Thanks to everyone who expressed interest in helping.
We drafted a petition letter and we're looking to get your input on it.
If you're interested in reviewing the draft, please email me directly - upsetfu@gmail.com
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I want to do my best to address your concerns. We'll continue to post information to the blog and respond to questions online, and we'll organize webinars over the next few days, but I'd also like to communicate on a more personal level. I'd like to invite the members who are posting to this blog to designate a small group of people with whom I can schedule a face to face meeting at the Freelancers Union office. If someone from the member side would like to take responsibility for scheduling, please contact me at sara@freelancersunion.org to let me know who will be attending and to set a date. We have a long history of common interests, and continuing to work on our members' behalf is our sole motivation.
ReplyDeleteWe are scheduling three webinars that are open to all members, so everyone can have an opportunity to have their questions addressed. The times will be:
2 p.m., Thursday, November 20
4 p.m., Monday, November 24
2 p.m., Tuesday, November 25
Check the FIC website for details later today.
I was upset by the last change (more money, less coverage), especially the incredibly condescending tone: “Good news! We’re raising your rates and giving you less for it!” I'm only now starting to investigate this new batch of "wonderful news." I'm happy to hear that people are calling bullshit on it.
ReplyDeleteTo Sara,
ReplyDeleteWe appreciate you concern and very interested in hearing your response. We are getting many responses from people who are only now waking up to realize the new changes, and are shocked, like we are. We would like to communicate after we sort out these complaints.
I just posted this to the FU web site, but thought I'd post it here too:
ReplyDeleteI just got off the phone with customer service and asked them why I should not switch to media bistro insurance, which is both cheaper and covers more. His answer: “People seem really happy with this new insurance.” Really? Have you looked at the web site? What exactly are they happy about? Paying more or getting less? The lies are pretty infuriating.
What scares me the most is the new maximum coverage amount. What is that all about? Isn’t that the main point of insurance, especially this bad insurance?
Is there any reason not to switch to a similar plan like Media bistro's?
sara's salary for 2007: $156,619 plus $17,500 in deferred compensation. All public record since FU is a nonprofit.
ReplyDeleteSara, I do hope you are planning on transcribing your webinars online. Some of us don't have landlines and are therefore unable to participate.
ReplyDeleteNone of your posts online have been very forthcoming or informative. Even my email to customer service has gone unanswered. I am incredibly disappointed with this rollout and will be considering all my options and will most likely be taking my business elsewhere. Nothing about your answers gives me confidence to stay. I used to recommend FU to friends all the time, never thinking that the initials might actually take on another meaning. No longer.
Here's an interesting article on falling health plan profits and rising premiums:
ReplyDeletehttp://www.ama-assn.org/amednews/2008/11/24/bil21124.htm
To me the biggest problem with the new insurance is that your upper limit (Max out of pocket) is a pretty significant chunk of money if you get hit with some bad luck.
ReplyDeleteGlad to see that there are others who feel the same way about the current Freelancers Union. While I'd prefer to continue getting my health insurance from them and recommending handfuls of people to them, it no longer seems to make any sense to do so.
ReplyDeleteAnyone who finds a better option for health insurance for freelancers, please post.
Our salaries aren't rising, but our bills are!!!
http://www.ama-assn.org/amednews/2008/11/24/bil21124.htm
ReplyDeleteThis article is dated Nov 24 2008!
On Tuesday, 11/11, I sent two e-mails with four questions to FU Member Services. I didn't hear back from them, and then I learned that questions were being posted on Sara's blog, so I reposted the questions there (with some minor changes in wording). I finally received an answer to one question via e-mail this afternoon:
ReplyDelete"That is correct. The $1,000 deductible comes up once you are admitted into a hospital or other facility as defined in footnote 4 on the Summary of Benefits PDF for PPO1.
"Other office visits and expenses in-network are subject to their own copays, not the deductible."
Of course, this was the answer to what was by far the least complicated of my questions, and it had already been answered on the blog. The other three questions I submitted, as well as other questions and concerns I have posed on Sara's blog since last Tuesday, have not yet been answered by e-mail and the answers do not appear anywhere on the FU or FIC sites. I haven't bothered to try to phone because it's too time-consuming and I keep hearing from others that they're on hold for long periods of time and the answers are often confusing and/or incomplete. I need to make a careful comparison of the PPO 1 Plan with plans offered elsewhere, but I can't do a proper job of comparison without clear, accurate answers to my questions.
When I worked on the benefits communications for large corporations, we began planning the communications for open enrollment months in advance; and if we were planning major changes, we started 6-18 months in advance, even before all the details of coverage and administration had been ironed out. FU is a case study of a poorly conceived and managed rollout of a new or radically revised plan -- the Member Services group was obviously woefully unprepared for our reaction. When the initial reaction last week was so bad, the least I would have expected would have been to see FU pull out all the stops, with everyone (including consultants, if necessary) working all weekend to come up with a comprehensive, well-written and well-organized Q&A to be posted by 9 a.m. today. That's what we needed -- not these incomplete bits and pieces we keep getting on Sara's blog or via e-mail.
Sara's answer seems to be to give us the webinars. She apparently thinks that she'll dazzle us by using the latest cool technology, and that will substitute for clear, carefully-prepared communications. But guess what? It won't. Technology can only enhance good communications -- it can't substitute for them.
She makes over $170 G's/year for jerking us around? Is she running for office or what? This fiasco (plus last year's HIP/BC switch) will look great on her CV.
ReplyDeleteHas anyone contacted the NY Times yet to do some story on this mess?
ReplyDeleteThat might get her ass in gear.
ReplyDeleteAs for the NY Times (and Huffington Post), please see:
ReplyDelete*http://krugman.blogs.nytimes.com/2008/11/12/hopeful-signs-on-health-care/?apage=4#comments (see comment #95)
*http://www.huffingtonpost.com/2008/11/15/will-the-safety-net-catch_n_144124.html (see Jacomina’s comment)
*http://www.huffingtonpost.com/michele-swenson/why-not-a-bailout-that-re_b_143318.html?show_comment_id=17960088 (another Jacomina comment)
Sarah got a McArthur "genius grant," so she -- and many others -- think she can do wrong.
ReplyDeleteHere's a comment I just made to the latest post on Sara's blog:
ReplyDeleteMore about the webinars on the News section of this site [FU site]: “Sara will talk about how FIC will work, why Freelancers Union started the insurance company, and what FIC means for the future of the organization.” And then we’re referred to Member Services for answers to questions about the plan even though many people report that they have to be on hold with Member Services for long periods of time and they’re not getting adequate answers. It sounds as though the webinars will be more “solidarity” talk and won’t really address the most pressing question most of us have — why the safety net provided by the Direct POS Plan is no longer available.
Outpatient surgery
ReplyDeleteFacility deductible, then
15% coinsurance
This is SO BYZANTINE and confusing!!!! Looks like there might not be an annual maximum out of pocket cap on the cost of outpatient surgery... who can tell... Ms. Horowitz please try to make sense of your info sheets... they're not modeled on any of the many I've seen before... they need full explication... (I posted this on her blog too)
The news is twittering out there:
ReplyDeletehttp://twitter.com/whatsnext/status/1006606534
http://mikelynchcartoons.blogspot.com/2008/11/freelancers-insurance-company.html
ReplyDeleteI just posted this comment on Sara's blog:
ReplyDeleteI haven’t registered for a webinar for the following reasons:
* A meeting of the membership this coming Saturday, November 22 — or perhaps a Saturday open house at FU headquarters, as one member suggested — would provide a more open environment and a better opportunity for members to voice their concerns and get answers to their questions. To accommodate the religious beliefs of all FU members, ideally there should be a Sunday meeting as well as a Saturday one. But whether or not a second meeting could be held, the Saturday meeting should be webcast for those unable to attend.
* Sara’s description of the webinars in the “News” section of this site indicates that she views the webinars as an opportunity to give the members more “solidarity” talk, not as an opportunity to answer our most pressing questions. She refers us to Member Services for questions about coverage, yet it seems to take at least five days to get an answer to a question sent via e-mail, most e-mails sent early last week apparently still haven’t been answered, members who call are being kept on hold for long periods of time, and when they finally get through, many report that the answers they’re getting are confusing or incomplete. Some members have even reported that they’ve been treated very rudely by Member Services. (If we treated our clients, customers and patients so poorly, we would have no business, and there would be no Freelancers Union insurance plans because none of us would have the money to pay for insurance. Until now, FU was the only game in town for most of us, or at least the only affordable game in town, so we had to put up with atrocious communications and customer service. But as a number of blog comments indicate, the rules of the game are changing for some of us….)
*Even if I thought that a webinar would present a valuable opportunity for me to learn more about the new FIC plans, the scheduling is terrible. The webinars are being held on weekday afternoons, at times which undoubtedly were chosen because they’re convenient for Sara and the FU staff who will be assisting her. If Sara were serious about reaching the members who are most concerned about the plan changes, she would schedule webinars in the evenings and on Saturdays. Just because we’re freelancers doesn’t mean that our schedules are completely flexible, and in this economy many of us need to be available to clients and potential clients even more than in the past.
From the November 12 issue of Brownstoner (http://www.brownstoner.com/brownstoner/archives/2008/11/commercial_klut_4.php):
ReplyDelete"...16 Court has important leases out; tenant Working Today/Freelancers Union of 45 Main in Dumbo is taking more space over at 20 Jay, twenty dollar deal we hear – we suspect tenant paid work to get that number, as 20 Jay is getting better, having renovated the lobby and added yet another elevator...."
More space for FIC, I presume.
Hey Sara, you should hire Carolyn. It seems she has our interests more at heart than you do. Thanks Carolyn for all your input and valuable info.
ReplyDeleteI just called Guardian regarding the dental plans. I would have to pay $600 a year and all that's covered is $1,000 out of pocket. This is ridiculous. One root canal and crown comes to $3,000. I am extremely upset over the medical plan. Do I take the PPO2 and save 120 a month over the PPO3, coming out ahead but if I land in the hospital, get stuck with a bigger deductible? It evens out but what if I need an MRI? I am supposed to pay 20%? MRIs cost $2000! This is horrible. I am SO offended by my intelligence being insulted by the letter's term "exciting". For whom? The owners? Certainly not for us who struggle as freelancers to make enough to get by. I am spending the rest of the week searching for something else. I cannot afford this at all.
ReplyDeleteI agree. Can we discuss the new maximum benefits, please? This is one of the new exciting benefits of this plan: a maximum amount all plans will cover. This is how people end up bankrupt with huge medical bills.
ReplyDeleteImmediate comment above, I don't think the new maximum benefits are a "deal-breaker" as the reality is that you could transition to any NY state plan with no pre-existing clause as long as there isn't a gap in coverage (or for that matter media bistro, or anywhere else) (Thankfully, because NY is a progressive state)
ReplyDeleteDepose Sara Horowitz!
ReplyDeleteJust spoke to Mediabistro - ANY 1099 worker is eligible for their plans – you could be a plumber or a freelance tooth fairy – plan rate for individual on top Oxford plan is $445 for Jan 2009
ReplyDeleteJust spoke to an Empire Blue Cross Blue Shield rep who states an organization can contract to use the Bluecard PPO network only if they use Empire BCBS as an ASO (Administrative Services Only), to process claims, etc. He stated thst is the only way to do it. Sara is just repackaging this cheapo Bluecard plan as FIC.
ReplyDeleteWhat do you have to say about that Sara?
And if you do reach the maximum then you are out of luck b/c no toher insurance company would take such a risk.
ReplyDeleteA black hole in a saftey net that is a stong as a cobweb.
Regard repackaging Bluecard as FIC - the website shows Anthem, not Empire (although it looks the same) and when I looked up my PCP who takes the current Empire plan, and many others, he did NOT come up.
ReplyDeleteAnd neither did two specialists - who also take Empire.
ReplyDeleteIf you reach the maximum or are approaching it, you can transition onto NY's individual plan... fyi (or media bistro or wherever) with no prexisting condition clause if there is no break (or up to 63 days?) in the coverage... THIS IS BECAUSE NY IS PROGRESSIVE IN THIS WAY...
ReplyDeleteI really think we need a forum - we all have many questions and knwoledge that could benefit from organization. - Julian
ReplyDeleteThe Oxford Plan #2 with mediabistro will lock in the 2008 rate of $401 for a year if you apply by Nov.25th. If you already paid december to Freelancers, the rep told me they will send you a refund. The one not so good thing about the Oxford is that if you're in the hospital, you have to pay $300 a day for the first 5 days. After that, they pick it up. But, x-rays, MRIs, etc are free unlike the 20% with Freelancers new plan. We are all under time pressure now, wish we had more time to plan a possible change. Is anyone else here choosing the Oxford 2 plan?
ReplyDeleteAll,
ReplyDeleteI just vetted my Columbia Presby. ob gyn and he is in the network, as well as a couple other names I tried... let's each verify this for ourselves? If I can get good mds, that could be a swing factor for me, to stay, at least for a while (THOUGH I'M FURIOUS ABOUT THE WHOLE THING AND HOW IT'S BEEN HANDLED). SH, what were you thinking.... the rest of your life at any party or anything in the NY area you're going to be one degree away from someone who has your named SEARED in their brain in venom... so idiotic... all that good will you had...
Isn't it time for Sara Horowitz to address us, if she's following this? Perhaps people should also email her at shorowitz@freelancersunion.org
ReplyDeleteThe lack of open communication and response is galling. I also do think she should commit to take this insurance herself (if she hasn't already). I assume she's immediately let all of her board know about this terrible response, and it would be nice to hear from them also. Really, where is everyone???
I'm switching to media bistro insurance, but as I mentioned in an earlier post, when I called FU customer service they claimed all of the calls have been really positive about the new plan! What really irks me is that they claim to be advocates for us and they're just a bunch of liars.
ReplyDeleteTo the person who wrote "the website shows Anthem," according to the Empire representative Empire falls under the Anthem company umbrella. It's all basically the same. As a matter of fact, under the current BCBS plan if you get a letter of approval for services, the company letterhead says Anthem.
ReplyDeleteAlso teigit.com offers oxford plans--468/mo oxford liberty (no deductible or coinsurance, decent md network....)(no presciption drugs, but target is only $4 for generic) (need to belong to an affiliated association like graphic artists guild for 60 days before applying, but then could...
ReplyDeleteactually for teigit have to be in the arts? and have 20 hrs for 8 weeks to qualify? that said, they do have a few oxford plan options...
ReplyDelete"Good responses" See this just reeks of cow manure.
ReplyDeleteHorowitz took an imperious dump on us and she is shocked that we didn't ask for more.
Galling.
As a ny'er of 17 years I hate feeling suckered.
I feel like I played 3 card monte and thought I could win.
I received yet another surprise today when I spoke to Empire BCBS. They have my application for Direct Pay coverage but they cannot process it because they are need to wait until Freelancers files/ processes notice of the group coverage termination including the last date of coverage. Now we know it ends on 12/31...why hasn't this been processed? The application may not be processed until the end of January...need I say more about if one needs to see a physician, medication, etc?
ReplyDeleteI am still stunned that FU had the audacity to enroll new members like me in their BCBS plan in Nov & Dec, requiring 2 months payment in advance, charging enrollment & application fees, knowing all the while that they were dropping the plan as of 12/31.
I am a health care provider. The change in insurance is bad enough but barriers that prohibit us from switching to another plan in a timely manner is the last straw. My first call in the morning is to the Dept of Insurance.
I do think we need media coverage at this point.
I have some info to share although it might not apply to too many FUers --
ReplyDeleteAlas, it's not quite true that any 1099 worker is eligible for the media bistro plans, at least not for the Oxford plans, which are the only ones I considered. I was all set to sign up for Exclusive Metro #2 until I found out that I couldn't meet the income requirement. Although there's no minimum income requirement, your 1099 income on your 1040 Schedule C has to be the majority of your income.
I've had a lot of bad luck the past couple of years, and my income has fallen off. To make ends meet, I tapped into my IRAs a few times, and my withdrawals exceeded my net Schedule C income in 2007, and they probably will again in 2008. I expect that all of my income, or at least most of it, will come from freelance work in 2009. But that would be too late for me to get the Oxford plan in 2009, and I don't want to stay in the FU plan after 1/1/09.
Example (theoretical, not my own #s) -- If you have Schedule C income of $32,000 and other income of $35,000, you can't qualify as a sole proprietor under Oxford's definition. I think this applies to just about any kind of income (withdrawal from tax-deferred plan, including IRA, taxable investment income, trust fund income, W-2 income from one or more part-time jobs, rental income, etc.). Not sure about that, though.
I think there have been a few minor changes in FU's rules since I applied a few years ago, but as far as I know they've always just asked for proof of income, unlike Oxford, which actually asks to see a copy of your Schedule C.
Here's the disclaimer -- I thought this info might be useful to a few people, but I'm no expert on any of this. And I never had a chance to check it out with the mb folks -- after I read what was on their website and left a couple of messages and they didn't call back (do you think maybe they're getting a few calls from upset FUers?), I didn't want to wait any longer for answers, so I called an insurance agent who was recommended by a friend who has the Oxford #2 sole proprietor plan.
The good news is that the agent has suggested another plan that I could qualify for. Although this HMO would cost even more than the FU PPO 1 or Oxford #2, it's an in-network-only plan, with no deductibles and coinsurance, and no lifetime or annual max, and I'd rather pay a little more money for a good product. The idea of paying $455 for a bad product from a new, untested company seems like a dumb move. I'm waiting for more details and the application to be emailed, and if the plan looks good, I'll write a short summary of the plan and give the agent's contact info here in this blog.
For the past week I've been waiting for answers to my questions about the FIC plans. My original idea was to start researching alternatives as soon as I had the answers. But yesterday I finally decided that it didn't make sense to keep waiting -- if there hasn't been a serious attempt yet to respond to our questions and concerns, there may never be one.
ReplyDeleteMy late start means that I'm still gathering information online and by phone. But some things are already clear:
*All of my doctors -- both the MDs I see for regular checkups and the specialists I may or may not ever see again -- are in the Healthnet network. And all of them but one (a specialist) are in the Oxford network. What's more, two doctors I had to stop seeing because they stopped taking HIP, don't take BC but do take both Oxford and Healthnet. The Oxford plan I'm looking at costs slightly less than FIC PPO 1, and the Healthnet plan costs a bit more. So the much-vaunted BC network doesn't look like such a big deal -- other "affordable" plans have networks that are just as good or better than the BC network.
* Other "affordable" plans for freelancers, sole proprietors and small businesses may not have the jazziest communications I've ever seen, but at least they provide much clearer charts/plan summaries that actually help you make informed choices. Just take a look at the Oxford charts on the media bistro site and compare them with the FIC charts.
Some of you may remember that I used to work in benefits communications, but I haven't done very much in healthcare communications since 2001, so I don't have the contacts I used to have. Yesterday, though, I happened to speak with someone who has worked in health insurance for many years. We didn't have time to speak for all that long, so I couldn't ask all that many questions, but here's what I learned:
ReplyDelete*As early as March or April, word was out in the insurance community that Empire already regretted the contract with FU -- I assume because of high utilization but I didn't have an opportunity to ask about the specifics. So it sounds as though our current plan would be/would have been significantly more expensive in 2009.
*The plan design that we all hate and fear is actually a standard BC product, albeit an inferior one. Again, I couldn't ask about every detail, but all the main features -- the $1,000 in-network deductible plus 15% coinsurance up to a $4,000 out-of-pocket max for both hospitalization and outpatient surgery, the 20% in-network coinsurance for certain services with no out-of-pocket max, the annual and lifetime benefit limits -- are part of that standard product. So, even if the plan design has been tweaked a bit, it's definitely not an innovative product or one that's been tailored for FIC -- it's just a standard design chosen to save money. The people who called PPO 1 a cut-rate or McDonald's version of our current plan were spot on. (Be that as it may, I can't help thinking that someone, somewhere must have done better charts and other communications for this plan. No matter how bad a plan is, it's going to seem even worse if it's communicated poorly.)
*This plan isn't marketed to individuals, only to corporations, but a corporation with just two insureds could purchase it, normally for significantly less than our cost for 2009. (Presumably, though, a corporation with high utilization would pay more, maybe about what PPO 1 is going to cost.)
*My contact seemed even more concerned about the risks that we'd take by going with a newly-formed insurance company than about the risks we'd take with so much more exposure to out-of-pocket costs.
*After speaking with my contact, I began to think more about the reasons why Sara didn't include the Direct POS Plan in our choices this year. Why would she risk alienating so many of her members when she's worked so hard for so long to build FU? Many of us have been saying that we'd like to keep Direct POS even if we had to pay a higher premium -- or at least that we'd like to know how much higher the premium would have to be -- and the fact that Sara hasn't yet responded to this makes me wonder whether it isn't a preferred research and social entrepreneurship model that's driving things. Over the past several days, someone (Laurie, I think) suggested that the start-up money for FIC is coming from foundations that are much more interested in the low-to-middle-income independent worker than in the middle-to-high-income independent worker. So maybe our much-beloved Direct POS Plan just doesn't fit the research and social entrepreneurship model preferred by the funders. Even if we're struggling in this terrible economy and have to make a lot of sacrifices to be able to pay for a better plan, and even if some of us are coping with serious medical problems, if we're opting for the top plan and we're possibly willing to pay a little more for it, we're relatively privileged. Maybe we just have to face the fact that FIC's top priority is to keep costs as low as possible for people who are less privileged. We can stay with FIC and agree to greater risks than we're accustomed to assuming, or we can go elsewhere. (Someone else called Sara a kind of anthropologist, and I saw a lot of truth in that observation and have to confess that I don't like being part of a social experiment.)
*Another consideration could be that FIC's actuaries can see that while a somewhat more expensive Direct POS option would work for a year or two, it wouldn't work after that. Sara keeps stressing the long term, and a lot of us have replied that in this tough economy we just want to get through one year at a time. I'm usually all for long-term planning and think that we haven't done enough of it in this country, but with so much uncertainty in the air, in the economy in general and in the healthcare sector especially, I keep wondering whether this is really a good time to start a health insurance company.
Clarification of the last point above: When I said that Direct POS might only "work" for another year or two, I meant that given the benefits offered, the structure of the plan, and the demographics of the plan participants, maybe cost containment would become hopeless and the plan would become prohibitively expensive for all but the wealthy. (I have a huge problem with all this. Not only do I want to live in a country that has universal healthcare, but if I'm going to be part of a "union," I want it to be promoting healthcare solutions that are more innovative and progressive than FIC.)
ReplyDeleteCarolyn,
ReplyDelete11.19.08 9:15AM - Just spoke to Mediabistro - IRA income DOES disqualify you - the key difference is between W2 and 1099 income - the logic being that if you are W2 then why are you not on your employer's plan
WARNING - Healthnet is AWFUL - I am currently part of class action to recoup valid but refused claims ($3500+) under Healthnet plan - my coverage was by a huge law firm I worked for. Really shabby coverage, customer support - bad in every way. - Julian
Bad typing corrention - IRA Inocme DOES NOT disqualify - Julian
ReplyDeleteCarolyn,
ReplyDeleteThat information from your contact was really, really helpful. Somehow I feel a little less screwed by FU, or at least happy to know they didn't pay someone a gazillion dollars to design this diabolical (hole-y) plan. That said, I wonder if really the main hole is the diagnostics not falling under the annual maximum out of pocket cap... the rest seems like it might be under the cap (so hard to figure out). Also, the high deductible plans seem solid, and it's a plus that while meeting the deductible your charges in network will be incurred at the network's negotiated rates...
hmmmm Your contact's distrust of a new insurer is the worst news however. I still have to assume that we are not liable for fees the insurer can't pay because of bankruptcy. That would make no sense? But, it would obviously be no fun to have a major illness and have to transition to another company. (And/or to have to do that when you hit the 2 or 5 million figure.) Sounds like other plans with Oxford (or Atlantis, perhaps?) make more sense, are a safer bet...
AIG, the largest insurer in the world failed. How can I possibly trust FIC with its lack of transparency?
ReplyDeleteJust sent my check to Mediabistro , 401 dollars locked in rate until end of December 2009, no cost for x rays, mris. Great doctors, liberty plan #2. Bye to Freelancers, it was nice while it lasted. So much for the letter saying "exciting"...the mass exodus should be exciting. Nobody likes their intelligence insulted. We all hustle to make money on our own and getting hit with this increase is "exciting?" People who run Freelancers should be in our shoes for one day and know what it's like being in your own business and worrying where the rent will come from next month.
ReplyDeletewhile I am indeed worried about going with a new insurer, it's also true that this venture is not a standard for-profit where shareholders are demanding dividends and high profit ratios. Not worried about the back-end, worried about the front-end: leadership, member services reps, ease of use, etc.
ReplyDeletetest
ReplyDeleteI wish New York State regulators would step in (Sara, are you reading this?) and put in writing that we are not personally liable for any charges incurred that FU would owe if they go under... then we know we can always transition to the NY State plan (with no prexisting conditions) and be confident our credit history wouldn't be permanently ruined. I think we need that in writing from New York who seems to think this venture is viable. That would go quite a way towards building confidence for me (though if I could I would leap to mediabistro immediately).
ReplyDeleteEdith Says:
ReplyDeleteNovember 19th, 2008 at 1:53 pm
This PPO1 is the worst insurance policy I have ever seen. It does not compare even remotely closely to the Empire POS Plan or even any individual Empire HMO plan( which is $888/month. Although all insurance plans in NY State are permitted to raise their premiums 20% annually ( which means BCBS would have probably risen to about $450 also), there should have been a comparison of the 2 plan options.
When you do the arithmetic on PPO1, the out of pocket costs can be catastrophic if something serious happens to you. There is NO CAP on copays. (BCBS has a cap). The $4000 cap on facility does not apply to doctor’s fees, diagnostic tests or drugs administered while in the facility. Anesthesia is covered but not the anesthesiologist. If the doctor drops by to see you and says “how are you doing”, it will cost you 20% of whatever he/she deems a reasonable charge. Regular gynecological tests like bone density and ultra sounds are now 20% copay. Regular ordinary x-rays which are never questioned by any other plan, are now 20% copay. An MRI or CT Scan can cost up to $2500 which means a $500 copay (NO CAP). I would rather have a pre-cert process.
The other blatant difference is that BCBS has NO annual or lifetime maximum for payment. If you are unfortunate to have a catastrophic life long injury or illness like Christopher Reeve or Michael J. Fox with FIC you are out of luck. I guess you have to hope you die sooner than later.
The thought of having only a few weeks to investigate my other options is making me physically ill. My resources have greatly diminished over the years and with the economy suffering this is a really big hit. I thought in April 08, when I signed up with FU I had found a silver lining with BCBS. I thought Sara to be brilliant and extremely qualified to make decisions for her “union”. I am appalled at these choices. I agree with those above on the lack of transparency, of not giving us a year transition where both plans, FIC an BCBS are available as options so that there would be a reasonable comparison and evaluation period. I did not even get a full year of health insurance at a reasonable cost.
I am aghast!
Laurie Says:
November 19th, 2008 at 2:11 pm
Edith,
we need to clarify that re the caps with FU; I believe the only thing that isn’t subject to the maximum out of pocket cap is the diagnostic testing. When I asked the FU person (who, admittedly, sort of had no idea what they were talking about), they assured me that doctor’s bills would be covered, because there’s just that one fee per visit? I don’t know… this is all crazy, but if what you say is correct this plan is much worse than many of us (at least I) had thought???
Just posted this to the FU blog, but I'm so angry I'll post it again!
ReplyDeleteAt what point does this FIC cease to be a viable option for FU? One assumes that in order for this new scheme to succeed there must be a minimum number of participants. Even if they have enough people to sign up initially, how many of those people are signing up only because we were given so little notice about these changes and are planning on switching to a more reasonable plan once they have things sorted out?
FU claims the response to this new plan has been positive. This, aside from being ridiculous, is impossible for three reasons:
There is nothing to be positive about. I don’t mean this as a snide comment, but we have been given zero concrete examples of why this FIC is to anybody’s benefit. We’ve been given only platitudes about how this is such an exciting and innovative development. We are going to be charged more and will receive fewer benefits. Period. Are we supposed to blindly believe that at some future date this will all be worth it?
MB has been inundated with FU members wanting to switch to one of their plans. This is only the response to MB. Who knows how many people want to switch to other plans?
I have yet to see a single positive post on this blog or the entire blog that was set up to deal with the unhappiness of FU members.
What exactly was achieved through the $17 million in loans and grants that Sara is so proud of? Better insurance FOR FREELANCERS exists for less money.
I'm signed up for the webinar tomorrow... is anyone else on here? Should we coordinate most important questions we need answered? (I'm f'ing stuck with FU for now, so mine would probably involve clarifying what "Edith" posted--that she's wrong, that the main "hole" in these plans is only diagnostic testing bills, not doctors' bills... our questions will be typed to Sara, so, we actually could put them together collaboratively, but maybe too much of a pain for others...
ReplyDeleteI'm afraid I might be stuck with FU for now as well. Basically I live in fear of insurance companies, rational or not. Turns out that Oxford has a right to audit your account at any time to see if you're still eligible, and if you're not then deny your claims. I know that this is a worst-case scenario, but if I have some kind of expensive illness or accident, Oxford could, theoretically, at any time make me prove that I have worked at least 20 hours every week. What if I go two weeks without a job? And I have a feeling that many other sole proprietors (writers in particular) are in this same boat. Insurance companies are not exactly known for their lenient "just pay the claim" policies, and in fact have done some amazingly shitty things to get out of paying a claim. I don't know if this is a risk I'm willing to take.
ReplyDeleteI don't think they can suddenly audit you when you put claims through.. I think you may be being overly worried here? more likely that they can ask for evidence every year when they sign you up again? I think at teigit.com they've never had Oxford intercede... you'd be the first person they'd do that on...?
ReplyDeletealso, if you're a writer, pen has some plans? I think you are being a little overworried... if it's never happened to anyone who gets insurance through pen (you could check with them... don't know what plans they offer, just that they do I believe)
ReplyDeleteAccording to Nathan, Oxford can in fact audit you at any time: "Oxford does have the right to audit your account at any time to verify that you are still eligible and if they ask you to provide documentation that shows you are ineligible, they are within their rights to refund premium and deny claims." I agree this would most likely not happen if I broke my arm, but if I have some seriously expensive medical bills, I'm not so sure. Stories are everywhere about insurance companies just denying claims. They're not exactly the world's most trusted industry. And if they did cancel my coverage, they would have every right to do so. Still scares me too much.
ReplyDeleteWow, that's blood curdling... I would think MANY people who have the insurance through media bistro and teiget.com would be in your boat...
ReplyDeletei think that there are not positive comments on here, defending the plan, because those who are OK with it, or need it, or don't worry too much, are not spending time thinking about this and writing about this.
ReplyDeleteTo the poster who wrote on 11/19 at 2:52 am.
ReplyDeletePlease let me know what you find out. I would be interested in that agent's name if the plans look good. I am beginning to research every possibility and was thinking of working with an agent as well.
My issues are different bur I may not qualify for Mediabistro because of a several month freelance project as a producer of a documentary series during which time the media corporation insisted on giving me a W-2 and taking out taxes--even though I had no other benefits provided.
You can e-mail upsetfu@gmail.com and ask for Jude's e-mail address.
Thanks!
Yes, to the poster from 11/19 at 2:52 am, please do post what you find out from the agent.
ReplyDeleteThis IS all pretty stressful. I've got a project to work on and find myself looking at all of this and worrying instead. Health costs are already a stretch! When I first read about FIC, I thought, great, I can pay a lower premium (with PPO2) than I did before (w/ Empire Direct POS). And I wondered what everyone was fussing about. But the more I looked at the new plans, the worse I've realized they are. Last week it was my mortgage, now it's this.
Will our Guardian dental coverage also be changed or elliminated?
ReplyDeleteI’m just furious! I’m starting to realize that it’s even worse than I thought. I emailed member services 6 days ago with some really acute questions and still haven’t heard back!!! 6 days ago!
ReplyDeleteI also called member services 3 days ago and what I heard from them is completely different from what FU just posted today. The lady at member services didn’t know what ultrasound is, it took her a while, but then she told me it’s completely covered! and so are the other pregnancy tests I spelled for her.
And now I discover that unlike what I was told on the phone, ultrasound and probably other pregnancy tests is considered an imaging service subject to 15% co-insurance, out of my pocket, with no limit.
I’m furious because even if some part in me wanted to believe that the switch to FIC is a good step for fu and its members in the long run, even if I was even considering paying more money for less insurance and stay here, I am now sure that FU IS NOT PREPARED TO RUN A HEALTH INSURANCE COMPANY. The move is so pre-mature and they are putting at risk so many people financially and health-wise.
Comment from Sara Horowitz posted to the petition signing thread
ReplyDeleteNovember 20, 2008 9:59 AM
Sara Horowitz said...
I'm sorry you feel like certain issues haven’t been addressed, despite my efforts to respond to your concerns. In addition to our e-mail communications and information on the Freelancers Union website, you are probably aware that I invited members from this blog to meet with me personally. I asked that you designate a group of people who can come to our office and talk about anything that’s on your mind. I have yet to hear from anyone. As you also undoubtedly know, we have scheduled a series of webinars where all members can have their questions answered. I hope you will join one of them.
November 20, 2008 10:37 AM
Anonymous said...
We would love to all come to meet with you, as many as could make it at a mutually convenient time--say a Sunday afternoon to maximize people's opportunities to make it? We've posted this all along, and to you, how can a small group speak on the fly for all of us; we don't even know each other... no time to organize or even understand this horribly complicated new model of health insurance... help Sara!
November 20, 2008 11:01 AM
Anonymous said...
Please Sara, we need official New York State assurances in writing that if you go under we are not responsible for medical bills FU would otherwise have paid
November 20, 2008 11:02 AM
What's the point of a webinar now? It's too late; the rates have been decided and you're not going to lower them. People have to make a decision for December coverage NOW in order to lock in 2008 rates and Mediabistro has to have our application by Tuesday for Oxford.
ReplyDeleteThis should have been done months ago.
Agreed! Open enrollment happens once a year. Nothing will change now. Too late. Cover yourselves. Cover yourselves now!!!!!!!!!!!
ReplyDeleteWhy on earth would anyone pay $445 for Freelancers plan, for heaven's sake, if you need an MRI, you will have to pay 20%...do you know what an MRI costs?! Not to mention every other deductible. The lesser plan is worse. Folks, this is about the last day to check out mediabistro's Metro 2 plan (seems the most popular), lock in the $401 rate for December, good for a year and if you already paid Freelancers, they say they will refund your December check (I hope so!). If you can't find mediabistro online, call them today so you can get the info to them by Monday 212-879-0122.
ReplyDeleteThere have been numerous statements on the blogs to the effect that X-rays and diagnostic imaging are the only services subject to 20% coinsurance with no out-of-pocket maximum. That's on page 1 of the "Summary of Benefits: PPO 1."
ReplyDeleteBut please look at page 2 of what I've been calling "a crazy quilt of a chart." Durable medical equipment, medical supplies (including diabetic supplies) and prosthetics/orthotics are also subject to 20% coinsurance with no out-of-pocket max. The page 1 and page 1 provisions should have been next to each other on the chart. I'll admit that most of us are much more likely to use the page 1 services than the page 2 services, but page 2 is VERY BAD NEWS FOR ANY PLAN PARTICIPANT WHO HAPPENS TO BE DIABETIC.
Comment above is Carolyn's. And I was typing too fast -- in the 2nd paragraph, 4th line, "1" should be "2."
ReplyDeleteYou should all come to the other blog where the questions are really being addressed:
ReplyDeletehttp://upsetfu.blogspot.com/2008/11/fic-alternatives.html
One of the heads of mediabistro is on the other blog now and clarifying everyone's questions. I agree, everyone should be on the other blog posted above.
ReplyDeleteBE SURE TO DO ALL YOUR HOMEWORK BEFORE SIGNING UP FOR MEDIA BISTRO'S OXFORD PLAN
ReplyDeleteI know that Nathan's a great guy, and that he's even received at least one marriage proposal somewhere on this blog, and I know that if you want to lock in the 2008 rates you need to act quickly, but I urge everyone who's planning to enroll in MB's Oxford Exclusive Plan Metro #2 ("the Oxford plan") to look before you leap. Maybe you're not concerned about keeping your current doctors, or maybe you've called all of their offices and are confident that they'll accept the Oxford Liberty network, but if that's not quite true, please read on.
I'm still waiting to find out if I'm eligible for the plan (more about that below), but I decided to do a little research while I was waiting to get the final word from Nathan. And now the Oxford plan looks far less attractive to me.
Before I get too far into my own situation, I want to add that I think the Oxford plan can work very well for some people. A good friend who is a real estate agent and independent healthcare consultant -- and who is neither an FU member nor an MB member -- switched to the Oxford plan, which she obtained through an independent insurance agent, earlier this year. She made the change because the plan was more affordable than her previous plan and was accepted by all her doctors (or at least all the doctors she really cared about). And she's been happy with the plan.
In my case, my research started with the Internet. My doctors are all NYU-affiliated. While their practices don't like to post anything about insurance, their faculty bios on the NYU Medical Center site list the plans they accept.
(Breaking news for anyone who's listening: Sara is now on WNYC talking about our problems and how freelancers need to be "resilient." I'm sure she thinks we're all whiners without that necessary resiliency. I'll finish this post later.)
To the above poster, when I used to have Oxford (Liberty) I found that a large swath of columbia presbyterian md's took it (out of 16 e. 60th office); so I just stuck with them... they were all tops...
ReplyDeleteI think the point that the above poster is making is that switching health plans is a significant deciosn, and we all need to do our own research before making any changes, no matter how shitty we've been treated by FU, and no matter how helpful Nathan and other agents may have been.
ReplyDeleteThere's no doubt that there are many wonderful doctors here in NYC, but I know that when I joined the Empire plan, my prior PCP was not covered, and my new PCP wanted me to redo several diagnostic tests and meet with specialists that she was comfortable working with. As these tests were covered under Empire POS, I only had to pay the specialist vist co-pay, and even that has cost me several hundreds of dollars and tons of time. If I would need to do these tests again under a new provider, such as Oxford, it might be cost prohibitive and my health care would suffer.
For those of us with chronic illnesses or in the midst of treatment for a serious illness, it doesn't matter that there are great doctors out there--what matters is how complcated and time consuming it might be to find a new doctor.
Earlier in th eweek I shared an anecdote about having an emergency a week before my insurnace started, and weeks before my appointment with my new Empire PCP. I had to pay out of pocket for services because, as a new patient, my new PCP had not yet seen me and was unwilling to see me during my emergency or earlier than our scheduled appointment and when we DID meet, then had many tests I had already paid for through urgent care repeated through her practice.
As an independent worker, every minute I am not working or making contacts to garner new work is a minute where I am not getting paid. In my work, timeliness for bids is a major issue, and I'd rather spend time doing due diligence about finding a plan that works for me rather than regretting it for a year of headaches.
While it's true that if you are committed to the mediabistro plans and want to lock in the rates, you must act quickly, remember that you can ALSO stay on one of the FIC plans until you feel ready to make a decision. You can terminate at ANY TIME, and pick up a new plan outside of FIC at anytime. Yes, the rates may change on other plans for 2009, but haste really can make waste.
Best practice? Take several representative months of health care costs for 2008 and go through several plans and find out EXCACTLY what those 2008 costs will cost you under different plans for 2009. You may be surprised to find that you are over- or under-insured given your actual practices while you may also want ease of mind and can afford to "over" insure your self. Just be deliberate in your decisons. Good luck, everybody!
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...
ReplyDeleteMy 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.
Let's not forget, this is a FOR-PROFIT new company people!!! They are not here to watch out for you as a union should do anymore.
ReplyDeleteMost members are in shock right now. Being given 30 days (you need to enroll by the 15th of the previous month to get coverage elsewhere) to research and pick another plan if they plan on leaving FU. It’s time consuming and annoying and so very EXPENSIVE especially at this time of year.
This is not a very nice thing to do to members especially when FU knew ALL along they were going to open up their own company with such DRASTIC premium/deductibles/co-pays increases compared to what we just had with BS...why so secretive?
A comparison as to what was offered from BC and what FU was to offer would have made more sense. I can’t believe anything that BC would have put on the table would have been worse. But no...bully us into taking it or leave it? That’s how we feel.
A lot of members will leave I am sure. And the ones that initially don't...will, that I am sure. The plan is horrible all the way around.
Now what will FU do then? Maybe they should come to reality that giving BC/BS another option for us would be the RIGHT and moral thing to do? Restructure FU’s offer and make it comparable to BS….something!!!
FU was built up to HELP people. This is not helping putting people in positions of desperation at a time in history when people can only take so much financially.
Hello-
ReplyDeleteI am not currently covered by FU insurance but was planning on returning to NY and enrolling.
I am a health care professional (ED physician) and have experience with a number of health plans. I have looked in great detail at the new FIC plans as well as at the TEIGIT plans (although I am not eligible) and Mediabistro, and even the individual insurance market plans.
My results were both heartening and disturbing. The bad news is that the new FU insurance was the worst, even worse than what was available in the individual market!!! That's crazy. Both mediabistro and TEIGIT had several OK options, better than the individual market. I cannot speak to the eligibility for TEIGIT or mediabistro, but the plans are certainly better and certainly better than FU.
It is sad...FU had the best freelance insurance plans and now has the worst. The out of pocket max is 14000 on their most expensive plan.
Any of your other three options is better, even going without and using the HHC hospitals and clinics is probably better!!!
Please send your comment to Sara Horowitz directly and post on the freelancers union website... your input seems very concrete... helpful, thank you...
ReplyDelete