Healing at Home in Illinois

Thanks to her prior work experience with the state, Health Alliance Medical Plans' senior VP and general counsel, Lori Cowdrey Benso, helps her firm keep its State of Illinois account thriving

When Lori Cowdrey Benso joined Health Alliance Medical Plans in July of 2003, her résumé included more than nine years working for the Illinois Department of Central Management Services—five as legal counsel, and four more as employee benefits deputy director. In those positions, she managed employee benefits, risk management, and deferred compensation.

Even if she didn’t know it then, she was also preparing herself exceptionally well for her next job. Benso’s prior experiences with the state have helped inform her approach to managing Health Alliance’s State of Illinois account—one that covers more than 84,000 lives and responsible for $500 million in annual revenue.

“It’s helpful to have prior relationships,” Benso says. “I deal with many of the staff who I worked with and are still there. I spent a lot of time testifying on various bills that would come up that affected employee benefits, so I established relationships with legislators, and that’s really key when you’re in an account like this.”

As the only provider-sponsored plan in the state of Illinois, Health Alliance represents the insurance solutions for a great number of people, with offerings that include individual and family plans, vision and dental, and the State of Illinois employee-benefits program. Benso is senior VP and general counsel for the company, responsible for litigation and contracts, hiring and managing outside counsel, government relations, and supervising more than twenty reports.

“When I came to work here, they didn’t have a lobbyist, which is almost unheard of for a plan our size that relies on a government account,” she says. “So now, we heavily rely on our lobbyist Julie Curry, who is a former state representative I work with, and also key senior staff who also worked in state government.”

Benso’s previous work also helped Health Alliance deal with two fairly large issues with the State of Illinois over the past dozen years. One involved Governor Rod Blagojevich’s administration in 2004, when it didn’t select Health Alliance for a request for proposal (RFP) that it issued. “We protested that decision, and we ended up finding out through a legislature hearing that Health Alliance was ranked second, with the highest technical score, and we should have received one of the five contracts awarded,” Benso says.

Since Benso helped write the procurement rules, she had a clear understanding of the state’s violations, and the bid was reopened with Health Alliance being selected the next time through.

The second issue occurred in 2011, during Pat Quinn’s term, when the Governor decided to self-fund the account and end the contract with Health Alliance. “We are a fully insured HMO, and they decided that they wanted to convert everything to self-funding,” Benso recalls. “However, they are required by statute to seek approval from the commission on government forecasting and accountability, and they did not take that step.”

“We ended up suing and were granted a stay based on the fact that they did not seek COGFA [Commission on Government Forecasting and Accountability] approval.”

Health Alliance settled the case, agreeing to drop the lawsuit if the state would issue a supplemental RFP, which the company bid on and won in 2012. Now, Benso and her team face the challenge of repairing the relationships from these two lawsuits. During the cases, they had to sue the chief procurement officer, the benefits administrator, and the director of the Department of Healthcare and Family Services.

Again, Benso’s past reputation came in handy. Former coworkers vouched for her, and she was able to mend the damage without compromising her work or drive.

Currently, the State of Illinois account comprises about one-third of Health Alliance’s total business and is key to its economy of scale and administration of benefits. However, the company has taken recent steps to alleviate some of the dependence on this one account.

“We’re trying to diversify the business and grow the business,” Benso says. “For example, we started a health plan in Washington with another provider system, plus we just recently received licenses in Indiana and Ohio to expand into those states with another provider system.”

One problem has been that in the market they currently cover, there aren’t many large employees with the largest being the University of Illinois and the Carle Foundation, which since 2010 has been the parent company of Health Alliance Medical Plans.

“Health Alliance offers all types of products, from HMOs, to point of service, to third-party administrative services to self-funded plans,” she says. “We are working with a consortium of school districts right now, as they get better rates when they combine forces.”

Yet perhaps the biggest change Benso is witnessing is the increased attention to wellness by those involved in the plans. “We get lots of questions from the state about what programs we are offering; asking what are we doing to incentivize employees to exercise, to eat right, and keep employee benefits costs down,” she says.

“That’s something that I think will continue to be a driving force in the years ahead.” AHL