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COBRA HELP!

Could anyone clarify whether we are required to pay the initial premium amount sent by Optum, which reflects the total before the subsidy is applied? I was advised by CNC HR that we must pay the full amount upfront and that Optum will later deduct the subsidy once they receive the relevant details, warning that failure to do so could result in the termination of our insurance on 9/30/26 without the possibility of retroactivity. However, Optum has provided conflicting information. Does anyone have definitive guidance on the correct procedure, as I am hesitant to pay $3,000 upfront to prevent my insurance from being cancelled?


Isn't it ironic

Isn’t it ironic that a health insurance corporation fails to provide the best health insurance coverage for its employees?

Found this gem in one of the older threads and I didn't know if I should laugh or cry. This is 100% correct. We're supposed to have the best coverage considering where we work and we're so far away from it that it's a joke.


Lots of finger pointing and blame happening on this board.

"We The People" are the su-kers!

Both the Democratic and Republican parties share responsibility for the structural issues within the U.S. health insurance system. They have shaped it through entirely different ideological approaches and legislative actions. Rather than a singular party being solely to blame, experts generally view the current system as a product of decades of bipartisan compromises, corporate lobbying, and conflicting political philosophies.

Health insurance is simi-legal fraud. From an economic perspective, critics argue that the private health insurance industry acts as a heavily bureaucratic middleman that adds cost without adding medical value. Health insurance is profit-driven. While health insurance companies operate legally under strict federal and state regulations, many of their standard business practices are deceptive and predatory to patients who pay premiums only to face denied claims or massive, unexpected bills. The underlying tension exists because private health insurance companies operate as profit-maximizing corporations, whereas consumers view healthcare as an essential, life-saving need.

Several systemic corporate mechanics shift financial risk and administrative burdens onto patients. This framework gives insurance companies a perverse incentive: to increase total profits, they must allow overall healthcare costs to rise, as a fixed percentage of a larger number yields a higher dollar return.
• The Illusion of Coverage (Deductibles & Out-of-Pocket Maxes)
• Claim Denials via Prior Authorization
• Narrow Networks
• The Complexity of "Explanation of Benefits" (EOB)


The Market Forces Quietly Adding Thousands to Patient Bills

This is what is just one of many things wrong with having large for-profit corporations to be handling the administration of Medicare. They are part of the problem of fraud, waste, and abuse…NOT the solution.

When a large corporation, owns several pieces of the supply chain, both acting as the insurer but also owning hospital facilities, labs, and urgent care centers, these same health insurance corporations can push providers to have procedures done in day a costly surgical hospital, even though the procedure would normally be done as a simple outpatient with local anesthetic. The difference between the two can be from $18,000 to just $3,000, for just this one example in the article. But I have read about much worse examples than even this with disparaging costs on the hundreds of thousands.

Please feel free to read either article, which are the same but in case you trust one news source over the other I am supplying both.

https://kffhealthnews.org/news/vertical-integration-high-health-costs-prices-hospital-mergers-pharmacies-pbms/

https://www.cbsnews.com/news/vertical-integration-healthcare-higher-patient-bills/


UnitedHealthcare to drop prior authorization requirements for range of conditions from Oct. 1 Reuters Tue, September 1, 2026 a

Sept 1 (Reuters) - UnitedHealth's insurance unit said on Tuesday that a broad range of conditions will no ‌longer need prior approval, effective October 1, as ‌it aims to eliminate prior authorization for 30% of healthcare services by ​the end of this year.

https://www.yahoo.com/finance/healthcare/articles/unitedhealthcare-drop-prior-authorization-requirements-101737062.html


ICHRA

OH and OK added as ICHRA states. Does this mean we no longer have the option to choose from the 4 options we had before?

I've heard from IN folks ICHRA is AWFUL, not accepted country wide and lacking providers who actually take the plan...


ICHRA

I am curious as to what kind of experiences those with the Indiana ICHRA healthcare plans are having this year so far. Are there any big challenges or any positives that you're seeing and has anyone been told whether or not you all will have to stay on those plans for 2027 and beyond?


Health insurers are dropping Medicare Advantage plans — and nearly 3 million older Americans will be affected

https://finance.yahoo.com/healthcare/articles/health-insurers-dropping-medicare-advantage-100000446.html

Thousands of seniors are receiving notification that their Medicare Advantage plan won't be available next year, and there's nothing they can do about it except find another option.
One in 10 Medicare Advantage policyholders face forced disenrollment this year, according to an analysis by researchers at the Johns Hopkins Bloomberg School of Public Health. That's as many as 2.9 million Americans.


Why is Via Benefits trying so hard to reach me?

Via Benefits is leaving messages that Wells Fargo authorized them to call me about Medicare. I did search and found them to be some sort of insurance advisory company. Before I call them back, does anyone have any experience with Via Benefits? Seems fishy, lots of companies want to “help” us Senior folks with Medicare.

Maybe they have a free knee brace offer that has a stage coach logo?!


Post Baker Hughes, Just realized the Health Insurance su-ked! I’m talking about the premium one the most expensive one they offered.

Was there for quite a while paid upwards of $1300 a month for many many years.

Deductibles were high, even on the plan where they deductible was the least amount.

Prescriptions were expensive, even with that insurance.

Post Baker Hughes I’m coming to realize that their insurance was not all that great..

Now at a different employer with their insurance, it’s 1/3 cheaper per month deductibles are very, very low and prescription medicine is cheaper.


Medicare & Medicaid Need to Be Administered by Non-Profits & Not-For-Profits

All of these large for-profit health insurance corporations such as Humana, Cigna, Centene, Elevance, etc. really need to go under or have the government completely remove their contracts for administering Medicare & Medicaid and those contracts need to be granted to non-profit and not-for-profit companies.

Shareholders and large banking firms never should have gotten their greedy fingers into heath insurance, which is intended to be a lifesaving and quality of life industry for our elderly seniors (and also the poor and disabled), which are human-beings, our brothers and sisters, that deserve our love and respect.


Farmers Insurance Cuts Jobs in Claims and Auto

Farmers Insurance confirmed job reductions last month. At least 350 positions were cut. These layoffs impacted personal and commercial auto, claims, and distribution. Smaller reductions also happened in 2025. These included auto repair, training staff, and commercial lines.

https://www.repairerdrivennews.com/2026/07/07/pc-specialist-reports-claims-department-layoffs-at-farmers-insurance/


$60,000 Fines for Mutual of America & Truspire in Florida

Long Term Boca Retiree here. The Florida Office of Insurance Regulation released it market conduct investigations report in April 26. Truspire is going out with a literal bang !

Florida cited and fined both Mutual of America & Truspire over a collective $60,000 in fines for violating Florida law & insurance statues. These were over some BS LTC filing. But, MoA & Truspire received more fines (5) then any other insurance company. Not sure who in the legal area w/the states dropped the ball but this is very embarrasing. For more details go to:

FLOIR.gov

and read for yourselves.

Someone was asleep at the switch. time to dock his pay or ship his role to India.


Conversion / Portability for Life & AD&D

I didn't realize you could convert the group life &/or AD&D insurance after severance into a Whole Life policy or port to term life / AD&D policy via MetLife. I always thought those coverages were just benefits available while you're employed and once you're gone you're done and gone.

For the life in particular, what made you choose Whole or Term? Did you compare rates with other carriers? For me personally, I don't think I'll qualify for anything else with anybody else because of medical condtions, so the whole conversion is making some sense, even if I can't compare rates.

I guess I could call Big Lou.


Medical coverage

I didn't receive the offer, but I'm still curious, what kind of medical coverage comes with it? Do you get a full year, 60 days, or something else? Considering current costs of health insurance, that's be the one thing that'd make me decide for or against taking the offer.