Company threatens to pull woman's health coverage over 1 cent

[RamboLiberal]

Source: Denver Post

La Rosa Carrington has more than enough to worry about. She's a single mother with two teenage daughters, she's fighting a type of leukemia that requires five days of chemo a month for four months, and she lost her job in May.

So the last thing she needed was news that her health insurance benefits would be terminated because she hadn't paid her premium in full. The shortfall? One penny.

"My medical bills are coming in like locusts, and you're holding up my benefits because of one red cent?" an incredulous Carrington said from her hospital bed last week as she recalled her conversation with a customer service rep at Discovery Benefits, an employee benefits administrator based in North Dakota.

Carrington said she talked twice to a customer service representative, who told her it was policy that the penny be received before the benefits could be reinstated. Write a check or send a money order, Carrington said the representative told her.

Carrington then asked to speak to a supervisor, who reiterated the company's policy and wouldn't budge on the penny. Carrington also threatened to take her case to the media, and that's why she thinks the supervisor called her back with some good news: The supervisor had pulled out her own calculator, done the math — and determined that Carrington was correct.



Read more: http://www.denverpost.com/news/ci_15456976?source=pop

---

Probably wanted an excuse to drop her. Idiots who don't allow their employees discretion to resolve a situation like this.

[virgogal]

1. What astonishes me most about this story is that the customer service

rep didn't offer to pay it herself.

What a world.

[regnaD kciN]

2. I'll bet, if the rep had done so...

...she would have been fired for not letting the company drop an unprofitable client. :grr:

[hayu_lol]

3. Another reason to consider firing...

our party reps/senators for giving us this purely bogus health insurance reform(reform?)bill.

We need a single-payer National Health Plan.

[DesertFlower]

5. single payer? unfortunately, i doubt whether

i'll see it in my lifetime.

[MedicalAdmin]

7. You will see single payer in your lifetime. You will!

Just go north of the border. Canadians will treat you without first asking for your first born male child, you pink slip, and your mortgage. And after they have treated you, they will give you a reasonable bill that can be easily paid off.

[DesertFlower]

10. thank you for that information.

my sister lives in toronto -- been there since 1974. i'm in phoenix, arizona and i don't like cold weather.

[librechik]

14. thank you and welcome to DU

losing hope that sanity will ever return to this lost confused country

[Jefferson23]

17. Welcome to DU!

[ProudDad]

16. If Jerry Brown wins in California

There's a decent chance you'll see it in California next year...

[SocialistLez]

21. Do you know how his #s are looking? NT

[CaliforniaPeggy]

33. His numbers look pretty good.

I saw a thread about him in GD/P today...

I'll see if I can dig up a link.

Here's the link:

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=433x367105

Enjoy!

[ProudDad]

45. Dead heat right now

But Meg's spent millions and Jerry hasn't started campaigning yet...

It should be interesting, their positives and negatives are almost dead even...

[Utopian Leftist]

4. Surreal

and unbelievable.

Like even if you thought you'd seen everything after 8 (shudder) more years of the Bush Crime Family™?

Still unbelievable.

[Ruby the Liberal]

6. KO tweeted that he is going to feature this on Worsts tonight.

[laughingliberal]

9. Cool. For a change I'm home in time to see him. nt

[frylock]

8. how uniquely american

[Demeter]

11. Ain't It the Truth

Makes one want to emigrate to a place with People in it.

[Ishoutandscream2]

23. +1

A new phrase - "Only in America." And that ain't a good thing.

[givemebackmycountry]

12. Keith just nailed them as "Worst Person in the World" GOLD MEDAL

What a bunch of freaking handjobs.

[TheDebbieDee]

13. You'd think that the sorry phnck that came up with the idea

of dropping Ms. Carrington over a shortage of a penny would have said to him/herself, "Self, what if the media finds out about this? Won't it make our company look bad?" The very possibility of everybody finding out should have stopped the idea of dropping this woman's insurance dead in its tracks!

These people are morans.

[ProudDad]

15. Univeral, Comprehensive Single-Payer Health Care?

Off the table!

Barack Obama, 2009

[Iowa]

28. +1

[joe black]

31. yeah thanks Barack.

[bhikkhu]

18. My boss had his family's cancelled over .09 cents

...having accidentally written the premium payment for $867.45 instead of $867.54 (or something thereabouts - I know the cents mistake but not the exact dollar amount). He didn't find out he was cancelled for a month, after which was invited to re-apply for coverage, while claims during the time went unpaid.

That was a Wellpoint company, and I think its a common enough occurrence that they have a name for it, which I don't recall, and I did read that the new health care bill protects against it.

[Lorien]

19. 3....2...1...

waiting for the finger waging accountability authoritarians to arrive.

[iamjoy]

30. Here You Go...

actually, no finger wagging here, just a different perspective.

I think the problem is that our health care system is so complex that when something like this happens (and it is probably quite frequent) no one is quite sure what to do. Everything is run by computers. So, somewhere in the software is a yes/no query as to whether the participant is paid in full. The program doesn't necessarily evaluate how much the shortfall is.

The people who should be looking at the situation and realizing how ridiculous it is may not be given the authority they need to really help people, or the access to wipe out that balance. Companies do this on purpose because they want to ensure consistency in their practices, prevent employees who are dishonest from cheating and of course, make sure everything is reconciled at the end of the month (from an accounting perspective).

La Rosa Carrington is not a person, she is an account number. The more customers a business has, the less likely that any individual is really considered a person. True Customer Service is rare nowadays. Some companies may claim that they train their people to provide good service, but really they've just taught them how to say "no" as nicely as possible and to handle abuse from customers who are angry at their needs not being met. Many call centers "measure" the average talk time of their representatives. So, they've actually provided a disincentive for any one employee to take the time to help some one rather than wrapping up as quickly as possible and moving on to the next caller. Companies have gotten so focused on "efficiency" that they've lost sight of individual needs.

Maybe I'm just so cynical that I don't even find this terribly shocking.

Oh, and please, don't think I am extolling the virtues of such a system or that I sincerely blame Ms. Carrington for wanting to be treated like a person. I wouldn't wish such an ordeal on anyone (except maybe people who oppose health care reform)

[freebrew]

40. Most other software wouldn't work this way.

Most company's accounting software would just add the penny to next month's statement.

[iamjoy]

43. the Nasty Thing About COBRA

the thing about COBRA is this -

Some one leaves a job due to illness - something so serious they've used up any FMLA and personal time they may have had. The person is eligible for COBRA, but in most cases it isn't automatic. The termination is sent to the insurance company who drops them. So the person enrolls in COBRA, but as is often the case, the carrier doesn't want to reinstate them until the administrator reports that the person has paid. The software is set up to look at "paid in full" as a yes/no criteria. While COBRA coverage may continue with underpayments of less than 10% of the premium, whether or not an account shows as paid in full can mean balancing to the penny. So coverage does continues (for what it's worth), and the penny is just added to next month, but the account won't show as current until it's rectified.

the whole process works fine for some one who isn't really sick. America truly has the best health care system in the world if you are rich or healthy.

[ProudDad]

46. The deep cause is

that in USAmerica, Health Care is a commodity -- to be bought and sold for a profit...

In the civilized world (of mostly single-payer but uniformly NON-Profit/Not for Profit systems) Health Care is a Human Right...

[alp227]

20. The insurance company should just go outside and search for a penny on sidewalk. n/t

[rurallib]

22. Good thing that Discovery Benefits of Fargo, North Dakota avoided publicity.

Because if I was a business man who did business with
Discovery Benefits of Fargo North Dakota
I would probably call the first thing in the morning and move my business.

[groundloop]

25. Everybody needs to mail a penny to Discovery Benefits of Fargo, North Dakota

Discovery Benefits, Inc.
3216 13th Avenue South
Fargo, ND 58103-3403
[phone]

[The Wielding Truth]

38. Just called to give them an hear full. Darn, It's too early. There's no live person to talk to yet.

[Chisox08]

24. This is why we need single payer health care

The insurance companies are nothing more than a bunch of con men, and gangsters. They should be nationalized and don away with.

[slipslidingaway]

26. "COBRA software rounded up ..."

http://www.gazette.com/articles/rosa-101227-carrington-threatened.html

"..Suzanne Rehr, executive vice president for Discovery Benefits, offered a slightly different account. She wrote in an e-mail that COBRA software rounded up from $161.1545 — which is 35 percent of $471.87 — while Carrington rounded down, and said that “our staff member reached out to her supervisor and immediately received approval to pay the penny ... due to the rounding difference.”

No matter which account is accurate, Carrington has her health insurance back for now, but she said it took three hours out of a day when she wasn’t feeling good, and upset her so much that she got a headache and had trouble sleeping. She’s outraged, and when she gets well, she wants to push for a policy to prevent people going through what she went through.

There are, indeed, others who have had the penny-owed experience, said June Harryman, supervisory benefits adviser for the federal Employee Benefits Security Administration regional office in Kansas City.

“We’ve seen it before,” said Harryman, whose agency works on COBRA issues. “It’s not the first, and it won’t be the last.”

It turns out that employers that carry the coverage or their benefits administrators can legally waive a penny, or any shortage less than 10 percent of the premium, and she’s not sure why many don’t..."

[RamboLiberal]

41. And the software didn't even do the rounding correctly

I know, I started as a programmer back in 72. And even before that basic math. $161.1545 is a round down. Ms. Carrington the policy holder is smarter than the software.

[Confusious]

27. Definition of evil

and money grubbing corporation.

[Crunchy Frog]

29. I would have written them a check for the penny.

It would cost them more than that to process it.

[Name removed]

32. Deleted message

Message removed by moderator. Click here to review the message board rules.

[iamjoy]

37. Actually, It May Be

I'm hardly naive, but employer based health plans are about treated everyone consistently and that's the problem here. Because of HIPAA the insurance company who handles the claims has to be very careful what health information they share with the employer. Furthermore, employers can't make decisions about who to drop based on their health claims. So, it's a little different than a private or individual policy in which they would probably be looking for a reason to drop her.

No, the problem is that the administrator/employer is supposed to be consistent and "ignore" an individual situation and needs. So, a person who doesn't have a critical need underpays their COBRA by 1 cent and just rolls their eyes at how ridiculous it seems, but catches up with the next payment. It's no big deal to them if they can't use their coverage for a month or have to pay out of pocket and be reimbursed if the cost is small enough. When some one is in the hospital awaiting (expensive) life preserving treatment that 1 cent discrepancy is a big deal to them, but business as usual for the administrator/employer. They don't want to play favorites here because some one is in a tough situation. Cold, right?

Google "Michelle's Law" sometime to read about the consequences of employer plans being coldly consistent. Consistent isn't always fair.

[ProudDad]

47. The REAL problem is the profit motive

In the civilized world, Health Care is a Human Right and they've found various ways to pay for Universal, Comprehensive Health Care for All...

In USAmerica, "Sick Care" is a commodity to be bought and sold for a profit!

That's the basis for the dysfunctional, costly, inadequate USAmerican Sick Care system...

[ck4829]

34. K&R

[Vinca]

35. Well thank heavens health care "reform" enshrined insurance coverage.

:sarcasm:

[awoke_in_2003]

42. Yep, these are the type of scumbags...

americans will be FORCED to buy a product from. Hey, but at least we won :sarcasm:

[area51]

44. +1

Each day, 273 people die due to lack of health care in the U.S.

We need single-payer health care, not a welfare bailout for the serial-killer insurance agencies.

[Enthusiast]

36. It is certainly an excuse

to drop her.

[nightrain]

39. they can't see the forest (need) for the trees (greed, lack of compassion)

More interested in losing a costly customer.

We'll probably be seeing more of that, in a more subtle way....

Keep track of those benefits administrator corporations' names.