Health insurance companies bitching about costs? Fuck you!

The BBQ Pit
1

Folks, I wish I could come up with a better title to encapsulate my rage. My utter, complete disdain. I am about 3.2cm from stepping right the fuck over the edge. I’m hoping this little rant will take the mentally- and emotionally-crippling anger down to a point that I can actually talk to these fucks tomorrow without the need to toss a bail bondsman’s salad to be considered bondable.

I’ll try to be brief and may leave out some details, so addendums may be forthcoming.

Last year my wife took a job with the hospital that offered health insurance with BC/BS on the first of the month following her start date. This was important as a 60 day lapse of coverage makes anything diagnosed a pre-existing condition. She worked for a bank for 8 years that switched insurance with 6 day’s notice that wouldn’t cover what we were currently being treated for. There was little choice.

6 weeks later I landed a job that had day 1 coverage, so I dropped from her policy.

This year we decided we’re better off putting her on my BC/BS policy. The coverage is stunningly better than hers and it would be cheaper having her as a rider than having 2 seperate policies with the same insurance companies. We both have BC/BS, we didn’t see any problem here.

I learned today there is a big fucking problem. We’re paying double for her coverage with no additional benefit.

Starting January 1st, I’m paying her premium, and she’s paying her premium. Essentially, she has two health plans at the same time. Now, we knew there would be a brief overlapse of premiums, but for a week we figured it was one of those things we would just deal with.

Why the fuck did I think having both the major health insurance company and the only hospital in the region dealing with each other against us ever work out in our favor?!? :confused:

My wife called HR to let them know that as of Jan 1 she was covered on my policy and would cancel coverage on Feb 1. The inception date of coverage was Feb 1, 2005. During open enrollment.

Read that again. Feb 1, 2005 was the open enrollment date when we got coverage through the hospital with BC/BS.

When she called today to cancel, she was told she missed the open enrollment and couldn’t drop the policy.

She was told she couldn’t end her coverage. There was no choice in the matter. Her payroll deduction would continue. And mine will continue. My wife has 2, count 'em, 2 health insurance policies in effect right now. And according to the assclowns at the insurance company, there is no way to correct this. I’m seriously thinking about taking her in for a full physical and demanding a check from the billing department since they’ll be paid on both policies.

My policy went up Jan 1 because I’m a scummy, evil smoker. The rate increase is justified by increased costs due to tobacco. (They made a very concerted effort to point out that drinkers and fat people didn’t increase costs. I swear on my mother’s grave there were flyers stating that.) So I signed the Affidavit of Second-class Citizenship when submitting the change in health coverage to include my wife.

I can deal with an increase. My Rx coverage gives me a net gain even if the premium tripled. But now they don’t even offer a reach-around collecting twice on my wife.

I’ll tell ya, I wish this would have helped a bit getting it off my chest. It isn’t. My head is pounding and if I had a generator pedal under my foot I could power half the neighborhood. 3 fucking policies being paid out of our pockets for 2 people.

I hope and pray every fucking insurance company and hospital goes bankrupt.

And I hope I’m still a free man tomorrow to visit with you all again.

Fuck my toe, I’ve never been this pissed.

2

Healthcare for profit at its finest.

3

Open enrollment occurs at least annually. Find out when open enrollment for her company will take place this year. If HR won’t tell her, call BC/BS and ask them. Ordinarily, they’ll send out forms requesting information about any changes (additions, terminations, changing from PPO to HMO etc.) I can’t believe they’re refusing to allow her to opt out.

4

I’m confused. If open enrollment deadline is February 1, which your wife complied with, why are they jacking you around?

5

I am a business analyst/systems analyst that takes care of all of this open enrollment data and other things being passed between companies for this type of thing. Open enrollment is a contract and it sets a whole lot of wheels in motion that are not easy to stop. I didn’t say that it was right. That is just the way it is and it is designed that way.

You and your wife are largely at fault for not realizing this and taking the necessary steps to avoid it. It is the equivalent of not reading a contract carefully and getting burned.

I know in a logical world outside the system it would seem easy to fix but is not. Let me give you some inside advise. The call center reps really and truly cannot fix it. They are lowly peons that are constrained by what they see on their screen. I design some of those screens and there are some things like this they simply cannot do by design. It is impossible for them. You might think that you could ask for a call center supervisor. Again, they aren’t that type of management and have no mechanism for doing that unless they feel like taking it on as a special case and handing it off to someone that can fix it. Not likely.

That said, it can be fixed. People in the right places can fix everything. I can’t say who that is in their company. You need to find the name of someone in operations management and contact them. Having double policies with the same company should be an easy appeal but you have to do the investigative work yourself. People are people and most will respond to a logical plea especially if you are persistent. They are just employess like yourself and get no bonus or pleasure from screwing and honest and sincere person over.

I would suggest you call the call center and not ask them to do anything, but to ask for a name of one or more people that might. E-mails would be a good start.

6

There is an open enrollment period at LEAST once a year for healthcare, and that is usually to opt IN, not OUT. To my knowledge, unless the frozen-ass tundra state where you live has some really ass-backwards laws, you can generally drop a health plan offered privately or through a company whenever you so desire.

Good luck Duff, and don’t let those dumbfucks push you guys around.

Sam

7

I’m sure Shagnasty is correct - someone can fix it. Recently I ordered concert tickets online and due to my own stupidity asked to pick them up rather than have them emailed. When I realised my bungle and rang the call centre staff I was told it couldn’t be rectified. I got the operator to put me through to her help desk, “The people you ring when your computer is playing up.”

Someone on the help desk just said, “Oh, yeah I can just insert a request in the email queue and delete the ticket request. Hang on.” While I waited the “impossible” email arrived. The guy on the help desk seemed pleased to be dealing with the public and finding a nice cowboy solution.

8

I had always been under the impression that being double-covered was a GOOD thing. That is, one policy would cover as normal, and the other would pick up the rest.

When my wife and I decided to have a child, we enrolled her in my work’s insurance as well. For two years we tried to get pregnant. Finally we did. That’s three years. Bills get submitted, and lo and behold, we get stuck with a couple thousand in bills that neither policy will pay, even though either policy alone covers 90%. Somehow, neither will cover that last 10%, even though one of them didn’t pay a dime.

Of course, this happened right after open enrollment. Another year passed until we could get her off my policy. Four years of premiums, and they didn’t pay for a thing. Fuck them all.

I feel your pain, duffer.

9

Hey, not that long ago I ran into this exact situation, covered on my husband’s policy and wanting to drop the very very expensive (better, but way not worth it) coverage through my office. I was told the same thing–you cannot drop it. So I talked to my boss and said apparently what I was going to have to do was quit, maybe she could hire me right back. And you know what? The problem got fixed.

The HR person (my office) said that, apparently, the insurance rep just didn’t understand that there was a “change in status,” which is what’s necessary to trigger an open enrollment change. The change in status was my husband reaching the point where he could add me onto the insurance.

10

Of course I meant a non-open enrollment change.

11

Actually, that is an extremely good point. There are certain types of allowable open enrollment drops and that is one of them. That might be even taken care of in the call center if the OP uses that language. Can’t be sure but it is worth a try.

12

Yeah, they don’t do that anymore. It’s called “coordination of benefits.” If there’s double coverage, the secondary coordinates with the primary to find out what they pay on the benefit. If the primary pays more than or the same amount as the secondary, then the secondary pays nothing. If the secondary allows more, they will pay out on the remaining 10 ( or 20, or whatever)% up to the amount the secondary allows. Not including co-payments.

13

I just remembered something that happened at the last place I worked. During open enrollment, the HR manager switched to a cheaper plan with much higher deductibles.

Shortly after the open enrollment deadline passed, his wife was diagnosed with cancer. He contacted our corporate HQ, who contacted the insurance company, and he was allowed to switch back to the other plan.

Nothing’s impossible. If you’re the HR manager anyway.

14

Damnit, I forgot to mention this part. When she called the HR dept, they said she couldn’t drop her coverage unless there was some sort of “qualifying event.” Qualifying events including death of a spouse, permenant disability, etc.

So according to these fucks I have to die so HER medical policy can be ended to go on mine. Of course, since I’d be dead she may or may not be allowed to be included on my policy. I’m thinking she wouldn’t be able to join the plan. Forget my taxes paid on a deck of smokes, dying would save me more than quitting smoking according to this convoluted shit. I’m starting to see a cynical pattern to my view of health insurance companies.

I don’t want to get into a GD about health care, but I must mention that for years I’ve tried to argue it isn’t the drug companies driving up the cost of health care. It’s the fucking insurance companies. (And I don’t give a shit about any partisan digs from either sides, the health insurance companies are an entity unto themselves.)

Tomorrow is my first day away from the office in 3 weeks. I get to spend it making call after call after call. And a few more calls if needed. This shit will be resolved and I’ll annoy, cajole, needle and berate until I get to someone that can do something about it. One benefit of having BC/BS is when I call the Fargo office, there is someone in that building that has enough authority to rectify this shitstorm. It’s not a 3rd party call center I’m calling. That may be a major advantage for me.

OTOH, it may be the hospital my wife works for. It wouldn’t surprise me that the institution that couldn’t tell me until 6 months later what kind of cancer my mom had died of is trying to pull some shit. Even if it is their fault, they are just as guilty for colluding with the insurance company.

There is going to be fucking hell to pay, and if we don’t get refunded the double charges, the money I’m out will be directly proportional to the required bail to sleep in my bed tomorrow night.

Jesus Christ, I never thought I could ever feel like this. I’ve been angry before, but this is a new realm I’m entering.

FWIW, I appreciate the advice and wisdom from everyone. I’ll take it all at this point.

15

Duffer, I don’t have any suggestions regarding your insurance, but I do want to say that as not only one of my favorite posters around here but an all around cool guy, I hope the day will come when you can kick that ol’ devil weed. I smoked heavily for twenty-one years and tried to kick the habit three or four times a year starting around the third or forth year. I know it isn’t easy, but here’s hoping the day will come when you can.

Regards,
SA

16

I’m not getting this at all. If she were able to change her coverage during open enrollment, 2005, is there not an open enrollment again in 2006 at the same time? I thought most companies had annual enrollment (at least) for insurance? When did they specifically say she could terminate her policy? That sounds just plain incorrect to me.

17

Most companies do open enrollment around the beginning of the fiscal year. Which, if I remember correctly, is around October? In any case, when I was still working for AAA with my wife, we both had the same coverage for each other…i.e., we had double coverage. She ended up having to call one of the vice presidents that she used to work for to get it fixed. I hate insurance companies.

18

You need to find out if gaining/losing coverage is also a qualifying event. It is with my company’s insurance, also through BC/BS. When my wife lost her insurance, I put her on mine for 3 months until she got hers back, no hassle from anyone.

I’m hoping that you just talked to a stupid HR person, instead of being stuck in a ridiculous insurance plan.

19

Get a cheapo divorce. That is a qualifying event. Get remarried. Have some fun with it.

20

No, unfortunately, they won’t. We’ve often had double-coverage, through my work and my husband’s. Used to be, whatever the first didn’t pay, the second one would. Say, the cost is 100 bucks, insurance 1 pays 80%. Then you submit to insurance 2. Their coverage is also 80%. They see that insurance 1 paid 80 bucks, so they’d just pay the 20 bucks.

Those were the good old days.

Nowadays, insurance 2 would see that insurance 1 paid 80 %, and they’d say “well, that’s all you’d have gotten from us, so we’re not going to pay one dime”. In other words, their coverage was a complete ripoff.

I do feel your pain. The whole “open season” really can be a massive PITA.

Oh yeah - qualifying events can include things like a spouse changing jobs and getting coverage through the new job. So you just need to quit your job and start a new one. Argh.