We use a little company called Assurant to administer the employee health insurance plan for our business. We have about 50 employees, not all of whom are on our insurance (some get theirs through a spouse), so we are in a particularly undesirable segment of the small-business market. Ironically, we have had a fair amount of difficulty in getting coverage which was affordable and sustainable. A lot of insurers wouldn’t even bid on us. Funny, right? The doctors can’t get health care insurance! Hysterical! So we wound up with an unusual sort of self-funded plan administered by Assurant, which was working OK.
Recently, however, a couple of our doctors wound up taking family members to the ER for various reasons — nothing serious, but common and reasonable presentations for an ER. And Assurant denied payment for the claims. They didn’t deny it outright, actually, just imposed a $500 “penalty for non-emergent use of the Emergency Room” on top of the usual co-pays and deductibles. Read more »
*This blog post was originally published at Movin' Meat*