ERM-BC-COOP: AvMed letter raises Customer ire and BP

I have been an AvMed Medicare Advantage customer for several years. Over all, it has been a satisfactory relationship - at least for me.

But this year, 2013, AvMed's communications with its clients has left more than a little to be desired.

For example AvMed sent me two documents in one envelop.

The outer document told me my plan was cancelled.

The inner document solicited my continued patronage with a new plan.

It seems AvMed cancelled one plan and substituted another.

One letter stating "Your plan [Plan ID] has been replaced with [Plan ID]. The only differences between the plans are listed below: " would have sufficed AND avoided confusion.

Remember. This is a Medicare plan, and that means a plan for geezers who (a) know how to read and (b) usually don't make assumptions.

The previous two-letter package pales in comparison to the letter I received yesterday in which I was informed that "Your enrollment in has been cancelled. This means you don't have coverage from AvMed Medicare."

The only date in the missive was the date the letter was printed.

Since AvMed delisted by Primary Care Physician (PCP), I looked at plans that listed my PCP. None of the plans favorably compared to AvMed. But since I already was looking at other vendors' plans, I decided to look at plans that omit my PCP from their list of providers.

I found such a plan and, surprise, it was better economically for me. AvMed was good, but Humana had a more wallet-friendly plan.

By the way, there is no such thing as a "$0 premium" plan. Medicare charges a Part B premium of about $104/month (sometimes less, sometimes more, depending on income). An advertised "$0 premium" plan means there is no additional premium paid to the vendor. On top of the $104 (plus or minus) from Medicare, the U.S. government kicks in much more, which is why there are so many vendors vying for a geezer's business.

OK, I know that on December 31, 2013 AvMed and I will part company, but to get a letter that states that I "don't have coverage" - and given the wording it has to mean I don't have coverage as of the letter's date - causes panic; the blood pressure soars and my normally calm disposition is rattled.

I call AvMed's Customer (dis)Service number and a Sweet Young Thing answers. I give her my name, rank, and serial number and finally she allows me to tell her why I am calling. She pulls up my file and assures me that I am covered through 12/31/13.

So what, young lady is your name if I need to refer back . . .

She gives me her first name and, when pressed, the last initial of her last name.

Not satisfactory. I can anticipate the response if I call back and say that "Miss [CS person's first name and last initial] told me … " I'll likely hear either (a) "We don't have anyone by that name, or (b) "We have a number of people with that name and it's impossible to know which one spoke with you."

I demanded to speak to a supervisor and was told all of her supervisors were busy. (How many supervisors does one person need?) She said she'd send an email to a specific supervisor and that person would get back to me.

A day later the supervisor did call - and explained that AvMed has a 24-hour window to return calls, something the first person failed to mention.

By now I'm thinking like a Risk management practitioner.

How can I give callers a CS person's ID without compromising their privacy?

Bingo: Employee ID. John110 or Judy10.

AvMed, the supervisor tells me, instructs its CS people to give their telephone extension. That may work IF the called notes the day/date and time of the call; I'm reasonably certain the extension is shared during the call-in hours.

Since AvMed and I are quits on the last day of the year, I suppose I shouldn't let this bother me, but it does.

AvMed generally is a good company, but of late it has had a serious problem with communication. I sent letters to two company executives, noting that I do not want a response - I think I've had enough blood pressure-boosting letters to last for awhile.

ERM-BC-COOP: You have to wonder

According to an article in the Knoxville (TN) News Sentinel, Don Cook, the National Nuclear Security Administrator’s deputy administrator for defense programs, said the government shutdown this fall cost the agency $330 million. And that was just for defense programs around the complex, Cook said this morning at the ETEBA’s annual Business Opportunities Conference at the Knoxville Convention Center.

So how much money did POTUS save vs. how much did POTUS' shut down cost the country - in dollars and in image?

From a risk management point of view, it appears someone failed to consider the consequences.

What did POTUS shut down?

He shuttered the Internal Revenue Service, the IRS. While that had to make a lot of people happy, it cost the nation income.

He closed the federal lands- the parks and forests.

Closing the parks meant that while expenditures were reduced - no salaries to furloughed personnel - there was zero income from visitor fees. Maintenance on the properties was put off, only to be made up later.

Visitors come from around the globe not only to see our cities, but to enjoy our parks and monuments. Putting up "Closed 'Cuz we can't accord to open" signs is disgraceful and, in the end, it wasn't true anyway.

Forest lands and open ranges managed by the US Forest Service and the Bureau of Land Management (BLM) were closed to people who normally pay to log trees and to send livestock to graze the land. Roads were allowed to deteriorate making people who could access the lands spend extra to repair vehicle suspensions. The road repairs still had to be made, but now the potholes were bigger and deeper.

Federal workers had to go on unemployment, some were forced to use food stamps and to turn to local (state) welfare agencies. Instead of paying taxes on their wages, they were forced to take tax money.

There are ways to cut expenditures. On the top of my personal list is to discontinue Saturday residential mail delivery. The USPS claims its financial woes are linked to the Internet, so at least those with an Internet connection won't miss Saturday delivery, particularly when the delivery is mostly bills and "junk" mail.

Then there is the Affordable Care Act disaster. Millions to develop a Web presence that doesn't work. Making flat statements that POTUS won't do something and then being forced by reality to do what he said would never be done.

The "bottom line" is that the nation's bottom line is no better - and in some cases it is worse - than before the shut down.

I know POTUS is not a risk manager, but it might have been good if he had sought input from a real risk manager, not a "yes man" who pretends to manage risks.

For want of a nail . . .