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Director reports on open enrollment progress; members raise concerns about dropped coverage and communications
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Summary
Executive Director Yand reported thousands of calls and over 1,000 applications during open enrollment and said staff will provide a December report on the dependent eligibility verification audit; public commenters described long vendor phone waits and instances where members discovered coverage dropped only after receiving bills.
Executive Director Yand told the board that, as of the meeting, open enrollment activity included 3,757 calls and approximately 1,068 applications, with more than 400 already processed. She reported that the self‑service system was in use and that staff had not experienced major glitches. Yand said the dependent eligibility verification audit is being wrapped up and that staff are working on a second‑stage appeals process, with a full report planned for the December board meeting.
During public comment, Richard Rothman — a longtime health‑service employee — thanked Kaiser for emergency care but said he experienced long wait times when contacting member services and delays receiving ordered durable medical equipment: "I waited 45 minutes," Rothman said, recounting multiple calls that exceeded published phone‑response standards. Mike Delaine described other members who were "kicked off" coverage and only learned of it after receiving bills, urging staff to ensure appeals and communications are effective.
Delta Dental representative Eliana DaSilva answered questions about SmileWay enrollment, explaining that members register online, indicate conditions and provide physician name and contact; those without online access can use the customer service line to enroll. Board members and staff discussed ways to improve outreach so members read packets and enrollment notices earlier in the process.
Yand said staff will report the audit findings and recommendations to the board in December and is considering options for handling members who did not respond to verification notices.
