State to stop disputed insurance practice

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By NATE JENKINS / The Associated Press

An insurance strategy that critics say discriminates against possibly hundreds of black state employees by offering them inferior health plans will stop Jan. 1.

But cost savings — not allegations of discrimination — made the state decide to offer the same health plans to all employees and stop using so-called “ZIP code splits,’’ said Roger Wilson, interim state health benefits administrator.

Lincoln attorney Kathleen Neary, who represents a woman who sued the state over the practice, said she found that hard to believe.

“Of course they’re not going to admit our lawsuit played a role, but of course it motivated the change,’’ Neary said. With the change, “we now know our client and other African American state employees will be treated the same.’’

Most black state employees — some 96 percent — live in areas covered by the ZIP codes 680, 681 or 685.

Of all the state’s 19,000 employees, about 63 percent live within those ZIP code areas.

State employees outside those ZIP codes had the option of a “significantly better health insurance plan’’ from Blue Cross & Blue Shield, including a more extensive network of doctors and better coverage, according to the lawsuit.

Within the ZIP code, employees were given a choice between two Mutual of Omaha plans and two Blue Cross & Blue Shield plans that offer coverage that’s not as good, the lawsuit says.

One example of alleged disparity: the better Blue Cross & Blue Shield plan considered many national hospitals, such as the Mayo Clinic in Minnesota, an “in-network facility,’’ meaning the plan pays more of the bill.

But one of the plans from Mutual of Omaha required employees to pay 40 percent of the cost at facilities like Mayo.

The decision to offer different plans by ZIP codes was made three years ago. Coventry Health Care Incorporated has since acquired Mutual of Omaha’s group health insurance business.

Now the state has signed an agreement with Blue Cross and Blue Shield to be the sole health insurance provider, essentially stopping the use of ZIP codes.

Wilson said his office decided the ZIP code split wasn’t a money-saver after doing a biannual review of insurance plans.

Last month, Lancaster District Court Judge Paul Merritt Jr. dismissed the lawsuit that alleges the constitutional rights of Omaha resident and black state employee Sandra Cartwright were violated. The judge ruled Gov. Dave Heineman and other individual defendants named in the lawsuit had sovereign immunity against the allegations.

An amended lawsuit filed Wednesday contains essentially the same allegations as the one filed last year, but says that state officials should not be immune because they knew or should have known the policy was discriminatory.

Attorney General Jon Bruning’s spokeswoman said the office will ask the court to again dismiss the case because state officials have sovereign immunity. Public officials have sovereign immunity from being sued for performing their duties unless it can be proved that they were negligent or violated the state or federal constitutions.

Asked if the ZIP code splits were discriminatory, Leah Bucco-White, Bruning’s spokeswoman, said, “We wouldn’t be filing a motion to dismiss if we weren’t comfortable defending the case.’’

Another related legal complaint from the same plaintiff is pending before the Nebraska Equal Opportunity Commission.

Neary said they haven’t decided whether to continue with the legal actions in light of the decision to stop the practice. Cartwright’s lawsuit also seeks damages for pain, suffering, humiliation, inconvenience and emotional distress.