Providing You with Peace of Mind When the Unexpected Occurs

In the latter half of 2024, the Pension Boards learned that various U.S. healthcare providers would stop accepting Humana’s Medicare Advantage Plan in 2025. The Health and Benefits Operations team worked diligently with Humana to assure they would accept out-of-network patients and confirm our members would receive the necessary coverage.

Jennifer Markewitz, Senior Manager Health and Benefits Operations, and Marie Myers, Manager, Health Plans Operations, answer questions surrounding these events and provide insights on the Pension Boards’ commitment to supporting our members.

PBUCC: Can you explain the unexpected events for the Pension Boards’ Health and Benefits team in the fourth quarter of 2024?

Jennifer: The year 2024 brought unexpected and impactful changes for the UCC Medicare Advantage Plan and its participants. Provisions of The Inflation Reduction Act designed to lower prescription drug costs were mandated to take effect in 2025. Insurers were given a tight timeline to address significant changes in their Medicare Part D prescription drug plans. The impact of these changes were uncertain until mid-year, leaving a narrow window for the 2025 rate development process and updates to communications and plan benefit materials. We were pleased to announce that, while many plans were implementing rate increases for their participants, we offered an enhanced pharmacy benefit paired with no annual rate increase for our Plan participants in 2025. Then came the next challenge.

Marie: Contract negotiations between providers and all insurance carriers nationally were particularly challenging this year, and the Pension Boards was directly impacted. There is a rising trend of local and regional business groups that own healthcare systems developing their own Medicare companies, which is creating a far more competitive environment for national insurance carriers. Some providers chose to leave the Humana Medicare network but still see our members out-of-network, while others decided to stop seeing our Humana Medicare members altogether. This created a lot of confusion and anxiety for our members. To make circumstances even more challenging, all of this was unfolding at the end of the year. 

PBUCC:  How did Humana assist PBUCC through this challenging situation?

Jennifer: Our agreement with Humana provides access to a dedicated concierge team. The concierge team goes above and beyond to ensure that every single inquiry is addressed in a timely and thorough manner. Through ongoing analysis of network participation and provider willingness to see participants on an out-of-network basis, close communication and collaboration between the Pension Boards and Humana allowed for keeping participants informed and well-equipped to make decisions about their health coverage.

Marie: Humana was as surprised as the Pension Boards at the increased difficulties with contract negotiations in 2024. Although we already communicate with Humana on a regular basis, the communication became more frequent during this period. As contract outcomes were finalized, the Pension Boards received updates almost daily. Our team had meetings with the Humana leadership team where they provided insight on their contract negotiation strategies and how they would communicate with our members.  

PBUCC:  We can see how stressful that might have been for our members. What approach did you use to navigate this situation?

Jennifer: Collaboration across the organization was critical in ensuring members remained informed and confident their insurance would meet their healthcare needs. As a small organization, resources can be a challenge, but staff were motivated to guarantee our members received timely and accurate information. Our agility was put to the test, and we moved swiftly to develop a communications plan.

Marie: The Pension Boards had a multi-tiered approach in addressing this situation. Our Marketing and Communications team mobilized our Crisis Communication Strategy. Email messages and videos were created and promptly sent out to conference ministers, employer organizations, and our members. We hosted a special webinar event to respond to this specific situation and to answer any questions. The Pension Boards’ Health and Customer Care Teams worked collaboratively to initiate contact with the most affected members, who were called and educated about the changes. Our staff made sure members understood the options best suited to their circumstances. We  care deeply about our members, and we remain empathetic to the frustrations this caused.  

PBUCC:  It is great to learn that Humana and PBUCC teams mobilized so quickly to address the needs of our members. How did members respond to the situation? 

Jennifer: Our members were very grateful to speak to well-informed and understanding Pension Boards representatives. We wanted to make sure that every member had the information they needed to make the best decision for their healthcare coverage in 2025.

Marie: Our members were understandably anxious and nervous about this situation—many  of them have been enrolled in our benefits for several decades. Although there was great concern about navigating coverage options, we were repeatedly told how appreciative our members were to hear directly from us. One member shared, “I did not want help from a stranger. I wanted help from someone I trusted.”

Our members trust us to keep their best interests at the forefront of our work, and this is a responsibility we take very seriously. We work hard every day to ensure that our members feel supported and maintain confidence in their healthcare coverage so they can enjoy peace of mind.