Barbara of Deer Island, Florida writes:

I worked for United Health Care in small group customer service. If a company was more than 5 days late in their monthly payments, United would “terminate” their coverage.

When they were terminated the group administrator from the “termed” company would call me to reinstate their coverage. I would take their phone number, go to my supervisor’s office and get a computer disk showing all small groups “loss ratios.”

If the company I was working with was in the high risk ratio, I was not to reinstate their coverage. This meant people in the hospital or scheduled for surgery would never nave coverage with any company because of pre-existing conditions if their coverage was less than 90 days.

Sometimes a new group misses payments in the first few months before they get on a payment schedule.

This is how United would “weed out” the high claims group. Their actions were not illegal, but were IMMORAL!

Source: Organizing for America: Health Care Stories for America

Susan of Portland, Oregon wrote:

Susan from Portland, Oregon

I just got off the phone with my health insurance company. I had just received an Explanation of Benefits showing my deductible was not met, and a bill from a doctor showing that I owed the whole thing.

Now this seemed curious. I have breast cancer and have already been through multiple imaging procedures, surgery, installation of a portacath and the first round of chemo. My deductible was met a long time ago.

The explanation? I have two deductibles on my plan, one for “in plan” and one for “out of plan.” [Read more →]

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