Some Postal Workers Pan HRA Plan Service

When researchers asked about claims processing, 93% of the FEHBP national PPO members said they were satisfied with claims processing, while only 86% of members of all new FEHBP plans and 87% of members of the APWU CDHP were satisfied with claims processing.

The APWU CDHP performed better on a measure of “access to care.”

About 85% of APWU CDHP members said they were satisfied with access to care, which was almost equal to the 87% access satisfaction level for FEHBP national PPO members and substantially higher than the 77% access satisfaction level for members of other new health plans.

The APWU CDHP performed worse on a measure of satisfaction with customer service. The 67% service satisfaction level at the APWU CDHP was much higher than the 59% service satisfaction level for all new FEHBP plans but lower than the 74% service satisfaction level for members of all FEHBP national PPO plans.

In addition, the APWU CDHP has reported an annual claims appeal rate of 1.98 per 1,000 enrollees, compared with an average of 1.11 per 1,000 enrollees for the national PPOs, and more than half of the appeals related to problems with tracking account expenditures or deductible balances, the GAO researchers write.

The GAO researchers note that the customer service problems at the APWU CDHP and many of the appeals may stem from a flaw in the APWU CDHP brochure.

“While one page of the plan brochure explicitly states that [dental and vision] expenses count toward the deductible, another page appears to indicate that such expenses do not count toward the deductible,” the researchers write.

The APWU has revised the 2006 CDHP brochure, and it has included dental and vision expenses when determining whether CDHP members have reached their 2005 deductible limits, the researchers write.

The GAO report is on the Web at //www.gao.gov/new.items/d06143.pdf