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Posted: 8/4/2002 6:59:13 PM EDT
Ok here's the deal. The company I work for is being sold as of August 9th. My job is not in jeopardy. But, As of July 15th the company that is covering my health insurance was shut down by the state if Indiana. None of my bills will be paid. my wife has a health condition that is rather expensive ($500 per month in medicine not to mention docs bills) I was told by my company that they haven't made a decision if they will pay the outstanding bills. So far thay say it is up to me to pay all the bills. I think (this is just a guess really) that they are stalling getting the new insurance and are waiting till the 9th. I just baught a new house and pretty much liquidated the savings account and can't cover the outstanding bills let alone the future ones and the medicine. Not to mention there is a 63 day window when my wife will be covered under any new plan. otherwise it will be a pre-existing condition. The brass of the company ain't say jack we are getting zero info and I am in NC and they are in IN. We are a small company about 100-150 employees. Here is the only option I can see so far. Take them to small claims court and get an injunction barring the sale until it is resolved. But this can and probably will get me fired. I don't think It will be hard to get a new job in the same salary range but would rather not leave. This really sucks I don't want to loose my first house, my wife isn't takeing her meds like she should to try and save money (no matter how many times I tell her to take tha damn things). I just really don't know what to do. I also don't know if oncew the sale goes through if all the liability for the outstanding bills vanishes. I really need help here but I can't afford an attorney.
Link Posted: 8/4/2002 7:52:53 PM EDT
[#1]
Link Posted: 8/4/2002 8:01:27 PM EDT
[#2]
Here's the State of Indiana Department of Insurance web site: [url]http://www.in.gov/idoi/[/url]

They may be able to give you some answers.

I don't understand the 63 day waiting period.  How long was she covered under the plan being taken over?  The amount of time she was covered under the old plan is supposed to be credited to the preexisting period of the new plan, from what I understand, under HIPAA.

Try this link for HIPAA information:
[url]http://www.hcfa.gov/hipaa/hipaahm.htm[/url]
It's not working at the moment, but I believe antiUSSA had a similar predicament, and I think this is the same link I gave him.

Do your fellow employees have new insurance already, and their dependents,too?

Also, is the current company HQ in Indiana as well as the insurance?

Is the acquiring company also headquartered in Indiana?

If it looks like you're getting in over you head (easy enough for ME to do), or you're getting stonewalled, it can't hurt to at least PHONE an attorney.  Many of them will give you a free short consultation to size the problem up, and you might be able to get one on a contingency of 25-33%, or on some sliding scale.  There are also ones who do pro bono {free) work in cases of need.

Because of this not being a single-state situation, there's the added factor of where to apply the leverage - which state.

Get you documents together for your current insurance/health plan and se if it says anything about ERISA or self-funded in there.

Also you need to maek an estimate of the expenses at stake, how much was billed, how much of a cut-back in the fees was to be written off because of the provider being part of the health plan network, how much was paid before and how much should be paid on the ones that are up 'in the air' and how much was/should be your responsibility.  This will help whoever you talk to get a better handle on the situation.

Are you of the belief that you and your wife may be getting mistreatment due to her medical status?  

There is the ADA law, but I can't say whether that would help because of your wife's condition (someone might be tempted to say that she's not the employee, so she's out of luck, but you're better getting the answer form an expert - ADA is not just about employees).  Better get the answer from someone expert in that area of the law.

After you have put some more information up about this, if I don't reply, remind me with an Instant Message, OK?  I may have a phone number for a guy with an office in Indianapolis.  I don't know if he practices much there, though.
Link Posted: 8/4/2002 8:01:32 PM EDT
[#3]
When my insurance was terminated when I left a job last year a company by the name of "COBRA" contacted me asking if I wished to continue my coverage for a fee. It was like $525 a month. You might consider contacting that or another company and pay for the insurance on your own until you get your situation straightened out.

Hope it works out for you. I have been there...

Take care,
John
Link Posted: 8/4/2002 8:07:12 PM EDT
[#4]
And if the new company was motivated (risking a bunch of employees getting P.O.'d would do it for me) enough, they might find a way to make new carrier write new coverage retroactive so that there was no break in coverage.  There might even be a state law / regulation about that.
Link Posted: 8/4/2002 11:22:26 PM EDT
[#5]
$500 a month means that temporarily between you and your wife you would have to work a few extra hours a week till it gets taken care of.

Go mow some lawns, go sell guns at WalMart for a while.
It's not like it's real money.
Link Posted: 8/4/2002 11:41:54 PM EDT
[#6]
Link Posted: 8/5/2002 7:06:48 AM EDT
[#7]
You need to get on COBRA which is a government subsidized program that does NOT have a pre-existing condition clause to my knowledge.

Secondly, take one of those THOUSANDS of credit card offers you are no doubt receiving since you bought a new home that have 0.9% interest for 6 months (or some low rate) and charge the meds to the credit card.  This will buy you time to resolve the meds coverage/payment issue.

Third, START LOOKING FOR A NEW JOB AT A LARGER COMPANY NOW...the bigger the company, the better the benefits.  Some insurance companies define "pre-existing conditions" differently than others, so depending on your wife's issue it may be covered immediately.

FOURTH...as crappy as this sounds, get a second job if you can live through the longer hours for a few months.  Wal-Mart, etc. can pay pretty well for what you have to do.  Heck, get a valet parking/bellhop position at a hotel on the weekends or evenings.  All you need is an extra $500 a month after tax, so take a job that can get you that.

Good luck!
Link Posted: 8/5/2002 7:35:21 AM EDT
[#8]
Check with your Home/Auto insurance company.

I have State Farm, and they have a few "interim" types of healthcare plans. They are ALL much less expensive than Cobra, which is a complete ripoff.
Link Posted: 8/5/2002 7:47:39 AM EDT
[#9]
Quoted:
You need to get on COBRA which is a government subsidized program that does NOT have a pre-existing condition clause to my knowledge.
View Quote


not sure if it's government subsidized because it's damn expensive.  

it basically is a program that extends your benefits and it's generally through the company that provided them previously.  it's supposed to be same exact coverage too.  

COBRA is not a company;  it's an acronym standing for The [red]C[/red]onsolidated [red]O[/red]mnibus [red]B[/red]udget [red]R[/red]econciliation [red]A[/red]ct of 1986.  it's not so much a government program as it is legislation requiring health benefits extension.  

check out this website for more information on eligibility and costs, etc.

[url]www.cobrainsurance.com/[/url]
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