Welcome to DU! The truly grassroots left-of-center political community where regular people, not algorithms, drive the discussions and set the standards. Join the community: Create a free account Support DU (and get rid of ads!): Become a Star Member Latest Breaking News General Discussion The DU Lounge All Forums Issue Forums Culture Forums Alliance Forums Region Forums Support Forums Help & Search

defacto7

(13,485 posts)
Sun Aug 24, 2014, 03:33 AM Aug 2014

I have always supported labor and continue to do so....

Even though my personal experience has been close to appalling, I understand the importance of unions and support of workers rights which certainly trumps my little world where it was not favorable.

I worked in the classical performance industry for quite a few years (I say classical for lack of a better term) and was a card carrying member of AGMA. Over the years I imagine they received more than $50,000 from my work through dues and insurance programs but I don't want to go into all the details but just share one. When I discontinued my career, I had a health insurance setup that is mandatory for all members. I had a balance of about $6800 in supplemental health insurance waiting for my one page application to apply for medical reimbursement. Over the years, I applied several times for repayment of medical items, doctor, primary insurance policies and whatnot, all applicable expenses. I have to date received $0.

Upon application, the printout they send back has a 2 character declined code for one reason or another. Once I sent in 10 pages of receipts and personal medical policy information... denied. In each case I tried to contact the offices of those who AGMA has hired to process their claims... no answer, on hold and no answer, recorded messages, no return calls, nothing.

A couple of years ago I gave up. It was a useless waste of time and my life didn't depend of the claim so I just stopped trying.

I got a statement today from AGMA Health Fund Plan B which starts with the words, "We are pleased to provide you with this statement..... blah, blah... Your closing balance: $388.28. They had been taking $500 per year out of the account for administrative costs. They didn't pay for a $200 pair of glasses because of a paperwork technicality yet they Blythely removed $500 a year for their expenses from my contributions.

Yes, I knew they were doing this, but since I gave up on pleading on my knees for my own insurance proceeds I just watched the amount dwindle to this.

Does anyone think the AFL-CIO or AGMA should be embarrassed by this long term behavior? I would think members of legitimate union affiliations would be embarrassed by such activities by other affiliates connected to their union. But this is the way AGMA has been run for all the many years I have been with it. It was useless and expensive and never gave me one break along the way. And now that my affiliation will automatically terminate by their own forfeiture provisions, their having cashed in on my contributions over the many years of my career without paying me a dime......

I say... fuck you AGMA!

Comments welcome.... I know most of you have been treated well but there are union problem fronts that make unions look pretty bad. This post is not meant to step on toes, it's meant to raise a flag, to ask others to keep an eye out for protection from the protectors and to make it right.

5 replies = new reply since forum marked as read
Highlight: NoneDon't highlight anything 5 newestHighlight 5 most recent replies
I have always supported labor and continue to do so.... (Original Post) defacto7 Aug 2014 OP
contact your state division or department of insurance Sherman A1 Aug 2014 #1
Thanks for the reply... defacto7 Aug 2014 #2
Having dealt with an interesting insurance issue Sherman A1 Aug 2014 #5
I agree. Enthusiast Aug 2014 #3
I don't think you stepped on any toes Omaha Steve Aug 2014 #4

Sherman A1

(38,958 posts)
1. contact your state division or department of insurance
Sun Aug 24, 2014, 04:08 AM
Aug 2014

and file a complaint. I believe this is more an insurance issue than a union one.

Do not fail to file appeal after appeal after appeal until you are satisfied.

I have to leave for work now, so I will check back later with a bit more.

Sherman A1

(38,958 posts)
5. Having dealt with an interesting insurance issue
Sun Aug 24, 2014, 07:21 PM
Aug 2014

years ago courtesy of my Charming Ex-Wife, (sparing the details of which) we ended up with some substantial (think multiple 6 figures 20 years ago) numbers in billing amounts. The insurance was less than enthusiastic about paying as one can imagine. I was even less so and that simply was not going to happen in any event.

So I appealed their decision with the help of a friend who worked in the insurance biz (and hated insurance companies). He helped me write the appeal using what he called "the magic words" so that the folks on the other end were left with the impression that they were not dealing with a dolt. Now it's been a very long time ago and I don't believe I have the appeal letter any more and my friend has sadly passed away, but as I recall the words were "reasonable & customary" when referring to the provider's billings that were being denied. Basically coming down to a determination of the provider's billings being within industry standards and if they were the insurance company had no choice but to pay them.

I will note that the insurance company did screw themselves as it was evident that they had pre-approved the item(s) in question and it was they who were dealing with sticker shock. They eventually settled for about half and the provider wrote off the rest after 2 collection attempts.

He also told me to continue to appeal any decision that I didn't like. That no case is settled until I decide it is.

Omaha Steve

(99,709 posts)
4. I don't think you stepped on any toes
Sun Aug 24, 2014, 06:57 PM
Aug 2014

And yes complain to the state about the entire chain of endless trouble. Keep us in the loop.

OS
Latest Discussions»Issue Forums»Omaha Steve's Labor Group»I have always supported l...