Coverage switch affects many Georgia seniors

Print Friendly and PDF By: Andy Miller Published: Apr 1, 2013

More than 7,000 Medicare beneficiaries in Georgia are switching health plans after a Florida-based insurer was ordered to liquidate.

All policies of Universal Health Care have been canceled.

Last week, federal agents raided the St. Petersburg headquarters of Universal Health Care, after a bankruptcy court trustee alleged a “pattern of dishonesty or gross mismanagement” at the company, including “side deals” that benefited insiders, according to a Tampa Bay Times article.

A judge placed the insolvent Medicare insurer into receivership a week prior to the FBI raid. About 800 Universal employees lost their jobs last week after the company shut down.

Effective Monday, the 7,501 Georgians who have Medicare Advantage plans through Universal and have not selected a new Advantage plan have been transferred automatically into traditional Medicare, with no gap in their coverage.

Beneficiaries with Universal prescription drug coverage will be enrolled in a comparable prescription drug plan, either with Coventry, Envision, Humana or UnitedHealthcare.

But these seniors also will have a special election period, from now through May 31, to change to another managed care or prescription plan.

Insurance officials in Georgia said Monday that they expect some seniors to find the transition bewildering.

“I’m sure there’s going to be confusion,’’ said Don Roof, director of insurance and financial oversight for the Georgia insurance department.

In November, citing Universal’s financial losses, state Insurance Commissioner Ralph Hudgens signed a consent order with the company, which agreed to halt the sale of new Medicare Advantage plans in Georgia.

Hudgens said Universal’s net loss of $27 million in 2011 and its loss of $22.1 million in the first six months of 2012 sparked his move to halt sales.

“We were worried that something like this was coming down the line,’’ Jay Florence, assistant insurance commissioner, told GHN on Monday.

Last year, Universal Health Care had an estimated 25,000 Georgians in Medicare Advantage plan.

Beneficiaries with a Universal plan can find out which plan they are enrolled in or to choose a different plan 24 hours a day, 7 days a week, by calling 1-800-MEDICARE.

Medical providers with unpaid claims for services must contact the Florida Department of Financial Services, which is the court-appointed receiver.

The Tampa Bay Times article reported that the bankruptcy trustee cited a transfer of more than $18.3 million to another company controlled by Universal founder Dr. Akshay Desai last year, and $2.2 million in “bonuses and “other compensation” to company officers and directors in addition to their salaries, also in 2012.

The parent company filed for bankruptcy in February.

Desai, 55, could not be reached for comment by the Tampa Bay Times.

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