Inicio ChaptersPanama Visit of J.J. Gomes. HRD/INS IDB. Health Insurance Plan

Visit of J.J. Gomes. HRD/INS IDB. Health Insurance Plan

por Angela Rivera Saettone

Panama, February 10, 2020

On January 31 of the current year, the IDB Representation in Panama was visited by specialist J.J. Gomes, who offered extensive explanations on the application of Medical Insurance that is currently in force for active and retired IDB employees. The talk was especially directed to the members of the Panama Chapter of the IDB Retirees Association. In response to the invitation made, there was very good attendance of retired members, showing the great interest that exists for having the best understanding regarding the benefits offered by the Plan and the processing of service requests and reimbursements of corresponding expenses.

It must be recognized that, during the transition period of the former Plan Administrator, CIGNA, to the newly hired Administrator, AETNA, there was some confusion and lack of understanding regarding the mechanisms of application for the services of the Plan. This, as is natural in every transition, occurred due to lack of full knowledge of the “modus operandis” of the new administrator and the facilities offered. One of the difficulties observed was regarding the management of new data and communication platform of AETNA, a topic that is very common in any technological transition.

However, the initial difficulties have been overcome in time, both by the efforts and interest of the Bank and AETNA Administrator, who after presenting the claims and difficulties expressed by the members of the AJBID, have been understood with as much diligence as possible. Even so, we cannot deny that there are still some “glitches in the system” to be resolved and that they could be corrected in the short term.

The explanations and answers of specialist Gomes to the concerns and specific questions, in some very specific cases by some of the assistants to the presentation, were wide, very clear and I could say without fear of making mistakes, very satisfactory. The general perception of those attending the event was a good recognition of the efforts made and the results to date.

A very important and relevant issue for the members was the use of hospital facilities and medical care in the country. To date, there were some difficulties in using these facilities since hospitals and doctors did not know in depth who AETNA the Administrator was, and consequently had some apprehension to provide the services and their subsequent redemption of payments for them. Specialist Gomes provided the details of his meetings with the four (4) most important local hospitals and concluded that there was now a better understanding of the application of the IDB Health Insurance in Panama. It should be said that in general, the local difficulties had not been so many or very complicated.

The Representation, very diligent coordinated with specialist Gomes to provide to all consulted hospitals, the official list of retired members, and IDB employees in Panama, so that when they arrive to request medical services the procedures were expedited and fully. All attendees were very satisfied with his decision.

Another important aspect explained and clarified during the presentation was related to the presentation of expense claims and reimbursements. There was a good amount of  diverse questions, which were answered fully and satisfactorily by specialist Gomes. I think that the degree of misunderstanding of the issues regarding the use of medical insurance is now much lower and the issues are much clearer and the difficulties, if any persist, will be much less and how to solve them will be at hand.

In conclusion, the visit of the HRD/INS specialist, J.J. Gomes was very beneficial, timely and satisfactory to a good degree. These types of activities are those that focus on the problems that might have occurred at the beginning of the transition of Administration of the Health Insurance Plan and that are very much necessary for the community of beneficiaries.

I think it is pertinent to thank the Bank, through the HRD/INS office and specialist J.J. Gomes, the interest and efforts to provide the best possible medical care to retired members of the Plan, who after serving in the Bank for many years, now must enjoy the facilities of Medical Insurance, not to get sick often, but so that when they get sick, which is in the game, they can go and find medical solutions for their ills.

 

Sincerely,

 

Cristóbal Silva

President of the Panama Chapter

AJBID