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Many (not all) policies have a clause about being at work when insurance becomes effective. Check your policy.
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There is a difference between a recommendation, a suggestion and medical necessity. I had a pregnant ee who due to an underlying medical condition had to take folic acid. Her doctor wrote a narrative explaining why it was medically necessary for h…
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My guess (and I emphasis guess) is that the ee has elevated (not high) cholesterol. He has probably been told to eat right (including foods that include Omega-3). The doctor has suggested the ee take the fish oil tablets. A suggestion is not the …
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[font size="1" color="#FF0000"]LAST EDITED ON 08-25-05 AT 09:59AM (CST)[/font][br][br]Ex-spouses are not covered under any of the plans. There is, of course, coverage under COBRA. Here, courts and/or divorce settlements can order ex-spouses to pro…
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I just looked at the applications for health insurance. What was interesting is that they include "files an application for insurance or statement claim containing any materially false information....commits a fraudulent insurance act, which is a cr…
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Question - When the insurance is terminated (since this involves fraud)is a COBRA letter sent to the spouse and if so, is period of coverage 10 months or 6 years?
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As they use to say "Something is rotten in the state of Denmark." I have never heard of an insurance carrier aloowing coverage for any married child. Second, why would any insurance company voluntarily want to be the prime carrier so they can pay f…
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We do not allow the managers to keep this info if they get it. There is no bona fide business need that I can think of for the manager to keep this info.
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You have every right to shop around for other insurance carriers. If you have a broker, they should do it for you. If not, get the claims experience for the past couple of years (including the first 8 months of this year) and contact other insura…
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What does your insurance policy say. Many policies do not cover the spouse if there is a legal separation. Therefore, when the Bifurcated Dissolutionof Marriage was issued, were the couple legally separated (under Florida Law)?
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I need additional information: What is the significance (if any) of 8/20/04 and 11/05/04? What do your insurance contracts say?
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PBM do get rebates. The problem arises when the "savings" is not passed on or when the formulary excludes any or all medications from a different manufacturer (particularly if the savings are being retained and not passed on).
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Hi. I'm also from NYC (Brooklyn). We have had ees who waived coverage and applied (and in some cases even got) government subsidized health coverage. In several of the cases, we got letters from the NY state government asking about what benefits t…
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You do not say who gave you this information. You apparantly have not spoken with the grandparents. Until you know the facts, no decision can be made (it is always possible that the children are visiting with their mother for a week or two).
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Yes, we are as flexible as possible. We have to be. In your posting, you stated that you pay "from death to the day after the funeral." However, we have ees who practice many different religions. In some, the wake is before the funeral and lasts o…
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Almost ditto with SMace. We require either info from the funeral parlor or a copy of the death certificate. Depending on the relationship we pay either 3 (basically in-laws)or 5 days (spouse, parent, child)from the time of death. Because of differi…
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I see no problem with making an EAP available to those who do not have health insurance. Since this is an inexpensive benefit, is your employer considering picking up the full cost?
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You have to read your policy and what it says about pre-existing condition.
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I gather nothing is in writing. Do you have any idea what was promised and/or agreed to by management. You are right to be concerned if management is setting a precedence.However,you state that it is the "usual practice" to terminate after 30 days.…
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Our plan gives the ee choices what to invest in. If the company automatically takes the deduction, where does the company invest the money?
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Don't know about Florida, but in NY and some other states, if an ee becomes disabled within a certain period of time after last working (for whatever reason), they are entitled STD. In this case, the ee would certainly get benefits.
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You have two different issues here. The first is STD. We leave that issue up to our carrier. The second is FMLA. Under FMLA, new parents are entitled to time off to bond. Also, you should check to see if your state has a medical leave act.
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Voluntary terms are covered under COBRA.
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Send the Cobra letter to the address on record for this dependent.
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We do not have bring your child to work day. We are principally a manufacturing company and it is too dangerous to have children around machinery and forklifts. Having said that, if your ware house has any machinery, forklifts and/or handjacks, it…
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We do not cover common-law spouses simply because common-law marriages are not recognized in NY or NJ. Since you are a multi-state employer, you should check on what the law is in each state. However, remember you can always be more generous that t…
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If the clause say that over the counter medications are not covered, they are not covered.
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This sounds discriminatory therefore illegal. I never heard of such a thing.
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We, also, require 30 hours. The number of hours is part of insurance policy. You should see what yours states.
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Never heard of it. Just thinking of it, is giving me heartburn. What if the employee cannot return to work. What if the employee returns to work ands goofs off because their job is guaranteed. What if the employer wants to have a RIF. What if t…