The process for avoiding Aetna IS tricky

It turns out, NYC retirees really are confused about how to avoid being placed into Medicare Advantage. Read on.

New York City municipal retirees will be moved to Aetna/CVS Medicare Advantage CONY September 1, unless they opt out, which the NYC Office of Labor Relations calls a decision to “Waive (terminate) City health benefits.”

I described yesterday that the process was confusing for several reasons:

• Calling it “waive” instead of “opt-out” is confusing. The form also says at the top that it is not an opt-out form.
• The form was hard to follow, with key text buried, and things that should go together listed separately.
• The explanatory page was laid out strangely, losing the opt out (waive benefits) part in the text, making harder to find than necessary.
• Requiring a two step process is unreasonably complicated.

I should add “terminate” benefits sounds permanent. It is not. But the mechanics of leaving the NYC benefit system and coming back should best be left for another time, and probably another author. For now, OLR used the word “terminate” on the form to describe an action that is not permanent, which is misleading.

But let’s look at that last one. I described a two step process for avoiding Aetna Medicare Advantage. Check off the waiver box on the form. And call Aetna.

Was I correct? I had four sources for this (some overlap, but essentially two completely independent sources). I felt confident writing what I wrote.

But in the last 24 hours I’ve gotten a bucket-load of comments and correspondence, claiming I (and indirectly, my sources) had misread, and that the call to Aetna is not required.

That smart and well-meaning people are giving me different answers – it is quite clear that half of them are certain that they are correct, but are actually wrong. It is the process, the form, and the OLR explanation which is at fault.

Was there intent to confuse?

People often want to assume good faith. But this is the New York City Office of Labor Relations. We know enough about them and what they do to be naturally suspicious.

1. The mistakes on the form, the confusing language, the capitalization errors, the bad spacing on the explanatory page, the ambiguity about the process (which may be a two step process) these may have resulted from rushed, sloppy work.
2. The mistakes on the form, the confusing language, the capitalization errors, the bad spacing on the explanatory page, the ambiguity about the process (which may be a two step process) these may have resulted from incompetence or a lack of concern about ease of use.
3. The mistakes on the form, the confusing language, the capitalization errors, the bad spacing on the explanatory page, the ambiguity about the process (which may be a two step process) these may have been intended to frustrate people trying to opt-out, in order to reduce the number of opt-outs.

I could be convinced of any of these, but I lean to #3. I think OLR wants as many people as possible in the Aetna/CVS Medicare Advantage. And I know from other dealings with OLR that there is very little that is beneath them.