OMG I cannot believe this - need advice!

[Ava]

So long story short the company I used to work for was sold in Feb of 2008 and the people who took it over are a bunch of crooks.

My whole satellite office and a large number from the corporate office were laid off in Oct 2008 with NO severence, then the company filed for bankruptcy. When I was laid off my partner was 3 months pregnant so we continued her health insurance through COBRA. We paid her COBRA premiums through my old company for Nov, Dec, & Jan, then the company dissolved completely so her COBRA coverage ended (which they didn't notify us of, I found out on like 1/16 that our coverage was ending on 1/31 through a co-worker who had contacted the insurance company about something else entirely and been told this was happening!)

On 1/26 my partner got a virus and had to go to the hospital. We gave them her insurance information for the COBRA plan, since she was covered under it through the end of Jan - OR SO WE THOUGHT! We just this week received an EOB from that insurance company (BCBS) for her hospital visit on 1/26 stating that her premium was not paid for that month. What the h-e-l-l, right? So she called them, they checked their records, and told her that they never received a payment from my former company for Jan 2009. They cashed the check, she has record of that, but they NEVER SENT THE PAYMENT TO BCBS! I haven't tried reaching out to my former co-workers yet to see if this has happened to anyone else, but it appears to me that my former company cashed everyone's Jan COBRA payments and ran with the money.

So now we have a $1300 hospital bill and don't even know where to start as far as legal recourse. The company no longer exists, and I don't even know who was in charge there at the end. I know the name of the family that started the company and I believe still owned a share when it went under, but that's it. Should I be looking for a state agency to report insurance fraud? I'm in NY and the company headquarters were in OH so which state? Or should I just try to work with the hospital to get the bill reduced/forgiven? I can't afford a lawyer and like I said I don't even know who I'd go after.

Ugh. Sorry this was so long, I'm just disgusted and kicking myself that I stayed working there when I knew things were going downhill.

 

[semo233]

Start keeping a record of EVERYTHING! Dates, who you speak to and all details. Write down everything you remember from the past, right NOW!

Call the state's attourney's office. Call the BBB and call the insurance fraud office. Keep calling until you find out what avenue to take.

You only HEARD that the insurance was good through 1/31, right? You were not notified at any time that coverage was ending...sounds fishy. Call all your coworkers you can and ask them to make similar complaints regarding notifications,if nothing else.

The squeaky wheel gets the grease!

 

[mickeyboat]

Call your state's department of insurance and department of labor. They might be able to point you in the right direction.

I wonder if you could pay the premium for January again, just to avoid the 1/26 hospital bill, and then seek renumeration from the company.

I am so sorry this happened to you! It's awful.

 

[kittychatalot]

that stated when your health care would end and the cobra pick up? I think the letter is called "letter of credible coverage. " if oyu ahve one of those then it does not matter whether BC/BS got paid- it should voer you

 

[Ava]

You only HEARD that the insurance was good through 1/31, right? You were not notified at any time that coverage was ending...sounds fishy. Call all your coworkers you can and ask them to make similar complaints regarding notifications,if nothing else.

That's correct, we never received any official notification that our coverage was ending on 1/31. I found out from a co-worker, who was told by the insurance company. At the time my partner did call the insurance company to confirm it and the person she spoke to told her that there is no law requiring the company to notify us. It sounded wrong to me but at the time we were just concerned with finding other coverage so we didn't pursue it.

I also mis-typed a detail in my OP - we don't actually have a bill from the hospital yet, just a statement from BCBS saying they didn't pay the claim.

I know I SHOULD do all the things you suggest, but I've got a lot of other things on my plate right now and don't know if I can handle it.

 

[Bren's Mom]

http://www.nysegov.com/citGuide.cfm?superCat=245&cat=255&content=main

http://www.ins.state.ny.us/complhow.htm

Good luck!!

 

[Ava]

that stated when your health care would end and the cobra pick up? I think the letter is called "letter of credible coverage. " if oyu ahve one of those then it does not matter whether BC/BS got paid- it should voer you

Yes, I have that. My coverage ended 10/31/08 and COBRA picked up on 11/1/08. I paid COBRA premiums to my old company for Nov, Dec, Jan but they never paid BCBS for Jan. All I have to prove that I paid the Jan premium is a cancelled check written out to my former company.

I wonder if you could pay the premium for January again, just to avoid the 1/26 hospital bill, and then seek renumeration from the company.

The company doesn't exist any more or I would definitely be going after them.

 

[big_red_s]

If what you're describing is accurate then it is insurance fraud.

As semo233 said, start writing down who you talked to, at what time and what the conversation was about. THIS IS CAN BE EVIDANCE IN COURT.

Contact your fellow workers, you might have a class action law suite on your hands. Someone cashed your check, if the company is in business or not should matter.

 

[Bren's Mom]

I know I SHOULD do all the things you suggest, but I've got a lot of other things on my plate right now and don't know if I can handle it.

I get it...and {{{{hugs}}}} to you...I know what it's like to feel overwhelmed with responsibilities. However, keep in mind that this isn't something that's going to just go away. If the $1300 is no big deal and you can pay it and just want to be done with it...fine. But if you can't, then you must deal with this in a timely manner or you'll end up with a worse mess. There may be time limits for filing insurance complaints. So you'll want to know right away what those limits are so you don't miss the deadlines. And when the bill comes from the hospital you will want to at least send a registered letter, return receipt requested letting them know what happened with your insurance, along with payment for what you believe is your portion of the bill (your 20% or copay or whatever) so they know you're serious and let them know what you're doing to correct the problem.

 

[bumbershoot]

I know I SHOULD do all the things you suggest, but I've got a lot of other things on my plate right now and don't know if I can handle it.

Oh hon...you gotta do it now. We were so overwhelmed with all the stuff that happened after DS arrived, we were awash in confusion. We had insurances paying too much, too little, we had OBs charging as out of network non-emergent care...we had that same OB not billing us until DS was something like a year or more old....

I'm the insurance person and I was just OUT of it for so long...hubby was useless....it all got pushed aside.

and DS is 5, and today I need to call a collection agency to pay off an assistant that somehow wasn't paid when everything else got paid, from DS's arrival.

If we'd done it all when DS was a baby, it would be done.

Do it now, so you're not dealing with this 5 years from now.


And you paid COBRA through your company? That's so weird! We have a 3rd part company that does it...I thought that's how it was done! Weird.