Feb 27, 2008

Health Insurance Update

The short story is that there's nothing definitive to report.

I did speak with the insurance company customer "care" people (now, isn't *that* an oxymoron?!). While they were nice enough, they claimed to have no notice of the situation (neither she nor her supervisor). The supervisor said that "typically" if a woman is so close to her due date, the insurer would still treat the hospital as in network. They wouldn't put it in writing though.

I also sent an email to the negotiating VP for the insurance company. Not surprisingly, I've gotten no response to that (though it didn't get bumped back either).

My OB 's office believes it's just, as Betty said, a corporate pissing match and that they're telling patients not to panic. All well and good except that they're not the ones faced with a $10K hospital bill if it doesn't work out. I was unable to confirm whether he does still also deliver at UConn or not.

My state legislator forwarded my stuff to "the appropriate lobbyist" to ask for help. Haven't heard anything further.

John's spoken with the insurance agent who says that, as long as we decide in the next week or so, we should be able to switch insurance carriers and he's getting quotes. The problem with that is that it means not just switching *us* but switching his entire office - which isn't really fair to the others in the office. The agent did feel that it was likely that this was just posturing for negotiation and, even if the contract talks failed, it was likely I'd be covered still under the principal of continuity of care.

So... how's that for a bunch of "up in the air"?! Some heartening info - but it's all so vague and no one will commit to anything. Argh!!!

The one thing I've discovered is that most people hate health insurance companies. Frankly, I think they ought to be non-profits. Because as long as there is money to be made, there is a fairly strong conflict of interest there. Just MHO!

Feb 23, 2008

Just a Little Health Insurance Freakout

Ok, I am seriously freaking out here.

I got a letter today from the hospital where we're scheduled to have the baby in early May. It seems they've been unable to reach a contract with our health insurer despite twice extending the deadline (the hospital is a nonprofit, the insurer is not) and, if they don't reach one in the meantime, as of April 1, we won't be covered if we have the baby there - it will be an out-of-network hospital.

I can't afford the OON fees (which, in our case, according to my insurance paperwork, would be just about the whole cost of having the baby - 2 years ago, it was about $13,000) and I sure as heck don't want to give up my OB at this point in the game (I'm 29 weeks tomorrow) - even assuming I could find another one.

I am hoping that one of the following happens:

(1) Best of all: they reach agreement and we continue as if nothing happened.

(2) I believe my OB has admitting privileges at the local medical school hospital *but* it looks from their website that he doesn't deliver there. I'd have to have one of their on-staff doctors do it and I'm not comfortable with that.

(3) I already have a letter from my health insurer (from the fall) approving me to deliver by c-section at my hospital - maybe because they sent me the letter already, I'll be ok?? Unfortunately, it also says that the approval is subject to the in-network/out-of-network benefits of our policy, so I rather doubt it.

I've emailed the negotiating VP for the health insurance company and plan to call his office on Monday. I'm also planning to call the customer service people at the health insurance company on Monday to find out if that letter will keep me from having to foot the bill or if there is some sort of exception for women about to have babies when this sort of thing happens. I'm *also* planning on calling my boss, who is also a state legislator, to see if she can hook me up with someone in the State Office of Health Care Advocate. Not that they can do anything really for me specifically but they could apply pressure to the health insurer to resolve the contract negotiation quickly and positively for subscribers.

Part of what's so damn stressful is that there's only about 10 weeks before I deliver (God willing) and, by the time the deadline passes, there will be only about 4 1/2 weeks remaining - that's very little time to get any other alternative plans in place, even if I knew for sure, today, what the end result of the negotiation was going to be.

This just sucks. I know, I know - there are so many more people with so many more urgent issues than this, but I'm freaking out all the same - this hospital and my OB have been really good and the idea of having to change is really frightening, particularly given the reputation of the "big" hospital (not the medical school hospital) in the area (currently on probation for a number of issues, including a fetal death from lack of monitoring).

Feb 15, 2008

Silent Flood

It is
an hour before you
expect me
to be finished work.
It is
Valentine's Day.

Pale blue satin skims a full breast,
echoing the blue lines
of the veins
in my chest and shoulders.
It is new, saved
for Valentine's Day,
almost too large, even for my
body as it grows with our
child.
I feel almost
pretty.

You have fallen asleep
in your clothes but
I expect
you will awake
as you usually do
when I come up from work.

You barely stir,
your feet hang off the bed,
soles up,
shoes on.

You do not notice that I am
an hour early -
a gift to you in honor of
today's saint -
nor that I
have put myself on
the line
again
by asking without words
for that which
most wives
find
too often imposes
on their bodies.

Your eyes creep open
as I
crawl
into bed.
They are so bleary,
I do not have
the heart
to impose.

I am
sorry
to have disturbed you.

I turn off
the light.
I cannot turn off
the
silent flood.

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Feb 9, 2008

Because I Feel Like Wasting Time on a Lazy Saturday Night

1. If your doctor told you TODAY that you were pregnant, what would you say?
No shit, sherlock!

2. Do you trust all of your friends?
Some of them with everything, some of them with some things, and the rest aren't really friends.

3. Would you move to another state or country to be with the one you love?
Been there, done that.

4. Do you believe that everything happens for a reason?
I do; though I also believe that we may not know what that reason is/was for a very long time - or even in this lifetime.

5. Can you make a dollar in change right now?
Not unless a dollar really equals $.17.

6. Which one of your friends do you think would make the best doctor?
Sarah or Cindy because they can keep things in perspective and still maintain their compassion.

7. Are you afraid of falling in love?
Again, been there, done that - guess not!

OK what happened to #8?

9. Is there someone who pops into your mind at random times?
Usually, it's my mother's nagging voice that pops into my mind at random, and unwelcome, times.

10. What’s your most favorite scar?
My c-section scar because, without it, my daughter wouldn't be here.

11. When was the last time you flew in a plane?
Mid-March 2005, an instrument flight lesson. (I puked and that was that until the baby came and now I can't afford to fly.)

12. What did the last text message you sent say?
Like I remember? Probably "hi" or something like that.

13. What features do you find most attractive in the preferred sex?
Eye crinkles and broad shoulders, a nice smile, and a good sense of humor.

14. Fill in the blank. I love ________.…
CHOCOLATE!

15. What is a goal you would like to accomplish in the near future?
Get through the jewelry show I'm doing at the end of the month with a HUGE profit.

16. If you were to wake up from being in a coma for an extended time, who would you call?
The nurse to find out how long I'd been in the coma

17. How many kids do you want to have?
Well, I have one, am expecting one, I suppose I could do one more than that without flipping.

18. Would you make a good parent?
My husband says I am a good parent. I'll let my kids' future therapists be the judge of that one.

19. Where was your favorite picture taken?
My current favorite picture was taken at a waterfall about 13 months ago - shows all three of us on an incredibly warm January day and is, amazingly, flattering for all of us!

20. What’s your middle name? Elizabeth

21. Honestly, what’s on your mind right now?
How annoying it is that most cold medications pass the placenta

22. If you could go back in time and change something, what would it be?
I've watched enough sci fi shows to know that effing with the past is a BAD idea.

23. Who was or will be the maid of honor/ best man in your wedding?
My sister was - and was way prettier than I was, unfortunately for me.

24. What are you wearing right now?
black knit pants, red shoes, red sweatshirt, and a black t-shirt that says "I'll bet she's tougher than that; she runs with vampires." (Jade - August 2!!!!)

25. Righty or Lefty?
Right

26. Best place to eat?
Local favorites? The Elbow Room, Olympia Diner
All time favorites? Tisha's Oceanfront Dining (Cape May, NJ)

27. Favorite jeans?
None right now, my maternity jeans itch!!

28. Favorite Animal?
Cats generally but our cat tends to be kind of annoying...

29. Favorite juice?
Pineapple

30. Have you had the chicken pox?
Ohhhh yeah - over Christmas when I was in 3rd grade.

31. Have you had a sore throat?
More times than I can count; including right now.

32. Ever had a bar fight?
Nope.

33. Who knows you the best?
Me.

34. Shoe size?
Increasing daily. Was 7.5, now 8.5 creeping to a 9.

35. Do you wear contact lenses or glasses?
Glasses - but cool ones.

36. Ever been in a fight with your pet?
Not unless you count when I try to get a pill down her throat.

37. Been to Mexico?
Nope

38. Did you buy something today?
Yep - trips to Target for everyday stuff (diapers, laundry soap) and Lowes for pre-painting supplies (TSP, stain-killing primer)

39. Did you get sick today?
Yes, sadly.

40. Do you miss someone today?
All sorts of people

41. Did you get in a fight with someone today?
A battle of wills with my 2 year old but not enough to qualify as a fight.

42. When is the last time you had a massage?
Oh, Lord, I don't know... Before I was pregnant with Katie, I think. I've had a gift certificate for one for the last year and a half but haven't been able to get time to use it.

43. Last person to lie in your bed?
Me

44. Last person to see you cry?
My daughter

45. Who made you cry?
My daughter (and exhaustion)

46. What was the last TV show you watched?
John is watching some TV show right now and I'm in the room - not sure what it is though.

47. What are your plans for the weekend?
Sit on the couch and be sick, then go to Mass tomorrow afternoon and then to Mom's for meatballs and spaghetti

48. Who do you think will repost this?
Probably no one.

49. Who was the last person you hung out with?
My husband, currently hanging.

50. If your significant other asked you to marry them TODAY, what would you say?
It's 11:37 p.m., where are you going to find a priest??!

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Feb 6, 2008

F*CK the NJ Dept of T@xation

With whom I spent the better part of 3 hours dealing this afternoon.

Now, I was always taught that following the rules was every citizen's duty so, when I signed up to do a late-July 2007 craft fair in NJ, I registered with the NJ Dept of T@xation last April, to be effective at the end of July. I did the craft fair and, immediately upon my return to CT, filed my 3rd quarter sales and use tax return. I knew that I wasn't going to be doing anything else in NJ so why wait? I filed online, paid nearly $200 for the privilege of being registered to collect sales taxes on behalf of the State of NJ, got a confirmation number, printed the page, and a few days later the NJ Dept of T@xation deducted the tax due from my business checking account.

And that was that, right?

Well, until today. Today, I get a Notice of Deliquency from the NJ Dept of T@xation stating that I am in trouble for not filing my 3rd quarter sales and use tax return and am subject to penalties of $100 per month.
  • Reaction No. 1: freak out!!!
  • Reaction No. 2: cry!!!!
  • Reaction No. 3: go find my printed confirmation. Yes, I did pay the damn taxes.
  • Reaction No. 4: fury
  • Reaction No. 5: call the NJ Dept of T@xation.
Ok, you'd think this could be easily cleared up because I have a confirmation number? No. Of course not. They can't find it. I have to mail in copies. By now, I've been on the phone for nearly 1/2 hour and I have come to:
  • Reaction No. 6: get the fuck out of NJ and never do business there again
  • Reaction No. 7: look on the website for the NJ Dept of T@xation, get referred to the NJ Dept of Revenuee.
  • Reaction No. 8: find the form I think I need on the NJ Dept of Revenuee's website, discover the instructions are confusing.
  • Reaction No. 9: call the NJ Dept of Revenuee for clarification
Which means another long stint on hold. Fortunately, this time, I get a very helpful person on the other end. Unfortunately, she has to wrangle some computer miracles to allow me to cancel my registration in NJ - which, again, takes time. But, on the plus side, I do discover why the NJ Dept of T@xation thinks I didn't pay the 3rd 1/4 sales and use taxes - they mistakenly put my business start date as June 1 instead of July 28 and credited my form and payment to the 2nd quarter sales and use taxes. So, she changes the start date which she believes will take care of it but suggests I still send in the proof of payment like the NJ Dept of T@xation suggested. She also tells me that I have to file and pay for ($50) an annual return before I can cancel my registration. Never mind the fact that I haven't even been in business there a year yet and that form technically should not be due until April. If I want to cancel, I need to do it.

So, off I go to the NJGBS website to do so. Alrighty, back to the form that was giving me trouble, fortunately, the nice Revenuee lady gave me a phone number to call at the Business Registration Department. As I am on hold, my husband calls, twice, so I think there's a problem. I pick him up, there's no problem, so I tell him I can't talk. I click back and they've hung up.
  • Reaction No. 10: swear as loudly as I can without waking the napping toddler.
  • Reaction No. 11: call back. The line is busy.
  • Reaction No. 12: call back again. The line is busy.
  • Reaction No. 13: call back again. Yep, still busy.
Give up and fill out the form as best I can. Gather all the enclosures that need to go with the form. Write both letters, gather the enclosures that need to go with the letters. Call the husband back to get him to bring home certified mail slips (I mean, the people lost my online filing which they clearly received as the money disappeared from my checking account; I'm going to trust them to actually receive my mail?).
  • Reaction No. 14: Try the NJGBS people one more time. To my shock, get through. Confirm that I've filled the form out incorrectly.
  • Reaction No. 15: Recomplete the form, make copies, prep certified mail slips and envelopes, write the check for $125 to pay for the cancellation.
All that's left now is to go to the post office tomorrow and pay the shot to mail these things certified mail.

And if you're wondering what the total is I've paid so far to the Charming State of NJ? Let's see: $200 with the original filing, plus $75 to the state of CT for the certification that NJ required, then $50 for the annual report, and another $125 for the cancellation certificate. So that's, what, $450? Now, if they deem my 4th quarter payment to be late (nothing was due); there'll be another $100 on top of that. Oh, and, of course, the whopping $82 in sales tax I collected on their behalf.

So, yes, all my life I've played by the rules (with the occasional exception of the speed limit). But, you know, I'm starting to reconsider that because, clearly, in NJ, if you play by the rules, you get fucked over but good.

Feb 4, 2008

Success is a Relative Term

First off, I have a splitting, toddler-induced, headache. I'm sure most of you will understand if I am not as coherent, cogent, or co-something'r'other as I might normally be.

The event last Thursday went well, I thought. It was not profitable (gross was about $100 less than costs) but people seemed to have a good time and the jewelry was well-received. Hopefully, the next two events will be blast-the-doors-out profitable and I'll start seeing some increased web purchases.

The website is what's been so frustrating. I know, I know - it takes a while for websites to start creeping into the public consciousness but you'd think that, in 9 months of having my website up, I'd have more than two sales (and a huge THANK YOU! to the buyer - you know who you are!!). Still, I'm keeping my hopes up - my business copier (leased years ago when I was still doing freelance paralegal work) will be paid off (it's a dollar buyout lease) in April and then my overhead is down to the $10/mo I get charged for my credit card processing service - so that should help ease the financial burden. LOL - and I get on John's case for being too hard on himself because his firm isn't an "overnight" roaring success!! Eh, call me a hypocrite; you'd probably be right in this instance.

In family news, John's sick and the Napless Wonder is being particularly demanding this afternoon. Can someone tell me, btw, when toddlers start understanding the concept of "why"? (As in, "why are you crying?", "why did you do that?!!" (the toddler-safe equivalent to "what the fuck were you thinking??!!"), etc.) I feel, much of the time, like I am talking to a wall!

Oh, and here's another question for the more tech/scam savvy! I was paying my cellphone bill on Saturday and realized it was $20 than the prior month so I actually studied the bill and, it appears, somehow I got signed up for some sort of monthly service (the nature of which I have no idea!!). Fortunately, the cellphone company credited me for that amount but what I'm wondering is how it came about! The service representative asked if I voted by text message for call in voting (like American Idol). (I politely told him no - I was too embarrassed to tell him I'd never even watched a reality TV show.) He said that was the most common cause. If anyone has any other ideas of ways it might have happened, I'm open to listening because, as helpful as they were, I'd really prefer not to have the hassle of calling them again!

Alrighty, John should be home with the eggs soon. We're having pancakes for dinner. I was going to make them tomorrow in honor of Shrove Tuesday but he requested something easy on the stomach (non-spicy, non-greasy, bland) and, after a look at my freezer, I didn't feel like serving a basket of saltines for dinner. And, really, that sounds pretty good to me tonight anyway. He's not home tomorrow night so Katie and I will just eat leftover pancakes tomorrow night.

Later, everyone.


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