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Recent Self Insurance questions
Patient is on a gh deductible health insurance plan. As
Patient is on a high deductible health insurance plan. As such, patient pay for all services after insurance company is billed unless there is catastrophic illness. Patient is advised by self-insured employer to get cost in writing prior to service. Patient gives in-network provider insurance information and gets cost by email. Cost given describes service in detail and expresses patient's cost as a percentage of the uninsured cost. For example, the cost was expressed as "procedure code xyz $16 x 20% = $3". Patient is not told this is an estimate or warned that this information should not be relied on. The service is performed and the insurance company is billed. The patient receives a bill for $21. The patient also receives an explanation of benefits form from the insurance company showing a patient responsibility of $6. The provider insists on billing $21 and the patient offers only to pay $3. The provider sells bad debt of $21 to a collector. The patient offers to pay $3 to the debt collector. The collection agency sues for $21 and refuses to settle for any amount lower than $21. Question: in a trial, what amount is owed by the patient?
I recently left the company I had been with 4 years. I was
I recently left the company I had been with for almost 4 years. I was in sales and rented several cars for work and through a direct bill program that was mandated by my company. In early 2015 I had to make a trip to the corp office for business and our travel manager booked me with Hertz (almost always use National but a member with most rental cos). It was a drop location (unmanned) so after my trip I filled it up, noted the miles and location and dropped the keys in the box. A few days later my office called to say Hertz was filing a claim for rear bumper damage. I was not involved in any incident and shared that I drove to/from the office and hotel. We are a self insured company and aren't allowed to purchase rental insurance. A few months I was contacted by Hertz directly and shared my experience and provided them with the name/number at my company to contact. A few months later they contacted me again and I told them the same thing but they hadn't heard from us- I sent a message and left a vcmail as well. Again months went by, I assumed it was handled then it showed up on my credit report- $2200. When I called the office again and told them this they paid it- although zeroed out, it's still on my report. Does my employer have a responsibility to get more involved and get this removed?
There is no sales tax in MA on Insurance however we are
There is no sales tax in MA on Insurance however we are renting out furniture and charging the rental amount and also adding a insurance waiver fee for damage or loss to the furniture. which we self insure we don't have an actual insurance policy is theinsurance waiver that we charge taxable?
I had an emergency medical situation in Dec 2014. Since the
I had an emergency medical situation in Dec 2014. Since the day I was taken to the hospital via ambulance, I have not returned to work. For the first six months I was on STD - after six months it converted to LTD with approval for two years, at which timemy case is re-examined for continuation. Because my medical bills have been so extensive (heart surgery in May and a craniotomy in December) and I am now living on 60% of my former salary. Wanting to be budget minded and fiscally responsible, I made the decisionto sell my condo and downsize to something smaller. I applied for a loan with a mortgage broker I used previously and upon discussion of my situation, he didn't think I could be funded. It was discussed with underwriting and they requested a letter from myemployer stating that in two years time, if it were determined I could go back to work, my job would be waiting for me. No employer, however understanding they are is going to guarantee any employees employment in the future (particularly when you are "atwill"). They then said that because my LTD wasn't guaranteed for 3 years, I was denied the loan. I have an excellent credit score (767 with one reporting agency and 804 with another) and no spots on my record. I pay all my bills on time. It is my understandingunder various federal guidelines lenders are not to discriminate for loans based upon disability and there are a few routes I can take/explore, including a complaint to HUD which is overseen by the justice department, as well as filing in Federal Court (onmy own), plus I live in the state of Washington it is a violation of the rights of the disabled. I have documentation (email) of all correspondence with this mortgage broker. I did go to another lender recommended by a friend - this broker got me pre-approvedwithin 3 days and I was able to close less than four weeks from the signing of the real estate contract. This broker couldn't understand why I was denied by the other company. Do you think I have the basis of a claim? If so, what route should I go? ShouldI hire an attorney? Thank You.
I am in NC. I ran over an 18 wheeler expelled recap on an
I am in NC. I ran over an 18 wheeler expelled recap on an interstate entrance ramp. It tore up the underside of my car. The State of NC has given me 3 points for this, and thus my insurance has increased $40 a month for the next 3 years. Can I appeal this decision and possibly have it reversed?
I have a workers comp case that is in the process. I still
I have a workers comp case that is in the process. I still have to go to the employers workers comp doctors. Then I think I would see the Judge. My question is my company is filing for chapter 11 and will go out of business. does that affect my case. this is in new jersey.My lawyer is on vacation so I was looking for an answer now.
I live in NC and I am insured by my wife's employer, Wake Forest
I live in NC and I am insured by my wife's employer, Wake Forest University. The University self-pays the claims and the claims are processed through Blue Cross/Blue Shield. The University has greater than 100 employees.If I have a personal injury case and it settles, am I subject to pay the Insurance company or the university anything back?NotesSeveral states have laws that prevent private healthcare plans from seeking reimbursement. If at the time of your injury you lived in a state that has these types of laws, then GRG will review your case to determine whether the state law prevents the insurer from seeking reimbursement. If at the time of your injury you lived in one of these states, you may not have an obligation to pay your private health insurance plan back for the treatment costs of your injury.However, even if state law would prevent the insurance company from seeking reimbursement, the insurance provider may still have a right to repayment under federal law. The plan can show that the terms of its insurance contract with you allow it to recover your treatment costs under a federal law. These types of claims are handled on an individual case-by-case basis.The following states have what are known as anti-subrogation laws, which seek to prevent insurers from reimbursement:ArizonaConnecticutKansasMissouriNew JerseyNew YorkNorth Carolina
We have a home inspection business and have had liability (E
We have a home inspection business and have had liability (E & O) insurance with a company since 2008. We have paid our premiums each year and have just been told that the agent we worked with was a fraud and there was no insurance coverage for that time. We have had to make an emergency decision for other insurance - or stay with this company for insurance that would be retroactive but at a huge price increase! We have no options because we have to have insurance to work. The insurance company says they have no responsibility to us and we are out the premiums since 2008 and we have to pay this high premium now for retroactive coverage??? Is this correct?
I own a small business. I have 2 full-time employees. I doView more legal questions
I own a small business. I have 2 full-time employees. I do not offer a group health plan nor do I have an official "fund" that is set aside to reimburse these 2 employees for actual healthcare or premiums; however, they have each purchased policies in the individual market and I have been reimbursing them tax-free for their monthly premiums. That was okay with IRS until now. My tax accountant is now telling me that ACA rules state that reimbursing employees is now illegal with hefty fines ($100/day for each employee). As I am not even obligated to provide health insurance for my employees, I don't see how reimbursing them for an ACA-compliant policy could possibly be illegal. I have spent about 20 hours on my own reading IRS, DOL and ACA docs as well as professionals' opinions and I think everything is a guess at this point. Varying opinions. The reasons for this fine-thing is that some large employers who were self-insured were not reimbursing for preventive services and were putting limits on the actual healthcare an employee received. I pay my employees well-- 50K and 45K respectively, so if I were to send them to healthcare.gov they would likely not receive any tax credits and their premiums would be about 3X what they can buy in the individual market, so that is not an option. I would very much like to continue to do what I have in the past-- reimburse them for their premiums, tax-free to them. Am I looking through rosey colored glasses? Want another informed opinion. Thanks.