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KERR COUNTY COMMISSIONERS COURT
Emergency Session
Wednesday, January 5, 2005
2:00 p.m.
Commissioners' Courtroom
Kerr County Courthouse
Kerrville, Texas
Discussion on Unresolved Insurance Issues
PRESENT: PAT TINLEY, Kerr County Judge
H.A. "BUSTER" BALDWIN, Commissioner Pct. 1
WILLIAM "BILL" WILLIAMS, Commissioner Pct. 2
JONATHAN LETZ, Commissioner Pct. 3
DAVE NICHOLSON, Commissioner Pct. 4
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On Wednesday, January 5, 2005, at 2:00 p.m., an emergency
meeting of the Kerr County Commissioners Court was held in the
Commissioners' Courtroom, Kerr County Courthouse, Kerrville,
Texas, and the following proceedings were had in open court:
P R O C E E D I N G S
JUDGE TINLEY: Let me call to order the
emergency meeting of the Kerr County Commissioners Court
scheduled for this time and date, Wednesday, January 5,
2005, at 2 p.m. Precinct 1 Commissioner Baldwin indicated
there was some problems, and asked that this matter be
brought before the Court. I think, in order to kind of get
an overview, it would be appropriate if we called upon a
representative of the new plan administrator to give us a
general summary of where we are now. With us today is
Mr. Jamie Ochoa with Mutual of Omaha, and are you prepared
to give us a plan to where we are in the entire enrollment
eligibility process?
MR. OCHOA: Yes, sir.
JUDGE TINLEY: All right. If you'd be kind
enough, we'd appreciate it, Mr. Ochoa.
COMMISSIONER BALDWIN: Judge, would you --
excuse me. Would you allow me just a moment to talk about
some of the things that -- thank you. The reason I put it
on the agenda was, there's several items that has been
brought to me, and one of those things is it appears that
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our employees are not in the system, particularly for
medications. Several of them, including Commissioner
Williams, has gone to get medications and cannot get them;
nobody's ever heard of us. And I find that a little bit
strange. Very strange, actually. Here we are, the 6th day
of January. And there was, on the enrollment forms, no
designation of beneficiary, and visiting with the County
Treasurer, she told me that she brought that to the
attention of the insurance agent, and he -- his comment was,
"Well, that's all right. We'll just go back to the previous
forms and get the beneficiary's name off there and put
it..." Well, that's unacceptable. What if I wanted to
change my beneficiary? Totally different program. That's
unacceptable.
And I understand that there are numerous of
our employees have enrolled, and the paperwork can't be
found. Those things -- those are three things that, to me,
are major. I can't remember exactly the date that we signed
on, but it seemed like to me it was around December 8th or
so, and everybody was very clear, January 1 being the -- the
date that we start our new insurance program. And here we
are, January 6th, and we're not anywhere near up and
running. And I know you have some answers for us here, but
I wanted to make those comments. And I consider -- I
consider the not having our people in the system and not --
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not able to purchase medications or other things
unacceptable, and I -- I consider that as a strike one. The
beneficiary issue, I consider it a strike two. And the
forms that have disappeared I consider strike three. And
Commissioner Letz is our baseball guru, and he'll tell you
that when you get three strikes, you're out. In my opinion,
you're out. It's over. So, I -- I think that we need to --
this Commissioners Court needs to back off this thing and
get back as fast as we can with E.B.A. and get some
insurance coverage for our people. And that's all I've got
to say at this point. You know, that's the reason I wanted
to have the meeting, is those issues right there. And I
know you're going to explain some things to us. I don't
know if they're going to be satisfactory, far as I'm
concerned, but --
COMMISSIONER LETZ: Wait, before you -- quick
comment. One, I know it seems like it's January 6th, but
it's only the 5th, Commissioner. I know we've had a lot of
calls the past couple days.
COMMISSIONER BALDWIN: These new watches, I'm
sorry.
COMMISSIONER WILLIAMS: You got a new one,
COMMISSIONER LETZ: I want to echo what
Commissioner Baldwin says, but I also want to emphasize
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again a statement that I believe I made when we awarded the
contract to Mr. Wallace and Mutual of Omaha, was customer
service and getting the job done, the level of service that
we expected. And, in my mind, y'all have failed on the
enrollment process, and you're failing today. And I'm very
close to where Commissioner Baldwin is, to basically saying
y'all have breached your contract and we don't -- you know,
we can terminate it today, tomorrow, Monday, whenever, and
go back -- go to our second high bid. I am pretty much fed
up with Mr. Wallace's company and Mutual of Omaha. So, now
y'all can explain why we should stay with y'all.
MR. OCHOA: Okay.
COMMISSIONER WILLIAMS: I'll wait till I hear
your answers.
MR. OCHOA: Okay. First of all, I'd like to
say thank you for inviting us here, and I'm here speaking on
behalf of Mutual of Omaha. Carey Malek was not able to
attend; he had a conflicting appointment, but he did want me
to come and explain -- at least try to give you an idea of
what is -- what it is that's going on, and a little bit of a
status or where we are in getting all of your issues
resolved. First of all, we have had some things out of our
control, and it has to do with weather. And Mutual of Omaha
is located in Omaha, Nebraska, and on Monday, they had an
ice storm, which caused a lot of people not to be able to
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make it to work because of the ice. And I've been on the
phone making sure that all of the areas that do all of the
data entering to get this group up and running, making sure
that they are holding this account in top priority. And
with that information, I did get a call on my way up here,
as a matter of fact, that they are able to enter the
override for those people who need their medications on an
urgent level, meaning if they want to go to the pharmacy
this evening, they'll be able to run that prescription
through.
MS. MEEKER: Ninety days? On the 90-day
supply?
MR. OCHOA: Actually, to her question about a
90-day supply, the 90-day supply is run through the
mail-order program, and the mail-order program does take
about two weeks for them to process your first order. So,
if you had mailed your mail-order information by January
1st, by the time they send it to you, everything will be up
and running. They have also assured me that by Friday
morning, everyone will be in the system, including in the
pharmacy system, and ID cards will also be sent out late
Friday afternoon, the -- the permanent ID cards. So, all of
the departments -- we understand that it's something that
was out of our control, and we do appreciate the patience
that y'all have given us. And we -- we just want to assure
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you that everyone that's working on this is taking it in the
highest regard, top priority, making sure that everything's
getting done. And that's the reason -- I've already turned
in four names of four individuals who need medications
urgently, and by late this evening they should be able to go
to the pharmacy and get those. The rest of the employees
will be keyed in, like I said, by Friday morning, when we
expect everyone to be in the system, able to get
prescriptions. And we tried everything we could to get
everyone into the system by January 1st, but there was just
some things out of our control that we weren't able to get
everybody in there.
COMMISSIONER WILLIAMS: The ice storm
occurred on January 3rd. What was out of your control
between the time we signed the contract and January 3rd?
MR. OCHOA: Well, first of all, we did have
quite a few enrollment forms that had not been turned in,
and I guess the first number was around 40. We had about 40
people who had not enrolled.
COMMISSIONER WILLIAMS: So, those that
enrolled are penalized because of those that didn't enroll,
for whatever their reasons are? Is that the way it works?
MR. OCHOA: No, sir. As a matter of fact,
the information had already been sent up, and the -- the
loading of the plan, all the other things that have to
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happen before the enrollment is actually keyed was already
in the works. But -- but on Monday, when everything was
supposed to be keyed into the system, that was the day that
we did not have full attendance in all the departments.
COMMISSIONER WILLIAMS: Is the system that
you've referred to that handles claims on the medical side
different than the system that failed to work on the
prescription side? Are they two separate systems?
MR. OCHOA: Yes, sir.
COMMISSIONER WILLIAMS: What have you done to
correct the second system?
MR. OCHOA: Well, actually, what happens is
we use a company called Express Scripts Incorporated to do
all our pharmacy administration.
COMMISSIONER WILLIAMS: And the last time I
checked, they hadn't heard of Kerr County; didn't know what
it was.
MR. OCHOA: And that would be correct,
because what we do is, we send them a file with that
information and they load it into their system, which all
pharmacists are connected to by computer. Because we did
not have that file ready on Monday to give to Express
Scripts, that's the reason why they have not --
COMMISSIONER WILLIAMS: When did we --
Mr. Auditor, when did we sign the contract? Or anybody.
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MR. TOMLINSON: I don't know.
JUDGE TINLEY: Ms. Nemec, when did we sign
the contract?
MS. NEMEC: I don't have that paperwork with
me.
COMMISSIONER LETZ: It's not really when we
signed the contract, it's when the Court awarded the
contract. That's --
COMMISSIONER WILLIAMS: Well, whenever the
Court awarded it.
COMMISSIONER BALDWIN: Around December 8th.
MR. OCHOA: Also, another thing that I wanted
to address is, Commissioner Baldwin had mentioned about that
they hadn't heard of us. One of the things is Mutual of
Omaha does not have their own network. We use a network
called Texas True Choice, Ethix Southwest, so we -- we
actually pay for the use of that network. One thing that
did not happen is, Texas True Choice was supposed to send
out a notice to all the providers in this area to let them
know that there's this new group sold, Kerr County; expect
some of their members to start showing up at the doctor's
offices. One of the big things that happens is if you walk
in the door and say, "I'm with Mutual of Omaha," the
doctor's going to say, "We don't take Mutual of Omaha." But
on the ID card, the permanent one, and also on the ID card
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documents which we made available to employees, one of the
-- second thing on the card is the name of the network,
which is Texas True Choice. Now, if you mention Texas True
Choice when you walk in, then they say, "Oh, yes, we take
that." And I -- I've also personally spoken to a couple of
the major providers in Kerrville who had called me to find
out if they were part of our network, the hospital being
one, and also Family Practice, one of the larger doctors'
offices here. They contacted me directly, and I explained
to them that we were part of the Texas True Choice network,
and as of January 1, to expect members of Kerr County to be
coming in. And that`s part of the -- the problem. Now, on
Monday -- Monday afternoon, Carey did contact Texas True
Choice. Tuesday morning they sent out -- they sent out
what's called a blast e-mail to all the providers letting
them know there is a new group in your area. That way all
the providers in this area know now that they are part of
the Texas True Choice network.
COMMISSIONER WILLIAMS: When did that happen?
MR. OCHOA: That happened yesterday.
COMMISSIONER WILLIAMS: Why didn't it happen
before?
MR. OCHOA: Well, what happened is Texas True
Choice just failed in sending that e-mail out prior to the
holiday. And normally that's what they do as a courtesy to
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the providers, 'cause normally the providers -- they have a
contract with Texas True Choice, and anybody who walks in
with a card that says Texas True Choice on it, they will
accept. But if you walk in and say, "I have Mutual of
Omaha," they don't -- they don't recognize that name. Not
until --
COMMISSIONER WILLIAMS: I have a strong
suspicion that we weren't made aware of these little nuances
when we made the decision to make a change. These are all
things that are being revealed to us ex post facto, if you
will. We didn't know that in advance. Could have been
explained, I can tell you that.
COMMISSIONER LETZ: I mean, did our employees
have the card that showed Texas True Choice on January 1?
MR. OCHOA: On Monday morning, I sent an
e-mail that had a --
COMMISSIONER LETZ: That's not what I asked.
MR. OCHOA: Okay.
COMMISSIONER LETZ: Did they have a card --
MR. OCHOA: No, sir.
COMMISSIONER LETZ: -- at the end of the
year, on January 1?
MR. OCHOA: No, sir.
COMMISSIONER LETZ: Why not?
MR. OCHOA: First of all, I had not sent out
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the -- the temporary ID card document until Monday morning.
The first --
COMMISSIONER LETZ: What if someone got sick,
you know, on January lst? January 2nd? What were they
expected to do?
COMMISSIONER WILLIAMS: Pay for it like I
paid for the pharmacy.
MR. OCHOA: Well, we would have -- first of
all, they had our -- Don's information and my information on
how to contact us, and we would have talked them through.
I've had quite a few providers --
COMMISSIONER LETZ: So, someone goes to the
emergency room and they're supposed to go through this red
tape?
MR. OCHOA: Well, actually, unless I knew the
specific --
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COMMISSIONER LETZ: Have you been to a doctor
COMMISSIONER LETZ: I'm just -- fortunately,
I don't think it happened, but I'm outraged that it could
have happened, and y'all weren't prepared to handle it.
MR. OCHOA: And -- and we're not saying that
we would not cover. We would definitely cover -- everybody
is covered as of January 1, and anyone who either saw a
provider or went to the hospital, all those claims will be
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recently, tried to fill out the insurance forms without any
information? Which our employees had nothing. And you
expect them -- what are they going to do?
MR. OCHOA: I understand your concern.
COMMISSIONER WILLIAMS: If we seem unduly
harsh, it's because we like to take care of our employees,
and I think we have a strong sense that what we thought was
right is turning out to be less than right, and that would
explain the attitude that you're facing today.
MR. OCHOA: Yes, sir, I understand. And,
again, we apologize for any inconvenience. And there was
some things out of our control that we wish could have been
different. And just to let you know that we are on top of
it and making sure that everything runs smoothly.
MS. THOMPSON: May I ask a question with
regard to prescriptions?
MR. OCHOA: Yes.
MS. THOMPSON: I can't send in my mail-order
prescription for a 90-day supply because we're not in the
system. You say, well, go to the local pharmacy. Why
should I be penalized having to go back to my doctor to get
another prescription, having to go to the local pharmacy and
pay $42 for a one-month supply when, if I had mail-away, I
could pay $80 and get a three-month supply?
MR. OCHOA: Okay, in answer to your question,
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you can send in your mail-order, because it takes them
approximately two weeks to process. And --
MS. MEEKER: What form? We don't have any
forms.
MR. OCHOA: The form -- okay.
MS. MEEKER: We have nothing.
MR. OCHOA: Let me explain. The form for the
mail-order is included in the enrollment kit that was passed
out at the meetings. And it is -- I brought one with me
just in case.
AUDIENCE: I've also sent an e-mail to
several employees.
MR. OCHOA: It was in this booklet that we
passed out. The mail-order information is on the last three
pages where you can either fax or mail your information.
MS. MITCHELL: That was pointed out at the
meeting, at least the meeting I was at.
MR. OCHOA: So, yes, you may go ahead and
send it, and by the time they finish processing everything,
it will be in the system. It won't be a problem with that.
COMMISSIONER WILLIAMS: What is the process
for recovering dollars spent for those of us who went ahead
and purchased our prescription at market value? What is the
process for recovering what we are entitled to recover?
MR. OCHOA: Okay, we would just need you to
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send us the receipt, and we would file that for you. You
can either submit it to myself or to Don's office, and we'll
make sure that all of those claims get processed.
SHERIFF HIERHOLZER: Is that for medical or
prescription?
MR. OCHOA: For either. If you had any type
of expense between January 1st and until the system's up and
running, which should be by Friday morning, everything
should be --
SHERIFF HIERHOLZER: Okay. So I have an
employee -- and this did happen -- that had to pay $300 out
of pocket to get some medicine that they had to have, okay?
If they send that receipt in, are they going to get
everything except for the normal co-pay back?
MR. OCHOA: That's correct.
SHERIFF HIERHOLZER: How long is it going to
take for them to get that money back?
MR. OCHOA: I can't tell you for sure how
long it takes to process the claim, but we will put that on
an urgent basis. And --
SHERIFF HIERHOLZER: $300 for our employees
that was unexpected right after Christmas is -- is putting
those people in a serious problem.
MR. OCHOA: Yeah, I understand. And we do
have contacts in the claims area where we can get those
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processed just as soon as possible.
MS. MCELHANNON: What about for the people
that can't afford their medicine and they're out?
MR. OCHOA: That are out of medication?
MS. MCELHANNON: I can't afford to go and get
mine.
MR. OCHOA: Well, there's a couple things you
can do if -- if you're completely out and you need some.
First of all, in the meetings we -- we told everybody, if
you're going to be out the first week of January, it's a
good idea to fill your prescription before; five days
before, they should be able to give you a refill. If you
didn't and you're out now, you can talk to the pharmacist;
they can give you maybe a week's supply until they can run
your prescription, and some pharmacists have agreed to do
that. Other than that, by this evening, if you give me your
name, I can go ahead and get you loaded into the system so
that you'll be able to run that prescription today.
MS. MCELHANNON: For three months?
MR. OCHOA: No, not for three months. For a
month's supply. Remember, at the pharmacy you only get a
30-day, but the three months is through the mail-order. And
the mail-order, if you needed some, you should have already
MS. MCELHANNON: I did, and they won't fill
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MR. OCHOA: Okay. But if you give me your
name, by the end of the day, they will be able to process
it, even though their normal processing time, the first time
that you enroll with the mail-order program, is a two-week
period. After that, refills, you get those in two to three
days. But the first time takes the longest, 'cause they
have to do all the entering of your information.
MS. MCELHANNON: So, all I have to pay is my
co-pay?
MR. OCHOA: Yes.
MS. MCELHANNON: Which is $560?
MR. OCHOA: That's your co-pay? Okay. I'd
have to speak to you specifically, 'cause I don't know how
many prescriptions you're ordering or why it's coming out to
that amount. So -- but you're correct, all you would have
to pay is the co-pay for the mail order.
MS. MEEKER: Four or five times more than it
was last year.
MR. OCHOA: Was there any other concerns
that -- that have not been addressed?
COMMISSIONER WILLIAMS: Well, a follow-up
question here I want you talking about. If you do whatever
it is you were going to do as an override of somebody's
system to accommodate some people who have medication needs
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now with their local pharmacist, I assume you're talking
about any and all pharmacists in this area?
MR. OCHOA: That's correct.
COMMISSIONER WILLIAMS: And, secondly, when
the pharmacist is finally able to find somebody that knows
about Kerr County, are they also going to be able to find
out what the co-pay is? My pharmacist told me, not only can
I not get in, I can't tell you what your co-pay is.
MR. OCHOA: And that's correct, because the
company that we use, Express Scripts Incorporated, once they
load the information into their system -- all pharmacists
have a connection, so when they run it through on their
computer when you're in their system, Express Scripts, it
comes back with the information that tells them exactly what
you charge for that medication.
COMMISSIONER WILLIAMS: Instead of loading in
a half a dozen or a dozen names of people who have some
immediate needs, why can't you just load the whole damn
bunch in, get it done with?
MR. OCHOA: Well, that will happen by Friday
morning. Everybody will be there. Our -- the way our
process works, once enrollment is -- is loaded into our
system, the file then takes 24 hours for it to roll over
into Express Scripts, so it does take an additional day for
everybody else to show up in the pharmacy system after they
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show up in our enrollment system. And what we're doing is,
those people who have an urgent need for that medication,
what we're doing is we're jumping those ahead of the rest so
that they can get their medication this evening.
COMMISSIONER BALDWIN: Mr. Ochoa, I have to
admit to you that us folks up here in Kerrville are
small-town, and we're -- some of us are a little bit
backwards and some of us are a little bit slow and that kind
of thing; not near as smart as big-city people. And I'll
admit that. But what really, really ticks me off is the
fact that County employees are paying good, hard-earned
money for something they're not getting a service for. And,
talking about right and wrong, that's wrong. Big-time
wrong.
MR. OCHOA: Yes. And I -- I agree with you
that having your employees have to pay out of their own
pocket is not a right thing. And I can assure you that we
will make sure that they get reimbursed in a timely manner,
and that from -- moving forward, that things will run
smoothly. And, like I said, I have been on the phone with
all these different departments, pushing them, making sure
that gets done, letting them know how top-priority it is
that they get it done. And they've assured me -- all of
them have assured me that they are going to get this done.
COMMISSIONER LETZ: I guess my problem is,
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why did you sell the County a plan that you couldn't
implement on time? I mean, you're -- we're not talking
about the 3rd. Okay, you had a cold day on the 3rd; on the
3rd you couldn't get to the office. We're talking about the
8th when we got this fixed. I mean, you promised us, both
companies, that we would be up and running basically by the
31st.
COMMISSIONER WILLIAMS: Seamlessly.
COMMISSIONER LETZ: Seamlessly, no problems
at all. So, I mean, you all have totally failed to live up
to your end of the obligation.
MR. OCHOA: And that is exactly what we had
hoped for, that everything would be up and running. But,
because of things that -- that we could not control, we were
not able to complete that --
COMMISSIONER LETZ: You could control them.
You didn't have to wait until the day of a possible ice
storm on January 3rd to do the information. This should
have been done before Christmas.
MR. OCHOA: I agree with you. And there was
other things that happened prior to that. I don't have all
the information and all the things that held things up, but
I do know that we were hoping to have everything done in
time. And it's just -- there's a lot of --
COMMISSIONER LETZ: But my problem is, you
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didn't say, "We hope we can do it." You said you will do
it, and you didn't do it.
MR. OCHOA: Yes, sir, I understand.
MS. THOMPSON: Are we still able to use Lab
One, or is all our lab work going to go against our
deductible now?
MR. OCHOA: Her question is in reference to
Lab One. We mentioned that also in the enrollment meetings.
You don't have the Lab One program any more; however, you
can use the labs that are part of the Texas True Choice
network. And we have -- that benefit pays the same as it
did with Lab One.
COMMISSIONER LETZ: If I'm not mistaken, at
the last meeting, when the other Mutual of Omaha guy was
here, he said Lab One was going to be used.
MS. MCELHANNON: Sure did.
COMMISSIONER WILLIAMS: Lab services --
COMMISSIONER LETZ: He said Lab One will be
the same as it was. I mean, no change.
COMMISSIONER WILLIAMS: There's more than one
lab in this town.
SHERIFF HIERHOLZER: And C.P.O. would not
cost anything either.
COMMISSIONER WILLIAMS: I use C P.O. What do
you use?
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MR. OCHOA: Is that correct? I didn't know
about that.
MR. WALLACE: Yeah, I checked on that for
somebody.
MS. THOMPSON: So, Lab One is still in
effect?
MR. WALLACE: At 100 percent, yes, ma'am.
JUDGE TINLEY: There's no separate deductible
for it?
MR.
JUE
MR.
MR.
MR.
was preapproved --
WALLACE: No.
GE TINLEY: Okay.
EMERSON: I have a procedural question.
OCHOA: Sure.
EMERSON: I have an employee whose spouse
COMMISSIONER WILLIAMS: Can't hear you, Rex.
MR. EMERSON: I have an employee whose spouse
was preapproved and scheduled for surgery Friday morning.
Is there going to be an issue with that?
MR. OCHOA: No. As a matter of fact, that
particular employee has been in contact with me already, and
there will be no problem. The hospital has the information
that they need. And I've also informed him that if the
doctor or the hospital need any more information on where to
file the claim and how it's going to be paid, that they can
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contact me directly. So, no, there will be no problem with
that.
MR. EMERSON: Thank you.
COMMISSIONER WILLIAMS: There better not be,
'cause I have a preapproved surgical procedure scheduled
next week as well.
MR. OCHOA: You shouldn't have any problems
at all.
COMMISSIONER WILLIAMS: Let us hope that's
the case.
MS.
for the two weeks,
MR.
MS.
MR.
that you might hav
MS.
medication.
MCELHANNON: But we will get reimbursed
right?
OCHOA: Two weeks?
MCELHANNON: Mm-hmm.
OCHOA: Anything that you -- any services
e had, are you talking about?
MCELHANNON: No, I'm talking about the
MR. OCHOA: The medication, yes. You'll get
-- if you paid for a medication out of your pocket and you
file a claim, we'll reimburse you.
MS. MCELHANNON: And we'll be able to do --
send all our medications in Friday, and in two weeks they're
going to be here? You promise that?
MR. OCHOA: Two weeks is the time that they
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tell us -- Express Scripts -- that it takes for the
processing, and that's the -- that's coming from them, that
in two weeks time, you will have your medication.
COMMISSIONER WILLIAMS: I don't understand
that two weeks business. Aren't you transferring electronic
files to these people with names?
MR. OCHOA: We are, but that's Express
Scripts. That's the information they've -- they've given
us, and I don't know why it takes them that long.
COMMISSIONER WILLIAMS: Pony Express can do
better than that.
MS. THOMPSON: I talked to somebody at
Wallace and Associates yesterday, and she told me that it
would be two to three days for them to process.
MR. OCHOA: And I believe --
MS. MCELHANNON: Can't they overnight stuff?
MR. OCHOA: I believe -- actually, I think
you do have the option of overnighting, but that would be at
your cost, 'cause they use regular mail. But it is two to
three days once you're in the system. So, the --
MS. THOMPSON: That's not what we were told.
MR. OCHOA: The first time that you sign up
for the mail-order program, the -- it takes about two weeks
for you to be in the system. Then, after that, after your
first 90-day supply has been used and you just want to get a
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refill, the refill is processed within two to three days.
So, there might have been some miscommunication. We
apologize for that. But that is -- the first time it does
take a little bit longer.
MS. MEEKER: Gentlemen?
JUDGE TINLEY: Ms. Meeker?
MS. MEEKER: I've thought from the beginning,
and I told all of you, this is poor planning. And I'm
sorry, but I have to say, for myself, a vote of no
confidence. And I think this is just the beginning.
MR. CASTILLO: I have one question. Brad
Alford here just mentioned something. I'm curious as to
where Commissioner Williams is going to get his
reimbursement from. If he's had -- he has the $600 plan or
whatever, will he get his reimbursement out of that $600, as
a penalty?
MR. OCHOA: As a matter of fact, I think
you're talking about the health reimbursement account. And
those debit cards will be -- they told us it would take two
weeks for the -- for them to get those processed in and to
you. And if you were wanting to use that $600 towards a
procedure that you're going to have in the next few days, or
that you had already, you can file a claim, just the same
way that you would after you use your debit card where you
send in your explanation, proving that it was a medical
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expense. You can also use that towards your health
reimbursement.
MR. ALFORD: That's not my question. My
question is, who's going to eat the cost on all these
overcharges right now? Prescriptions, who's going to eat
the cost on it? Mutual of Omaha or Kerr County?
MS. MCELHANNON: Employees.
MR. WALLACE: He's going to get all his money
back except the co-pay.
MR. OCHOA: Correct.
COMMISSIONER WILLIAMS: Which I understand
that.
MR. WALLACE: Except the co-pay. Is that
your question?
MR. ALFORD: Yes. It doesn't come out of the
$600 or anything else?
MR. WALLACE: Not unless he --
(Court reporter interrupted and asked
everyone to speak one at a time.)
MR. ALFORD: That was my question, was who is
going to take -- assume the cost of it, period? Does it
have to come out of the $600, or is this something that
Mutual of Omaha -- all the pharmacies and all that stuff?
MR. OCHOA: Okay. On a prescription, if you
paid out of your pocket for the prescription, they will
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reimburse you, minus your co-pay. Now, that is separate
from whether or not you wanted to use your health
reimbursement account.
COMMISSIONER WILLIAMS: Okay, hold it right
there. That's what the gentleman wants to know about. So,
if he wanted to use his reimbursement account from the
get-go to take care of his co-pay, and all this is not set
up, that means it's out of his pocket. How -- how does he
recover that? Is that your question, Brad?
MR. ALFORD: Yes, sir. Thank you.
MR. OCHOA: Okay. You would file a regular
form to get that reimbursed to you. So, it's just like a
claim, and you would get that back minus your -- and if you
wanted to use that -- the health reimbursement to pay for
the co-pay on your medication, then we'll file a form to
where they take that from that.
MR. ALFORD: No, I don't want to right now.
I want to save that. My question is, where we normally go
in and pay $40 for a refill, we're having to pay $120. Who
is going to cough up the other $80?
MR. OCHOA: We're going to reimburse you. We
will reimburse you.
MR. ALFORD: Kerr County will never see this
$80 again? They don't have to worry about y'all --
MR. OCHOA: No, that goes directly to you.
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If you pay for your medication, we're going to reimburse
you, minus the $40.
MR. ALFORD: I understand. I'm just asking
who's going to eat the $80, Mutual of Omaha or --
MR. OCHOA: Yes, we're the ones that
reimburse you, Mutual of Omaha.
MR. ALFORD: Thank you.
JUDGE TINLEY: Okay. Mr. Wallace?
MR. WALLACE: Well, I'd just like to say,
I've been doing this 18 years, and I have never had a plan
implemented that ran 100 percent smooth. There's nothing
going to run 100 percent smooth, you know, whether it's a
large group or a small group. There were some delays. One
of the problems we had in getting everything going, we
had -- I don't know if you know much about contracts, but
until we got the contract signed and got a check, the
contract was not legal until we got a check and got it
signed. So, once we got that, we got hard to work to try to
get everything going. I don't remember the dates on all
that.
COMMISSIONER WILLIAMS: Does that mean you
didn't start on the process --
MR. WALLACE: No, we --
COMMISSIONER WILLIAMS: -- and enroll these
people until you got a check in-hand?
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MR. WALLACE: No, we were working on it. We
were having enrollment meetings prior to that. But until
that was finalized right there, you know, it wasn't
100 percent implemented. And the -- the contract is not a
contract until you have a check in-hand.
COMMISSIONER LETZ: I go back to the what I
said before. Why did you tell us you could do it in this
time frame if you couldn't? You never mentioned about this
-- that we had to expedite the contract. We were told that
this would be up and running, and this was December 8th or
thereabouts. We were told if we accepted y'all's low bid,
it would be up and running seamlessly by the first of the
year. You know, you shouldn't make statements that you
can't back up. And, clearly, you all couldn't back up the
statements when you sold us.
MR. WALLACE: Commissioner, I understand
where you're coming from, but there were some unforeseen
problems, and -- that Mutual of Omaha encountered, and --
and there was nobody that could control some of those. We
-- we did everything we could to get it up and running, get
everybody enrolled. We still have people that haven't
turned in applications. We had -- I think Jaime said about
40 that we were trying to run around and try to get.
COMMISSIONER LETZ: Well, that goes back
also -- I just brought up this thing -- Commissioner Baldwin
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brought up about some that are lost. One of the people that
was lost, 'cause I know they're on the list still, turned in
their application. And I'm quite confident that that person
didn't just say they did it. It's one of our department
heads.
MR. WALLACE: Sure.
COMMISSIONER LETZ: You know. So, I mean,
again, it was not the County or the County employees' fault.
It was somewhere in your system or Mutual of Omaha, it got
lost.
MR. WALLACE: Right. I --
COMMISSIONER LETZ: So, you know, if you're
going to penalize -- you can't use that as an argument as to
why it was delayed when it was y'all's fault that it is
delayed.
MR. WALLACE: I don't know how many -- I
don't know. Mutual of Omaha took all the applications and
started processing them, and if there were some -- I don't
know. But --
JUDGE TINLEY: Sheriff?
SHERIFF HIERHOLZER: I've heard Mr. Wallace
make the comment that none of them go smoothly, regardless
of what county or what size of the deal. The only thing
that I think I'd like to say for my employees is, I've been
here with this county 25 years; this is my 25th year, and
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I've seen a number of insurance companies get changed and
things go. I never seen one that has had this kind of
problem getting implemented. I've never seen one that you
have different representatives, whether it's from Mutual of
Omaha or the third-party administrator type -- Mr. Wallace
that had given the employees different answers to the same
question, and caused nothing but mass confusion and failed
to -- to inform the employees of everything that was going
on. And, personally, I'm real close to being like what
Billie said. I hope this isn't an idea or a sample of what
kind of service this County's going to get. But, as far as
low confidence in this group right now -- and I can't say
it's Mutual of Omaha's fault or Mr. Wallace's, but it's
somewhere in there. And I'm kind of like Buster; I don't
think this plan's going very well, and I hope this isn't a
sample of what kind of service we're going to have for the
next year. And that's -- I'm saying that on behalf of my 94
employees.
JUDGE TINLEY: Any member of the Court have
anything further with respect to this particular issue?
COMMISSIONER LETZ: I think the only comment
I have, Judge, would be that I think on Monday's agenda,
which I know we're past posting, I think we need to add it
as a late item or whatever, this same topic, and we
either -- for consideration, whether we're going to continue
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insurance with Mutual of Omaha or not. And I'll add the
County -- let the County Attorney look into it from the
standpoint of, you know, we've not -- well, we're as of the
6th, and we still don't have what we paid for, and we have
paid for the month of January already. What are our rights
as a county of opting out and changing?
COMMISSIONER BALDWIN: I beg your pardon,
Commissioner. It's the 5th.
COMMISSIONER WILLIAMS: It's the 5th.
COMMISSIONER BALDWIN: Not the 6th.
COMMISSIONER LETZ: It's going to be the 8th
before we get on the plans.
COMMISSIONER WILLIAMS: How about the 10th?
COMMISSIONER LETZ: But, anyway, I think on
Monday's agenda on the 10th, I think we need to have the
same discussion, because it's unacceptable. Okay, that's
all I have.
COMMISSIONER WILLIAMS: Anybody in this room
who needs to have their name added to this list for
expeditious handling should tell this gentleman.
MR. OCHOA: Yes, I'll be glad to take your
name after the meeting. And, again, this is when you need
something on an urgent basis, because remember, within two
days everybody will be in the system.
SHERIFF HIERHOLZER: Well, to get the people
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out of 94 employees -- 95 I have, we're going to have to
make a lot of phone calls today to find out who all besides
about five that I know of have not been able to get their
prescriptions and have to pay out of their own pocket to try
and get them on that list. I think that's totally
unnecessary work that this County's having to go through to
do y'all's job.
MR. OCHOA: And, again, we do apologize for
any inconvenience. And, like I said, we -- we are
definitely committed to making sure that it runs smoother.
And, like we said, there was some unforeseen things that
were out of our control, and we want to take care of all of
the issues and make sure that everybody is reimbursed any --
any money they were out.
JUDGE TINLEY: Anything further from any
member of the Court?
COMMISSIONER BALDWIN: No, sir.
JUDGE TINLEY: Thank you, Mr. Ochoa.
COMMISSIONER NICHOLSON: I'll just say to
Mr. Ochoa, he's a very courageous man. You could tell that
there's a -- a lot of concern among our employees, and I
would encourage you to go the extra mile to get it fixed.
MR. OCHOA: Yes. And that's -- as far as my
commitment, I am the account executive on this account, and
so I -- I come on the service side. So -- and that's why I
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give out my number to anybody who needs help on anything;
they're welcome to call me. As a matter of fact, the number
I give is my cell phone, so --
COMMISSIONER WILLIAMS: What is that number,
Mr. Ochoa?
MR. CASTILLO: It's area code 512, 797-1343.
COMMISSIONER WILLIAMS: 1343?
MR. OCHOA: Yes, sir.
COMMISSIONER BALDWIN: What about a home
number? No.
COMMISSIONER NICHOLSON: Well, as a matter of
fact, that is my home number.
COMMISSIONER BALDWIN: I see. Let's test
him.
JUDGE TINLEY: Anything else, gentlemen?
We'll stand adjourned.
(Commissioners Court adjourned at 2:39 p.m.)
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STATE OF TEXAS ~
COUNTY OF KERR ~
The above and foregoing is a true and complete
transcription of my stenotype notes taken in my capacity as
County Clerk of the Commissioners Court of Kerr County,
Texas, at the time and place heretofore set forth.
DATED at Kerrville, Texas, this 6th day of January,
2005.
JANNETT PIEPER, Kerr County Clerk
BY: ___ __ __ _ ____ ____
Kathy Ban k, Deputy County Clerk
Certified Shorthand Reporter
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