Hi Everyone.
DH receives insurance through his employer. Legally, the company he works for (the one he shows up to every day) is actually just a leasor. Legally, Todd is an employee of ABC Payroll Company, who then leases Todd to 123 Dealership. Every person at the dealership is the same way. It's set up this way, basically because by having everyone at 123 Dealership, plus 456 Restaurant, and XYZ Bank, etc, they're all 1 large group under the same employer (ABC Payroll). This basically means cheaper, better insurance than any one of those small companies with their small number of employees could get on their own. We just found out that the Payroll Company self funds their own (our) insurance. It's all administered by a benefits administrator (3rd party company). So there are 4 parties involved--the employee, the dealership, the payroll/insurance company and the benefits administrator. Typically when an employee has a question, we call the benefits administrator.
A few weeks ago we went to the doctor, who asked us to call the insurance and find out why they (doctor's office) had not been paid. We called the benefits administrator, who said we had to call the payroll/insurance company because they had done all they could and the checks were just sitting on the payroll company's desk, waiting to be signed.
We called. And called. And called. And called. The HR person at the dealership called. And called. And called. The owner of the dealership called. And called. And called.
Finally we find out that something hinky happened at the payroll/insurance company, basically leaving them unable to pay claims (even though they've been taking money out of our paycheck every month). We received word yesterday that they dropped everyone and we no longer have insurance. God has been good in that the owner of the dealership has already found a company who will insure our group immediately so benefits from here on, out should be ok.
The prayer requests are these:
1. These claims go back to April. Technically, we were insured through yesterday (August). They've taken several hundreds of dollars from our check each month. So we're not sure how that will work out. We're out the money for the premiums, and now we might be in the position of having to pay everything the insurance didn't, so basically we'll pay for everything twice, which we can't afford to do. DH's boss said the payroll company is going to try to settle with the providers-please pray that they do so that we're not on the hook for the outstanding bills.
2. They shut down our flexible spending account, too, which is money that's been pulled out of DH's check every month since January 1. In an FSA, the money is pulled out pre-tax, and then you can use it for medical needs including copays, over the counter medications, prescriptions, out of pocket expenses, etc. We incur the charges and pay up front, and submit receipts for reimbursement. You have the entire calendar year to use it up. You don't have to spend it at the rate you save it, or vice versa. So while we've paid in $2400 to date, we've only used about $1600. We would, theoretically, have til December 31 to use the other $800, plus any money that would have been taken out of future checks. Since there are no future checks, (at least through this payroll company), future money is not at risk. But that $800 is. That's about half the cost of the transfer we were planning to do in October and it's a sum we can't quickly recover. We have the other half in savings already, but this FSA WAS our savings account for the first half. We were fully funded for the costs of the procedure. Would you pray that we get that money back? It would most likely mean that we don't do a transfer this year, which would be very upsetting for me.
3. Please pray that we (all employees) are actually able to be enrolled in a new company, with no lapse in coverage. Please pray that the payroll company would act ethically and honestly in all things. Pray for wisdom and patience for DH's boss, who has to deal with this whole mess through no fault of his (or any of his employees') own.
Thank you very much!
Update: After I posted this, the lady from the payroll company, who we've been trying to reach for literally, almost a month, finally accepted our phone call and said the FSA money is safe. They're switching who manages it though, so it will take a few weeks til we can access it. I'm still a bit nervous til that actually happens, but I feel much better. Thanks for your prayers!
I'm so glad the savings fund money is at least safe! Praying for you on the rest.
ReplyDeleteI've been praying for you guys, I hate health insurance issues but this one sounds especially terrible :-(.
ReplyDeletePraying things get resolved soon Jen!
ReplyDeleteJen, I am so sad to hear about this insurance mess. Glad your FSA money will still be available to you. How frustrating this all is! I subscribed to your blog's feed so I can still know what's going on with you. I'm praying everything gets straightened out quickly.
ReplyDeleteWhoops! sorry for the "Jenn" instead of the "Jen"!
ReplyDeleteHey, Jenn! I've been thinking of you lately and just wanted to let you know that you've been on my mind. I hope things are going well with you!
ReplyDelete