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Old 08-13-2013, 01:56 PM  
Cave Johnson Cave Johnson is offline
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Dying Man Denied Health Coverage Over Missing 26 Cents

American health care, WE'RE #1!!!1!!!

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When Sergio Branco was diagnosed with acute myeloid leukemia earlier this year, his family knew the resulting medical expenses would rack up quickly.

Which is why, the Star-Ledger reports, the Edison resident and his wife Mara did everything they could to ensure that he was fully covered by a health insurance provider.

Unfortunately, after three months of leave to undergo chemotherapy, the 33-year-old truck driver was fired from his job at the waste management company Russell Reid.

Luckily, the Brancos had a fallback plan: Keep Sergio's health coverage going by signing up for coverage under the Consolidated Omnibus Reconciliation Act, or COBRA.

ThinkProgress explains:

Employers pick up a big part of the tab for their workers’ health insurance premiums (that’s why it’s “employer-sponsored”). Under COBRA, however, terminated employees must cover the entire cost of their health insurance premium themselves — which means that health care becomes a significantly bigger expense for people after they lose their job. Workers receive written notification that they are eligible for COBRA coverage, and have 60 days after that point to decide whether they want to accept it.

With Sergio scheduled to undergo a $500,000 life-saving bone marrow transplant in mid-August, Mara knew it was critical to apply for COBRA coverage right away.

And so she did, sending a check for $518 to Paychex, Russel Reid's third-party benefits administrator.

Except that in her rush to maintain Sergio's health insurance, Mara inadvertently neglected to write down the full monthly premium amount on her check: $518 and 26 cents.

Neither she nor Sergio knew anything was amiss since Paychex happily cashed the couple's check, but a few weeks later Sergio was abruptly informed by the hospital that he was no longer covered.

Thinking it was just a matter of sending Paychex the missing 26 cents, Mara was shocked when a representative told her the company could not accept any additional payments from the Brancos per Russell Reid instructions.


Mara's next call was to Russell Reid’s human resources rep Rich Gross.

"The whole time he said Paychex is giving me false information," Mara told the Star-Ledger. "I told him if he’d just make a phone call everything would be alright. He said he’d see what he could do."

Gross did nothing, Mara said, and neither did the Department of Labor.

Even a letter from Sergio's doctor saying plainly that the young father would die without the transplant had no effect on the parties involved.

It wasn't until reporters and attorneys got involved that Paychex suddenly changed its tune.

Last week, just days before the transplant was set to take place, the Brancos got their health insurance back.

"The Department of Labor said the company will reinstate him from May till now," Mara is quoted as saying. ""They said the company did it wrong. I am super happy. It’s like a weight has lifted off my shoulder."

The Brancos have since decided not to pursue legal action.
http://gawker.com/dying-man-denied-h...nts-1122761781
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Old 08-13-2013, 02:12 PM   #2
alpha_omega alpha_omega is offline
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That ain't shit...just wait till the gub'ment is in charge...then you'll see some real clerical errors.
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Old 08-13-2013, 02:15 PM   #3
Pawnmower Pawnmower is offline
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wait so they weren't denied care or coverage?
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Old 08-13-2013, 02:18 PM   #4
Cave Johnson Cave Johnson is offline
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Originally Posted by Pawnmower View Post
wait so they weren't denied care or coverage?
They were denied coverage from the date of the BS 26 cent issue up until days before the surgery.
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Old 08-13-2013, 02:25 PM   #5
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Quote:
Originally Posted by Cave Johnson View Post
They were denied coverage from the date of the BS 26 cent issue up until days before the surgery.
I guess they shouldve looked at their mail?

SOunds like a mess.....I've had several instances of property insurance almost expire and they usually send notices etc....

I'm gonna guess they threw that shit away without looking.
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Old 08-13-2013, 02:27 PM   #6
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Originally Posted by alpha_omega View Post
That ain't shit...just wait till the gub'ment is in charge...then you'll see some real clerical errors.
...and denial of coverage based on age. Let 'em die, they're too expensive to treat.
But that will be okay to the left, because it's not a private entity doing it.
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Old 08-13-2013, 02:27 PM   #7
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Wow talk about a disingenuous thread meant to spread an outright lie. This has nothing to do with our healthcare system but has to do with a third party HR and payroll company. Did you seriously think people would be dumb enough to not see that?
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Old 08-13-2013, 02:33 PM   #8
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Old 08-13-2013, 02:36 PM   #9
Cave Johnson Cave Johnson is offline
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Quote:
Originally Posted by AustinChief View Post
Wow talk about a disingenuous thread meant to spread an outright lie. This has nothing to do with our healthcare system but has to do with a third party HR and payroll company. Did you seriously think people would be dumb enough to not see that?
a) Paychex (per the article) is the ER's 3rd party benefits admin, not HR/payroll

b) This type of arrangement (ER provided health insurance) comprises the majority of our current HC system

c) If you're going to bold something like an asshole, at least be correct
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Old 08-13-2013, 02:49 PM   #10
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Quote:
Originally Posted by Cave Johnson View Post
a) Paychex (per the article) is the ER's 3rd party benefits admin, not HR/payroll

b) This type of arrangement (ER provided health insurance) comprises the majority of our current HC system

c) If you're going to bold something like an asshole, at least be correct
Listen dickless, I know what Paychex is. Apparently you are clueless. They are a third party that companies use to manage payroll, HR, benefits, etc. Paychex is contracted by his former employer Russell Reid. (The reason his FORMER employer was on the hook for facilitating health insurance was because of COBRA.) In this case, they cancelled the health insurance because the people involved didn't send the full amount due. While technically this is fine it is a dickhead move on their part. That doesn't change the fact that it has nothing to do with the health care provider nor the health insurance company

Reading comprehension isn't your strong suit is it?

ER? As in Emergency Room? What the **** are you talking about with ER? Do you mean EMPLOYER?
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Old 08-13-2013, 03:19 PM   #11
Cave Johnson Cave Johnson is offline
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Quote:
Originally Posted by AustinChief View Post
Listen dickless, I know what Paychex is. Apparently you are clueless. They are a third party that companies use to manage payroll, HR, benefits, etc. Paychex is contracted by his former employer Russell Reid. (The reason his FORMER employer was on the hook for facilitating health insurance was because of COBRA.) In this case, they cancelled the health insurance because the people involved didn't send the full amount due. While technically this is fine it is a dickhead move on their part. That doesn't change the fact that it has nothing to do with the health care provider nor the health insurance company

Reading comprehension isn't your strong suit is it?
I don't really give a shit what other functions Paychex performs. For the purpose of this story, they were the liaison between the covered ex-employee and employer. They and the latter engaged in the beyond common "blame the other guy" routine. It didn't work out in this case (probably because the optics were terrible for the company), but I'd bet this sort of BS procedural denial of healthcare is an effective tactic in the aggregate.

Quote:
ER? As in Emergency Room? What the **** are you talking about with ER? Do you mean EMPLOYER?
You figured it out all on your own. Congratulations!!
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Old 08-13-2013, 03:36 PM   #12
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Quote:
Originally Posted by Cave Johnson View Post
I don't really give a shit what other functions Paychex performs. For the purpose of this story, they were the liaison between the covered ex-employee and employer. They and the latter engaged in the beyond common "blame the other guy" routine. It didn't work out in this case (probably because the optics were terrible for the company), but I'd bet this sort of BS procedural denial of healthcare is an effective tactic in the aggregate.



You figured it out all on your own. Congratulations!!
Jesus dude. Who the **** abbreviates EMPLOYER as ER? That's retarded. Especially when discussing healthcare.

As for the rest of your post... yes Paychex was chickenshit and yet again it has NOTHING to do with the health provider nor the health insurer. So your premise for the thread is a bunch of bullshit. Admit it, it was dishonest as shit. This would be like you screaming about the injustice of your favorite gay porn site canceling your membership because Mastercard refused to let them charge your card. It's not BigDickDaddies.com's fault.
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Old 08-13-2013, 03:40 PM   #13
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Quote:
Originally Posted by AustinChief View Post
Jesus dude. Who the **** abbreviates EMPLOYER as ER? That's retarded. Especially when discussing healthcare.
No idea about the rest of the world, but in the legal world it's done informally all the time. ER is employer, and EE is employee.
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Old 08-13-2013, 03:50 PM   #14
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Originally Posted by Amnorix View Post
No idea about the rest of the world, but in the legal world it's done informally all the time. ER is employer, and EE is employee.
Seems like a pretty dumb move in a discussion on health care.
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Old 08-13-2013, 03:53 PM   #15
Cave Johnson Cave Johnson is offline
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Originally Posted by AustinChief View Post
Seems like a pretty dumb move in a discussion on health care.
Care to hazard a guess as to the abbreviation for insurer, genious?
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