Posted on 10/31/2013 6:17:41 PM PDT by ToastedHead
"The Departments recognize that plans may utilize multiple service providers to help administer benefits (such as one third-party administrator for major medical coverage, a separate pharmacy benefit manager, and a separate managed behavioral health organization). Separate plan service providers may impose different levels of out-of-pocket limitations and may utilize different methods for crediting participants' expenses against any out-of-pocket maximums. These processes will need to be coordinated under section 1302(c)(1), which may require new regular communications between service providers."
(This is found in the second paragraph of Question #2)
(Excerpt) Read more at dol.gov ...
I wonder who gets sued on January 3rd when someone cannot afford their injectable clot busting drug, and then goes home and dies.
Will it be me? I’m the little guy on the totem pole in my faux scenario. CVS/Walgreens/Kroger/RiteAid won’t protect me. If I tell someone “Nope, sorry, it’s gonna be $1000” and they do not have $1000, am I the “licensed evil man” who gets the lawsuit?
My guess at this moment in time is yes, and that’s why I’ve decided to not engage in “retail” again until at least mid 2015, when there is some semblence of law and order again. I carry my own malpractice insurance, but it’s puny compared to the big guns. And I have to think of my kids.
Then there's a ultimate security threat of the world having every American's information
being sold to every thief in the world market. Maybe that's in the plan too, because it
absolutely will happen. Then the fix will be a national ID, accept for illegals.
Who writes all this crap?
Who takes the time?
We know why.
I guess that’s what they breed the kids to do in college now. Write completely nonsensical (but intimidating) legislation, all in the name of marching towards a utopia where no one ever has to do anything. “Healthcare is a right!”
Any bill brought up by congress needs to be made available on the web for the people to read. Didn’t Obummer say he was going to do just that? We should demand that of any candidate.
Would make for some interesting reading.
TostedHead noob poster. You did good.
If you pushed the button tomorrow -- and all those Obamacare coverage mandates vanished into thin air -- the insurers would be offering those 10-15 million people their old policy (or something akin to it) within hours.
They would jump thru hoops not to lose these customers.
Problem is, of course, nobody's going to push that button...tomorrow.
“TostedHead noob poster. You did good.”
I appreciate you! I am starting to relax. Now I need to post something highly controversial and cause mayhem.
You’re probably right about that. I got my first divorce letter from BCBS, dated Oct 2nd, telling me my policy would no longer exist after Dec 1, 2014. I got a second letter, dated Oct 22nd, reminding me they will have tons of other options and thanking me for my business. It had a feel to it of “we see we’re gonna get screwed because no one we can make money of off is enrolling, so please keep us in mind.”
I appreciate your analysis of that clause and it makes sense but while you’re viewing it contractually and it would seem with some inside knowledge of the healthcare system, I view this through the prism of a government that slips seemingly incoherent verbiage into legislation with the sole intent of providing a means to further screw us :-).
We have to build one before we know what it is. /s
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