Hello folks, it is I David. Things have been progressing and I want to thank everyone who has emailed me about continuing with BCBS and formation of our own group. If you have not yet received the pdf files I will get them out to you. At this point if we count everyone who has written to me and is serious about this then we have over 50 people and the number has been growing.
I need a new count so I am asking the following from everyone who has written to me. Please send me a new email with whether or not you are still serious about this, number of people you are seeking insurance for, and your skill set since we will need to delegate tasks for this venture to work and any relevant information. I am looking to setup a conference call for over the weekend. You will all be emailed with the number when things are in place to call in. Please get the word out and if you have any way of helping with getting this together you can email me about that as well. There will be more to follow in the email to you about the conference call and the details of what we are hoping to do.
I hope that I have not forgotten anything
Time to go to sleep or wake up.
David
Subscribe to:
Post Comments (Atom)
Posts
I really don't understand the source of your unhappiness with the changes at FU. I was happy to see that they were dumping Empire, which I consider to be a greedy money-mill of a company that offered surprises in coverage at many turns. We had a baby last year, and our Empire policy through FU paid for NO lab tests and NO prenatal testing. WHAT?!?!? We couldn't believe it either. The extra cost was around $6000. Empire is not a good insurance company. They are big, well known, and have a large provider network, but they wield this power against doctors and individual insurers like us. Maybe you could post a list of very specific gripes you have with the changes at FU so people like me could check it out. So far I love the changes, and am looking forward to saving money and getting increased coverage for 2009. Thanks.
ReplyDeleteMatt, what you are saying is very strange. I'm currently pregnant and been with Empire Direct POS for the last 2 months and they covered EVERYTHING, expensive genetic testings, ultrasounds, lab tests. They cover ALL prenatal testing. Your post is really confusing, because when you call them they specifically say that EVERYTHING is covered during pregnancy. Maybe you should check with them, maybe you were under a very basic plan? please elaborate.
ReplyDeleteReally, Matt, all of the gripes have been posted over and over again, and doctors have corroborated... have you read the plans? beginning with the life time and annual maximums? what could you possibly be happy about? There are no caps on coinsurance for diagnostic procedures; FIC could go down leaving us all personally liable for our bills if the reinsurer didn't make good (we have yet to find out who that is). (I'm assuming you're not a plant for FU... not the way to go about it if so, FU... (all your credibility will be lost if you resort to that?))
ReplyDeletethe high deductible plan isn't all bad, but that has a 30% coinsurance for prescription drugs that never hits a cap, and the high ded. plans also have the annual and lifetime maximum benefits unlike any other ny plans that I can think of that are widely available, atlantis, hip, oxford, you name it...
ReplyDeleteI strongly agree with the two replies to Matt and find his comment very strange and completely at odds with the BCBS benefit summary we all used this past year. Also, I've done A LOT of research since FU announced dropping BCBS and I consistently hear only very positive reviews of Empire BCBS compared with the other companies...
ReplyDeleteMatt sounds like an FU plant...
ReplyDeleteIf anyone is planting comments on behalf of FU, I suggest it stop immediately and may be very illegal; you may be subject to liability if you do so (per the recent case with someone taking on a false identity on the internet). It is not that big a deal for us to link posters to internet addresses.
ReplyDeleteMaybe "Matt" had a HIGH-deductible BCBS '08 plan or went OUT of network and omitted these facts in his post above? There's NO way he paid $6K out-of-pocket if his wife got her care on BCBS POS plan and stayed IN BCBS's network.
ReplyDeletematt is smelling like a very dirty sock puppet
ReplyDeleteMatt, could you email us an example of these bills at member.upsetfu@gmail.com. Please don't take offense, but we're guessing that you went out of network somehow. Please share these concrete facts by emailing to the above address. (Otherwise it's difficult to not assume that you just misunderstood your policy and the claims filed; perhaps your wife handled that?; or, that you may be posturing to "spin" things in a better light on behalf of FIC.) Thank you for understanding.
ReplyDeleteI'm not sure where to post this, but I thought it might be of interest and decided to post it here.
ReplyDeleteFrom 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 Headache
The 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.
Fellow Members- If you already signed up for FU's PPO 1 for January coverage but are interested in possibly joining our group after January, email David and let him know. His email address is: member.upsetfu@gmail.com
ReplyDeleteThank you for the above post from the PricewaterhouseCoopers press release. Very well written and informative! Should we direct our complaint letters to a particular person at the NYT and WSJ? Via email or snail mail, or does it matter?
ReplyDeleteTo all interested parties:
ReplyDeletePlease check your email for important information about tomorrows conference call to discuss insurance
Hi David,
ReplyDeleteI won't be able to make the conf call. Could you please post a summary here (or a link to review the call)?
Thanks!
Ditto, I cannot make the call, and I also have two highly unhappy FU friends who are just waiting to hear if you get something up and running (they are swamped in work, will sign up for FIC for now unless something becomes concrete with your plan).
ReplyDeleteI'd rather be uninsured that underinsured.
ReplyDeleteDavid, is this group going to include Family plans too?
ReplyDeleteCan we get detailed benefits summaries for the plans you are considering? In particular I would like to see a summary for Direct Share POS.
Thanks for your work on this.
I did not make it on the calls, but something to keep in mind is that if we do get a plan up and running, we could also contribute money if we don't contribute time, so the people who do the brunt of the work make $15 an hour for that work (all of the other associations factor that in?) that should be very doable (we could cap the hours, but figure out a fair way to do it) This would make the operation perhaps more viable over the long run...
ReplyDeleteAny word on progress on this front?
ReplyDeleteI couldn't make the call, but I'd be thrilled to contribute and get in on this. I'm a little concerned that there doesn't seem to be any info posted anywhere about what happened. Did the whole thing just fizzle?
ReplyDeleteWe had 2 conference call meetings (Sunday and Monday) and are planning another group phone call to be announced shortly. Meanwhile, a few of us are following up on delegated tasks. There will be a more thorough update and announcement of the next scheduled call very soon. We should all check this blog and our email accounts regularly in order to make sure to attend the next call.
ReplyDeleteAnswers to some questions in comments above:
ReplyDelete1) Our new group is considering plans that include the option of Family coverage.
2) If you are interested in joining our group or know someone who is, email David and tell your friends to email him right away. He'll email back to you with pdfs of example plans. These plans we are considering are NOT written in stone - at this point the pdfs circulating are just examples of the types of plans that we are considering. Our goal is to shape the plan based on the group's feedback.
Answers continued:
ReplyDelete3) JANUARY insurance coverage: We are working as fast as we can to form our new organization, but the deadlines for January insurance are already upon us. We've done a lot of research and spoken to several brokers and have found some good interim insurance options for individuals that are still better and cheaper than FU/FIC's policies. Therefore, we're finding that it's NOT necessary to sign up with FU out of desperation if you don't like their plans but want uninterrupted coverage.
The deadlines for January are upon us, so email David right away if you want to be put in touch with a broker to obtain interim insurance for January. One of us will then get in touch with you quickly.
4) As we all know, FU's sudden and unexpected mid-November "surprise" caught us totally off guard, so we are doing our best / working as quickly as we can to pull this new group together. We look forward to meeting new members on our next group call. David will email an announcement with call date/time and instructions shortly. Please make sure to participate in the next group's call if at all possible.
I applaud what you guys are doing. Another option, if you're a graphic artist or fine artist, is to get one of the plans offered by Fractured Atlas, a non-profit arts organization:
ReplyDeletehttp://www.fracturedatlas.org/site/healthcare/state/NY
They offer a high deductible plan similar to FU's, but with the important addition of a HSA, and their HIP PPO#1 plan is very similar to FU's $455/month plan, but only costs $299/month!!! I have no idea why FU couldn't negotiate something comparable, I really don't. The Fractured Atlas folks are amazingly nice and responsive, as well. Good luck to all of us; what we really need is nationalized, single-payer healthcare for all!
A "single-payer health care for all"? Can you imagine the corruption that will arise out of that? JD, you did the leg-work for getting insurance on your own. So did I. What's the problem?
ReplyDeleteThere's a problem with Fractured Atlas HIP $299/month plan. If you are hospitalized, for singles: there is a $2000 deductible and 20% CO-INSURANCE, with a $5000 co-insurance max! (And even more for family coverage.) Take a careful look at the benefits summary labeled "benefits details" on their site http://www.fracturedatlas.org/site/healthcare/state/NY It's located to the right of the plan description.
ReplyDeleteI think we're better off with an Oxford plan that we've found: Oxford HSA Exclusive Freedom Plan. It has 100% coverage AFTER the $2000 deductible is met. Modest co-payments. NO CO-INSURANCE. Out-of-pocket max is $2000. Also, before you meet your deductible, all PREVENTIVE doctors visits, labs, mammos, colonoscopy are all paid for as long as they are preventive. It is also an HSA plan, so the $2000 deductible is a tax write-off. Call the broker we've been speaking with to get a benefits summary. Call right away. The deadline for January 1st coverage is early next week. Call Chris Serraro 914-277-8600 His email is: serraro@abouthealthinsurance.com
ReplyDeletewebsite: http://abouthealthinsurance.com/
This could be a good interim plan while we get our new group organized and seek group health insurance.
Regarding interim insurance, Chris Serraro also mentioned an "IRBA HIP Prime Plan C" that is similar to our old Freelancers Union HIP Prime coverage, but the price is much higher @ $470. (We used to pay a lot less as a large group with Freelancers Union I suppose.) Those were the days! Anyway, I prefer the Oxford plan I wrote about in my prior comment because the Oxford Freedom network is much larger and the premiums are cheaper. Also, if you travel a lot, Oxford Freedom gives you access to United Healthcare's National network. I'll email everyone in our group Chris Serraro's contact info and the benefit summaries for both plans too.
ReplyDeleteI'd like to say that though I resigned up with FIC till this gets further along, I'm so so grateful to Lisa and David for their work and certainly want to donate something financial toward the effort when expenses are tallied (to counterbalance the huge time I imagine they're putting in). Thank you so much!
ReplyDeleteI have other plans available for you to compare. Licensed agent/broker for 20 yrs. Gary Boehr 866 761 6996. affordableNYcoverage.com
ReplyDeleteWhat happened? I was on the last conference call and never heard anything more. I signed up with FIC for Jan and Feb (because I am receiving ongoing treatment constantly and had to have something) but I was thinking that there would be an alternate plan I could join by now. I now see the plea that we sign up right away for January. Am I off the list because I signed up with FIC? Is there a group to join? The last comment here is Dec. 21. I AM NOT A PLANT, just a cancer patient.
ReplyDelete