Posts Tagged ‘Congressman’

er1Trip and fall breaking your arm at home – no problem.  Slip out of your saddle and break your arm while enjoying your motorcycle hobby – you may get slapped with a major medical bill!

Why?  Health plans do not have to notify individuals and employers of any exclusions or limitations on their health benefits at the point of sale.  Many employers or individual “consumers” shopping for health care coverage are led to believe that care for the broken arm, for example, is the same regardless of how the injury happened – but this is not the case.

But, it looks like help is on the way.  Congressman Michael Burgess, MD (R-Texas), introduced the Burgess Bill (HR1253) requiring more transparency in health insurance.  The bill would make a technical correction to HIPPA (Health Insurance Portability and Accountability Act) and would instruct health plans to notify individuals and employers of any exclusions in health benefits.  The bill recently passed the house and will:

  1. Require that any limitations and restrictions on health plan benefits be explicit and clear;
  2. Require that the health plan be disclosed to the sponsor of the group health plan in advance of sale and,
  3. Require that the issuer, in an easy to understand way, provide participants and beneficiaries a description of the limitations and restrictions as soon as they enroll.

Important to note is the Burgess Bill, originally submitted in September 2008 to the house as HR6908 was received, but no action was taken by the Senate.  Mr. Burgess reintroduced the bill (video HERE) with Congressman Bart Stupak (D-Michigan) as HR1253 (Health Insurance Source of Injury Clarification Act), but it’s identical to HR6908.

Health care transparency is good.  Punishing riders for enjoying their hobby with exceptions buried deep within an insurance plan only to be caught off guard is plain wrong!

UPDATE: April 10, 2009 – Received feedback from experts (thx Kitty!) in the field.  Although the post is accurate, making blanket statements is difficult since each state has different provisions and rules.  However, in the state of Oregon, Individuals (people who are interested in buying their own private policy) are provided with a carrier brochure/application by their broker or the insurance carrier which includes the covered services and exclusions.  With Group Insurance , the employer makes the decision on the plan purchased and is given a copy of the carrier proposal which would include the benefits and exclusions.  All insurance carriers must provide employees with a copy of the employee insurance handbook at time of enrollment.  The book includes covered services and exclusions.  Handbooks are mailed to home addresses by the insurance carrier to be sure employees receive this important information.

Photo courtesy of NBC/ER.

All Rights Reserved © Northwest Harley Blog.

Read Full Post »

Jim Jones

Jim Jones

Every now and then I’ll deviate from a specific motorcycle post and such is the case today.

I remember the time like it was yesterday.  At the time I was living in Alexandria, Virginia and would drive down to visit my grandfather and step-grandmother who was a most religious woman.  They lived on a large well-maintained ranch with the literal white-picket fence in a Richmond suburb that had many more retired civil service employees living out their days versus actual working ranches.

For weeks she spoke of the second coming…as if drugged with some “opiate” of religion and everyone had to be brought on board a new level of enlightenment.  She relayed stories about an engaging speaker out of San Francisco, a pastor who drew religious people together from all across the country. This minister had built a communal organization and set up an integrated sense of family which was rare to have an integrated Christian congregation filled with young, idealistic and many college-educated people.  Unable to enlighten or convince my grandfather to make the appropriate changes, she took all the money from the family savings account, packed a small suitcase with only a few belongings, boarded a commercial air flight and left my grandfather to live out his remaining days alone.

The flight was headed to Jonestown, Guyana and home of the Reverend Jim Jones, the twisted leader of the Peoples Temple cult.

Later on we learned that Congressman Leo Ryan who was concerned about constituents that had joined the group arrived on a fact-finding mission to Jonestown on November 18, 1978.  After meeting with Jones and his followers, their small party was ambushed by Peoples Temple gunmen as they were leaving. The congressman and four others were killed.  The shootings were just the beginning of the carnage as later in the day more than 900 members of the Peoples Temple died in a mass suicide ceremony, most after they lined up to drink poisoned Flavor Aid.

I never understood the path my step-grandmother took, how she became misled to give all her money to Jones, or sought out acceptance and a sense of family through this cult.  It turns out that many people were fooled by this engaging speaker or character who called himself a minister. It’s been reported that Jim Jones entertained people and had a way of spinning words with a tremendous power in his voice. He drew people who were basically religious, were hard-working, and drawn to his messages and promise of a paradise.

Not a year goes by that I don’t stop to remember Jonestown and the terrible loss.

Photo courtesy of NYT

All Rights Reserved © Northwest Harley Blog

Read Full Post »

%d bloggers like this: