for other tasks. They said it was recommended by the non-profit organization SHIP National Technical Assistance Center, which works with similar agencies across the country.

North Carolinians checking policies through the new database via SHIIP are asked to provide age, zip code and other metrics, information that could be valuable in the healthcare data industry in the United States, which is worth several billion dollars.

Representatives of CSG Actuarial and the National Technical Assistance Center SHIP did not respond to questions sent by email on Monday or Tuesday about the use of the data submitted to the company. SHIIP representatives said they were unsure how recipient data could be used for a federal grant to CSG through the SHIP National Technical Assistance Center.

In a declaration on its website, CSG said it has experienced exponential growth in data compilation since its beginnings as a product development consultancy.

“With a keen understanding of the insurance market and a knack for creating quality insurance products, the team began to compile data on premium Medicare supplement pricing and turned a huge amount of data into an unbiased and easy-to-use online quotation tool, ”the statement said.

Advantages and disadvantages

Those who question this year’s new approach said it would make the job of helping older people more difficult by taking away the ability to seek their own choices and requiring more communication between counselors.

Insurance professionals said the state had adopted a system that worked reasonably well and changed key parts of it. Among them was Jeff Saleeby, an insurance agent from Salisbury, who said he had referred clients to SHIIP for years.

“You can go to the site, NCshiip.com, and scroll down to where you see the comparison database, and you can get an unbiased view at the same time right in front of you, not someone providing it to you, ”Saleeby said.

SHIIP management overturned the decision on Monday, leaving the outside source in place, but, in addition, re-establishing the public database familiar to many Medicare beneficiaries.

The decision to add the old presentation, made by Melinda Munden, director of SHIIP, follows questions from North Carolina Health News and other users of the system, insurance department officials said.

“It’s not the best”

Among those interviewed about the move was an older woman who used to log into the SHIIP system and go directly to the plan descriptions that had been compiled by state employees, said Commissioner Marla Sink. communications assistant in the state insurance department.

“If they’re doing research late at night and want to continue, that’s not the best information but it will give them an idea,” Sink said.

For people over 65 who are Medicare-eligible, choosing a supplement or Medicare Part B, which pays for doctor visits and other services, can be crucial in terms of health and spending. Part A, mainly intended for hospitalization, is deducted from the social security contributions of beneficiaries.

Gina Upchurch, from Durham, is founder and director of Senior pharmacy assistant, a non-profit organization that helps low-income people with prescription drug problems. There are pros and cons to the new system, she said, but one big minus would be the loss of practical control for an increasingly computer and media savvy age cohort.

Some difficulties in negotiating masses of information in the new system involve significant drawbacks such as having all phone numbers on separate pages in the new database.

“My biggest concern is that it’s not consumer-oriented,” Upchurch said. “I can give Miss Jones three of the top three picks, but then she can decide” I don’t want any. “”