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Workers compensation insurance elusive for many

workers comp claims It wasn't the shot heard 'round the world, but in 2008 when stripper LeAndra Lewis was hit by a stray bullet fired during a fight in the Boom Boom Room in Columbia, S.C., the pain was felt across the country. The bullet, which passed through her intestines, liver and pancreas, prevented LeAndra from working for quite some time. Lewis felt she was entitled to a workers compensation claim. Employers pay for workers comp to pay for injuries that employees suffer while on the job. If they cannot work, it covers their medical care and lost wages. But a South Carolina Court of Appeals ruled that Lewis couldn't collect. As a stripper at the bar, LeAndra worked as an "independent contractor" and was therefore ineligible to collect workers comp. And as an independent contractor myself, I sympathize. 'Alternative arrangement' More and more Americans work in what the Labor Department calls an "alternative arrangement." Somewhere along the line a bean-counting company may have outsourced their jobs and then brought them back as independent contractors. Insurer Allstate did this to hundreds of its agents, who are now appealing to the Internal Revenue Service to review their work status. Independent contractors like Lewis now… (continue reading......)

Health care decision: The Supremes 'keep us hangin' on'

US Supreme Court At this moment there are hundreds of Washington, D.C., reporters, lobbyists and pundits with their feet in the starting blocks waiting for the signal to race up the marble steps of the U.S. Supreme Court and hear the decision on health care. Will the Patient Protection and Affordable Care Act, aka "Obamacare," survive intact? Will the judges throw it out? Or -- the third option -- will the Supreme Court chew it up and spit out pieces like the individual mandate, which requires everyone to get health care? So far, the nine justices have succeeded at one thing: agreeing to a "mum's the word" policy. The Supreme Court chambers, like the Federal Reserve, seem to be more leak-proof than the White House, where President Obama is fighting for his political life amid enough leaks to resurrect the Watergate plumbers. I don't have the answer. But like everyone else -- Republicans, Democrats, health insurers, consumer advocates and the media -- I'm willing to hazard a guess. Likely split I believe that whatever the decision, it will be messy. Our judges are seldom like Solomon, who refused to cut the baby in half. It seems to me that the four-to-four, conservative-liberal split… (continue reading......)

Corruption comes to town: Insurance and the mayor

money2 My sleepy New Jersey suburb was recently rocked with scandal when our highly respected and popular mayor was accused of extorting bribes from a health insurance broker. For me, that's bad news. But what's worse is that this could happen in your hometown. Yes, I know all about the Garden (of Corruption) State: home of the Sopranos, leaking landfills and the infamous New Jersey Turnpike. But my township, and our mayor, had a good reputation. Our garbage is collected and our taxes are no worse than any other New Jersey jurisdiction, so our mayor was re-elected by a 2-to-1 majority. Then things went awry. First, The Citizens Campaign public interest group started to question why our school board's insurance broker had been working without a contract since 2009. Then the FBI showed up and littered our township government and school board with subpoenas. Finally, our mayor was charged by the Offices of the United States Attorneys with soliciting $12,400 from said insurance broker, allegedly "to pay his taxes." Pay to play Insurance brokers arrange for businesses, townships and school boards to buy health insurance and workers' compensation for their employees, property/casualty insurance to protect against fires and slip-and-falls, and auto… (continue reading......)

Cracking the health care code

code When my wife fell on the ice two winters ago, her wrist didn't look as nature intended. She went to her doctor, who advised her to go to the X-ray department in the building. With her wrist still crooked months later, she got a second X-ray from her usual imaging facility so that the orthopedist could compare the two. The health insurer sent the explanation of benefits (EOB) for each X-ray, which showed how much it cost. Big difference. The EOB for the initial X-ray was $1,200, while the EOB for the second one was $100. Why was the original billed at Cadillac cost? Her doctor's office is in a building owned by a corporation which also owns area hospitals. When she asked about the difference in price, they told her that the first X-ray was performed at a hospital and therefore billed at a hospital rate. My wife said that seemed strange, since the so-called hospital had no emergency room, no beds for patient admission and wasn't listed on the state's insurance website under its directory of hospitals. The outcome: the corporation offered a refund of $1,100 -- the difference in price between the two X-rays. Co-pay or not… (continue reading......)

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