
Lizzie asks…
In 2005 I filed to receive Short Term Disability. In 2010 I find out my employer never signed me up!?
In January of 2005 I filed to receive STD. As well as health/dental insurance & life insurance. I completed all applications for this benefit and was comforted in the fact that my Employer (or the approved representative to HUMANA) would take care of everything. Fast forward to 2009 when I was involved in a motor vehicle accident. I was medically taken off work for 6 months as a result of a spinal injury. At this time I had reviewed my last pay check stub to realized there had been no STD payments withdrawn. I figured I must have been mistaken and never signed up for STD in the first place. In Dec of 2010 I went to my benefits department and signed up for STD via Humana once again. On 1-26-2011 I am having spinal fusion and will be out of work once again for at least 2 months; maybe more. However; I will not be covered as there is a 1 year pre-exisiting clause. I asked my employer if they could pull my original file from 2005 and check to see if I had applied for STD back then. It turns out I DID! But the person never did anything with the application. My question is: Shouldn’t either my employer or HUMANA have to compensate my STD for the 6 months I was out of work as well as the time I will be off of work from 1-26-11? If it werent from the negligance of the clerk I would have been covered. Please keep in mind there was never a payment made; I assumed they combined it in with my medical insurance payments.

Medicare Insurance AZ staff answers:
Every year, during open enrollment, you subsequently have to “opt in” or “reconfirm” your benefits.
So, if you had discovered that you didn’t have coverage, via paycheck deductions that weren’t happening, or just asking, BEFORE the next open enrollment period, then you’d have a clear-cut “employment benefits liability” issue with your EMPLOYER (it’s not Humana’s fault, they never turned the paperwork in!) However, since you didn’t review or add anything at, what, four additional open enrollment periods afterwards, you really aren’t going to have a leg to stand on, pardon the pun.
It’s not just the HR negligence . . .it’s the “open enrollment” where you have a chance to review your benefits, and either didn’t bother, or accepted them as they were. After the FIRST open enrollment period where you didn’t notice you didn’t have that coverage .. . It becomes your fault.

Daniel asks…
I need help coping with a severe back injury?
For years I have been suffering from a back injury and things have recently come to a point; I have two ruptured discs in my lower back. Due to the limitations that it has imposed on my life, I have been released from my job and have been disabled since Feb. Fortunately for the company, there is a waiver on their policy stating if I was injured at work, I’m not eligible for disability. However, workers compensation (now along with my private insurance) has refused payment as they both think the other is responsible. Conveniently, the deposition keeps getting moved further and further back. Due to the extreme cost of care, all surgical treatments are unavailable right now. Regardless, different neurosurgeons find that 1) yes I need a fusion, 2) I don’t need a fusion, 3) anywhere in between. Through an alternate therapy, my pain got significantly better, plateaued, and then took a significant nose dive.
I feel like I’m falling. I’m running out of money and I feel like I’m running out of life. I’ve always been an extremely results driven person that enjoys completing tasks. I’ve always done well in college taking a full load while working 50+ hours/week. Without work and without school for the summer at least, I don’t know what to do. I’ve been pulling my hair out since this went down in Feb and it has gotten worse.
I feel useless, disposed, and cast aside. I had three exemplary years as a supervisor with yearly reviews stating above standards. I worked hard for that company and I’m their garbage now. On good days I can walk nice distance, but on bad days I can barely get out of bed; I’ve lost my independence. There are seemingly no jobs that I am eligible for as the market is saturated with candidates with graduate degrees which make an Associates look like a GED.
I feel like this pain is destroying my morale and soul. My fiancee, who has been simply amazing throughout the two years of dealing with this pain, is starting to drift, and I don’t know what to do. She always makes comments on how sweet I am to her even when I’m in pain, but seeing me in so much pain hurts her to the point that I don’t think she wants to be with me much longer.
I know counseling is an option, but it takes a lot of money; one must have a job to make money; hard to have a job when you’re disabled in the insurance term of the word.
I’m not sure what to do, I feel like my life is slipping away from me; I’m beginning to hate the things that I do even on a normal basis. I especially hate the way I’m hurting the one I love, but I can’t find anything to do about it. The pain she sees is the pain that makes it through; the rest I hold back.
I’m thoroughly confused and downright scared.
I’m open to anyone’s recommendations and I also feel like I need to sit down and just talk (and/or chat) with someone as the way I feel is extremely embarrassing to me.
Thank you in advance to everyone.

Medicare Insurance AZ staff answers:
Everybody does have serious concerns about some of the dynamics in your relationship. And our concerns are both about how your girlfriend relates to you, as well as how you are responding to her hurtful behavior. What this shows is that your girlfriend is not truly interested in working on being more loving and respectful to you. In a relationship with real caring and respect, the person would genuinely feel terrible at making you feel so badly and would make real efforts at ensuring that kind of behavior didn’t continue.
I think it is important that you get help from a professional therapist on ways to relate to others that is better for your emotional well being. I also think it is important that you grow to have more love and respect for yourself and to demand it in a way from others where people are crystal clear that you are serious about how you wanted to be treated.
Since you report being very depressed, not having your girlfriend support and are not doing things that you used to enjoy, you probably would benefit from some professional help. Having someone to talk to about your feelings might make you feel better about yourself, and your counselor or therapist can offer you some advice about how to deal with your negative self-image. Even though you have heard the expression “nobody’s perfect” a thousand times, you need to realize that it is really quite true. Sometimes people have an idealized vision of what they want their bodies or personalities to be like, but because so few people actually live up to these unrealistic standards, they are bound to be constantly disappointed with themselves.
Take care as always.

Jenny asks…
Hi, is this a scam email I received?
I’m pretty sure this is a scam since I don’t have any idea how they know I’m a finance and accounting major, and never gave my email address out to anyone, but I’m having a hard time figuring out just exactly what the scam is since they aren’t asking me for any personal information, even in follow up emails. anyway, this is what the email says:
fromJovita Bernat
tog**************@gmail.com (I blocked my email out)
dateWed, Dec 2, 2009 at 4:32 AM
subjectEntry level position at MF GMBH is available now
mailed-byhotmail.com
hide details 4:32 AM (6 hours ago)
MF Group GmBH has a new enty level job opening in the Accounting Department. (No previous accounting experience is required). We are the largest Insurance Company in Europe with a successful long term commitment history.
About the Job:
We are looking for career oriented individual to join our accounting staff. This position is entry level and will be in our financial reporting and operations accounting areas. Candidate will handle various accounting responsibilities, including: perform data entry of journal entries, assist in performing financial transactions, assist with month�end, quarter-end and year-end financial reports, monitor and review transaction details, perform other duties as assigned.
About us:
Ag Int. is an independent, private, owner-managed company since 1993. Our headquarters are in Hamburg, Germany. Founded in 1993, we now have a global network of subsidiaries and offices around the world. Ag Int. has ended the year 2008 with USD3.22 billion in assets under management. The company provides unmatched convenience in Europe and the United States, serving more than 130.000 consumer and business clients. We take a global approach to our core businesses of general and life insurance. The diversity of our portfolio, both geographically and by line of business, is key to our strategy. We offer a comprehensive range of general and life insurance products and services for individuals, small businesses, commercial enterprises, mid-sized and large corporations and multinational companies. Our customers are some of the world’s largest industrial, c ommercial and professional service firms, insurance companies, and financial institutions. They trust us for our superior financial security, risk expertise, and service excellence. They value our fundamental strength � our capital and our people. We aspire to become the leading global insurance group in our chosen markets, and to consistently deliver top-tier results for our shareholders. By so doing, we will create strong relationships with our customers, agents and brokers, and provide rewarding opportunities for our employees.
What we offer:
Full/Part time employment
Compensation 45.000 � 55.000 USD + 13th salary
An excellent growth platform and a great working environment
Zero cost health insurance, matching 401(k)
Annual Partnership Exchange Programs
Free Regular Seminars
What are we looking for:
Must be US citizen or legal alien authorized to work in the US
High School degree (college degree is a plus)
Experience in Accounting/Bookkeeping is a plus
Must be willing to work overtime during certain parts of our month-end process
Ability to handle multiple tasks within a strict timeframe
Must have strong communication skills and customer service background
Should be able to work independently in a team environment
MS Office System Skills
Principals only. Recruiters, please don’t contact this job poster.
This company will appreciate your contributions and you will be valued for your dedication. AG Int. Is an equal opportunity employer and encourages applications from qualified women, minority and disabled candidates.
To Learn more about this position please contact Human Resources Department representative by replying to this E-Mail: alex.nuberg@gmail.com . Your request will be forwarded directly to a Recruitment Officer.

Medicare Insurance AZ staff answers:
Yes, it’s a scam. I am NOT a finance/accounting major and received the same email. A large company will not recruit employees in this manner and would not use a gmail account. Mine was from piter.herrick@gmail.com. Also, a large company would not state that this position requires a HS diploma, but that a college degree is a plus. Most large companies expect a college degree so unless you are working an internship partnered with your school and are A) excelling in school and B) excelling in your internship, this type of offer would not be common. The other possibility of this type of job offer without a degree is that you are already employed by a company and have demonstrated outstanding performance and capability on the job.
You should cease communication; they are probably looking for your personal information…i.e. Social security number, birth date, name…information to steal your identity. You say they haven’t asked…yet, but that will come when they “determine” you are their ideal candidate and want to “finalize” your application.

Donald asks…
Is Michael Moore a Moron or does that title belong to Roman Polanski?
Friday, October 2, 2009
MOVIE REVIEW: ‘Capitalism: A Love Story’
Sonny Bunch
Michael Moore’s new film, “Capitalism: A Love Story,” chronicles the galling excesses of our modern economy in brutal detail, jumping from home foreclosures to businesses cashing in on life insurance policies they had taken out on their dead employees to bank bailouts to million-dollar-bonuses paid out to executives of failed banks. As he comes to a crashing, triumphant crescendo, the merry prankster of modern moviemaking says he wants to get rid of capitalism and replace it with a better, fairer, more just system — democracy!
Democracy?
It’s a head scratcher. One doesn’t replace an economic system with a political system. Saying you want to replace “capitalism” with “democracy” is like saying you want to replace “public transit” with “puppy dogs.” It’s not quite right.
It’s obvious why he chose such a malapropism: “Socialism” is what Mr. Moore is really after, but that’s a far more disturbing word to the average American. He wants to replace one sacred-yet-secular American word (capitalism) with another sacred-yet-secular American word (democracy), fully obscuring that neither word means anything close to its dictionary definition in Mr. Moore’s worldview.
To Mr. Moore, capitalism isn’t an economic system that has delivered billions around the globe from poverty and subsistence existences by virtue of the profit motive.
No, to him, capitalism is an exploitative sham, an economic system designed to deliver money from the poor into the hands of the wealthy. If he had stuck to the recent bailouts of the banking industry, he might have had a point. Unfortunately, he spends much of the movie flying far afield of that travesty.
And that’s the main problem with Mr. Moore’s movie: His focus is too diffuse, his aim too scattershot. It’s old hat for the director to argue only one side of the story, but this is the first time he has so blatantly failed to focus on the primary issue at hand, flailing, instead, at all the wrong targets.
Consider Mr. Moore’s take on the foreclosure crisis: He sympathetically portrays two families who have gone through foreclosed after failing to meet their repayment obligations. Foreclosure is a terrible thing, something no family should have to suffer — unless, of course, they fail to repay the money that has been lent to them.
Credit is a bedrock of capitalism, but credit comes with certain responsibilities. Banks are not charitable institutions, and there have to be consequences for failing to pay back the money they advance. The subprime loan crisis was caused only in part by banks lending money to unqualified borrowers: No less complicit were the irresponsible citizens who took out far more money than they could afford on terms they could not possibly understand.
In a way, Mr. Moore and his ilk are the ones ultimately responsible for this crisis. By turning homeownership into a basic societal entitlement — irrespective of credit-worthiness — they encouraged the poor to borrow recklessly and leaned on lenders to give money even more recklessly.
Mr. Moore’s suggested solutions to the crisis of capitalism are almost as absurd as his diagnoses. As the film draws to a close, he asks us to reconsider Franklin D. Roosevelt’s second bill of rights, and one of those rights in particular jumps out: the guarantee of a job with a “living wage.”
This has been a constant bugaboo of Mr. Moore’s. He thinks General Motors Corp. — faced with competition from cheaper, better, more fuel-efficient vehicles from Japan and elsewhere — has shot itself in the foot. Not because it refused to build better cars or agreed to a back-breaking deal with the labor unions that made the cars too expensive, mind you. No, Mr. Moore seems to think GM has come to ruin because it has laid off too many employees, leaving the once thriving cities of the Midwest, including his hometown, Flint, Mich., wastelands with no business prospects.
Let us think about this for a moment, shall we?
GM automobiles are too expensive and too fuel-inefficient. They carry massive legacy costs providing health care benefits and pensions to both current and past employees of now-defunct plants. Increased plant efficiency and decreased need for labor are trumped by union demands to preserve jobs, resulting in excess workers collecting most of their pay for what amounts to make-work.
Yet GM should guarantee these people’s jobs and gold-plated benefits? Or the government should step in and subsidize inefficient companies to pay now-redundant employees?
Mr. Moore has always been long on provocative questions and short on answers. “Capitalism” is no different: He suggests a bright and shiny future without adequately examining the likely consequences of such a future or offering much in the way of proposals for bringing it to life — other than sophomoric pranks like showing up at a bank headquarters to

Medicare Insurance AZ staff answers:
Is there some reason that they both can’t be morons?

Mark asks…
Is the search for higher metrics from every working individual in fact diluting productivity?
I’ve worked for years in customer service/product support positions and have at least 1/2 an idea how to do the job. Now employed as an insurance adjuster, I’ve rarely had quite so many individual tasks to accomplish in as short a time as possible. Considering I’m bilingual (English/Spanish), have above average typing speed (70 wpm), and I’ve placed my on-line and desktop tools in the optimum configuration for my needs, I’m getting a bit frustrated with the continued (and now recently increased) expectation of a higher number of calls-per-hour.
Basically, I have to receive a call, review notes, examine holds, determine if they next steps require my intervention or if the customer (or other departments) need to complete further steps, search accounts, perform document reviews, use tools for product confirmation, product use in period of loss, perform identity checks, clarify conditions and terms (especially when a customer is enraged about paying a deductible – you’d be amazed how many people think insurance is a magic ‘premium only’ transaction and no matter what the cost of their insured item/service, we as the insurer are ‘wrong’ to expect them to share a partial burden in replacing items or services, even if their premiums would skyrocket), establish deductible payment parameters, shipping expectations, and answer any remaining questions – in the meantime documenting my activities, decisions, and prepping for the next call so I have NO remaining details to address prior to closing out my activity on an individual claim.
At the beginning of my training, my trainer (and supervisor) were satisfied that I was getting as few as 5 calls per hour completed. I was assured this is a normal speed for a beginning adjuster, and that with time my speed would increase to the (then) department expectation of 8 calls per hour.
Sure enough, I’ve passed the 8 calls per hour threshhold – but now, we’ve had an even higher call per hour expectation set: 10 calls per hour.
I’m not tooting my own horn when I say that I’m professional on the phone – I get above average or outstanding quality checks on performance and other metric ratings. I’m not a control freak (I don’t hang up on a customer when they meltdown – I talk them through it and give them enough information (and explanations) to (in at least 80 % of the cases) continue their claims process to deductible payment and replacement. I deal with people from many different cultures, some who have never had insurance on anything else in their entire life, and some who simply are not the sharpest knives in the drawer and bring out the educator in me (because no one should insure something without knowing exactly what their contract allows and how it applies to their claims). So it is really starting to aggravate me that in order to achieve an incentive (which is also, undoubtedly, part of the reason my supervisors and department managers are so gung-ho about it – they must in some way, receive additional compensation if the team or department achieve a certain performance metric) – I have to do ALL of the things described above in about 6 minutes PER CLAIM.
Such a cookie-cutter approach to claims (not to mention customers) is driving me straight up the wall. I’m not saying it isn’t possible (and certainly some in our department appear to be meeting this goal – but only by cutting corners or engaging in practices that ‘trick’ the metric performance measuring tools used by our employer to think more performance is being accomplished than is actually the case – and I’m not blowing smoke here, I’ve been the one catching the claims falling through the cracks in several of those situations) – but it is neither realistic or acceptable (to my mind) to expect such an ideal in dealing with the public involving something so sensitive as an insurance claim. Can you imagine? 6 minutes to do make a decision as to whether insurance coverage will be provided for a claimed product/service – and for some of these customers, it’s one of the most necessary items/services that they use in their daily lives.
I’m losing sleep now over this – even with increased exercise, better diet, and and attempt at relaxation techniques (including meditation). Part of the problem is my perfectionist nature (if I can be perfect in one way in my job, I would like to be perfect in all ways – another unrealistic (and job-fostered) expectation) – but I also realize that this is a common problem facing an American worker today. We are one of the hardest working societies in the world – yet I (like many working individuals I know) have fewer vacation days, less flexibility with my schedule, and more demands on my time at work than ever before in my life. If I miss ONE day or arrive late or leave early (no matter the reason – illness, car accident, inclimate weather, etc…) I’m no longer eligible for the incentive structure – and it takes me a month just to build 5 hours of personal t
time (which is used for both vacation days/sick time/leave time – no exceptions).
Does anyone else feel like they are losing pride/ownership in their job due to increased metric expectations? In my case, it’s getting to a point where I’m thinking about a career shift or changing departments – if such an option is available to me…

Medicare Insurance AZ staff answers:
I work in a similar type of job, where we claim customer service as the #1 priority, but in fact, cutting company costs clearly comes in first.
Like you, I prefer to actually resolve a request properly, as opposed to simply focusing on quickly, but in the time that is often set there’s little more to do than ensure you rush to make sure you get paid properly.
But when it comes down to it, if a company has 500 employees doing 6 calls an hour, they’d be “better off” having 300 do 10 an hour. And it sucks. But it’s simple math.
The accountant always wins.
Ever considered going into accounting?
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