You know I was up at 6am took my wife to work and thought just another day. Then logged into Medco and well-read last POST.
The man I spoke with at 1199 assured me he would get back to me before my 2pm appointment with my oncologist. He didn’t of course so I went to my appointment like planned. I told the staff what happened and had blood work done {they do it in the office} and waited for the Doctor.
He was grim when he came in and he wanted a Cat scan done Monday. I told him what happened and he reluctantly agreed to postpone till Wednesday. He warned me it was imperative I have the test soon or he wouldn’t be responsible. So a nurse from his staff calls 1199 and they tell her what they told me, my coverage was terminated. She didn’t know why. I call on my own ph. and another woman tells me I was terminated. I told her I was going to file a complaint with the New York State Department of Financial Services, created by combining the New York State Banking and Insurance Departments.
I then went to Skidmore with my wife to payroll and personal just to check to make sure that the money withheld from the wife’s check paid the premium. What they told me was shocking. Many unionized members had come through the door to report the spouse coverage had been terminated. They called a union rep who was unavailable and they said most likely they would reinstate it in a few days.
Now I must explain the unique relationship between Joyce, Skidmore and 1199.
Joyce works for Skidmore and is a member of 1199, she doesn’t have a choice and pays $50 a month for the “privilege.” 80% of Skidmore is non-union and they have a choice of three health plans. Joyce has no such choice and must buy “union insurance” from 1199. Skidmore pays a lump sum a year in the name of each employee for health insurance directly to 1199. The difference between that amount and the Union premium is paid by the Union employee. Right now that amount is $280 a month. The union can and has increased it with 30 days’ notice.
Now I just found out I can’t file a complaint with the New York State Department of Financial Services, created by combining the New York State Banking and Insurance Departments
What are my options if I wish to file a complaint against a self-insured plan, union plan, or Multiple Employer Welfare Association (MEWA)?
Answer: The above entities are exempt from state regulation under ERISA. They are however regulated by the United States Department of Labor. You may make complaints to the US Department of Labor.
U. S. Department of Labor
200 Constitution Ave., N. W.
Washington, D. C. 20210
202) 219-8233
Did I mention that 1199 SEIU is the largest campaign contributor to Barack Obama?
I got home today to find a letter from GHI telling me my dental insurance through 1199SEIU had been canceled May 1 of 2011. You just can’t make this shit up.
6 comments:
People just don't realize how bad unions are and how they screw the little guy!
I doubt Skidmore or the Union have a health care advocate that works on behalf of their employees/members but there has to be someone at the union fund office who can work on this pronto.
I work for a major insurer (claims and customer service but on the dental side not medical) and eligibility is tape fed from most employers to us and glitches do happen. Someone at the union or skidmore needs to escalate this and find out who all has been dropped and get it fixed. I can tell you that it does take a day or two to bridge when we have this issue and someone has been dropped.
Hang in there it will be corrected.
Hope you have good news with your tests. We need you to keep up the good fight.. I got a pass from my C-R surgeon yesterday at my 6m checkup and dont have to go back until my year anniversary.
John, as you are fond of saying "I am no lawyer." But with a bit of quick double-time, there seems to be an air-tight requirement in "Obamacare" that works in your favor here-- According to one major provision of Health Care Reform (Obamacare) “individuals must be provided with prior notice of cancellation of coverage.” That much seems clear... and damn 1199 to Hell.
1199 was granted a waiver from Obamacare
OMG! theremust be something ucan do. Just watched RAchel Maddow and she was blowint Obams's health care. Why don't u send her a letter. Bet she would put it on the air. So sorry. What assholes.
CNSNews.com – Three local chapters of the Service Employees International Union (SEIU), whose political action committee spent $27 million supporting Barack Obama in the 2008 presidential election, have received temporary waivers from a provision in the Obamacare law.
The three SEIU chapters include the Local 25 in Obama’s hometown of Chicago.
The waivers allow health insurance plans to limit how much they will spend on a policy holder’s medical coverage for a given year. Under the new health care law, however, such annual limits are phased out by the year 2014. (Under HHS regulations, annual limits can be no less than $750,000 for 2011, no less than $1.25 million in 2012 and no less than $2 million in 2013.)
The SEIU, with more than 2 million members nationally, includes health care workers, janitors, security guards, and state and local government workers.
The three SEIU locals, covering a total of 36,064 enrollees, are covered by the federal waivers, according to the Department of Health and Human Services.
HHS gave a waiver to Local 25 SEIU in Chicago with 31,000 enrollees on Oct. 1, 2010; to Local 1199 SEIU Greater New York Benefit Fund with 4,544 enrollees on Oct. 10, 2010; and to the SEIU Local 1 Cleveland Welfare Fund with 520 enrollees on Nov. 15, 2010.
So far, the Obama administration has issued waivers to 222 entities, including businesses, unions and charitable organizations. Of that total, 45 were labor organizations.
A total of 1,507,418 enrollees are now included in the waivers. More than one-third -- 512,315 – of the enrollees affected were insured by union health plans.
SEIU Local 1199’s health plan put a $50,000 cap on medical expenses for its New Jersey nursing home workers, according to 1199 SEIU spokeswoman Leah Gonzalez. That’s $700,000 under the 2011 limit stipulated by HHS regulations.
In September, HHS announced it would grant waivers to employers to prevent some workers from losing their benefits if the insurer could not meet new health care law’s requirements on annual limits. The waivers are granted by HHS if the department determines “compliance with the interim final regulations would result in a significant decrease in access to benefits or a significant increase in premiums,” according to a Sept. 3 memo by Steve L. Larson, director of the HHS Office of Consumer Information and Insurance Oversight.
Local 1199, SEIU's Greater New York Benefit Fund, requested the waiver specifically with respect to its separate plan for New Jersey members, according to Gonzalez. This waiver primarily affects low-wage New Jersey nursing home workers whose health care plan provides medical, hospital, prescription, dental and vision benefits.
The New Jersey members now have an annual maximum health care benefit of $50,000. Gonzalez said fewer than 1 percent of members have ever reached that cap, and that those members who did received additional help.
“The members’ health benefits are paid for by the employer and are negotiated through collective bargaining,” Gonzalez said in a written statement to CNSNews.com. “Several years ago, facing limited dollars from the employers for this small group, the members themselves chose how to shape their health plan to get the most out of their coverage.”
Gonzalez added that prescriptions are excluded from the cap. “For example, if a member maxes out from a hospital stay, she/he can continue to get their life-saving medications throughout the year while accessing alternative coverage at low-cost community clinics.”
Neither SEIU Local 25 nor Local 1, nor the national organization responded to CNSNews.com’s request for comment.
The SEIU's Committee on Political Education made $27,829,845.91 in independent expenditures on Obama’s presidential campaign in 2008. SEIU-affiliated groups in Illinois have long supported Obama’s campaigns and endorsed him for the Democratic nomination for U.S. Senate in 2004. In 2008, the national union backed Obama for the Democratic presidential nomination.
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