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An American Saga
Author: velveeta jones    Date: 01/20/2008 17:40:05

August 02, 2007
Dear Ms Jones * (*not my real name)
Thank you for selecting ________ Health Insurance. We appreciate the confidence you have expressed in our organization and consider every interaction an opportunity to exceed expectations and invite your ongoing critique of that objective.

Your new cards will be arriving shortly, and if you have any questions concerning your coverage, call our Customer Service Department at our toll free number ###-###-####. You may also visit us at ____________.com where you will find a variety of helpful information under the Member section.

Again, thanks for choosing __________ where Innovative Health Care is Designed Around You.

Sincerely,
Paula Dixon
Individual Membership Administrator

************


From: Chris Cook
To: Velveeta Jones
Subject: Re: Why is my rate so damn high
08/26/07
Hey girl! I have spoken with Phil, my rep at ___________ to inquire about the rate. There may be some red flag from the medical survey, that's all I can figure out right now. Phil says he will be contacting you (or someone will be) to speak with you about the issue.

See you Saturday?

xxooxx (and to ________ as well)
Chris

************


August 30, 2007
Dear Ms Jones:
We are responding to a recent inquiry requesting the specific reason for our underwriting decision. Due to the confidential nature of health information, we are sending this response directly to you.

Our rating and underwriting decision communicated to you previously for your __________ policy was based on the following condition(s):

Gall bladder disease and epilepsy/seizure disorder

If you disagree with our decision or would like your file re-reviewed, you may appeal within 90 days of the receipt of your original decision notice from _______. Upon receipt of this additional information, we will review your appeal and provide you with a written response within 21 business days.

Thank you for this opportunity to be of service to you.

Sincerely,
Lynda McMichaels
Vice President, Insured Customer Assistance, Retention and Enrollment

************


September 5, 2007
Dear Ms McMichaels:
Thank you for giving me an opportunity to appeal your decision for my health insurance. According to your letter, I was denied for 2 reasons. Perhaps I was not clear enough in the notes on my medical survey. So, I would like to re-address them:

1. Gall Bladder disease. I do not have a diseased gall bladder. My gall bladder was removed years ago, and since its removal, I have suffered no ill affects whatsoever. If you look back to the survey, youıll see where I wrote in "gall bladder removed". Unless you know of a reason for a removed organ to still be diseased, then I think we've solved that problem.

2. Epilepsy/seizure disorder. I have never been diagnosed with either epilepsy or a seizure disorder. I have had some "petite mal" episodes, however numerous doctors could find no cause for them, nor did they ever witness an episode. The best explanation given was that they occurred due to scar tissue (from successful brain surgery in to remove a blood clot). Since my last one in or around March of 2005, I have not had an occurrence as I began a program of taking Omega-3 on a regular basis. There is research by Dr. Edward Bromfield, Associate Professor of Neurology at Harvard Medical School and chief of the Division of Epilepsy and EEG Dept at Brigham and Womanıs Hospital that strongly links an increase of these fatty acids with brain activity. He, along with other researchers, suggest that an important
way to control these seizures may be as simple as consuming more foods rich in DHA. Having changed my diet to include more of these foods, along with adding my supplement of Omega-3, seems to have succeeded in preventing further episodes.

Please consider also, that I was a member of __________ under a group plan and had no major medical conditions during for the past 3 years. Please also consider, that in 2003 I applied for a plan with you ­ and was accepted at a very reasonable rate, even with the same conditions! In fact, I would characterize my health as improving since that time.

I am enclosing some copies of my medical records regarding the seizures. And I hope that you will reconsider your decision.

Regards,
Velveeta Jones

PS: Please note that I am in the process of moving, and any further communication should be sent to:
9 Hydrangea Drive
Marshal, NC 27715

************


October 5, 2007
Dear Ms Jones
CASE: ##-###############
Your request for a re-evaluation of our rating and underwriting decision has been opened and assigned a case number. Please refer to this number in all communications.

To help us further, we are requesting that you provide to us, at your own expense your entire medical history for the past 5 years. Please forward these records to the following address:

Upon receipt of this additional information, we will review your appeal and provide you with a written response within 21 business days.

Sincerely,
Lynda McMichaels
Vice President, Insured Customer Assistance, Retention and Enrollment

************


October 25, 2007
Ms McMichaels:
Re: Case ##-#############
Enclosed are 5 years worth of medical records. They are in no particular order, since you told me to send these to you at my expense, I assume you are saving lots of money and can certainly afford to have some office peon sort through these.
Also, please note, that your last letter had to be forwarded to me, which only continues to delay our communications. My new address, again, is:

9 Hydrangea Drive
Marshal, NC 27715

Regards,
Velveeta Jones

************


December 17, 2007
Dear Valued ______________ Member:
Thank you for using ______________ for your health insurance needs. Enclosed are your new ID cards and Summary of Benefits. You may begin using your cards as of January 1, 2008.

We appreciate you as a customer and welcome the opportunity to serve you and your health insurance needs. If you have any questions, please visit us at __________.com or contact our Customer Service Dept. toll-free at ###-###-####.

Sincerely,
Lynda McMichaels
Vice President

************


January 4, 2008
Dear Ms McMichaels:
Thank you very much for reviewing my case and resolving this issue. Just a couple of items Iıd like to point out to you. First, you are still sending mail to my old address and so I am only getting my ID cards today, Jan. 4, when the postal stamp claims they were sent out on Dec. 19, 2007. Please update my address (see below).

Secondly, I have not received any further communications from you regarding my rate. Maybe another letter is lost in the mail forwarding, and Iıll keep my eye out for it. However, to insure that you are promptly paid, perhaps now would be an excellent time to jot down my correct (new) address and keep it on file!!

Best,
Velveeta Jones

************


FIRST AND FINAL NOTICE OF FEES DUE
Account Number ########
Amount Billed: $1796.80
Balance Forward: $0.00
Total amount covers (from) 09/15/07 (Thru) 02/14/08

To avoid termination, payment is due within 31 days of this date: 09/15/07
__________ offers you an easy way to pay your premiums! EasyPay____ is our convenient monthly payment service ­ your premium is automatically withdrawn from your checking or savings account. To enroll, go to _________.com or call toll-free ###-###-#### 24 hours/day.

************


Sandra: Thank you for calling __________Customer service, this is Sandra, how may I help you?
Me: (after explaining situation and going back and forth on my few options) so, basically, I have no choice but to pay this bill ­ a bill that I received in mid-January, and starts my insurance in January - but goes back to September 2007?
Sandra: Yes.
Me: But, can I just re-apply?
Sandra: Oh yes, you can re-apply.
Me: Will I have to go through that 1 year waiting period ­ because now its been over 6 months since I lost my group plan?
Sandra: Yes.
Me: (after long sigh) so, let me see if I have this straight. In order to have your health insurance, you want me to pay you $1800 for a "product" that you sell, but you're not going to give me the actual "product" I'm paying for?
Sandra: Well.....
Me: Isn't that what you're saying? I mean, I can't use the insurance for Sept, Oct, Nov and Dec. 2007, right?
Sandra: Right........
Me: So, you are telling me that in order to be able to receive any health care I must pay you this money, even though I get NOTHING. How is this different from a mafia payoff?
Sandra: uh........
Me: How is it different? You just want the money isn't it? You think I'm some sort of risk, so the only way you'll take me is if I pay you off, right? Be honest.
Sandra: Well..............yes
Me: Man you guys are killing America. Just take your insurance and stick it where the sun don't shine. Goodbye.

************


January 16, 2008
Dear Velveeta Jones,
Recently we received information from the United State (sic) Postal Service (USPS) that indicates your address has changed. For your convenience, we have updated your information in our system to reflect the new address.

Your new billing address is:
Your old billing address was:

Please take a moment to review the new address listed above. If the new information is not correct, please call our Customer Service Department at the toll-free number listed on your ________ ID card.
We appreciate this opportunity to better serve you.

Sincerely
Dan Prather
Senior Director
Individual Membership Administration & Application Processing.

Fin

58 comments (Latest Comment: 01/21/2008 05:22:35 by livingonli)
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Comment by BobR on 01/20/2008 18:08:05
This is at once amazing, familiar, and distressing...



No more health insurance! Government provided health care for everyone!

Comment by livingonli on 01/20/2008 18:18:55
This should be in Hawke's thread at UNN about Health Care. The insurance companies are nothing but parasites.

Comment by Raine on 01/20/2008 19:12:08
New blog info! VJ, not only did I Digg you, I farked you too...

Comment by Raine on 01/20/2008 19:55:51
I am so ready for football!



And yes, we are now under 1 year of the bush regime!

Comment by Raine on 01/20/2008 19:57:32
Quote by livingonli: This should be in Hawke's thread at UNN about Health Care. The insurance companies are nothing but parasites.


Post a link, liv!

Comment by velveeta jones on 01/20/2008 20:02:38
Quote by Raine: New blog info!



VJ, not only did I Digg you, I farked you too...


ppppppffffffffth. Get in line.







Comment by Raine on 01/20/2008 20:04:15
Weather for Foxboro, MA

23°F

Mostly Cloudy

Wind: N at 15 mph

Humidity: 39%



Unless our local regional representative informs us differently, I would say this is perfect football weather!

Comment by Raine on 01/20/2008 20:10:28
Actually seems as tho that wether forecast is incorrect... Foxboro seems a lot windier than 15 mph.

Comment by livingonli on 01/20/2008 20:16:07
Quote by Raine:
Quote by livingonli: This should be in Hawke's thread at UNN about Health Care. The insurance companies are nothing but parasites.


Post a link, liv!


I had to go look for Tri's post but here it is.

Comment by Raine on 01/20/2008 20:17:39
Quote by livingonli:
Quote by Raine:
Quote by livingonli: This should be in Hawke's thread at UNN about Health Care. The insurance companies are nothing but parasites.


Post a link, liv!


I had to go look for Tri's post but here it is.


hee hee... I meant that you should post a link over in THAT thread to this blog!!!

Comment by livingonli on 01/20/2008 20:22:40
Quote by Raine:
Quote by livingonli:
Quote by Raine:
Quote by livingonli: This should be in Hawke's thread at UNN about Health Care. The insurance companies are nothing but parasites.


Post a link, liv!


I had to go look for Tri's post but here it is.


hee hee... I meant that you should post a link over in THAT thread to this blog!!!


I have to leave for work and re-register at UNN. When I get a chance I will do so. :D



I also hope that I am able to watch football at work today. The only hope is if Comcast New England is doing a Pats post game show, we may be able to see a feed of the game at work.

Comment by TriSec on 01/20/2008 21:53:46
Howdy folks...passing through. I'm at Papa TrSec's today watching the big game on the new HDTV...and recruiting some new members, too!

Comment by livingonli on 01/20/2008 21:54:16
Oh, another day in the salt mine. The work computer is solow as shit and there's no tuner access to the games so I have to follow them on Sportsline. If someone can post the blog link on that thread that would be cool. Otherwise, I will try tomorrow.

Comment by livingonli on 01/20/2008 21:56:31
Quote by TriSec: Howdy folks...passing through. I'm at Papa TrSec's today watching the big game on the new HDTV...and recruiting some new members, too!
Now that sounds like fun. Wish I could do that. I caught the first 20 minutes of the game on the HD set before I had to leave.



Comment by velveeta jones on 01/20/2008 23:06:44
Quote by livingonli:
Quote by TriSec: Howdy folks...passing through. I'm at Papa TrSec's today watching the big game on the new HDTV...and recruiting some new members, too!
Now that sounds like fun. Wish I could do that. I caught the first 20 minutes of the game on the HD set before I had to leave.



Seems the NE Patriots won, and are rumored to be going to the Super Bowl. (New England? Are they a multi-state team or, are they just fickle)?



Does this mean its closer to BASEBALL SEASON!!

Comment by livingonli on 01/20/2008 23:20:57
During the Devils game at work, one of the announcers was referring to a player's "wide stance". And it made me think of Larry Craig.





l

Comment by Raine on 01/20/2008 23:22:32
Quote by livingonli: Oh, another day in the salt mine. The work computer is solow as shit and there's no tuner access to the games so I have to follow them on Sportsline. If someone can post the blog link on that thread that would be cool. Otherwise, I will try tomorrow.
so it is written so it shall be done. (actually... it was done... )

Comment by Raine on 01/20/2008 23:23:08
:grumble: Congratulations New England... (smiling, smiling, smiling)

Comment by Raine on 01/20/2008 23:24:57
Getting to be about time to make some hot wings... Hot wings are the official NFL football food for playoffs in Casa De Braine.

Comment by Raine on 01/20/2008 23:25:57
Quote by TriSec: Howdy folks...passing through. I'm at Papa TrSec's today watching the big game on the new HDTV...and recruiting some new members, too!
new members!! Excellent! Remeber everyone, Digg and digg often!

Comment by Raine on 01/20/2008 23:50:41


Part one!

Comment by velveeta jones on 01/21/2008 00:36:29
Interesting! For those of you actually watching the football game on TV, I have it on as background noise.............



but I loved this FOX investigative reporting by the women in the stands "The seats in this section are supposed to be heated. But I have put my hand on the seats, even TAKEN OFF MY GLOVE, and these seats are NOT heated!!! Back to you........."







Comment by TriSec on 01/21/2008 00:49:52
Hey Velveeta...



They used to be the "Boston Patriots" when they actually played in this fair city.



I don't know the full story, but the name was changed when they moved to Foxboro...since they didn't play in Boston anymore and nobody knew where the hell Foxboro was, th-e Sullivans changed it to "New England", supposedly to represent the entire six-state region in the NFL.



I know, it's only filler. The

equipment truck heads south in 3 weeks!



Oh yeah, and they're the defending champions, aren't they? :metal:







Comment by velveeta jones on 01/21/2008 00:52:56
Quote by TriSec: Hey Velveeta...







I know, it's only filler. The

equipment truck heads south in 3 weeks!



Oh yeah, and they're the defending champions, aren't they? :metal:









Tee hee.........

That made me a little tingly



Comment by Raine on 01/21/2008 01:15:14
Part two... edwards rally in Atlanta:





Comment by Raine on 01/21/2008 01:17:09
Edwards Rally in Atlana, part three!



Comment by Raine on 01/21/2008 02:27:12
This Giants/Packers game is pretty amazing.

Comment by livingonli on 01/21/2008 02:35:05
I wish I could see it.

Comment by Raine on 01/21/2008 02:41:52
5 minutes left and the score's tied 20-20. The Giants just missed a 40+ yard field goal.

Comment by Raine on 01/21/2008 03:05:50
And the Giants just missed another field goal... :thud:



going into overtime.

Comment by livingonli on 01/21/2008 03:10:19
It is turning into a nail-biter indeed.

Comment by Mondobubba on 01/21/2008 03:12:23
Ohh boxed wine on this show we are watching on A&E about a chemistry professor turned meth maker.

Comment by Raine on 01/21/2008 03:14:35
HOLY SHIT!!!



GIANTS WIN!!

GIANTS WIN!!

GIANTS WIN!!





47 yard field goal in overtime!!



We're going to the Super Bowl baby!!

Comment by Mondobubba on 01/21/2008 03:17:49
Quote by Raine: HOLY SHIT!!!



GIANTS WIN!!

GIANTS WIN!!

GIANTS WIN!!





47 yard field goal in overtime!!



We're going to the Super Bowl baby!!






:give Raine a big ole high five:



Comment by Mondobubba on 01/21/2008 03:19:11
Oh BTW Bobber & Raine, I love the countdown until Dick Lips is out of office, but it's not 365 days, it is 366 days. You forgot that 2008 is a leap year. :D

Comment by TriSec on 01/21/2008 03:25:13
*snort*



Wonder if the rest of America is looking at the Super Bowl and saying "What, New York and Boston AGAIN???



Ah, screw 'em!



:party:





Comment by shelaghc on 01/21/2008 03:25:34
Quote by Mondobubba: Oh BTW Bobber & Raine, I love the countdown until Dick Lips is out of office, but it's not 365 days, it is 366 days. You forgot that 2008 is a leap year. :D






Smartypants....



Comment by livingonli on 01/21/2008 03:27:51
Quote by Raine: HOLY SHIT!!!



GIANTS WIN!!

GIANTS WIN!!

GIANTS WIN!!





47 yard field goal in overtime!!



We're going to the Super Bowl baby!!


Yay baby! :banana:



The Northeast rules. Although we do hope there's a different outcome than from the December meet-up.

Comment by Mondobubba on 01/21/2008 03:27:53
Quote by shelaghc:
Quote by Mondobubba: Oh BTW Bobber & Raine, I love the countdown until Dick Lips is out of office, but it's not 365 days, it is 366 days. You forgot that 2008 is a leap year. :D






Smartypants....





:shrug: I'm just sayin! :kick can:

Comment by TriSec on 01/21/2008 03:36:19
Ya know, Liv...for a lot of old-timers, this is a "subway series".



Before we had the Patriots, a lot of people up this way used to follow the Giants...



And since the Pats are AFC, the Giants are "our " NFC team...



Sure is going to be interesting.





Comment by livingonli on 01/21/2008 03:45:14
Blog Super Bowl Party. Who's up for it?

Comment by Raine on 01/21/2008 03:55:57
Have I told you???? THE GIANTS ARE GOING TO THE SUPERBOWL!!!!!

Comment by Raine on 01/21/2008 03:57:06
Quote by TriSec: Ya know, Liv...for a lot of old-timers, this is a "subway series". Before we had the Patriots, a lot of people up this way used to follow the Giants... And since the Pats are AFC, the Giants are "our " NFC team... Sure is going to be interesting.
Tri Is indeed correct. This is going to be a great superbowl!

Comment by Mondobubba on 01/21/2008 03:58:51
I'm kinda diggin this new show on AMC called "Breaking Bad"

Comment by Raine on 01/21/2008 03:59:49
OMG... can I tell you that My voice is hoarse? I was jumping up on the couch! (oh, have I told you my sister is a long time Die Hard Green Bay fan??? )

Comment by Mondobubba on 01/21/2008 04:00:43
Tri, I have need of your Subaru knowledge. Anything weird or costly in your routine maintance because of the boxer style engine??

Comment by Raine on 01/21/2008 04:01:19
REgarding this Superbowl... The pats... #2 defense in the League... guess who has the number one defense??? the Giants...

Comment by Mondobubba on 01/21/2008 04:01:27
Quote by Raine: OMG... can I tell you that My voice is hoarse? I was jumping up on the couch! (oh, have I told you my sister is a long time Die Hard Green Bay fan??? )




Okay Tom Cruise. :rofl:



Comment by BobR on 01/21/2008 04:03:46
Quote by Mondobubba: Oh BTW Bobber & Raine, I love the countdown until Dick Lips is out of office, but it's not 365 days, it is 366 days. You forgot that 2008 is a leap year. :D


well then the server that calculates the date difference between 01/20/2009 and now is making the mistake.

Comment by Raine on 01/21/2008 04:05:56
Why even before tonits game... we were planning on having a lil superbowl party... My first one ever in Georgia... And now I get to brag a little for the north! (and of course for the giants...)