Employment contracts 101

Employment law is a complex area, but generally, the laws favor the employer over the employee.  Be weary of signing agreements that give you little recourse in the event of a breach.  For example watch out for–

  1. Covenants not to compete.  These may be in sales contracts, or other industries that rely heavily on a book of clients.   For example, the contract may have you promise not to work for a competitor for a period of two years, and may also limit the geographic area you can work in for a competitor.
  2. Temporary employment contracts that are strictly at will.  These contracts may have you promise that you understand the nature of the employment is at will and can be ended at any time by either party.  Alabama and Georgia are “at will ” states, meaning, if your employer doesn’t like the color shirt you have on that day, you could be fired.  Literally.  They do not have to show a reason.  You do have protections for discrimination based on age, race, sex, religious belief, etc., under Title 7,  but these types of claims are very time consuming, and difficult to prove.

There are some employee friendly states in which case law precedents have accorded the employee  a reasonable time to demonstrate his/her ability to do the job..i.e. 90 days.  In addition, the “at will” nature of an employment agreement has exceptions and an enforceable contract may be formed:

  • Where the employer has made some assurance of job security, the act of relocating to accept an offer creates an implied contract.
  • When circumstances surrounding the formation of the contract, such as resignation of old employment and relocation, are legal precedents to conclude that there is an enforceable contract.
  • When the circumstances surrounding the employment agreement are fraudulent
  • When the employee has relied on a promise of employment to his/her detriment and injustice can be avoided by enforcing the contract

Overall, your outlook should be cheerful and exciting when you embark on a new job.  Be the best you!  But also be aware of your rights, and be cautious.

Disclaimer: This blog is Commentary Only and nothing here is to be interpreted as legal advice, solicitation, or any claim that the quality of legal services offered by The Keli R. Edwards Law Office, LLC is greater than the quality of legal services performed by other lawyers. I welcome your feedback and comments!

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Why I cancelled my Affordable Health Care Insurance Plan. Are you required to use a network of “preferred labs?”

Read the fine print. You hear it all the time. Be advised, your new insurance plan under the Affordable Health Care Act, may leave you up the creek without a paddle.

Case in point, I was excited to have my Bronze Saver plan through Blue Cross Blue Shield, and based on the brand of Blue Cross, I thought I had “good insurance.” Well, shortly after I used my plan for routine tests I received a nasty letter that read something like

You must review your benefits online before visiting your doctor to make sure those services are covered. Your recent lab services were not sent to in-network labs, and are not covered. It is your responsibility to review this information before you see your doctor.

Really?

Yes, my plan required me to use a series of “preferred labs.” This was indeed a little different for me, having a background in managed care, and health insurance, I found it extremely odd. Even the billing specialist at my Doctor’s office was unaware of the “preferred labs” requirement when she submitted my lab work, and “it wasn’t clear on the insurance card….they usually tell you…”

Even after all this, I stuck with my plan, and began the appeals process, which is actually one of the protections under ACA–a guaranteed right to appeal coverage determinations. This is what pushed me over the edge though–

At a visit to a primary care location I called my insurance plan Blue Cross Blue Shield, knowing my history of the rejected lab charges, and simply asked “What Doctor can I use in this area that will utilize the lab that you want me to use?” The agent directed me that the lab was Quest Diagnostics and that I would have to ask the doctor at my visit which lab they used.

WHAT??! Me: “So you are telling me you can’t give me or direct me to a list of providers that use your “preferred labs?”

Agent: No, I’m sorry. But you can go to an in network hospital…

Me: This is ridiculous, you can just cancel my plan right now!

And that’s how it happened. I just share this so that you can be aware of the fine print. Health insurance is a good thing but if you are not informed it can be a drag. Talk about drag. After my appeals were denied, I had to settle a bill for lab services in excess of $1300.

If you haven’t already, review your benefits plan online. They probably didn’t send you a real booklet. Another tactic that I feel is terribly unfair. But life is not fair, nor is the law of contracts. So if they directed you to review your plan online, Do it! Read everything before you use your plan. Don’t just assume because your insurance is a certain, or “trusted” name that you are good.

The idea of a “preferred lab” versus a preferred provider, is still very hard for me to accept.

I can understand your insurance plan being a HMO or restricting you to a certain group of MDs, but the idea that we should take the extra step to inquire where my MD is going to send my urine or blood sample after my visit to make sure it is a preferred lab is a little over the top.

What do you think?

Disclaimer: This blog is Commentary Only and nothing here is to be interpreted as legal advice, solicitation, or any claim that the quality of legal services offered by The Keli R. Edwards Law Office, LLC is greater than the quality of legal services performed by other lawyers. I welcome your feedback and comments!

Bankruptcy 101

Considering Filing for Bankruptcy? You probably have some questions and concerns. No worries…

341 Hearing, commonly known as the Meeting of the Creditors, is one of the first steps in a bankruptcy proceeding.  As the person who files a petition for bankruptcy, you will meet with the trustee, who is not a judge, in the bankruptcy court. The trustee represents the interests of the creditors.   The creditors will not likely show up; if they do, they can ask you questions about your assets, but the trustee will limit them to brief questioning.

The trustee will review your bankruptcy paperwork for accuracy, and compliance with applicable bankruptcy law.  You will have to swear under oath that the information you submitted and your answers are true.  The trustee will ask you questions about your assets, to determine your ability to pay, for example whether you have a security deposit box at the bank?  Or if you have any other “hidden” assets.    Questions may focus on any errors in completing the bankruptcy forms, and search to discover undisclosed income, property of value that you have that you transferred to another in attempt to defraud the process, or any other suspected abuses of the bankruptcy process.    Be aware that failing to disclose assets or attempting to defraud the bankruptcy process can result in criminal prosecution.

Sample questions the trustee may ask at a Meeting of the Creditors

1)      Have you listed all your assets on the bankruptcy schedule?

2)      Do you have any safe deposit boxes?

3)      Have you transferred any property to another in the last year?

4)      Do you own any interest in any real estate?

5)      Is all the property listed yours?

6)      Do you have any law suits pending against you?

**Then the trustee will direct any creditors who may be present to ask any questions**

Your bankruptcy attorney will prepare you for this hearing and help you to get the best outcome in your bankruptcy estate by being strategic about managing your assets.   In fact, gathering information before this meeting is the most important step.  You must work with your attorney to locate and notify all of your creditors.  Also, you must attend the required debt counseling classes.  After the hearing, there is a waiting period for the creditors to object to your bankruptcy petition.  Then, the trustee will issue a court order.

BANKRUPTCY OVERVIEW

In a bankruptcy, your debts are discharged, which doesn’t necessarily mean you don’t owe anything.  The treatment of your bankruptcy estate depends on whether your debts are secured or unsecured.  Secured debts are those that are “secured” by some tangible thing,  i.e. a mortgage note on your home, or a car note for your car.   The debts for these items will not be discharged in bankruptcy–either you can give them up, which is probably not what you’d desire, or work with your attorney to get an affordable payment based on your income.  Everything else falls into unsecured debts, i.e. credit card payments, medical bills, utilities.  There are some exceptions, debts due to fraud, a DUI driving offense and student loans cannot be discharged in a bankruptcy.

The Bankruptcy shouldn’t be thought of as getting rid of your debt, it is literally starting over.  You get a second chance to re-establish your credit and all the existing debts that can be discharged will be after a certain time.

References

http://www.uscourts.gov/FederalCourts/Bankruptcy/BankruptcyBasics/DischargeInBankruptcy.aspx

http://www.alllaw.com/articles/nolo/bankruptcy/questions-meeting-creditors.html

Disclaimer: This blog is Commentary Only and nothing here is to be interpreted as legal advice, solicitation, or any claim that the quality of legal services offered by The Keli R. Edwards Law Office, LLC is greater than the quality of legal services performed by other lawyers.  I welcome your feedback and comments

Ups and Downs with my New Affordable Health Care Act Bronze Saver Plan

Good news first, then the bad:

The last time I went to the pharmacy I used my new Prescription insurance, Blue Cross Blue Shield Bronze Plan, and I thought I did something wrong when the clerk told me my prescriptions had no co-pay!  I was very excited about that.  I also got a decent price on my antibiotic.  So that is the plus.

The cons are that I was never notified by my plan Blue Cross that I had to use preferred labs! So now, I just got slapped with a $900 lab bill for a service that should have been covered under the ACA.  The insurance company did not send the book explaining my benefit plan, instead all I got was a card and a bill.  It was on me to investigate my plan and make sure that I was using preferred labs.  I was supposed to log on and check the benefits before I went to my doc.  This info was buried on page 18 of the 52 page document.  Apparently insurance companies can get away with these types of practices, so I am going to appeal the coverage decision (a new guaranteed right under ACA).  Not sure how it will come out, but more likely than not, I will lose..  Just a warning to those of you who may have a Bronze plan.  The Silver and Gold plan do not require you to use preferred labs with Blue Cross.

Recently I gave a talk and overview of the ACA.  Here are some key points to know:

March 31st is the deadline to enroll for 2014 coverage and avoid being taxed!  if you miss it, the tax penalty (Individual Mandate) will be $95 per person or 1% of household income, which ever is higher, and if applicable  $47.50 per child under 18

Some exemptions, that would excuse you from paying if you don’t sign up, include:
foreclosure on your home, being homeless, filing bankruptcy, or if the lowest priced plan would exceed 8% of your annual income
Affordable Care Act Overview: 
  • The ACA bans lifetime limits on coverage for most benefits
  • College age children get coverage on parent’s plan until age 26
  • Women’s preventative care covered–well woman visits (pap smear, pelvic exam)
  • Contraception (religious organizations exempt)
  • Mandates coverage for those with pre-existing health conditions, and children under 19 with pre-existing condition cannot be limited (cancer, long term disease)
>>>Did you know that previously pregnancy, previous Cesarean section, or a history of having survived domestic abuse, were considered pre-existing conditions and could have been used as reason to deny coverage or adjust rates? The ACA stopped this practice.
Grandfathered plans?  Yes you can keep your old plan for now, but this is only a one year grace period.  If your old plan is found to be non compliant with the ACA, for example, if it does not guarantee your right to appeal a coverage decision, after 2015 you will still be subject to the tax (individual mandate).
There are ups and downs here.  Please share your stories here. Sign up at www.healthcare.gov , if you haven’t yet, time is running out;    You may qualify for income subsidies to contribute to the cost of your health care insurance.  
 Disclaimer: This blog is Commentary Only and nothing here is to be interpreted as legal advice, solicitation, or any claim that the quality of legal services offered by The Keli R. Edwards Law Office, LLC is greater than the quality of legal services performed by other lawyers.  I welcome your feedback and comments
 

HealthCare.gov: I signed up.

So, I finally signed up for “ObamaCare.”  I was able to get a Bronze plan for $180/mo with approx. $6k deductible. No tax credit for me though.  My plan is set to start Dec, 31, 2013.  The website was a little laborious at times, but not much unlike applying for a job.

I did find it annoying that I had to keep logging back in to continue the process.  The first time, it will verify your email, then it sends you a letter with your plan eligibility and whether you can get tax credits, or Medicaid, etc.  Being that I’m in Alabama, the Medicaid was a long shot, but that was already impossible due to income restraints.  Medicaid is like the best insurance ever, but I digress.  According to sources, the Medicaid expansion in Alabama would enable some 300K citizens to become insured, with “the best insurance ever”  to quote myself.  I once worked in the state Medicaid realm, so I can definitely back up this claim.  Stay tuned, there is still one more month for the expansion to occur, before Jan 1st, when that provision of the Affordable Health Care Act (ObamaCare) kicks in;  Not sure how many “working days” are left for the Ala. legislature to consider it though.

Back to my Healthcare.gov adventure.  So I waited a week before I decided on a plan.  It wasn’t that difficult because of the “monopoly” Blue Cross Blue Shield has here in the State, I just went with them, especially to ensure I get my choice of providers (doctors). It was a pretty fast choice deciding, since the choices were limited.  It was either hamburgers or hot dogs…(The available selections of plans averaged seven in Alabama, compared the the national average of over 50. )

***The Healthcare.gov site just warned me that I would be logged out due to inactivity, or to refresh my session***.  This always happens on my online banking site.  I have been following the media concerns about security of personal info.  At this point, it’s more “wait and see.”

Please, Share your thoughts with me.

Disclaimer: This blog is Commentary Only and nothing here is to be interpreted as legal advice, solicitation, or any claim that the quality of legal services offered by The Keli R. Edwards Law Office, LLC is greater than the quality of legal services performed by other lawyers.  I welcome your feedback and comments!

Paying off a loan

Unless you were born wealthy, many of us have had or will have loans, but I just want to offer this brief advice concerning paying them off.  Aren’t you so excited when you finally pay off your credit card, or that small loan? When you get to the point of that final payment, you have to be careful to avoid extra interest charges.  

Case in point, I’ll use a hypothetical example:  Jerry finally paid off his credit card debt by putting out  $1,000 on 6.7.13.  He had closed the account, but was still working on paying off the balance. Jerry’s billing statement ended on 6.22.13;  Jerry was glad to have that BURDEN off him.  Next month, he received a bill cut on 7.22.13 that stated he owed an additional $4.00.  He was LIVID and insisted he had paid in full, but the credit card company explained that was the interested he owed.  So reluctantly, he paid up again.

This can really happen to you.   In this case, the company charged Jerry interest from the time he made the “final” payment until the end of his next billing cycle.  The amount, although nominal, is troubling.  Some tips to avoid Jerry’s fate:

1) Remember that when dealing with loans and credit cards payment is usually applied to interest (extra amount derived from your interest rate and the amount you owe) and principal (the amount you owe).  Payments are applied to the interest and principal according to a formula.  If you don’t pay a certain amount above your minimum amount due, you may end up paying more interest in the long run.

2) At the time of your final payment, ask for an official letter stating your balance is paid is full. This is easy to do, even if you prefer to pay bills online.  It’s as simple as a quick email, and it could save you time and help you if necessary.

3) Or, make your final payment with an agent on the phone, but make sure there is no additional service charge.  At that time, you can ask what the interest would be and how much you need to pay at that point in the billing cycle to keep from incurring additional bills.  Basically, your amount due, is deceptive because they are using a formula to collect interest at all times on that amount.

4) If you make a final payment, and request a letter stating your account is paid in full (for a closed credit card account only or loan) you have some bargaining power.  If you do incur another final bill, consider arguments in your favor:

  • That you have a letter stating your account was paid off (obviously)
  • That you spoke with a customer service agent at the time of payoff (if applicable) and provide the confirmation number from your interaction.  Always get a confirmation number!
  • That you have made all your payments on time generally (hopefully) and since you are a “good” customer, it is really bad for them to treat you this way
  • And keep this one for a last resort–that you’ll never do business with them again because of the way they deceived you.  No business wants to loose future business, so in the course of “good will,” they will cave, and you will prevail.

Watch out for that interest y’all.  It’s a real bubble buster.

Disclaimer: This blog is Commentary Only and nothing here is to be interpreted as legal advice, solicitation, or any claim that the quality of legal services offered by The Keli R. Edwards Law Office, LLC is greater than the quality of legal services performed by other lawyers.  I welcome your feedback and comments!

Up late–ObamaCare Senate Fake Filibuster

Right now, as most of you sleep the night away, several of our Honorable Senators are having a slumber party attempting to defund ObamaCare, aka The Affordable Health Care Act.  This is all symbolic I suppose, to accomplish what ends, I can’t understand…Regardless, the fat lady will sing tomorrow when the debate is closed and the voting begins.  (the filibuster is fake because this pro-longed talking and discourse on the Senate floor will not actually delay the vote)

How did we get here?  Just last week I watched a small group of our honorable representatives coo and yell in excitement over their “victory” last week to force a government shut down by attaching an ultimatum to defund ObamaCare to the  budget, the federal budget that really affects my check!  I’m one of thousands of federal government workers that could be affected by this sideshow.

The Supreme Court has spoken on The Affordable Health Care Act, noting in its 2012 opinion that the mandate to purchase health insurance was NOT unconstitutional.  The penalty for failing to do so was interpreted by our Honorable Justices as a tax, and well the last time I checked taxes  are pretty much legal.  

Here are some important things to know—in anticipation of this defunding measure failing to be approved by the senate ( and messing with my check):

Oct 1, 2013: The Health Insurance Exchanges open and the option to purchase insurance in your state begins.

Dec 15, 2013: Deadline to chose a plan and sign up.

Jan 1, 2014: You should have signed up for a plan so that your new coverage begins to be active on this day.

As we know many states have been resistant in implementing the Health Insurance exchanges, and information has not been getting out to people who need it due to the politically charged law.  That is where the navigators come in.  The ACA has allotted over $65 Million to organizations to help people to enroll and “navigate” through their options.  The exchange in Alabama will be operated by the federal government, as Alabama law makers did not take the option to run the exchange at the state level.  Details are scarce but three major companies Blue Cross Blue Shield, United and Humana have applied to offer plans.

Who are the Alabama “navigators”?  Ascension Health, Birmingham-based AIDS Alabama Inc., Samford University, Catholic Social Services –Archdiocese of Mobile and the Demopolis-based Tombigbee Healthcare Authority.  View the complete list

Can you believe this side show is still going on? *time currently 2:27 am.  

Time for me to sign off, but to close, and in case you need a refresher here are some of the key provisions of the Affordable Health Care Act (ACA) aka ObamaCare:

*Eliminates the “Donut hole” coverage gap for Medicare Part D prescription drug plans by 2020

*Prohibits Health Insurance plans from denying coverage based on pre-existing health conditions.  Did you know that a prior pregnancy has been considered a pre-existing condition by some health plans?

*Allows children to be covered under their parents’ insurance until age 26

*Guaranteed free or reduced fee for preventative health screenings and benefits to include: Sexually Transmitted Disease (STD) screenings, smoking cessation, birth control, women’s exam (OB-GYN) , breast feeding supplies, depression screenings, blood pressure screenings

*Expands Medicaid eligibility, in states that chose to do so, by increasing the income requirements for Medicaid so that some who are struggling but not quite “poor” enough for Medicaid are now eligible for Medicaid

These are just some of the benefits.  It’s amazing that there is such a dynamic and sensational effort to derail and defund the ACA—Money talks.  Awaiting with baited breath what’s next to unfold in the ACA saga.

And the fake filibuster continues….

Disclaimer: This blog is Commentary Only and nothing here is to be interpreted as legal advice, solicitation, or any claim that the quality of legal services offered by The Keli R. Edwards Law Office is greater than the quality of legal services performed by other lawyers.  I welcome your feedback and comments!