I am yet another pregnant member; with the new co-insurance elements of the PPO plans I may have no choice but to opt for the HD plan instead, as I don't want to be in the hospital 16 hours into labor worried about getting pain relief as it will jack up my hospital bill.I will be returning to grad school for public policy in the next few years and I would be interested in following this fouled-up implementation of the new system as the perfect case study of how NOT to do things. I think I could get quite the thesis out of it.Please Please Please RENEGOTIATE with BCBS!!!!
From what I understand, FU will not renegotiate with BC/BS. It's a "done deal"
The Actor's Fund holds weekly seminars on getting health insurance and care in NY. It was extremely helpful and I highly recommend attending one. For more info:http://new.actorsfund.org/services/Health_Care_and_Health_Insurance/Health_Insurance_Resource_Center/index_html
Why is the HD 5000 not HSA-compatible? It's so twisted that a plan designed for catastrophic coverage might be a better and more affordable alternative than the PPO plans for those of us who want the security and peace of mind of knowing what we might have to fork over for in-patient or even out-patient hospitalization. Or for all those tests that require 20% co-insurance with no cap. Plus the premium.So why isn't this HD plan HSA-compatible? I belong to a credit union that offers a very attractive HSA.What public policy or self interest is served by not permitting this plan to be HSA-compatible?Sara, this is a policy question that Member Services can't answer so please respond to this and our open letter to you. In writing.Thanks.
Sara was just on WNYC talking about the problems of freelancers and saying how we have to be "resilient." No doubt she thinks we're all a bunch of whiners without the requisite resilience.I didn't have time to call in, but a few of us managed to post comments at the WNYC site:http://www.wnyc.org/shows/bl/episodes/2008/11/21/segments/116265
I have to say I CAN NOT believe she would take the time to do that and not be up all night constructing open responses to this website. I think she has NO SENSE OF PEOPLE. IS anyone friends with friends of hers???? Really, I think that might be what we're dealing with here.
all please post here at the wnyc comments--this is a much wider audiencehttp://www.wnyc.org/shows/bl/episodes/2008/11/21/segments/116265#comment77259 I'm sorry the link isn't "live" but someone posted it live at chatter on fu website
Sara Horowitz, FU's Founder & Executive Director (and now, conveniently, President & CEO of the new Freelancers Insurance Company) was on the Brian Lehrer show this morning (unfortunately Brian himself was off today) discussing the topic of Freelancer security and I was not the only one to notice and point out the hypocrisy of it, considering how Sara and FU have just made many of us freelancers much less secure for 2009...My comments on the WNYC website can be found here: LDNY from 11201 ( http://tinyurl.com/6zs92s ) and there are comments on Sara's own Blog (her posts feebly attempt to explain and excuse this horrible thing that they have done to their members) on the FU website: https://be.freelancersunion.org/blog/ -- if you feel as strongly as I do, please leave your comments on those sites, as well as here.
Sara: you really need to change the first page on the blogs. Your credibility is shot.Why we’re hereWorkers helping other workers: that’s what Freelancers Union is all about. Whether it’s forming a group to get a lower rate on insurance or helping each other find work, everyone does better together.
Hey!Where are my posts!?I posted four different posts and they disappeared. upset Freelancers Union member - you are manipulating this blog?????????????????Freedom of speech? Why? How is this helping?
November 21, 2008 3:49 pm Freelancers Union forms health insurance companyNearly 1 million people who work independently are eligible for coverage. Print Email Add a comment Daniel Massey The Freelancers Union has launched a health insurance company to insure the city’s nearly 1 million independent workers.Coverage from the Freelancers Insurance Co. will replace plans operated by commercial carriers that the organization previously offered. A coalition of philanthropies and businesses—including the Rockefeller Foundation, New York State Health Foundation, Ford Foundation Prudential Social Investment Program, the Pioneer Portfolio of the Robert Wood Johnson Foundation, and the New York City Investment Fund—contributed $17 million in grants and loans to get the company off the ground. The investors agreed to a 2% rate of return. “The traditional insurance industry was just not going to provide a level of safety for freelancers going forward,” said Freelancers Union Executive Director Sara Horowitz. “We needed to start building our own institution.” The new company provides the Freelancers Union with standard medical care and allows it to customize health plans to include such coverage as mental health, massage therapy and chiropractic treatment, among other services. Five separate plans were designed, based in large part on feedback from member surveys.“This initiative is an excellent example of innovation that could spread insurance coverage to thousands of workers statewide,” said NYSHF Chief Executive James Knickman.More than 3,000 members have signed up for coverage, and the company expects 19,000 to join by the end of the open enrollment period on Dec. 31—the same number covered under the group’s current plan in New York. For now, the new coverage is only available in New York, though officials hope to expand it to other states soon. The switch has not been without controversy. A small, but vocal, group of members have railed against the new company, upset over an increase in monthly costs. Under the new arrangement, the price of the most comprehensive plan for individuals has jumped from $370 a month to $450 a month. They’ve posted their concerns on a blog headlined, “Upset Freelancers Union Members.” Ms. Horowitz says prices assuredly would have increased had the organization stayed with private insurance plans and that the pace of enrollees is outstripping that of previous years. “If you look around, the prices are going up everywhere,” she said. “We’re really trying to figure out how to keep things affordable and innovate and keep things moving in a direction that’s good for our members.”Filed Under: Labor/Unions , Media / Entertainment Print Email Add a comment
article is from crainsnewyork.com
Poster above who thinks their posts are gone... I've been tracking the numbers on each thread (pathetic I know) since this started so I know when there's something new to read, and I have to tell you none of them have dropped 4, or any amount that I've noticed, though if your four posts were on different threads I guess it's conceivable that they dropped and then someone posted, so I missed it... okay, I know I need a life... but REALLY if there has been any EDITING the moderator needs to let all of us know, I agree!
Heads up.Last year when FU switched from HIP to BC/BS, there was no one in FU's office from the last week in December to the beginning of January. They were away on a holiday vacation. Frantic calls (left on voice messaging only) were made by the members to see where their BC cards were, if scheduled medical procedures would be covered, etc. This period was total bedlam. What will be FU's office schedule this year during another critical transition period? Will Sara Horowitz be in Aspen or the Caribbean while the membership suffers through another FU information meltdown?
man - I can't believe they seem to haved learned nothing from last year's debacle. In a way I would really like for a nonprofit insurance co to be successful. But this has been so poorly handled and communicated that I don;t have a great feeling about how they will administer the plans. Does anyone there know what they are doing? Did they even hire anyone new who has insurance co or broker experience???
The article from Crains is so misleading -- it doesn't address the co-insurance and other substantial changes to the policy. Also, a note about the HD option -- if I read it correctly, you are covered in network after the deductible but it seems to me that out of network they pay 50% after the deductible but never 100%. If you are seriously ill and need an out of network facility you could go bankrupt under the terms of this policy since they will never pay all costs.
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comment on crain'sThis article is very misleading. The plans are extremely confusing and have uncapped coinsurance for dianostic testing and other services. This reporter really should have read the policies himself; they're very hard to decipher. Also, people have been signed up as recently as a few weeks ago, never being informed that they were giong to be forced to an untested new insurance company (read social experiment?) with much less coverage at a much higher cost than what they had this year. In some cases people are stuck, but those that can are moving to better plans offered by media bistro and fractured atlas.
(ie, comment is posted on the crains website after the article)
As for "The Mysterious Case of the Disappearing Posts," I'm a non-techie with a lot of questions about how both this blog and the one on the FU site work. I just keep merrily (or not so merrily) posting comments, but I'm not posting much these days on the FU site for a number of reasons. One reason is that several days ago a couple of long, long comments that I'd worked on for a while -- and that I thought might actually be useful to others (I have a background in benefits communications) -- disappeared into cyberspace immediately after I posted them, before they ever appeared on the FU site. Obviously, no one was censoring them. I mean, I don't bother with accusing FU of stuff they don't do -- as it is, there aren't enough hours in the day and night for me to bring up all the problems connected with what they DO do. However, I can't devote my ENTIRE life to making and posting these comments, and I was highly annoyed. My high-speed cable Internet connection seemed to be working OK. So then I started saving my posts in Word before I posted them, and once, after yet another comment disappeared into cyberspace, I reposted immediately, using what I'd saved in Word. But all this business of saving comments in Word was just too much trouble, so I began to post here more and more and only occasionally at the FU site. My comments here have always gone through, although with the longer comments I sometimes get a message that the comment hasn't gone through (yet) and that I should try again, and my comment has always gone through on the second try. I've wondered if I usually have to try twice because I so often have a lot going on on my PC -- more often than not, I'm streaming WNYC, WQXR or MSNBC while I work on non-client-related stuff.Another odd thing about the FU site that I've kept forgetting to ask the more technically-adept among us until this very moment: I'm one of the people who arranged the meeting at Grand Central last Saturday and then showed up. When I was gathering papers to take to the meeting, I decided to print out all the comments that had been posted here, as well as everything that had been posted on the FIC-related posts on Sara's blog. (I use a PC and don't have a laptop or any of those hand-held devices. I don't even use my cell phone all that much -- usually just for emergencies and for appointments on especially hectic days. I told you I was a non-techie.) This blog printed out beautifully. But a funny thing happened on the way to Grand Central...I tried printing out two of Sara's posts with the comments, and both times just Sara's post and enough of our comments to reach the bottom of the first page printed out, and then several pages of paper went through my printer and came out blank. It occurred to me that the FU site was actually programmed to do that, but I told myself that surely I was being paranoid to think such a thing. I haven't tried again, though. Has anyone else tried to print from Sara's blog? Can anyone explain this to a poor, downtrodden member of the technically illiteratae? (My apologies to all dead, literate Roman women for making up that word. But maybe it's not such a bad word after all --my six years of high school and college Latin are long behind me and I can no longer judge.)To be continued....
And here's the continuation of Carolyn's non-technical comments about technical matters:Sadly, I can attest to the fact that these comments are not, and never have been, moderated, and that they can't be moderated even when there might be a very good reason for moderation (both senses of the word intended here). Without going into all the gory details (what follows is a simplified account), another one of the frequent commenters on this blog posted something about my situation that wasn't quite accurate, and when I e-mailed to ask him to remove his comment (I, non-techie that I am, thought he could do that), he not only sent me an e-mail about the matter, but also responded here on the blog with another somewhat inaccurate post that included a nasty personal comment about me. This wasn't exactly my idea of solidarity with my fellow suffering FU members, so I e-mailed the administrator/moderator with a request that his comments be removed or at least edited, and I heard back that comments cannot be edited or removed. (There are so many comments posted now that I can't even find all the comments I've referred to here, and I just have to let bygones be bygones. At one point, before I saw the nasty personal comment on the blog, I sent the commenter an e-mail apologizing for my first e-mail, which I admitted was brusque since I was in the middle of getting something to a client, and he accepted my apology. And I realize that we're all so stressed out about FIC that some mistakes are inevitable.)Still another odd thing about the FU site (but then again, maybe it had nothing at all to do with the FU site and someone can enlighten me as to what was going on):A few nights ago, I was exhausted (I wonder why?), and I lay down on my bed early in the evening "for just a few minutes." Many hours later, in the middle of the night, I awoke with all the lights on and the disgusting taste of unbrushed teeth in my mouth. I'd also left my PC on, with several windows open; Explorer was in one window, at the FU site. I leapt out of bed and went over to the computer to close the windows and log off. Within a few seconds, some weird things were happening that I'd never before seen in the four years that I've had this PC, including flashing lights, and the PC quickly froze. Since I'd just awakened from apocalyptic nightmares featuring yours truly begging for money to pay my medical bills on the streets of New York, which were beginning to look more like the streets of Calcutta, my first irrational thought was, "FU is trying to destroy my computer so that I won't be able to post comments." But I calmed down, and fortunately, after I pulled the plug and logged back on, everything seemed to be fine -- my PC operated normally and no files seemed to be missing or damaged.To be continued....
Final installment of Carolyn's non-technical comments about technical matters:On the WNYC site, someone was upset about all the "trolling" regarding Sara. And some people had good responses to what he'd said, pointing out, inter alia, that "Anonymous" is the default identity here. I'd just like to add something about the fact that so many of the comments here are "Anonymous." When this blog was created last week, I was among the first to register as "Carolyn." I even created a profile, which I've never done before, even at sites like HuffPo where I've been registered for a long time (not as "Carolyn," so don't bother to look for my comments there). And although I hadn't even requested it, the moderator/administrator, who knows I'm technically challenged, was kind enough to set up an upsetfu e-mail address for me.For several days, everything was fine. Whenever I signed in, posted a comment and selected "Google Account" as my profile, I was identified as "Carolyn" at the top of my comments. I couldn't figure out how to access my profile again, nor how to access my upsetfu e-mail, but that was OK since I didn't really need to add anything to my profile or to see my e-mail (because I didn't think I had any).But then, a few days ago, when I was signing in, I decided once again that I wanted to try to access my profile. I fiddled around a bit, and I really don't remember exactly what I did, but somehow I disabled my "Carolyn" identity and could no longer get it to appear on my comments. I just couldn't be bothered to spend any more time, so I decided to live with the "disability." Since then, I sometimes remember to sign my comments "Carolyn" at the end, and I sometimes don't. I've only posted "Anonymous" comments intentionally a couple of times. So does that make me a Troll?If anyone has been patient enough to read through all of these extraordinarily non-technical comments, you probably think that I'm not just a non-techie but also a moron. But please don't tell me that -- it's really not helpful, and in the long run I don't think it's going to make you feel that much better. I know that I don't belong in an Internet community like this one, populated mainly by people who are so much more technically savvy; and although I'm sure you're all great people, I would never be here if my health insurance weren't so important to me -- if this weren't, at least potentially, a matter of life and death, of solvency vs. insolvency. I can't wait until this is all over and I can leave and go back to HuffPo.Ciao,Carolyn the Non-Techie
Saturday morning musings from Carolyn:Someone somewhere on this blog suggested that Sara and all the FU employees should have to be covered under one of the FU/FIC plans. Of course, they can't be because they're not freelancers, but I really wonder if they have comparable coverage? Whatever coverage they have now, I wonder if FIC is going to have a plan effective 1/1/09 that's designed for the FU and FIC employees, maybe even designed with an eye toward meeting any special needs of Sara and her family?When I worked in benefits in a big NYC company, we had certain benefits that we informally named after the senior executive who "inspired" them -- "Mr. X's orthodontia benefit" and "Mr. Y's eldercare referral service," for example. But those benefits were then available to all of the thousands and thousands of company employees, so it was all to the good.Many of you will call me a Pollyanna for this, but that's one reason why I'm so hopeful that we'll get some sort of reasonable national health plan in the next few years: We now have a President-elect whose mother had to worry about her health insurance while she was on her death bed suffering from cancer. He may be the coolest politician we've ever seen, but he's emotionally invested in this issue in a way that very few of our recent national leaders have been. So, HOPE and CHANGE, that's about all I've got left -- I certainly don't have my FU safety net left, or I won't after 1/1/09, and it's beginning to look as though I don't have any good alternatives to PPO 1.
Carolyn, you are a hoot!
Given the number of people who were sold coverage without mention that the insurance being sold would be effective for only a month or so, he only remaining option appears to be a suit filed by those who were defrauded by the deceptive business practices of Freelancers Union, and a creation of a class-action by the entire class of suddenly under-insured paying FU members.There is no rating for the Freelancer's Insurance Company on A.M. Best, or on any other of the bond/investment/insurance ratings services. This means that the "offering" from Freelancers Union is pure puffery, or a completely speculative venture, with no standard metrics available to be able to judge the survivability of the venture.Further, there are basic questions that remain unanswered about simple things, like "Do coinsurance payments for X-rays and MRIs count towards the deductibles?" and "What is the maximum out-of-pocket one pays for each plan?". No sane person picks an insurance plan without such basic information.Tuesday, Nov 25th is the last day that "2008" premiums can be locked in over at Mediabistro, so Freelancers have little or no time to research the options. Heck, we still don't even know what "Facility Co-insurance" means, do we?The fraudulent misrepresentations were made by a "Fiduciary", held to a high standard of care. (A "fiduciary duty" is the highest standard of care at either equity or law.)Real insurance companies take preimums, invest them in things like commerical real estate, and pay claims from the returns on the investments. Clearly, big is better in a case like this. Freelancers Union is no bigger than a mid-sized company (a traditional CUSTOMER of insurance companies), and has no business trying to "self-insure". Even if they were to do so, in which vehicles might they invest? This is not a good time to be assured of sucess in the crucial 'Investment" side of the business. This scheme is either based upon dellusions of grandure, or is a simple "Pyramid Scheme" where today's claims will be paid directly with yesterday's premiums until it all comes crashing down due to an inability to find investments that can perform well. (Too bad Elliot Spitzer is no longer around, but we should countact Andrew Cuomo and ask for an investigation.)
Contacting Cuomo is a great idea -- I just sent letters via e-mail to Hillary Clinton, Carolyn Maloney (Congresswoman), Liz Krueger (NYS Senate) and Dan Garodnick (NYC Council), and I've started making inquiries about finding a good pro bono lawyer for our group, but I somehow forgot all about Cuomo. We'd better get to him quickly in case he's offered a job in DC. (Hey, do you think Spitzer might be available to work for us pro bono? For all we know, he may be interested in rehabilitating himself by taking on pro bono cases.) I urge everyone to write Cuomo and as many of their elected reps as they can find time to contact. If Thanksgiving week is a slow week for you, please take time to write letters rather than go to the movies or visit museums....
Cuomo seems like he might be amenable to help. He's now launched an investigation of colleges that force students to take campus-oriented health insurance when they might already be covered under their parents' plans. Health insurance is definitely now on his radar screen.
i have created an excel spreadsheet to compare offerings from media bistro, empire bc/bs, and fic for a single healthy female, manhattan, in network. it will answer questions such as what is facility co-insurance, et al. (didn't include fractured atlas b/c i am not an artist.)i still need to call the rep for each to answer several questions and complete all of the blanks for an apples to apples comparison. i will be glad to share this once i complete the exercise. you can use it as it, expound on it, or use it as a template for a different situation.i am targeting next weekend to have it finalized and available to anyone who wants it. will advise.cynthia
Cynthia, thanks so much for doing this. It should be a great help to many people. In my case, I'm fairly certain that Media Bistro isn't an option for me (I'm still waiting for answers from Nathan), so I probably won't be able to use your spreadsheet to help me decide which plan I'm going to enroll in for 2009 coverage, but I think it could support arguments we might make in discussing FIC with the media or local officials.I plan to create my own chart comparing Empire Direct POS, FIC PPO 1 and possibly a Healthnet HMO for sole proprietors that is better than PPO 1 in all respects except hospital coverage. (It's possible that the hospital coverage isn't as bad as it looks in the summary of benefits chart, and an insurance agent is supposed to get back to me with answers to my questions.) However, I'm comparing the plans on the basis of my own health situation, not only my current situation with no serious ongoing problems, but also my problems of the past few years that I hope I never experience again (e.g., 50-odd PT appointments in one year after breaking my arm).By the way, are you getting answers to your questions about the FIC plans? I still haven't received answers to some of the questions I asked via e-mail on 11/11. Some of my questions have been answered on the FU Web site, but most haven't. That's one reason I haven't done my chart yet -- if I did it now, there would be a lot of question marks in the FIC columns.
Just posted my latest experience with Freelancers Union on my blog: http://jennaglatzer.blogspot.com/2008/11/freelancers-union-worst-of-worst.html
Contact info for Foundations that funded FICThe Rockefeller Foundation - http://www.rockfound.org/about_us/contact.shtmlNew York State Health Foundation - http://www.nyshealthfoundation.org/content/feedbackFord Foundation - http://www.fordfound.org/about/contactusNew York City Investment Fund - http://www.nycif.org/contact.htmlRobert Wood Johnson Foundation - http://www.rwjf.org/global/contactus.jsp
May I suggest that someone update this Wikipedia page? http://en.wikipedia.org/wiki/Sara_HorowitzI think it's time for some more facts about Sara, don't you?
FROM THIS WEEK'S NY MAG:Freelancing Isn't FreeDecorporatized health care. The Freelancers Union is thriving as the media business collapses, adding around 3,000 new members in October, 50 percent more than in a typical month. Now the group, which has offered group-rate health coverage through deals with traditional insurers, will launch the Freelancers Insurance Company. Founder Sarah Horowitz was frustrated by rapidly escalating premiums at the established providers, so she made a list of ten required services, got bids for each function, and then assembled what the union hopes will be a cheap system with good coverage. The state requires insurance companies to maintain sufficient cash to pay all claims; the Rockefeller and Ford Foundations, among others, gave grants and low-interest loans to create a $17 million reserve. The new plans, which start January 1, will carry higher premiums than 2008’s, but Horowitz hopes future increases will stay in check. “We’re the boss, so it’s not about what’s most profitable,” she says.
Jenna, I just looked at your blog, and I love it! Thanks for giving such clear examples of what so many of us are going through.Anonymous, I don't expect to have much influence, but I'd rather not see any of us get into playing around with Wikipedia revisions. There are so many more constructive things to do with our time. Maybe if a great investigative article with real credibility appears somewhere in the media, then someone can update Wikipedia using that as a source. Unless you have some great sources that I'm not aware of, I think that getting into the whole Wikipedia thing will just make us look like childish whiners. Our efforts shouldn't be about personal attacks, but rather about seeking information and -- dare I say it? -- justice.Carolyn
"@Miller, LDNY, laur, nancy -How are you helping to change the system? Negative press is just another attempt to kill any type of change. I hope you're not going to run to the press when prez-elec Obama changes your income tax rates. I'm not in a safe place economically either. Call me a dreamer or whatever you’d like. Nevertheless, I just have to believe that this is the beginning of something better. Sure it started really badly (for some more then others). Then again, show me beginnings that are easy? when was the last time someone tried to do something new in the health care arena in this country? never? why kill it before it starts and for the rest of us? just because you need a "quick fix" to your issues? channeling your anger on the rest of us just seems wrong. Now back to work. I've spent enough time reading these blogs, and comments and such. This is health insurance not national elections"Now, I have a number comments since reading the upsetfu blog frightens me:1. There seems to be a lot of misinformation - members who are lawyers, writers, x-health consultants. It is really wonderful that we're helping each other. Then again, if you are not certain that the information you have is correct regarding FIC don't post it. It's confusing and misleading. Or post and and disclose the fact that you are not sure about what it is that you're writing. 2. I somewhat agree with Robert. According to FU there are about 19,000 of us. 19,000!!! who are covered. Why are you trying to destroy the only avenue that is dedicated to work for freelancers protection. I understand that some of us got screwed badly. I still don't think it's a reason to try to sue and try to bring down something that works for the rest of us. I've looked and there are about 50 to 100 people here. What about the rest of us? 3. Comparing - I've looked and compared plans as well. I've checked out MediaBistro (a for-profit company part of jupiter media that posted losses the last Qtr), fractured atlas, etc. I'm sorry, but as someone who was on the POS plan it seems like the FIC options seems the most attractive one under the BC/BS netowork (unless you join MBs plan today - last day!!!). 4.Trusting FIC - hell I don't trust any of the insurance companies out there. Especially not the private/public for-profit ones. From what I've read on the FIC website, video and FAQs, it seems that no one is making money of off this insurance company. The only people that will benefit from this are freelancers (i know, it sounds odd). The only shareholder of FIC is FU. And FU does not have any shareholders. It is a 501c(4) - membership organization. Thinking about this some more, shit, how can we trust any org out there - new or old - checkout latest citibank, the automaker industry. etc. What I did find out from ny magazines website is that they’ve raised $17m for this. The NY State Dept of Insurance has approved FIC which tells me that they had to do a lot of work to get this in place. I doubt that NY State department of insurance will approve this operation without having all the checks and balances in place. I also read that they have re-insurer in case the org goes under. 5.Communications - again, from what i’ve read on the FU website - they couldn’t notify anyone until they got the approval from the NY State department of insurance. So then I wonder, like many of you, why didn’t FU stop people from applying two or more months prior to the end of the year. I’m guessing (and yes, i’m guessing), if I had to run that operation , how would I explain to members that are interested in joining that they can’t register because of a reason I can not disclose ? 6.Webinar- I just attended the webinar. Sara and Anne(?) were helpful. Sounded like there were about 10 of us on the line. I thought that there were going to be a lot more members seeing this list here. Mostly there were good questions that were clarified for the most part. There was one woman who was very angry. I didn’t understand her questions (if she had any) - but it seemed like she was really unhappy. She wondered why the plan went up or were removed. Did she just start being covered this year? Lets get real - premiums go up every year. And if you use your plan a lot (which seems to be the case for our plan) the premiums are going to go sky high. My thoughts are - FU has the information on what’s going on - we depend on FU to make the right decision. With that being said : a. why would FU have any alternative motives beside helping its members? a non-for-profit that is working (obviously hard to get this insurance company) - to protect freelancers? why would they screw us? I also learned that the BC/BS POS plan sucked a lot of the money from the rest of the pool of members and that BC/BS will not offer the same plan in NY starting 2009. One woman raised the fact that she’s in NJ and that this plan exists there. I’m guessing again that they have a different regulatory environment.
>>I'd rather not see any of us get into playing around with Wikipedia revisions.Carolyn, you're right and I should have been clearer. I didn't mean that we should launch personal attacks-- but I do mean that it's time to get more information out there. I literally did mean "facts." Why is it that we all know so little about the Union and its founder and how it's really run? I'm tired of being sold a bill of goods about how this organization is all for helping freelancers, and no one's profiting but the freelancers, and how our future is all sunshine and roses. Also: has anyone else tried calling their customer service line? What happens? Do you get stuck on hold and then disconnected, too?
to 6:20PMOur criticism of FIC is absolutely legitimate. Many people don't even bother to write on this blog and just leave FU and look for a better health plan. The fact that FU didn't even negotiate with BC/BS and wouldn't give a good and convincing reason to that is the key of our frustration. It's especially annoying that FU PR present us as a small but vocal group that's upset about higher premium. Our premiums go up anyway and we can deal with that, what's unacceptable is way higher co-insurance and deductibles and less coverage.You can't ignore the fact that people with real health needs CAN NOT accept the plans that FIC is offering. They leave many people with no choice at all but to look elsewhere. With all their high rhetoric of solidarity and helping the freelancers I didn't expect them to throw a group of people over board (even if it's "only" 100 people).
I believe the webinars "get filled up" which may be why there were only ten people... I am surprised there haven't been scads more postings and signatures, and I have to say, the friend I have just who has FU and agrees says she "can't deal with this right now" (re reading, changing, signing, anything..) don't know how pervasive that is...
Here is a link to the complaint form for the New York State Insurance Department:https://awebproxyprd.ins.state.ny.us/onepage/StartForm.jsp?link=/ciims_forms/StartForm.jspIf you feel you have a complaint that the department can help with, I'd suggest contacting them.
Got to vent a bit on FIC - it's an outrage...The best way to sum up FIC: IT'S A KILLER....Now we know what the FU in Freelancers Union really stands for....With FIC death by colon cancer is a guaranteed.(Do the math on what the out of pocket & copays costs for the procedure are with any FIC plan)....Maybe FU could include UTUBE Death Postings in their plan. Since FIC is so useless at least we could post our dying days on the web.
Above post a little strong but that's exactly what we need to determine.... whether something like an endoscopy done in an md's office would have the annual maximum cap applied... (or for that matter if was done as an outpatient in a hospital or surgical setting) wordsssssss
To Anonymous who attended the webinar and enumerated various points above:*I'd rather pay higher income tax rates -- and also higher monthly premiums -- than be so underinsured that I run a serious risk of being bankrupted by healthcare expenses. I want a reasonable degree of peace of mind, but now FU is really marketing anxiety and calling it peace of mind.*Like the other Anonymous above, I reject the idea that it's OK to throw 100 people overboard because there are thousands left on the ship. This blog may frighten you, but the kind of ethical system implicit in your comments is what terrifies me. Do you really mean to say that the end justifies the means to the extent that the good of providing insurance coverage for freelancers completely justifies lack of transparency, inadequate notice of major changes, and misleading, possibly deceptive enrollment practices? I know that we can't all afford all the "Cadillac care" that we might like, but this plan was never about Cadillac care -- until now it was always about providing a full range of basic medical services with a strong enough safety net so that those of us who could afford the premiums and were willing to budget for them wouldn't have to put off getting screening tests or other care our doctors recommended just because we couldn't afford the copayments or coinsurance this month. *Also, I suspect that ultimately we're talking about a lot more than 100 people. Most people probably don't even know about this blog, since, apart from the very limited media coverage, the only way to find out about it is to go to the FU blog. And I suspect that a lot of people have been too busy to comment on either blog, or even to visit either one. And new people are visiting both blogs each day as they finally get around to reading their enrollment materials.*And who in the world is the Robert with whom you "somewhat agree"? No Robert has commented on this post. If you're going to cut and paste your comments from some other site (the FU blog?), please be more careful. You're complaining about misinformation on this blog -- and I'll admit that there's a certain amount of it here, although I do think that we're trying hard to help each other in the absence of complete information from FU -- but you're not helping things by commenting so sloppily and unclearly.*You mentioned that Sara said at the webinar that Empire is no longer going to offer the same POS product. I hadn't heard that before -- only that Empire would have increased its rates dramatically for the same coverage. But that made me wonder whether anyone whether FU considered going back to HIP. I know there were lots of problems with HIP (I experienced many of them myself), but I'd much rather have the old HIP plan that I had in 2004-07 than this scary FIC plan that's being offered to me for 2009.Carolyn
Correction to the comment above (last asterisk): "...that made me wonder whether anyone at the webinar asked whether FU considered going back to HIP to contain costs."Carolyn
to anon at 6:47: YES! I was on hold forever with member services and then was cut off! UGH!
Carolyn, even though she alluded to it, I don't think Sara meant to say that Empire Direct POS wouldn't exist for us. She backed off that point when I reminded her that on her blog she said she never shared 3rd quarter numbers or negotiated with BC/BS about last year's plan. By then she was focused on FIC and the future. What she did say was given all her years and experience negotiating with insurance companies, she believed the same plan in the same price range would not have been offered.At which point the Laurie on the call tried to make Sara understand how unfair that was, not knowing for certain what might have been offered and giving us that choice even if it competed with Sara's own plans. So before people start reporting that our POS plan would not have been offered, Sara said that she couldn't say for certain what changes would be since they didn't negotiate but her experience told her there would be changes--and anyway, she even said she was already looking to the future and what she felt FIC could bring to the table.
I’m posting my e-mail and responses I get in the hope that for those of us who haven’t committed to another plan yet, maybe we can at least clear up some fundamental confusion that exists so we know more. And maybe there are some areas in which Sara could tweak the plan since there are parts of the plan and costs that defy logic. Without getting specific, she conceded mistakes were made.________________________________________To: firstname.lastname@example.org, email@example.comSent: 11/24/2008 9:54:33 P.M. Eastern Standard TimeSubj: thanks for agreeing to answer/clarify specific plan questions Thanks for agreeing to answer some specific plan questions. Even though I may have been one of the lightest users of the Direct POS plan, just having it gave me peace of mind. I have been enormously grateful to Sara and FU for creating the safety net for us in the past that we had come to rely on. Which is why I am trying to make FIC work for me but I'm not sure I can. Part of the problem is that there is so much confusion among the reps in member services, perhaps understandably so, that I can't really trust answers without hearing it from Sara or one of Sara's group. And posting more of these answers on the FU website could clarify for others similar confusion. When I called member services to ask if an annual sonogram as well as a mammogram is covered 100% -- the rep I spoke to didn't know the answer. Which is better than giving out incorrect information. She gave me a different number for "FIC." Separate customer service group, I guess. (What's the difference?) The rep I spoke to there didn't know the answer either but after putting me on hold for a while, she at least came back with an answer: that it's subject to co-insurance. Sara, maybe you can rethink this: for those of us who have dense breasts which make mammograms hard to read, an annual sonogram is as standard as a mammogram. These two tests are thought of the same way because they do the same thing. It would show an understanding of women's issues not to treat breast mammograms and sonograms differently. Regarding my questions from the webinar for which I had received contradictory information earlier from member services: For example: 1. I have an annual sonogram and mammogram at a breast clinic inside NYU but I was told that I would be subject to the "facility" deductible plus co-insurance though the rep didn't sound very sure of herself since it didn't sound right to her either. When I asked a different rep, I received a different answer. Could just stepping into a hospital for anything trigger all those facility costs? 2. I also have a doctor who is part of a group practice in Lenox Hill Hospital--I did not come away with a clear answer on that scenario regarding "facility" charge. 3. Same if a doctor whose practice is in a hospital sends you someplace inside the hospital for an x-ray or MRI. Not clear if that also triggers the "facility" charges as well as co-insurance for the x-ray or MRI. 4. Without giving us exact figures, can you give us a range of what the negotiated rates would be for all the tests that require co-insurance. Just so we have an idea of what we might be forking over? Is that something we can know before getting a Cat-scan, MRI, ultrasound, etc. I don't think it's fair to send us in to a situation where we have no idea what we'll be forking over. Maybe that's something that can be answered case by case if the numbers can’t be posted. We need to know what they are at some point since we’re being asked to pay 20%. 5. There's a lot of confusion regarding outpatient surgery. For example, I had my very first colonoscopy in 2006 inside NYU Hospital when we were covered by HIP. Am I correct in assuming that this would be treated just as an inpatient hospital stay in terms of the $1,000 deductible, then 15% co-insurance--up to $4,000? Wow! 6. I was told by member services that if I had a colonoscopy done in the doctor's office rather than a hospital setting, then it would just be treated as a specialist's visit--and not outpatient surgery. Is that right? Even if he removes a polyp? If this is wrong, please correct. Or what about a virtual colonoscopy when nothing is removed? 6. And the same for a simple breast biopsy--if I had a needle biopsy in a doctor's office or a free-standing outside facility (but not a hospital) that does diagnostic imaging and biopsies at the time of a mammogram and sonogram or it's rescheduled for another day. Does that trigger all those facility-only deductible and coinsurance charges? 7. I'm lucky I've been healthy--a lot of the things I mention above are routine tests. But I get the feeling after talking to a few member services reps--and getting conflicting answers--that they are as confused as I am. 8. I get the feeling that any time one steps into a hospital--even for tests--all those onerous facility fees, dedcutibles, and copays kick in. Even if it's not an inpatient stay or not really outpatient "surgery." Can you distinguish between outpatient surgery and outpatient procedures? 9. I couldn't get clear answers. If it is correct, and all these scenarios are treated equally, then maybe you should rethink this--somehow come up with a distinction between what constitutes outpatient surgery versus an outpatient procedure. Or maybe just treat the outpatient procedures/surgery similar to the POS plan and not triggering the same deductible and co-insurance as an inpatient hospital stay. I think this is one area where you might be able to clean it up in the interpretation and it would go a long way to restoring a sense of fairness in that you could make these changes to acknowledge that your plan is a work in progress and that we've been heard. 10. And here's my last question for now: in my frustration the other night I began looking at the HD 5000 plan to see how it compared to PPO1. Especially if there was a hospital stay. But then I noticed the HD plan was not HSA compatible which really surprised me. I belong to an excellent, very large national credit union in Chicago that offers an extremely attractive HSA. Why would you design a HD policy that isn't HSA compatible--even if that HSA is administered by another group? You should check it out www.Alliantcreditunion.org. The HD 5000 plan makes no sense without an attractive HSA. Even though you can't contribute the full amount you would spend, the money there could be getting over 5% interest tax-free to offset medical costs. Thank you Sara and Jen. I think many of us might feel better if we had answers to the kinds of questions I have asked. It would be great if you could respond in a timely way. And thank you for the webinars. They may be more symbolic than anything else, but may I suggest that for next week's that you don't limit it to an hour--it's the last time many in the group will have contact with you. Having been at both, I think it was important for you to hear the fear and anger that comes from losing a safety net with a rollout that only exacerbated our first terrifying look at the plan. We were unprepared for what we saw. At the same time, I found your answers today more forthcoming and direct and for the first time since Nov.11th, I felt that you were hearing us and I felt I was hearing you. To your health, Jude From: firstname.lastname@example.orgSent: 11/24/2008 9:54:56 P.M. Eastern Standard TimeSubj: Re: thanks for agreeing to answer/clarify specific plan questions Thanks for your message. While I can't respond to every email individually, I check this address regularly, and I appreciate you taking the time to write.If you're a member and you need help or have a question, please contact email@example.com. Our Member Services staff responds to most emails within 24 hours.Best,SaraSara HorowitzExecutive DirectorFreelancers Union________________________________________To: firstname.lastname@example.org, email@example.comSent: 11/24/2008 10:25:37 P.M. Eastern Standard TimeSubj: Re: thanks for agreeing to answer/clarify specific plan questions Sara, I'm assuming I've been sent an automated response. During the webinar, Jen wrote that I should send my questions to firstname.lastname@example.org and that a written response would be forthcoming. I was hoping you could review and make sure the answers are indeed correct since these questions about what a "facility" means in various contexts are very important to many in the membership. And there have been conflicting responses from reps both at membership services and FIC. Thanks, Sara. Jude
Hey Jude,What a year! Just as everyone is preparing to have the 2-year election process wrap up and let us take a breath, this insane economy comes along and we're smack in the middle of another information maelstrom! Too much to digest! So, we elect Obama, get set to relax the gray matter for a few minutes, and along comes this challenge.Despite how crucial it is to collect accurate information, and analyze and discuss it prior to making a decision, it's just such a wearying task. I am in good health, in general. I am not going to be getting pregnant (though apparently it's now less of a miracle for men to do that.) But I would like to be able to know it would only cost me $75 + $30 + 30 (hospital, PCP, GI) for a colonoscopy, as it did last year.My point, at last, is that you have raised some very good specific questions. Many others have, too, of course, but you've done it pretty concisely in one place and with at least one clear aim of seeking to have the offerings "tweaked" to accommodate hospital outpatient treatments with less financial severity.I'm not sure that even if FIC wanted to it could accomplish that. I've formed that impression after reading at least once among these posts about the (apparently only projected) increase BC/BS would have demanded this year, and why. Apparently, I guess, they misunderestimated how efficiently FU members could use their plan in the course of a calendar year … necessitating the sort of sizable increase that Sara projected, prompting her to go in another direction entirely.It's a direction that seems extremely risky, and as a startup is unquestionably inconvenient for its instant guinea pig members. Even if FIC could find (and afford to pay) extremely qualified Customer Service reps, how many FIC executives and managers really have a firm enough grasp on every detail of the coverage to train those reps to answer all these questions we've seen -- from the simple and straightforward to the more fractal musings? And if Customer Service is unable to handle basic questions now, what on earth are we to expect in terms of plan administration as of 1/1/09!?I suppose I may have to elect one of the inexpensive coverages and then try to make sure that if I need to see my PCP, I can discourage him from ordering any gratuitous testing. Speaking of which, it amazes me that among the thousands of words I have read (OK, skimmed) in here, very few have been dedicated to calling out physicians and health care providers for milking these plans.Whether it's the cost of the care or the cost of the insurance, attempting to roll back prices is a Sysiphian task (or may even lack the potential for that much temporary success).I'll be looking for the spreadsheet Cynthia says she's created. I'm going to have to do something, and maybe that will help me delude myself into thinking I've adequately researched all the alternatives and made the right choice, damn it! Then, I'll relax and let the little gray cells rest awhile (especially if I get that job offer!).Pax out
Jude, thanks for sharing your e-mail correspondence with Sara. You've done a great job of posing your questions. I think that many of us have the same or similar questions. Certainly the whole issue of when the "facility" charges kick in is crucial. I really hope that you get answers soon.There's a slight chance that I'll decide on another plan that I've been looking at, but it's looking more and more as though I'll be signing up for PPO 1. So I'm becoming more and more aware that I have a stake in seeing a good written piece, a Q&A or something similar, ideally with some examples of how claims are paid. If I'm going to be in the plan, I want to use it as wisely and efficiently as possible, and I don't want to panic all the time because I'm not sure what my out-of-pocket costs will be. With the HIP and Empire plans, the plan designs were more straightforward, so we could get along more easily with just a summary chart and later a contract. With the more complicated PPO 1, we really need more help.If Sara and her team could take the most commonly asked questions from e-mails, phone calls and the webinars and combine them into one comprehensive piece, and post it on the Web site by mid-December, it would be a big help to the last wave of enrollees, but it would also help everyone in the plan as they begin to use it in January. I know that FU has a lot to handle now between handling enrollment and launching the new company, but in the long run a high-quality written piece will save everyone time and aggravation, and people will be getting a consistent message. And if people are calling less often because they have access to a tool that answers most of the more common questions, the reps will be able to focus on giving good answers to the people who ask the really tough questions.But do you think FU will be responsive to a request for a comprehensive Q&A? Carolyn
Carolyn, why don't you send your request for a comprehensive Q/A to the same e-mail addresses I used and post it here or sign on to the webinar today and directly ask that question?I'm waiting to see if I get a timely response.Because of all the confusion I think we need our answers in writing.
I'm amazed that sara keeps insisting that she can be contacted directly with any questions and then her email just sends an automated response. Hilarious, if it weren't so sad...
To the person who keeps criticizing our criticisms - if an organization cannot withstand scrutiny then the organization is not viable. Transparency has been almost completely lacking in this FIC creation process.You can treat FIC as a religion and have faith that it will provide service based on your supplications.On the other hand I will make health care decisions based on hard data, not trust in an organization that has not been able to meet basic customer service in the past. - Julian
Jude,Thanks so much for your suggestion about e-mailing Sara at the same address you used. After Thanksgiving, I may be able to do more work on our concerns and follow up on your suggestion. Over the next couple of days, however, I need to catch up on the rest of my life, including client work, so that I can enjoy Thanksgiving. And as I just explained a while ago in a comment on the FIC Alternatives post, I'm probably not going to be able to blog as much going forward.One reason I haven't been e-mailing Sara is that I've e-mailed her in the past about other issues and received no answers. And on November 11, within a few hours of receiving the e-mail with our enrollment materials, I e-mailed Member Services a total of four questions. About a week later, I received an answer to one question, but I still haven't received answers to the other three. I decided to turn to the blogs rather than e-mail because e-mail didn't seem to produce the results I needed.Over the past 4 1/2 years, until this open enrollment period, I've been very grateful to have the FU coverage, even though I've often been critical of the communications and customer service. Last year, I immediately enrolled in the Empire plan as soon as it was announced, and I never thought of complaining about the premium and copay increases or any other plan changes -- although I did complain later about the poor communications, the length of time (eventually eight months) that it took to get our benefits booklets online, and also the switch in prescription drug plans since I had some problems with that a few months into the year. But throughout the time that I've been with FU, I've felt that it was unresponsive to customers' questions, complaints and suggestions for improvement -- so at this point, with all that has been going on, trying to communicate with FU via e-mail or phone just seems like beating my head against the wall.Carolyn
One final thought before I stop blogging (I keep saying I can't keep making comments, but it's addictive):I feel tremendously heartened because this morning I received word that someone in government is looking at what I sent. Maybe nothing will come of it, so for the time being I'm not even going to hint at who this is.But I wanted to post this comment just to encourage anyone who has the time to write to your local representatives and anyone in state government who could be of help. Over the past week, I've e-mailed or faxed letters to several elected officials. It was a pretty scattershot effort at different levels of government since I didn't have the time and resources for a well-organized, well-researched effort. This will sound corny, but I just picked the officials who have impressed me most as having the people's interests at heart. But if enough of us do the same, our squeaky wheels may be heard. And even if it's too late to do anything about our 2009 coverage, maybe at least we can get the information and customer service that we need and even some improvements in 2010 coverage.Happy Thanksgiving to All!Carolyn
In a message dated 11/25/2008 5:35:02 P.M. Eastern Standard Time, email@example.com writes:Jude,Please let me know if someone from our office contacted you today.JenEvents ManagerTo: firstname.lastname@example.orgSent: 11/25/2008 8:36:13 P.M. Eastern Standard TimeSubj: Re: thanks for agreeing to answer/clarify specific plan questionsHi, Jen.No, I've heard from no one which is disappointing.Many other members are as confused as I am about "outpatient"/facility charges and have questions similar to mine.Don't you think it would be beneficial to those of us who are grappling with the plan to have my questions answered concretely--in written response--because I certainly don't want to pass on information that isn't confirmed in writing to others who have the same or similar questions.Some suggested that FU post a FIC blog solely for the purpose of question/answer regarding the terms of the plans. I need to make a major decision about my healthcare for next year and I need some straight answers from FIC that I can take as true since I've received completely different answers to the same questions.So the short answer is I haven't heard from anyone and I was hoping to understand at least this piece before Thanksgiving.Why don't you have someone designated at FU or FIC who can e-mail the answers to my questions accurately?It would be a great help. Thanks.Jude--------------------------------------------------------------------------------
Just thinking after taking another look at the PPO 1 chart....Questioning the values of the people who designed this plan a little....In the same year that pregnancy and maternity benefits are slashed dramatically, the plan increases outpatient mental benefits from 20 visits to 60! (Though of course the copay goes up, as it does for everything else)....Now, I'm all for mental health benefits, but what does this say about the world view and ethical system underlying this plan? Are these people progressive, forward-thinking? (This comment comes to you from someone who has never had a child but has been in weekly therapy, though not under any of FU's plans. But I happen to believe that we should all support maternity, that the future of our society depends on our adhering to this simple core value.)
Buyer's Remorse: Why, oh why, did I ever hitch my health insurance star to the Freelancers Union? Couldn't I see that there had to be something really, really wrong with an organization that had the initials FU? And then there's that pesky, threatening bee they put on everything. I happen to be allergic to bee stings -- and it's my one and only allergy. (And under the new plan, a bee sting would probably lead to thousands in OOP expenses.) Oops is right! I think God was trying to tell me something, and I just wasn't listening....
"Jen" from Freelancers Union promised that all my questions regarding outpatient issues would be answered by today at the latest. See all correspondence posted above. Have heard nothing from Freelancers Union. Can you imagine asking a real insurance company basic questions about its terms and not getting an immediate response much less a promised one?Amateurs.Scary.
Received an answer from Member Services Coordinator after complaining that FU failed to respond as promised.I'm stunned: If I get any services inside a hospital--even see a doctor who has an office there or get a mammogram, and the hospital billing dept. bills FIC for services--even those that are doctor visits or a mammogram that is otherwise 100% covered, I pay as if I've been hospitalized--deductible, co-insurance up to $4,000. This makes absolutely no sense. I cannot believe "experts" designed this plan.Is this nuts or am I missing something?To: email@example.comCC: firstname.lastname@example.orgSent: 11/26/2008 2:12:08 P.M. Eastern Standard TimeJen, why didn't I receive a promised response for yesterday or today? From: email@example.comSent: 11/26/2008 3:06:59 P.M. Eastern Standard TimeHello Jude,Sara Horowitz has asked that I respond to you personally and address your concerns. I will discuss your comments with the Member Services staff and will do my best to answer your questions. It seems that most of your questions revolve around services that may take place in a hospital. For the PPO plans, the facility-related benefits (deductible, coinsurance, out of pocket max) apply to all inpatient stays and outpatient surgeries that take place in a hospital. Typically, doctor’s office visits and outpatient imaging tests are not considered “facility.” However, how the benefits are applied depends on how the doctor or hospital bills the insurance company. You may wish to ask your doctor. If the insurance company receives a hospital bill, it will apply the hospital benefit rules.As mentioned on the webinar, actual negotiated rates for the BlueCard PPO® network are not available for publication. This is typical for most insurance provider networks. We will certainly look into what resources might be available to help members estimate out-of-pocket expenses associated with specific services. Again, discussing rates with your doctor may be helpful.You are correct that the FIC HD 5,000 plan for 2009 is not HSA compatible. This is not something that can be changed for 2009, but is something we will look into for the following year. Thank you for providing information about your credit union – I am sharing that information with our business development team as well.
Jude,I just saw your comments above and decided to take a break from cranberry sauce making....This may not be quite as bad as it looks although I have only my own experience at NYU Medical Center to go by.Under the HIP Prime POS Plan in 2004-07, following injuries in 2004 and 2007, I had numerous X-rays and two MRIs at the Faculty Radiology Practice at NYU Medical Center. My EOBs (explanation of benefits statements) always gave the name of one of the radiologists as the provider, so the charges must have been submitted to HIP by the radiology practice (or the radiologist), NOT by NYU Medical Center.Similarly, I went to an orthopedic surgeon who was in an orthopedic group practice with offices at NYU Medical Center. And the EOBs listed him as the provider.Carolyn
Carolyn said:Jude,I suggest that we "Upset Freelancers Union Members" pool our 2008 Empire Direct POS experience with various medical procedures that are now subject to coinsurance. I suspect that if all of the people who have signed the open letter check their records and post information here, we'll be able to draw up a list that will at least approximate Empire's negotiated rates for the most common medical procedures.I'll start the ball rolling:May 2008Colonoscopy and endoscopy (considered ambulatory surgery)Office visit (pre-surgical)Provider (gastroenterologist) submitted: $360.00Empire paid: $125.77I paid: $25.00 (copayment)(Negotiated rate: $150.77)SurgeryProvider (gastroenterologist) submitted: $1,300.00 + $1,415.00 = $2,715.00 (Note: I don't know the procedure codes, so I don't know which charge is for the endoscopy and which for the colonoscopy.)Empire paid: $256.24 + $102.36 = $358.60 (Note: Full allowance was provided for the procedure with the greater allowance, and one-half payment was provided for the procedure with the lesser allowance.)I paid: $0(Negotiated rate: $358.60)FacilityProvider (NYU Hospitals) submitted: $6,350.30Empire paid: $2,119.50I paid: $75.00 copayment(Negotiated rate: $2,194.50)Provider (anesthesiologist) submitted: $1,260.00Empire paid: $696.00I paid: $0(Negotiated rate: $696.00)Provider (pathologist) submitted: $455.00Empire paid: $122.97I paid: $0(Negotiated rate: $122.97)Comment: Under PPO 1, mammograms and prostate cancer screenings are paid in full, with no deductible. But a colonoscopy or endoscopy entails significant out-of-pocket costs. GI problems, including cancer, run in my family; breast cancer doesn't. And I'm obviously not worried about prostate cancer. I feel that the cancer screening provisions of PPO 1 discriminate against someone with my family history -- although I understand, of course, that NYS law mandates coverage for mammograms and I guess it must not provide that colonscopies be covered generously, or presumably FIC wouldn't come up with this kind of plan design. (I haven't done all that much benefits work in the past seven years, so I'm not up on everything, I'm afraid.) A good plan design would encourage all of us to have all the screening procedures indicated in light of our age and medical history -- this plan certainly doesn't. In a period of lower earnings, we might feel that we had to postpone a colonoscopy and/or an endoscopy recommended by our doctor.May 2008Capsule endoscopy (radiology, at doctor's office, presumably would fall under "X-ray and diagnostic imaging" on PPO 1 chart, with 20% coinsurance and no out-of-pocket limit)Provider(gastroenterologist)submitted: $2,500.00Empire paid: $1,262.03I paid: $0(Negotiated rate: $1,262.03)Note: It took several months for Empire to pay this claim. They first denied it on the grounds of medical necessity, and my doctor and I both filed appeals. According to my doctor's office, although Empire does not do pre-certification for this procedure, it routinely denies every claim, no matter what the patient's medical history (including previous screenings and lab tests) indicates. In my case, because of blood test results indicating that I had severe anemia and an exceptionally low iron level (below the level where transfusions are sometimes recommended), and then negative results from the colonoscopy and endoscopy, my doctor thought I should have the capsule endoscopy to examine my small intestine as soon as possible. (The results of the capsule endoscopy were also negative.)MEDICAL NECESSITY ISSUEI am concerned about how medical necessity will be covered under PPO 1 -- this is an issue that we need to take up with FU/FIC. Will Empire or FIC determine medical necessity? Standard practice is for the company that insures or administers the plan to determine medical necessity. From a benefits booklet that I wrote in the 1990s:"To be covered under any of the ... plans decribed in this guide, services and supplies must be:*considered medically necessary for treatment under generally accepted medical standards, as determined by the company that insures or administers the plan, and*performed or prescribed by a licensed doctor or surgeon or by another licensed practitioner acting within the scope of his or her license."August 2008This year, for the first time in my life, I had to return to the radiologist for a second mammogram and a sonogram (results were negative).I have not included the charges and payments for the first mammogram since we have "first-dollar coverage" for that. However, since footnote 8 of the PPO 1 chart seems to indicate that only one mammogram a year will be covered, I am including the charges for my second visit to the radiologist.Provider (radiologist) submitted: $800.00Empire paid: $189.47I paid: $0(Negotiated rate: $189.47)
Brevity and concision are virtues that are sadly ignored.
"Brevity and concision are virtues that are sadly ignored."You're an idiot. How's that for brevity?
It's interesting to watch FU delete Julia's comment #4 on their recent post: "FIC Plans: What if I am hospitalized?""Oh Sara, you are such a cunt."Methinks Milady Julia doth hit the nail squareth on the head?
Well, Julia's comment was repulsive and unhelpful, and I, for one, am glad it was deleted. Although FU's mishandled this entire episode, I think you're all mad at the wrong people.
Mad at the wrong people? Horowitz goes around "championing" the "poor little freelancers" and then shafts them at the last minute?Horowitz: It's my football. If you don't like it, tough s___t and go play somewhere else.
Like I said, I think it was mishandled; I'm just not going for the lame-assed conspiracy theories.
In my long comment posted above where I discussed the problem of poor coverage under PPO 1 for colonoscopies and similar screening procedures -- the comment which apparently occasioned the following comment about brevity and concision -- I noted that I feel PPO 1 discriminates against plan members with my particular sort of family history and "must-have" screening procedures.What I forgot to mention is that I also feel PPO 1 discriminates against me and other older members. It's middle-aged people for whom colonscopies are recommended, for example, even if there's no family history or medical problem prompting a doctor to recommend them at an earlier age. Of course, if younger members are women who are having children or contemplating motherhood, PPO 1 also discriminates against them. So, we've got a plan design that incorporates sex discrimination as well as age discrimination -- a plan design that, in the long run Ms. Horowitz likes to talk about, will attract chiefly younger members...as long as they don't want to be parents and don't have major health problems. Where is the great social utility in this? The "innovation," the "excitement"? If it takes a "genius" to come up with a plan like this, I fervently hope that many fewer "geniuses" will be contributing to our society in the coming years.Carolyn
A PRACTICAL TIP (FOR AT LEAST SOME OF US)I just received a notice from Caremark that I have "one or more" prescription refills available. I have enough left of my one prescription drug to get me well into 2009, but it occurred to me that it would be a good idea to reorder soon, definitely before December 31. This way, at the very least, I'll be able to delay paying the $100 deductible for prescription drugs in PPO 1 until April 2009. And maybe I will have managed to find a new plan by then even if I can't manage that by January.
How about a new thread solely devoted to Carolyn's lengthy musings and detailed medical history? A real must read.
Please stop the nasty and offensive posts. I have learned a tremendous amount from Carolyn. The point to sharing and detailing medical history is to understand what we might have to pay out of pocket since FIC won't share the negotiated rates. In addition FIC just disclosed that any time a hospital bills FIC--even if it's just for a blood test or an x-ray or a mammogram or whatever--you have to pay "facility" charges, including deductibles, co-insurance, out-of-pocket maximum as if you were having outpatient surgery or an inpatient stay. Even if your doctor just happens to use an approved BC/BS hospital lab that bills FIC. If you are not interested just skip over the posts that bore you. What we are learning each day is that the devil is in the details and Carolyn's posts are helpful.
found this posted on a blog titled "mind for rent" could use more emphasis on the lack of out of pocket caps for diagnostic imaging and outpatient surgery...Wednesday, November 12, 2008Freelance Insurance Changes = Crazy I've posted once before about the Freelancers Union as they have a great low cost group plan for consultants, but that just changed. Big time or did it? They have decided to become an insurance company called FIC. See jump below:FREELANCERS UNION TO LAUNCH FREELANCERS INSURANCE COMPANYI am besides myself. How is it possible for a Nonprofit Union in today's crazy world of Health Insurance to just decide it's now a provider?Currently they offer Empire Blue Cross Blue Shield and FIC says, "all Doctors on the Empire plans will service the new FIC plan," but I doubt this. Though I have not researched this situation deeply, I doubt all of this very much.I phoned Empire and to continue my current plan directly I ( Single male, 40 years old, no preexisting medical conditions - sans herniated disks ):A) Cannot as they do not have the plan and will have to switch to a Direct Pay HMO or a Direct Pay HMO with out of net benefits.B) First plan costs: $887 a month.C) Second plan costs: $1483 a month.D) Crazy. That's more than 3 and 5 times my current monthly.E) Current plan:Plan: Individual + Child(ren) + Spouse/Partner Family Empire EPO 2: $277.79 $477.29 $535.59 $777.42 F) FIC's new plan for 2009:Plan: Individual + Child(ren) + Spouse/Partner Family FIC PPO 2: $336.00 $596.00 $668.00 $977.00 G) Out of network deductible includes a "$1,000 - $6,000 and co-pay for Hospital* deductible (in-network).H) "*Hospitals and other facilities, such as skilled nursing facilities, maternity hospitals, and chemical dependency centers."I) Depending on plan that can increase:"Annual deductible for individuals: In-Network: $10,000.Annual deductible for individuals: Out-Network: $15,000."E HEALTH INSURANCE QUOTE:Empire Blue Cross Blue Shield:Indemnity Plan: $122.63 month. No C0-insurance. No deductible. Office visits not covered.GHI Alliance Value Plan:PPO Plan: $451.84 month. No C0-insurance. No deductible. Office visits not covered.Empire Blue Cross Blue Shield:Direct Pay HMO: $799.08 month. No C0-insurance. No deductible. Office visits $15 co-pay.Freelancers Union IM blog members are asking about options:1) E-Health-Insurance? They have Oxford with no deductible/no co-insurance for $411 (and other plans for cheaper). Plus Oxford reimburses up to $400/year for gym memberships.2) Insurance through Media Bistro/Avant Guild. They have Oxford.3) You can get cheaper insurance through Fractured Atlas.4) www.fracturedatlas.org is a similar org to FU5) FIC. Staying, but what about access, approvals, co-pay, deductibles, claims, open refill, what if I'm in a car accident and the nearest hospital is like who the fuck is FIC?6) Preffered, FU's previous provider and still in use in New Jersey, was not accepted by any Doctor I could find in New York. I paid visits out of pocket.7 FIC's answers here: FIC Questions.8) For FU members, please be advised that FU IM blog must be posting propaganda. "Like, oh I'm sure if your Doctors haven't heard of FIC yet, they will in the future. Just check back with them. Sign up it will be fine." Scary people giving advice about peoples lives.Read the Executive Director of the Freelancers Union pitch here:A Message from Sara Horowitz.Here is a competitor's pitch:Media Bistro / Avant Guild Insurance.A friend and fellow consultant had this to say:"Found out you can't get "association rates" in NJ, NY and a few other states.Why? Because the insurance industry has a beef with certain legislationthose states have passed (not clear on details) and as such, no longeroffers association rates to residents of those states.That might be what happened with Freelancers Union."WHAT CURRENT FU MEMBERS ARE SAYING ABOUT FIC:• "I'm completely frustrated ... anyone have other options for reasonable insurance other than FU?"• "I read the message from Sara. Don't you think we should wait before changing. The Gov. will announce new guild lines that will cause another change."• "ehealthinsurance.com's Liberty Exclusive Plan Metro looks better than FU."• "Hey Sara, way to go! A big FU to the freelance community by starting a for-profit insurance company within a non-profit. I guess these years of courting are going to pay off for you."• "If the point of these new plans is to better serve FU members, why are we being forced to pay more for less? aaaarrrgh."• "And I'm shocked at how little info they have put out and how sudden the announcement was."• "I think it's safe to say this new plan is a disaster."• "This is ridiculous! in these times they raised this insurance so much. I just spoke to a rep, and they said it will go up again in 2009."• "In the last 2 years I had to change insurance twice, with all the deductibles. How many times do you have to screw the people that are keeping the freelancers union alive."• "I have been so upset by these new insurance plans/rates. They will surely put me in the poor house. Thanks FU!!"• "Family rates increased 24% which is double the average for the northeast. Sigh."• "Yes, a big FU. I'm so sick of this. If there is a petition to stop this insurance change, please let me know so I can sign it. Otherwise I'm leaving the freelancers union."• "It's sad they finally had a good provider in Empire and now we pay more for less. Great job FU!"• "I even emailed FIC about their new so called better plan and no one has replied. FIC is the worst"Here's another blog (not mine) set up to help with FU/FIC:Upset Freelance Union MembersPosted by Kevin Amter at 9:53 AM Labels: Consulants, FIC, Freelancers Insurance Company, Freelancers Union, Healthcare 5 comments: Tripp said... Man, that's totally insane.November 12, 2008 12:41 PM laurie said... This post has been removed by a blog administrator. November 12, 2008 6:09 PM laurie said... This post has been removed by a blog administrator. November 12, 2008 6:13 PM laurie said... Dude, thanks for taking down the posts, but please know that what you currently have up is not what I intended to say. Sorry if it came off that way. Peace,laurieNovember 13, 2008 1:01 PM Alan Wolk said... This is why I've always thought that selling national health insurance as "pro-entrepreneur" would be the way to get mass acceptance.It's a sound strategy because it's true: from "Joe the Plumber" to "Kevin the CD" solo practitioners have to pay through the nose to get any sort of acceptable insurance plan and it stops many people from going out on their own.November 13, 2008 7:19 PM Post a Comment
(this is the web address of the above)MINDS FOR REnt http://advertisingfreelance.blogspot.com/
Sara Horowitz's post on a blog dmiblog.comSara HorowitzThe Missing Link in the Health Care DebateBlame it on the zeitgeist: this election cycle, everyone wants to get in on the health care debate. It used to be political poison, but now it's a required talking point for every presidential candidate.In all the plans we're seeing from Democrats, which Jacob Hacker has helpfully anatomized, one thing seems to be missing: intermediaries. There's the single-payer model; the public/private hybrid, which assumes that competition will drive efficiency; and the mandatory buy-in, like in California and Massachusetts.But all these proposals force consumers into a direct relationship either with the government or with an insurance carrier. Neither is a particularly good fit. In the former, the individual is one of millions; in the latter, a consumer is merely a source of potential profit. The reason the employer-based system works -- to the extent that it does work anymore -- is that the employer acts as an intermediary. It creates a group, and spreads risk across a diverse pool of consumers.What we need, now that fewer people are getting insurance through employers, are new intermediaries. Professional associations, community groups, and even religious congregations could aggregate their members and negotiate with insurance carriers for lower rates and better coverage. And a group that represents a big chunk of revenue for an insurance company can throw its weight around for its members' benefit, acting as an ombudsman when a consumer needs to dispute a claim.One thing I've learned from talking to freelancers is that America is a country of entrepreneurs and innovators. It's time for policymakers to take an innovative approach to health care. We don't have to duplicate the Canadian system, or even anything else that's out there now. Let's just think about what works: forming groups and building institutions to act as intermediaries. I'd like to hear something new from a candidate on the stump, and talking about intermediaries as part of the health care solution would certainly be that.Sara Horowitz: Author Bio | Other PostsPosted at 6:45 AM, Apr 24, 2007 in Health CarePermalink | Email to Friend | Comments (5) CommentsWhy?Why would we weigh down this human right with professional associations or book clubs? Almost every other developed nation in the world has some form of a system where there is a single, national, non-profit risk pool administered by a public agency that pays healthcare providers. Everyone is in, there is choice and competition among providers, and we don't waste 30% of care dollars pumping up insurance industry profits. Intermediaries would just serve as a new layer of bureaucracy serving to siphon off care dollars and exclude patients.Why wouldn't we go with what's already working around the world?Posted by: California Nurses Shum | April 24, 2007 07:31 PM I think the issue is national financing, not necessarily national delivery of healthcare. And the financing should be national. But as our economies get decentralized, it makes sense for people to have options of where to get their insurance -- not just through or an employer, or just through the government.Posted by: Sara Horowitz | April 26, 2007 01:56 PM Intermediaries? One-third of our health spending is already wasted in layers of administrative waste. The systems with less intermediaries can spend more on care for precisely this reason.If huge employers covering millions, Like GM, FORD and Xerox can't use their huge purchasing power to negotiate affordable premiums, why in the world would you think that a local community church could?Posted by: Nicholas Skala | April 26, 2007 02:49 PM You say waste--I say restructuring so that people get benefits from the groups they plan to be members of for a long time. A membership group's central mission is to promote the well-being of its members. It can focus on wellness, prevention, and affordability, as opposed to most companies, whose central mission is profit maximization.The government should finance healthcare. Unions, nonprofits, and others should deliver it. We are an example of that model.Posted by: Sara Horowitz | April 27, 2007 10:07 AM Your suggestion has fallen on hard ground because too many peoplewith an opinion on health insurance fail to understand the coreconcept of health insurance (spreading the risk [with risk poolsubsidy where spreading risk cannot deal with costs equitably]).Posted by: seer15000 | April 29, 2007 10:09 AM
I finally got onto the anthem provider search, and it does seem very good... Memorial Sloan Kettering is part of it, which is pretty great (I would think, if one needed cancer care). Just WISH there was maximum out of pocket caps...
(And I would certainly rather be with empire blue cross!)
archival chatter with FIC's explicit interpretations to a member (over the phone) (so we have a record)Monica:They're saying that if you have a baby, under the family plan, you pay OOP $24K under PPO2!!! Who in the world can afford that? Posted: Monday Dec. 1, 2008.Info11:53A Monica:Can anyone confirm which is correct given this conflicting info between FIC and FU? Posted: Monday Dec. 1, 2008.Info11:52A Monica:I spoke w/FIC directly, and Susan at ext 127 said FU is interpreting wrong: she says if only 1 person is hospitalized under family plan, individual OOP max of $4K and $12K apply under FIC PPO1 and 2. Posted: Monday Dec. 1, 2008.Info11:50A Monica:I have a family plan and was confused by how FIC plans are written in case only 1 is in hospital. Looks like OOP could be $24K!!! What family could take on that risk? Even $8K would be disastrous. Posted: Monday Dec. 1, 2008.Info11:33A Deborah: Call in is a disaster. I held for 30 minutes only to get transferred to voicemail. I have waited 2x - as caller #22 and #20. I've gone all the way
fyi, all, a quote from FU re outpatient surgery costs being capped...Yes, outpatient surgery costs go towards your annual out-of-pocket cap.Please contact us if you have any questions.Member ServicesFreelancers UnionTel: 800-856-9981Fax: 877-707-3576Email: firstname.lastname@example.org.FreelancersUnion.org
Has anyone made an effort to confirm whether his or her (family's) PCP has heard of FIC and is prepared to participate? Or, has anyone established that the asserted connection with the BCBS network will be "automatic" for FIC? You know what I'm asking. Are you confident hat if your choice ultimately lands you with FIC your PCP wll be there? Thanks
I managed to speak with someone in 'member services' (you don't want 'enrollment,' I found out after waiting 20 min.) who more or less indicated this transition should be seamless. If your PCP participates with BCBS (which ought to be the case, D'oh!), then because FIC will be part of or affiliated with the BCBS network, you should automatically be able to use him/her. If I were better at this I would have followed up with questions about how/who physicians will bill, but perhaps someone else can do that, or I will try to get through again later on. Sorry this wasn't more useful.
fu chatter update (for archive) : 04:18P Andrew:Is there a POS plan with FIC? Posted: Tuesday Dec. 2, 2008.Info03:52P Liat: I was just thinking of joining the health plan. But the rates changed so much. You can get the same of around $400 on your own with the same coverage. So what is the point? Posted: Tuesday Dec. 2, 2008.Info03:31P Robert:bye Posted: Tuesday Dec. 2, 2008.Info03:29P Robert:So I think this is all one big snafu while they try to get the new company up with a bunch of new employees trying to handle more traffic than they can. Posted: Tuesday Dec. 2, 2008.Info03:28P Robert:Though I must say I've been with FU for many years and have gotten good coverage... Posted: Tuesday Dec. 2, 2008.Info03:27P Robert:well, if they don't straighten this all out, they may be finding an angry crowd outside their door at 45 Main St in Brooklyn some cold January morning. Posted: Tuesday Dec. 2, 2008.Info03:26P Pasquale: yeah this seems like a bit of a boondoggle right now Posted: Tuesday Dec. 2, 2008.Info03:20P Robert:... though it *does* show up when I examine the "view your future benefits" page Posted: Tuesday Dec. 2, 2008.Info03:19P Robert:I've sent 3 emails 2 2 weeks trying to get assured my transfer to PPO1 is good, but no answer. Posted: Tuesday Dec. 2, 2008.Info03:19P Robert:No one monitors this except those of us customers who are on to complain. Posted: Tuesday Dec. 2, 2008.Info03:17P Emily:You are really letting us down. Posted: Tuesday Dec. 2, 2008.Info03:17P Emily:Our insurance was supposed to begin yesterday and Empire has no record of us. I hope management reads this feed. Posted: Tuesday Dec. 2, 2008.Info03:11P Dani:on hold for 30 minutes and then hung up for me too! Posted: Tuesday Dec. 2, 2008.Info03:03P Julian:30 minutes waiting . . . down to number 2 to be answered . . . get disconnected. Posted: Tuesday Dec. 2, 2008.Info02:09P John:20 min in queue, i get an agent..disconnected. Get Posted: Tuesday Dec. 2, 2008.Info01:46P Michelle:I had the same awful experience this morning. The phone and email systems need to be fixed PRONTO! This is not a joke FU... Posted: Tuesday Dec. 2, 2008.Info01:40P Thomas:last year was much worse Posted: Tuesday Dec. 2, 2008.Info01:39P Thomas:I had a very different experience. Had Qs so called the 800 # and choose the gereral ins info option; got a person in about 2-3 min. Hope others can get their issues answered quickly. last year was mu Posted: Tuesday Dec. 2, 2008.Info11:59A Julian:RIDICULOUS. I just held on the phone for 20 mins only to get dropped after being first in line for about 5 mins. I am looking to take my business elsewhere... Way to go FU. Fail. Posted: Tuesday Dec. 2, 2008.Info11:44A Mirit:Jasmine - if you need insurance, you should look for a place that offers one, i'm not sure any of FU new plans are offering insurance for those with real needs Posted: Tuesday Dec. 2, 2008.Info11:41A Jasmine:um would now be bad time to sign up for insurance.. I really need it but everyone seems to be having a lot of trouble...but man do I need it now Posted: Tuesday Dec. 2, 2008.Info11:38A Jessica:I just waited on hold for an hour. Went from 12th in line to first. When it said I was the next caller it seemed like my call was finally being answered, then it hung up on me. Posted: Tuesday Dec. 2, 2008.Info11:37A Darren:I emailed with the idea of specific time for appointments, that ideas was not even considered Posted: Tuesday Dec. 2, 2008.Info11:27A Mirit:if you want to join BCBS as a group check - http://upsetfu.blogspot.com/2008/11/interested-parties.html Posted: Tuesday Dec. 2, 2008.Info11:22A Christine:WOW! thats all i can say Posted: Tuesday Dec. 2, 2008.Info11:21A marco:this is crazy. A lawyer should be involved! Posted: Tuesday Dec. 2, 2008.Info10:35A David:Cut off again... This time after 25 minutes... Posted: Tuesday Dec. 2, 2008.Info10:15A David:This is my second day of "coverage" by FU and I'm completely disgusted... Posted: Tuesday Dec. 2, 2008.Info10:12A Christopher: What is wrong with your phone system! Trying to get through!! Posted: Tuesday Dec. 2, 2008.Info09:56A walter:Has anybody ever physically gone down to FU's offices and "hondled" there in person? Posted: Tuesday Dec. 2, 2008.Info09:43A Judith:I cannot get thru again Help I need some question answerd Posted: Tuesday Dec. 2, 2008.Info09:32A Robert:Webmaster, the phone system is still dropping calls! Yesterday and today is the worst experience I have ever had with trying to resolve a problem on the phone! Posted: Tuesday Dec. 2, 2008.Info08:31A walter:This has been the "Mother of All Screw-ups". Sara Horowitz touted herself as being a "Labor Genius" Yud'd think she would have floated this new insurance plan back in the summer for member feed-back Posted: Tuesday Dec. 2, 2008.Info06:26A Peter:that doesn't mean all the money is reinvested in benefits. The new FU insurance comes from the same source but rebranded so I am suspicious. What a screwup this has been. Posted: Tuesday Dec. 2, 2008.Info06:24A Peter:Can't get through with insurance questions and the clock is ticking. Also, rates took a nice jump on new plan. Does anyone know where salary and expense info is for FU? It's non profit but... Posted: Tuesday Dec. 2, 2008.Info12:08A Shelley:very unprofessional Posted: Tuesday Dec. 2, 2008.Info12:08A Shelley:i cant find open invoice and cant get through on phones wow Posted: Tuesday Dec. 2, 2008.InfoTuesday Dec. 2, 2008 10:23P Elda:It's only the beginning people. Posted: Monday Dec. 1, 2008.Info05:57P David:Too little... too late.. Posted: Monday Dec. 1, 2008.Info05:57P David:Who cares? Offices are closed now. Posted: Monday Dec. 1, 2008.Info05:32P Vanessa:arrgh.... Posted: Monday Dec. 1, 2008.Info05:32P Vanessa:i'm very worried because i think my health insurance is about to get dropped for lack of payment -- but i cant find an open invoice! Posted: Monday Dec. 1, 2008.Info05:31P Vanessa:the webmaster said that it's working now, but i was just on hold for 30 mins, and then got dropped Posted: Monday Dec. 1, 2008.Info05:30P Vanessa:what is up with the phone system at FU?! Posted: Monday Dec. 1, 2008.Info05:19P Webmaster:Some of you experienced dropped calls and a brief phone outage earlier today. We know this is frustrating. We apologize, and want you to know that the phone systems are now up and running. Posted: Monday Dec. 1, 2008.Info05:07P David:So lame.. Posted: Monday Dec. 1, 2008.Info05:07P David:Yup... Cut off... This mailbox can no longer receive messages. Posted: Monday Dec. 1, 2008.Info04:50P David:If I get cut off a 5 because of "quitting time" I'm gonna lose it.. Posted: Monday Dec. 1, 2008.Info04:50P David:Unreal... It's almost 5 and I've been waiting on hold since 3:30. Posted: Monday Dec. 1, 2008.Info04:40P walter:Has anyone succeeded in getting their insurance through "www.ehealthinsurance.com"? We now have less than 2 weeks to sign up for Jan.1 coverage outside of FU. Posted: Monday Dec. 1, 2008.Info04:35P David:I'm signed up for Empire for December only as well and NOT IN THE SYSTEM!!!! Posted: Monday Dec. 1, 2008.Info04:12P Lisa:Also, I emailed member services in mid November but never got a reply. I emailed benefits dept yesterday... we'll see if that one gets an answer. Posted: Monday Dec. 1, 2008.Info04:08P Lisa:i finally got through, was speaking with a billing rep but then line went dead suddenly. I called back & spent 30 minutes on hold, got to be caller #1 but then answering machine! Very frustrating. Posted: Monday Dec. 1, 2008.Info03:54P Julia: I have the opposite issue - I am trrying to cancel my coverage and just need to make sure they received my written request, but My Account still says I'm enrolled. Posted: Monday Dec. 1, 2008.Info03:44P Marlene:Yea, as of today I'm basically sitting here with no coverage. A scary thought. Posted: Monday Dec. 1, 2008.Info03:33P Robert:That's why I don't want to lose my coverage because of some web snafu Posted: Monday Dec. 1, 2008.Info03:33P Dwyane:i need free money Posted: Monday Dec. 1, 2008.Info03:33P Robert:I have to say, Marlene, FU has been great for me for several years now. Posted: Monday Dec. 1, 2008.Info03:32P Robert:now sent 3rd email in a week... Posted: Monday Dec. 1, 2008.Info03:31P Robert:I still have my Empire coverage, but that stops Dec 31 Posted: Monday Dec. 1, 2008.Info03:30P Robert:sigh Posted: Monday Dec. 1, 2008.Info03:30P Marlene:I can't find ANYONE to talk to about this. Posted: Monday Dec. 1, 2008.Info03:29P Marlene:Similar problem. Due to when I joined FU I had to sign up for Empire for December only. I paid Nov. 14 and received an enrollment confirmation. Called Empire today. I'm not in their system!! Posted: Monday Dec. 1, 2008.Info03:25P Robert:I don't want to lose my coverage. Posted: Monday Dec. 1, 2008.Info03:25P Robert:anyone else having this problem? Posted: Monday Dec. 1, 2008.Info03:25P Robert:I filled out new form for the required insurance switch 2 weeks ago, yet "my insurace" does not yet reflect the change. Posted: Monday Dec. 1, 2008.Info03:09P Marlene:Does anyone have the extension of someone to call in Brooklyn? I can't get through there either. I have some issues that need to be dealt with immediately. Posted: Monday Dec. 1, 2008.Info03:05P Michael:is anyone monitoring this chatter? Sounds like some major issues need to be addressed ASAP Posted: Monday Dec. 1, 2008.Info03:04P David:I just waited on hold for 45 min to get cut off!!!! Posted: Monday Dec. 1, 2008.Info02:57P debra:i have been trying to get thru on the 800# anybody else successful? Posted: Monday Dec. 1, 2008.Info02:42P Julia: I spent 30 minutes on hold, got to be caller #1 and got answering machine as well. Rediculous! Posted: Monday Dec. 1, 2008.Info02:31P Richard:1 hour worth of calling, operator will NOT take call back #, got disconnected. Anyone have one or the CEO's home #? Posted: Monday Dec. 1, 2008.Info02:17P Oliver:could anyone make a payment online? Posted: Monday Dec. 1, 2008.Info02:09P Kristin:Plus...on hold for 45 minutes only to get put through to an answering machine. Just terrible Posted: Monday Dec. 1, 2008.Info02:08P Kristin:The best plan doesn't even come close to the direct POS plan from Empire and it's $100 more per month plus at elast a $1,000 deductible! Posted: Monday Dec. 1, 2008.Info02:07P Kristin:The new plans are a huge step back in coverage for considerably more money Posted: Monday Dec. 1, 2008.Info02:06P Marlene:I was on hold 33 minutes to get an answering machine!!! Posted: Monday Dec. 1, 2008.Info01:45P Julian:So. 30 minutes on hold, get someone who says they can't help me, let me transfer you, then back through the same call system only to be told "your call cannot be completed due to technical difficulty Posted: Monday Dec. 1, 2008.Info01:40P an:anybody knows a god doctor and dentist in the west village? Posted: Monday Dec. 1, 2008.Info01:14P Julian:Grar. Can't get through on the phone. Posted: Monday Dec. 1, 2008.Info01:09P Timothy:this union is pure chaos. they do not have it together...can you say "ghetto"? Posted: Monday Dec. 1, 2008.Info01:06P Edward:I just waited on hold 90 minutes and got cut off as soon as a live person answered Posted: Monday Dec. 1, 2008.Info12:52P Timothy:i personally am very unhappy that i have to switch my insurance for the 3RD year in a row, and it continues to be more expensive. and this new FIC crap beter be as good as the empire pos plan... Posted: Monday Dec. 1, 2008.Info12:12P Monica:They're saying that if you have a baby, under the family plan, you pay OOP $24K under PPO2!!! Who in the world can afford that? Posted: Monday Dec. 1, 2008.Info11:53A Monica:Can anyone confirm which is correct given this conflicting info between FIC and FU? Posted: Monday Dec. 1, 2008.Info11:52A Monica:I spoke w/FIC directly, and Susan at ext 127 said FU is interpreting wrong: she says if only 1 person is hospitalized under family plan, individual OOP max of $4K and $12K apply under FIC PPO1 and 2. Posted: Monday Dec. 1, 2008.Info11:50A Monica:I have a family plan and was confused by how FIC plans are written in case only 1 is in hospital. Looks like OOP could be $24K!!! What family could take on that risk? Even $8K would be disastrous. Posted: Monday Dec. 1, 2008.Info11:33A Deborah: Call in is a disaster. I held for 30 minutes only to get transferred to voicemail. I have waited 2x - as caller #22 and #20. I've gone all the way down the list and then have been transferred to vm Posted: Monday Dec. 1, 2008.Info11:27A Howard:can you email your questions to them somewhere??? Posted: Monday Dec. 1, 2008.Info11:06A Donis:Are there any freelance phone system specialists on this forum? ;-) Posted: Monday Dec. 1, 2008.Info11:05A Donis:Am I the only person UNABLE to get through to make a payment? I've been disconnected 6 times (so far) this morning. I'm on hold (again). I can't believe there is no RELIABLE way to pay our bill!!! Posted: Monday Dec. 1, 2008.Info10:53A Eric:the call-in system is a mess. i tried several times before i finally got through...and often by the time i worked my way down the list from #16 i was cut off. once i got down to #8 and was #1 Posted: Monday Dec. 1, 2008.Info10:35A BRYAN:i cannot get through to the open enrollment form. i called and was on hold for a long time, then disconnected Posted: Monday Dec. 1, 2008.Info10:31A Jerilyn:I also just called and was hung up on. First I was number 16 on waiting list. Then I went down a few numbers then up to 18 then waited some more then got disconnected while still on hold. This is n Posted: Monday Dec. 1, 2008.Info10:11A David:facility only means "Hospital" ... so the cap they talk about only applies to bills if you're admitted to a hospital ... there doesn't appear to be a cap on non-hospital co-insurance fees. Posted: Monday Dec. 1, 2008.Info10:04A Andrea:I just spent over half an hour on hold, then was cut off while still on hold, then called back to get only a busy signal Posted: Monday Dec. 1, 2008.Info10:04A Andrea:let me just say that the phone system is extremely messed up!!!! Posted: Monday Dec. 1, 2008.InfoMonday Dec. 1, 2008 07:30P Taryn: As a freelancer in NY, are your dental insurance monthly payments a write-off just like your regular health insurance? Posted: Sunday Nov. 30, 2008.Info01:52P Alev:Has anyone gotten an asnwer on what 'facility only 'means on the new FIC insurance? Posted: Sunday Nov. 30, 2008.Info12:54P David:Does anyone have any idea how much I should charge for buidling a database in access to be used for recording and graphing student assessment information for public schools? It contains a lot of VB
FU looking for:+ Communications ManagerWe are seeking a Communications Manager with significant experience crafting messages for multiple audiences to facilitate the development and implementation of our communications strategies directed. The Communications Manager will report to the Executive Director and will play a key role in advancing and developing a public face for the multiple facets of our organization. These include: expert facilitation of communication to members, including marketing products and service as well as rapid response to member concerns; presenting issues to policy makers, thought leaders and the media; communicating with partner organizations; working with the advocacy team to formulate messages for advocacy campaigns; and shaping brand identities for multiple business enterprises associated with the organization.Other responsibilities include:- Work across the organization to develop and facilitate messaging and communications plans for conveying key information to F.U. members, with a focus on advocacy and policy issues- Use F.U. website(s) and email to respond quickly and thoroughly to member concerns- Work with internal teams to implement marketing and communications plans- Manage relationships with outside consultants, including PR firm and advertising firm- Lead the planning of biannual advertising campaigns and continue to expand them to other cities nationwide- Define brands for multiple business entities, and manage those brands over time- Work closely with the director of policy and advocacy to shape messaging on policy issues and campaigns- Work closely with the executive director to develop long-term marketing and communications strategiesSuccessful candidates will have demonstrated:- Strong experience managing communications for a member-driven organization with a focus on energizing and mobilizing membership behind key initiatives and issues. Experience with advocacy and policy issues a strong plus- Strong experience directing or managing communication strategy and implementation for a company or nonprofit organization, including marketing communications, PR, and advertising (both online and offline)- Expert familiarity and agility using web-based communication (blogs, email, chats, etc)- The ability to manage multiple projects, including managing other communications staff- Excellent written and verbal communication skills- A collaborative work style and an entrepreneurial spirit- Strong customer relations communications experience is a plusTo applySend a resume and cover letter with freelance rate/salary requirement, and writing samples addressed to Freelancers Union, via email to email@example.com. Resumes sent without a cover letter/salary requirement will not be considered. No phone calls, please.[hide]
I guess the equivalent of FIC would be to think of a company "self-insuring." The irony is if one was taking a job at a company, probably the last thing one would consider was whether the company was solvent enough to meet the health bills their insurance is supposed to be covering on one's behalf. How idiotic this whole thing is! I guess I'm saying that if I went to work for some huge corporation that self insured I wouldn't think at all about this issue, no, but it would also apply in that situation (individual's possible responsibility for bills if the company failed...)
See comment #31:http://economix.blogs.nytimes.com/2008/12/05/workers-give-up/?hp&apage=2
Anyone ever looked into the Oxford Plans offered by NASRO http://www.nasro-co-op.com/health/state/ny/index.shtml
I'm not sure where to post this, but I thought it might be of interest and decided to post it here.From a PricewaterhouseCoopers press release dated 12/11/08:"The financial downturn, a new President and growing public demand for reform of the health system will force health organizations to react quickly in 2009, according to the Top Nine Health Industries Issues in 2009, published today by the Health Research Institute at PricewaterhouseCoopers LLP (PwC). In its annual review of the top concerns for health executives and policy makers, PwC says the health industry will face a plethora of challenges in the year ahead, including how to deal with more underinsured, adapt to new coding and payment methods, and fund new cures in a capital-starved market...."2. The Underinsured Will Surpass the Uninsured as Healthcare's Biggest HeadacheThe uninsured draw most of the attention, but the number of underinsured is growing even faster - an estimated 25 million adults qualify as underinsured, an increase of 60 percent since 2003. With some but not enough health insurance, the underinsured often can't or won't pay the high deductibles and co-pays for the services they need. In 2009, we could see more bad debts for hospitals, more cost-shifting to commercial plans and more patients delaying or foregoing care.With growing unemployment, self-pay is becoming a major part of providers' revenue cycle processes. Many hospitals have begun to prequalify patients. Some are using credit card-like swipe machines to verify eligibility and estimate insurance coverage. Others are using credit cards and extending their own lines of credit. Not-for-profit hospitals must tread carefully, as they don't want to further complicate the credit for uninsured and low-income patients. Business operations will likely look to technology and processes from the retail, banking and credit industries to manage self-pay patients and the underinsured."More and more commentators are focusing on the problem of the underinsured. Those of us who will be newly underinsured under PPO 1 and who are writing to the NYT and WSJ to challenge their one-sided reporting, as well as those contacting other media, should be sure to give details of how they are now underinsured -- e.g., how they might have to postpone a colonoscopy for several months or even years if business is slow, or how they might have to raid their retirement savings to find the money to cover the deductible and coinsurance for a maternity hospitalization.
Thank you for the above post! Very well written and informative! Should we direct our letters to a particular person at the NYT and WSJ? Via email or snail mail, or does it matter?
sorry I don't have the link, but this is (mildly)interesting, the ny state insurance report (you can find it on the web)REPORT ON ORGANIZATIONOF THEFREELANCERS INSURANCE COMPANY, INCAS OFOCTOBER 23, 2008DATE OF REPORT OCTOBER 23, 2008EXAMINER KENNETH I. MERRITTTABLE OF CONTENTSITEM NO. PAGE NO.1. Organization 22. Scope of examination 43. Capitalization and subscription 44. Balance sheet 55. Authorized powers and minimum capital required 56. Holding company system 77. Other service agreements 88. Conclusion 9STATE OF NEW YORKINSURANCE DEPARTMENT25 BEAVER STREETNEW YORK, NEW YORK 10004David A. Paterson Eric R. DinalloGovernor SuperintendentOctober 23, 2008Honorable Eric R. DinalloSuperintendent of InsuranceAlbany, NY 12257Sir:Pursuant to instructions contained in Appointment Number 30255, dated October 23,2008, and attached hereto, I have made an examination “on organization” of FreelancersInsurance Company, Inc. and the following report thereon is respectfully submitted.The examination was conducted at the Company’s office located at 45 Main Street, Suite710, Brooklyn, NY 11201.Whenever the terms “the Company” or “Freelancers” appear herein, withoutqualification, they should be understood to refer to Freelancers Insurance Company, Inc.21. ORGANIZATIONFreelancers Insurance Company, Inc. was incorporated on January 28, 2008, pursuant to theCompany’s submission of a Declaration of Intention and Charter (“Charter”) to the New York StateInsurance Department (“Department”). Such Charter was approved by the Department pursuant toSection 1201 of the New York Insurance Law and placed on file with the Department on the samedate.The Company’s by-laws stipulate that the number of directors, which shall constitute thewhole board of directors, shall be fixed from time to time by the board of directors, consistent withthe provisions of the Charter. Freelancers’ Charter states that the corporation shall have not less thanthirteen (13) nor more than seventeen (17) directors. As of the date of this report, the thirteen (13)members of the board of directors were as follows:Name and Residence Principal Business AffiliationJohn Baackes Chief Executive Officer,Menands, NY Senior Whole HealthNancy Biberman President,Pelham, NY WHEDCOStephanie Buchanan Writer,Brooklyn, NY Self-employedCheryl Dorsey President,Washington, DC EchoinggreenIan Duncan President,West Hartford, CT Solucia Inc.Matthew Hancock Assistant Director,Chicago, IL Center for Labor and Community Research3Name and Residence Principal Business AffiliationCharles Heckscher Director,Princeton, NJ The Center for Workplace TransformationSara Horowitz President and Chief Executive Officer,Brooklyn, NY Freelancers Insurance Company, Inc.Lisa Howie Secretary/Treasurer,New Haven, CT Freelancers Insurance Company, Inc.Andrew Kassoy Co-Founder,New York, NY B CorporationsHanan Kolko Vice President, Office Counsel,Montclair, NJ Meyer, Suozzi, English & KleinMegan Mardiney Principal and Creative Director,Brooklyn, NY The Mardiney GroupAndrea Phillips Senior Vice President,Brooklyn, NY SeedcoThe principal officers of Freelancers included the following individuals as of the date of thisreport:Name TitleSara Horowitz President and Chief Executive OfficerHanan Kolko Vice PresidentLisa Howie Secretary and TreasurerSara Horowitz, in addition to being the President and Chief Executive Officer of theCompany, is also executive director of Freelancers’ parent company, Freelancers Union, Inc.42. SCOPE OF EXAMINATIONThe examination was comprised of a verification of the issuance of the Company’s capitalstock, the receipt of capital and surplus funds, and the determination of assets and liabilities. Therecords examined included the Declaration of Intention and Charter, by-laws, corporate minutes,stockholders’ register, holding company file and contractual arrangements. In addition, an affidavit,appended hereto, was obtained from two officers of the Company indicating that the transactionsnoted in this report were bona fide.3. CAPITALIZATION AND SUBSCRIPTIONThe Company is a wholly-owned subsidiary of Freelancers Union, Inc. (parent). This is fullydescribed in Item 6 of this report. On October 15, 2008, the Company issued to the parent company100,000 shares of $2.00 par value per share capital stock for a price of $160 per share, resulting in anaggregate purchase price totaling $16,000,000. On October 16, 2008, the Company infused anadditional $225,000 in surplus to establish a statutory investment account for the Superintendent ofInsurance.54. BALANCE SHEETThe following balance sheet sets forth the Company’s financial condition as of the date ofthis report:AssetsCash $ 0Bonds (U.S. Treasury Bills) 16,225,000Total assets $16,225,000Liabilities 0Capital and SurplusCommon capital stock $ 200,000Gross paid in and contributed surplus 16,025,000Unassigned surplus 0Total capital and surplus $16,225,000Total liabilities and surplus $16,225,0005. AUTHORIZED POWERS AND MINIMUM CAPITAL REQUIREDThe Company is authorized pursuant to its Charter to transact the kind of insurance asdescribed in the following numbered paragraph of Section 1113(a) of the New York Insurance Law:Paragraph Line of Business(3)(i) Accident and health insurance6In addition to the above authorized line of business, the Company’s Charter also stipulatesthat Freelancers may also engage in any other kind or kinds of business to the extent necessary orincidental to the kind or kinds of business which it is, or may hereafter be authorized to transact inthe state of New York.The Company’s minimum financial requirements for the above mentioned line of business,as set forth in Sections 4204 and 4206 of the New York Insurance Law, are as follows:Initial Surplus $300,000Surplus to be maintained $200,000Deposit $200,000Capital $200,000Minimum capital investments $200,000Pursuant to the provisions of Section 1314 of the New York Insurance Law, the Company asof October 17, 2008 had placed into a bank account at HSBC USA NA, in the name of theSuperintendent of Insurance, a qualifying security investment with a par value of $225,000($224,777.25 book value), in satisfaction of the $200,000 deposit required pursuant to Section 4206of the New York Insurance Law.76. HOLDING COMPANY SYSTEMBelow is a chart of the holding company system applicable to the Company and its relatedparties as of October 23, 2008:Freelancers Union, Inc. (“FUI”), a non-profit 501(c)(4) tax exempt corporation, is the parentcompany. Although not a unionized labor organization as the name might suggest, the parentcompany operates as a membership organization consisting of independent workers such asfreelancers, consultants, the self-employed and others who lack a permanent, long-term arrangementwith a single employer. FUI provides its members with access to various services and products,including health insurance. Working Today, Inc., a 501(c)(3) non-profit organization, is devoted toresearch and advocacy. Independent Workers Services, Inc. is a for-profit corporation that providesadministrative and support services to all the members.8The Company has an inter-company leasing agreement with Working Today, Inc. (“WTI”),effective September 16, 2008, wherein Freelancers leases certain employees, equipment andfacilities from WTI for its day-to-day operations. Such arrangement was approved by theDepartment effective September 16, 2008.7. OTHER SERVICE AGREEMENTSThe Company has the following additional agreements with non-affiliates which arecurrently pending the domestic insurer securing its license from this Department:I. Vision Services Agreement with Davis Vision IPA;II. Administrative Services Agreement with Empire HealthChoice Assurance, Inc.;III. Empyrean Benefit Solutions Master Services Agreement with Empyrean BenefitSolutions, Inc.;IV. Non-Marketing Third Party Administrator Agreement with Health Design Plus NewYork, LLC;V. Integrated Prescription Drug Program Agreement with Medco Health Solutions, Inc.;andVI. Group Medical Excess of Loss Reinsurance Agreement with Munich ReinsuranceAmerica, Inc.9In addition, Freelancers has a custodian agreement with HSBC Bank effective September 4,2008, for the purpose of maintaining the statutory deposit for the Superintendent of Insurance, asnoted in Item 5 herein, which was approved and filed with the Department on September 10, 2008.8. CONCLUSIONBased upon the foregoing examination, it is concluded that the Company sold 100,000 sharesof $2.00 par value per share capital stock for a sale price of $160 per share resulting in a total saleprice of $16,000,000. In addition, the Company infused another $225,000 in surplus when itpurchased an investment for the purposes of depositing it into the account of the Superintendent ofInsurance to meet its statutory requirement.
1. FUI Incorporated January 28, 2008. That's almost one year ago, folks. Anyone hear about this over the past eleven months?2. $16 million in assets. That's a lot of colonoscopies.3. "Although not a recognized labor organization as the name might suggest..."A 3-card monte game?
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