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PostPosted: 01/26/11 12:37 pm • # 1 
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UNFRIGGINGBELIEVABLE!!! ~ this insurance company and others just like it are the real death panels St Sarah should be bitching and moaning about ~ Image ~ Sooz

One of the worst abuses of the private health insurance industry is the practice of denying claims to pay for necessary care or revoking the coverage of policyholders for frivolous reasons. A Vietnam veteran from Thornton, Colorado, is the latest victim of this practice.

Vietnam vet Ronald Flanagan has been battling cancer for more than two years. Two weeks ago, Flanagan was getting prepped for a bone biopsy at the local Exempla Rock Creek Medical Center. But at the last minute, his wife called the hospital and told them to stop the procedure because she had just received notice that they no longer have insurance. The reason why? The couple had accidentally underpaid their insurer by two pennies and it decided to drop them from their plan:

[quote]

Two pennies. That's the difference between a potentially life-saving surgery, and a dropped insurance plan. Those two cents could cost Vietnam veteran Ronald Flanagan everything. “Everybody we talk to is very surprised that two cents is enough to do this,â€



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PostPosted: 01/26/11 12:57 pm • # 2 
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No consumer protection against insurance companies?


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PostPosted: 01/26/11 12:58 pm • # 3 
Ceridian Cobra Services isn't an insurance company.


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PostPosted: 01/26/11 12:59 pm • # 4 
Then what are they?


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PostPosted: 01/26/11 1:08 pm • # 5 
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Apparently they're some sort of "benefits administration" thingie... probably one of those that get bonuses for ripping people off by going through fine print with vigour.


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PostPosted: 01/26/11 1:09 pm • # 6 
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gop, I know you are one for dotting all your 'i's, crossing all your 't's, and using spell-check on everything from liberal blogs, but try focusing on the bigger picture here ~ a man could die for underpaying by 2 cents ~ the couple pays their health insurance premiums to Ceridian, Ceridian is apparently the contact for pre-approval, and Ceridian is the face of this couple's health insurance ~ FTR, several insurance companies are rescinding policies for really frivolous reasons too ~ we have plenty of posts exposing recission specifics ~ you can search from the General board first page ~

Sooz


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PostPosted: 01/26/11 1:10 pm • # 7 
Ceridian is a payroll services company that also provides third-party administration services for company employee benefits. Cobra services collects premium payments from COBRA participants and forwards the payments to the insurance companies.


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PostPosted: 01/26/11 1:11 pm • # 8 
What price a moral decision? Apparently 2¢


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PostPosted: 01/26/11 1:13 pm • # 9 
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oskar576 wrote:
No consumer protection against insurance companies?

The consumer protections are just going into effect now, oskar ~ January 1st, I think ~ the Flanagans might well have a solid case ~ but in the meantime, Mr Flanagan isn't getting a bone biopsy ~

Sooz
  


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PostPosted: 01/26/11 1:13 pm • # 10 
Ceridian does not provide pre-approval for medical procedures. They collect premiums, and forward pYment to the insurance companies. This is an administrative problem on their end, not by the insurance company.


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PostPosted: 01/26/11 1:16 pm • # 11 
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I'm willing to bet that Ceridian functions under very strict orders from the companies it represents ~

Sooz


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PostPosted: 01/26/11 1:29 pm • # 12 
They function under strict legal guidelines. Why happens is that administrators within the COBRA administrator don't use common sense and then they declare the consumer out of compliance with legal requirements and they inform the consumer their policy is no longer in effect. The insurance company only functions based on the information and premiums forwarded by the COBRA administrator, and doesn't make a decision to terminate the policy. This is strictly a problem with the administrator, not the insurance company.


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PostPosted: 01/26/11 1:32 pm • # 13 
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Sooz, that's all part of the great free-market kapitalism gopqed loves so much.


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PostPosted: 01/26/11 1:36 pm • # 14 
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We'll see how or if this specific case is adjudicated ~ hopefully before Mr Flanagan dies ~

Sooz


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PostPosted: 01/26/11 3:03 pm • # 15 
gopqed
Ceridian Cobra Services isn't an insurance company.



Right- they're a death panel. Some greedy righty couldn't have reviewed that and let it go? Shylock lives.


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PostPosted: 01/26/11 3:16 pm • # 16 
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bunkerhill14 wrote:
gopqed
Ceridian Cobra Services isn't an insurance company.



Right- they're a death panel. Some greedy righty couldn't have reviewed that and let it go? Shylock lives.
Nah, they're just cretins who follow orders.
Seig heil!


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PostPosted: 01/26/11 4:34 pm • # 17 
This family's COBRA coverage has been reinstated.

Insurance Company Reinstates Vet After 7NEWS Story

Ronald Flanagan's Health Insurance Was Dropped Over 2-Cent Shortage

POSTED: 1:39 pm MST January 26, 2011
UPDATED: 6:42 pm MST January 26, 2011

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PostPosted: 01/27/11 12:56 am • # 18 
gopqed
This family's COBRA coverage has been reinstated.




Thanks to the negative press about the company- otherwise he still wouldn't have insurance. They had to be embarrassed into doing the right thing. The president of the company saying he wanted to talk "man to man"
is classic BS.


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PostPosted: 01/27/11 2:19 am • # 19 
Publicity is a very effective way to expose the bad decisions companies make.  The third-party administrator (not the insurance company) was responsible for mishandling this family's case, and was properly exposed as having made a mistake.

Those who attempted to use this to attack insurance companies were just operating out of ignorance and knee-jerk animosity toward insurance companies.


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PostPosted: 01/27/11 3:03 am • # 20 
gopqed wrote:
Publicity is a very effective way to expose the bad decisions companies make.  The third-party administrator (not the insurance company) was responsible for mishandling this family's case, and was properly exposed as having made a mistake.

Those who attempted to use this to attack insurance companies were just operating out of ignorance and knee-jerk animosity toward insurance companies.

Agreed. It didn't take them long to correct this issue. Publicity is a wonderful thing. 


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PostPosted: 01/27/11 3:54 am • # 21 
I wonder however if there would be ' knee jerk ' reactions or animosity toward health insurance companies if there had not been situations where very ill patients were effected in a negative way by the behavior of some insurance cos. In this particular situation mentioned in the OP I am v ersed with ceridian v the insurance co. However a a nurse I absolutely no doubt in my mind that my opinion on the heath care reform issue has been shaped by a number of things and that includes patients and behavior by their insurance cos.


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PostPosted: 01/27/11 4:09 am • # 22 
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Exactly right, susanne ~ and I am convinced that third-party administrators take their orders from their insurance company clients ~ if a stupidly hard line works, great ~ if the insurance company gets found out, it's the admin's fault and they'll 'humbly' apologize for that error ~

Sooz


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PostPosted: 01/27/11 4:37 am • # 23 
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Those who attempted to use this to attack insurance companies were just operating out of ignorance and knee-jerk animosity toward insurance companies.


Those who defend insurance companies as if they never screw people over are just as ignorant.


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PostPosted: 01/27/11 4:39 am • # 24 
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http://www.examiner.com/sonoma-county-civil-rights-in-san-francisco/insurer-cancels-entire-state-s-coverage-to-avoid-paying-one-client-s-medical-costs

In a blatant example of what is wrong with the US health insurance industry, New York-based Guardian Life Insurance Co. canceled plans throughout the state in order to avoid continuing coverage for Ian Pearl, a 37-year-old man with muscular dystrophy, who requires round-the-clock medical treatment costing $1 million a year. New York state prohibits insurance companies from cutting costs by canceling individual patients' coverage, so Guardian did an end run around the law by simply ending all New York health plans similar to Pearl's.

According to Pearl's parents, whose Guardian premiums had risen over the years to $3,700 a month, the insurance company had been trying to find an excuse to discontinue their policy for a long time before it resorted to this sweeping move. [b]An email exchange between Guardian executives obtained by the Washington Times[/i] revealed that the mass health plan cancellation was considered necessary to “get rid ofâ€



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PostPosted: 01/27/11 4:40 am • # 25 
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Ceridian Corporation is a leading business services company that uses reality-based KnowHow to help companies maximize the power of their people, lower their costs and focus on what they do best.

http://www.ceridian.com/a...nav/1,6267,15572,00.html


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