I got our premium bill in the mail today, due February 1st. I noticed that the amount due was considerably higher than my last payment (for January) -- exactly 24.89% higher. I remembered reading back in October that Anthem was hiking rates for individual policy holders up to 30%, and I think I did my usual ranting about it, but when we didn't get a notice, I was relieved. For once, I thought, we got a pass.
Evidently not.
I quickly called Anthem and filed a grievance. I told the unfortunate agent that I believed they were out of compliance in not notifying us of the rate increase within a reasonable time. The Unfortunate Agent told me that I had been informed. I took a long drag on my breadstick. I said that I had not been informed and so it goes. I filed an oral grievance on the phone with her, and when I asked her for a written copy of the letter they claimed to have originally sent, she claimed that she would speak to a supervisor about it. I took another long drag on the breadstick. She also said that she would file my grievance and that I would be notified in 30 days that it had been filed and a "decision" would be made 30 days after that. I told her there is no "decision" to be made, and then I asked her for a written copy of the grievance. She told me that she couldn't give me anything but a tracking number. I took yet another drag on the breadstick. I asked her for the number of the California Insurance Commission. She gave it to me, and then asked me if I needed anything else. I told her that I felt sorry for her having to work for such an unethical business, and she asked me, again, if I needed anything else. Bless her heart. I placed the call immediately to the California Insurance Commission and had a lovely chat with the Fortunate Agent who told me that she was hearing about these rate increases and the lack of notification about them. She told me that she would call me tomorrow morning with an update and when I asked her about Sophie's drug problem, she told me that she could help me with that, too.
I finished my bread stick and called it a day.
The whole thing would make me take up smoking for real. And it takes special people to work for an insurance companies and collection agencies. I would rather be starving on the street that be working at either of them.
ReplyDeleteYou kick serious ass.
ReplyDeleteWhere is your martini?
I know, right? It was really just a tad too early for a martini; what I should have done was pour a shot of the old iced vodka.
DeleteSo does "bless her heart" in Calfornia-speak mean go eff yourself the way it does down here in the South? I used that phrase and "aren't you sweet?" (loosely translated to stuff it up your @$$)a lot with insurance types.
ReplyDeleteOh, yes, Brandi! I have a grandmother from the Mississippi Delta and I grew up from the age of ten onward in Atlanta, so I'm very familiar with the "bless her heart" REAL meaning! I adore the expression -- it's just so damn perfect.
DeleteMotherfuckers.
ReplyDeleteGrrrr.
ReplyDeleteIt was nice of you to tell her you felt sorry for her.
I'm an insurance agent (commercial property and casualty, not health). Most states' regulators require carriers to notify policyholders of possible rate increases, in writing, with ample lead time. The representative of the insurer with whom you spoke should have been able to produce an electronic image of whatever the company says it mailed you, on the spot. I am very surprised you were not offered a copy, e-mailed or faxed immediately.
ReplyDeleteI am on the East Coast. I believe California is a "file-and-use" state, relative to rate increases. File-and-use states have to file new rates with their insurance departments usually thirty days before raising them. Not much hoop-jumping involved. If the insurance department doesn't react, they are free to implement the increases after that thirty-day window. Any inquiry or investigation by the insurance department can come only after that implementation -- when consumers file complaints.
Insurance departments in this part of the country are generally tough watchdogs, and take consumer complaints seriously. Unfortunately, to some very large carriers, regulatory fines are simply a cost of doing business in a particular state -- not enough of an incentive to change the status quo.
Thank God you're not a health insurance agent or I would have had to cast a spell on you! Just kidding, and in all seriousness, thank you for your comments and advice. Anthem Blue Cross is a big, bad dirty word not just in my house but in much of California. Not a week goes by (and there was an article in today's LA Times about them)that there isn't some article about their nefarious doings. We're sort of stymied in the individual market until 2014 when the exchanges open. I'll be doing my research until then -- and probably a whole lot of ranting!
DeleteYou are breaking through to the other side. Some are born to sweet delight, some are born to endless night.
ReplyDeleteWe are led to believe a lie. When we see not through the eye. (But a breadstick works, no?)
DeleteIs it bad that you made me laugh? I know this stuff is serious and seriously aggravating but that breadstick...wishing you a series of fortunate events in this war.
ReplyDeleteLaughing your ass off is the only thing TO do, no? It works for me.
DeleteBlue Cross raised our already outrageous rate again too. Those of us with individual policies and health issues are truly screwed until we see how things will shake out a year from now. I'll be amazed if the Insurance Commission makes BC back down, that's been a rarity, but if they need complaints, I'll get in line.
ReplyDeleteEmail me if you want the number. She was at least civilized, and I'm talking to her tomorrow about the drug situation I have with Sophie. There was an article in today's Business section of the LA Times about Blue Cross' rate increases and Cigna's rate deductions. The whole thing is a clusterfuck.
DeleteI thought I smelled a breadstick burning...
ReplyDeleteIt took me a second because I'm slow like that, but when I got it, I really got it and then I laughed out loud -- actually guffawed.
DeleteThey should be giving you a discount for only smoking that breadstick! You are saving them money. ;)
ReplyDeleteI hope you get some help from the insurance commission.
You look surprisingly calm in that photo. I think steam would be pouring out of my ears -- or out of my breadstick.
ReplyDeleteI cannot even begin to imagine what you're up against in this kind of system. I'm amazed at your fortitude. Keep puffing those breadsticks!
ReplyDeleteYour Seamus Heaney quote snagged me this morning, the miracles, cures and healing wells. I believe impossible things happen. From this post, it sounds as though some of them are in process. And what a beautiful photo of the lovely Sophie you posted a few days ago. And, another and, thank you for the link to The Improvised Life, whose links I could have followed all day. Off to do my own writing. xo
ReplyDeleteModern fucking life. For-profit health providers and insurers. Sorry this happened to you and your family. Not. Fair. Not. Right.
ReplyDeleteOh honey. I love the breadstick, but I'd almost need to smoke something real. We could talk for ages about BCBS-IL, as we self insured for two decades, watching the increasing costs and deductibles strangle us financially. It always made me crazy when people blamed Obamanomics for small businesses going under. Ours is done now, but done in by health care insurance costs, fuel costs and bad raw materials from bad manufacturing batches. It's been a ride. But the point of my rant is ours went up 20-29% every year, even though the number of covered employees and families remained less than 12 all those years. I hope something magical happens next year, because even though hubby landed on his feet and has a job for now that pays the premiums, we still have a 10K deductable until the coverage kicks in. Which means, like you, I get to see what shit really costs, especially medicines. I don't know how most people manage. This system is so very broken.
ReplyDeleteAnyway, thanks for the smile you gave us, and keep fighting the good fight. We rage against the machine and we hope for change.
I saw the article on the most egregious rate-raisers (with Anthem among them) and wondered about you. I am so sorry that you had to do this with only a breadstick (I would have lit mine just because), but I am so impressed that you continue to get all up in their faces when you need to. So many people have just given up. I will continue to hope that you get some relief soon.
ReplyDelete