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Employer not paying claims


Guest tjomac
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I would appreciate any advice that someone could offer on my situation. I had to be hospitalized last November and required on going medical care thereafter. My employer had a partially self-funded health plan and discontinued it July 1, 1998. Now they have a plan where they just pay premiums, they are no longer self-funded. Due to the nature of my position at this company I had knowledge that their financial status is precarious. They are not paying my health claims and the third party provider won't even talk with the insureds any longer. They are referring us to the Treasurer of the Board of Directors. He has told me that paying the claims is not a priority. Some of my bills date back to February, 1998. The third party provider cut the checks, but the company has not funded the check runs. I have contacted the Dept. of Labor. They recommended that I speak with an attorney. She won't take my case on a contingency basis. I am on disability and cannot afford to run up a lot of legal bills. I pay my COBRA every month, but I wonder what good it is really doing me. Now the providers are starting to threaten me with collections. Please offer me any advice you might have. Thanks!

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Even though you say your employer's former plan was partially insured, it might be a good idea to contact the State Insurance Department in your state or commenwealth. Even if they have no authority over the self insured portion of the plan, they still may be able to lead you in the right direction. You should also call more attornies, because it sounds as though you are going to need someone to put pressure on your employer.

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Even though you say your employer's former plan was partially insured, it might be a good idea to contact the State Insurance Department in your state or commenwealth. Even if they have no authority over the self insured portion of the plan, they still may be able to lead you in the right direction. You should also call more attornies, because it sounds as though you are going to need someone to put pressure on your employer.

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