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Insurance

Theatre Three suffered damaged to costumes, props and other mechanical equipment, though productions went on a mere 72 hours after the storm. Photo by Kyle Barr

Though the floodwaters have receded a week later, cleanup and questions still remain.

Port Jefferson Village was hit with more than four inches of rain in about an hour during the evening Sept. 25, and while village trustee Bruce D’Abramo joked Port Jeff might have been prepared to handle a 100-year storm, it wasn’t ready for the “200-year storm” it sustained. The extreme rate of rainfall resulted in flash flooding that inundated Main Street, trapped motorists in cars, washed out those dining out in restaurants and soaked auditioning actors at Theatre Three. The theater and other businesses like Ruvo East on Wynn Lane and Old Fields of Port Jefferson a block over experienced high water marks of about four feet. Old Fields was closed for a few days after the storm while Ruvo remained closed for renovations due to the flooding as of Oct. 2. Port Jefferson School District’s two instructional buildings also were affected by the flooding, according to its website, and officials are in the process of determining what aspects of the damage are covered by insurance.

Theatre Three suffered damaged to costumes, props and other mechanical equipment, though productions went on a mere 72 hours after the storm. Photo by Kyle Barr

A furious volunteer effort ensued to get Theatre Three up and running in time for its Sept. 28 productions.

“We managed to get everything ready for Friday night and ran the entire weekend,” said Jeffrey Sanzel the theater’s executive artistic director.

Bradlee Bing, who serves on Theatre Three’s board of directors and was one of its founding directors in 1973, said cleanup efforts were undertaken by dozens of volunteers and staff in the 72 hours between the storm and Friday night’s productions. Work was done around the clock, spearheaded in large part by Brian Hoerger, the theater’s facilities manager, who Bing called the “champion” of the cleanup effort for his organizational and leadership role.

“As dark a day as it was, the sunshine and light of the volunteers really rejuvenated our energies and enthusiasm for what we’ve [been] doing these past 50 years,” Bing said. “The number of people that came down, multiple dozens of people that committed their time to putting everything back in order. The support of the town and community was overwhelming.”

He said restaurants donated food to help keep volunteers going, and The Home Depot and Lowe’s donated supplies to help remove the tons of mud and other remnants of the flood. He said much of the theater’s electrical wiring was destroyed. Sanzel said some other important items sustained major damage, including an HVAC unit, the boiler, costumes, a large chunk of props used in annual productions of “A Christmas Carol,” all of the props from the touring show “From the Fires: Voices of the Holocaust,” along with “many, many other things.”

“We’ve experienced in the past certain types of flooding in Port Jefferson,” Bing said. “This last one was the worst flooding event we’ve ever experienced. Wednesday morning was a mud disaster in the theater.”

Theatre Three suffered damaged to costumes, props and other mechanical equipment, though productions went on a mere 72 hours after the storm. Photo by Kyle Barr

New York State Assemblyman Steve Englebright (D-Setauket) indicated he’s seen severe flooding in Port Jeff in the past during nonhurricane weather events, but this particular storm raised his eyebrows for a number of reasons. The storm occurred during low tide and flooding was not due to tidal waters, meaning had it occurred during high tide it’s possible tidal floodwaters would have combined with the flash flooding to cause water levels to reach in the ballpark of 10 feet instead of the four to five feet that actually occurred, Englebright said.

“When you put a layer of sand on top of a living marsh and then build housing and buildings on it, and rename it from Drowned Meadow to Port Jefferson, and hope nobody would notice, nature will come back and bite you from time to time,” he said. As the chairman of the Assembly’s Committee on Environmental Conservation, Englebright indicated storms like this one could become more frequent. “That’s a kind of a preview of what’s going to happen if we don’t seriously address climate. The big flood is still in the future, but the signposts all point toward continuing sea level rise. So I’m concerned.”

Englebright suggested in the meantime serious consideration be given to raising future structures constructed in the village above ground level.

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The Port Jefferson Volunteer Ambulance Company serves Port Jefferson, Belle Terre and Mount Sinai. File photo

Village officials have blocked the local ambulance company from billing residents for service, three months after an explosive debate on the practice.

A few residents argued during a Port Jefferson Village Board of Trustees meeting in November that it was unfair, after paying ambulance district taxes, they received bills for ambulance rides when their insurance companies either denied a claim or left them with a hefty deductible to pay. But the board insisted such bills were not the intention of the plan enacted several years ago to help their emergency medical organization recoup expenses.

Faced with rising costs in the ambulance district — which includes Port Jefferson, Belle Terre and Mount Sinai — the board authorized the Port Jefferson Volunteer Ambulance Company to bill patients’ insurance companies for service within their jurisdiction, using the collected funds to offset ambulance taxes.

The bills being sent later on to patients, according to PJVAC Deputy Chief Rob Stoessel, originated because his group and its third-party billing company are obligated to ask for the balance if the insurance does not cover the entire cost. In November he described the requirement as a “good faith attempt.”

Before insurance, the fee on a call for emergency medical care is $900, with an additional $18 for each mile the ambulance transports a patient. Stoessel said that amount takes into consideration both medical and nonmedical expenses like gasoline.

Both he and Mayor Margot Garant agreed that when the billing program was created, the idea was for patients to receive three notices for bills, with no consequences for not paying — as the ambulance company does not have a mechanism for collections.

“The insurance companies, God bless them — collect every nickel from them,” Garant said in November. But “we didn’t want the resident to be pursued for any of the fees.”

Residents who received the bills complained that wasn’t common knowledge, and they were concerned about their credit ratings.

Monica Williams was denied Medicare coverage for her treatment.

“I don’t really think that any village resident … should be looking at a bill like that,” Williams said in November. “It’s surprising. It’s disappointing.”

She called it “being billed for the same thing twice.”

But Williams saw a solution on Monday night, when the Board of Trustees voted to ban the ambulance company from billing residents.

The previous law that allowed the company “to bill, directly, village residents for the use of its ambulance services … is hereby rescinded,” according to the measure members approved at their meeting. It also forgives all unpaid balances currently hanging against residents.

PJVAC will still be able to collect funds from the insurance companies.

Garant said there would be consequences “if we hear of any resident getting any more collection documents from the ambulance [district].”

Some question why district’s proposed plan covers less

Northport High School. File photo

After a lengthy battle, Northport-East Northport school district’s security greeters have been offered health care benefits. But the fight may not be over.

Although the district has presented health insurance plans to the nine full-time greeters, some say the plans are expensive and don’t treat them the same as other district employees.

The duties of a greeter, also known as a security monitor, include monitoring who is coming and going from a school building, assisting in late arrivals and early releases and helping parents get forgotten items to the students, among other day-to-day tasks that may arise. The position was established about 10 years ago, according to the district supervisor of security, and the district employs one full-time greeter for each of their six elementary schools, two middle schools and one high school.

Under the plans, the district would pay 60 percent of the greeters’ health coverage, according to Diane Smith, the greeter who has led the charge for benefits.

Contracts on the district’s website indicate that it pays 75 percent of superintendent Robert Banzer’s coverage, 82 percent for administrators, 79 percent for teachers and 86 percent for security guards.

Diane Smith has been asking for health care benefits for her and her fellow employees for months. Photo from Smith
Diane Smith has been asking for health care benefits for her and her fellow employees for months. Photo from Smith

Smith said she is grateful the district granted greeters health care coverage —“I’m happy to get that, it’s fabulous to have any kind of a break,” Smith said in an email — but she wants treatment equal to fellow employees, specifically security guards.

When asked about the difference between greeters and security guards, the district said in a statement, “Security guards and security monitors are civil service appointments. Both positions require security certifications and the ongoing completion of security training.”

As is, the employee contribution for the greeters’ proposed insurance on a family plan “will cost us exactly every other entire paycheck,” she said. “How did they come up with that [number]?”

Smith’s salary is $20,000.

According to Smith, the greeters were offered more affordable plans, one of which would have covered 75 percent of health care costs, but they wouldn’t have provided coverage for families. She said in addition to working as a greeter full time, she has been working a second job part time to pay for private health insurance for herself and her two kids.

“Each year the district examines its policies in an effort to further benefit our valued employees,” Banzer said in a statement through the district’s public relations firm, Syntax. “Through prudent budgeting and research with our providers, we are pleased to offer multiple health care coverage options to our greeters. Although the district has not provided this coverage in the past, as it is not required, we felt it was an important step to make this available to them.”

Despite her criticism, Smith expressed gratitude.

“It’s still really good,” she said in a phone interview Monday. “I would not turn it down. It would help my income for sure.”

Smith had a meeting with a district insurance specialist on Wednesday to get some more questions answered and ultimately decide on a plan.

According to her, the greeters must sign up by Feb. 1 to begin getting coverage.

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Port Jefferson residents say taxes should cover cost of medical care

The ambulance company serves Port Jefferson, Belle Terre and Mount Sinai. File photo

A presentation about the service of the Port Jefferson Volunteer Ambulance Company devolved into an argument about perceived unfair billing practices on Monday night, with residents, village officials and the ambulance company’s deputy chief going back and forth for an hour.

A few villagers are in a lather over the process for recouping expenses after an ambulance ride through a billing program that began a handful of years ago. Faced with rising costs in the ambulance district — which also serves Belle Terre and Mount Sinai — Port Jefferson Village officials authorized the emergency medical organization to bill insurance companies for service within their jurisdiction, with the funds offsetting local ambulance taxes.

The friction that heated up Monday night’s Port Jefferson Village Board of Trustees meeting built around cases when an insurance company denied a claim or the patient had a hefty deductible — thus obligating the ambulance service and its third-party billing company to send a tab to that patient, according to PJVAC Deputy Chief Rob Stoessel.

Two residents who received such bills, Monica Williams and Mary Moore, expressed their dissatisfaction over the matter, saying the taxes they pay each year to the ambulance district should be enough and also complaining about the price tag.

“I’m paying my ambulance district tax,” Williams said. “I don’t really think that any village resident … should be looking at a bill like that. It’s surprising. It’s disappointing.”

She called it “being billed for the same thing twice.”

Before insurance, Stoessel said, the fee on a call for emergency medical care is $900, with an additional $18 for each mile the ambulance transports a patient.

“We went based on other agencies, other 911 services throughout the region,” he said about how the ambulance company arrived at that figure. “We went on what it cost us to provide the service,” including non-medical expenses like gasoline.

The deputy chief said the ambulance service and its billing company is required to make a “good faith attempt” to solicit deductibles from patients or whatever costs are associated with a trip that an insurance company denies coverage for.

According to comments from the residents, Williams was denied Medicare coverage for her treatment and Moore has a high deductible.

Mayor Margot Garant insisted it was not the board’s intention, when it authorized the ambulance company to bill insurance, to pass large bills along to residents.

“We didn’t want the resident to be pursued for any of the fees,” she said. But “the insurance companies, God bless them — collect every nickel from them.”

Although the mayor and Stoessel rejected responsibility, debating whether the billing was a village program or an ambulance program, they agreed that the idea was for patients to receive three notices for bills and there would be no consequences for not paying, as the ambulance company does not have a mechanism for collections.

But there was debate from the public about whether that was common knowledge in the village, or whether not paying would affect someone’s credit rating.

According to Garant, village officials are working out a method of waiving costs that would otherwise be passed along to patients — to limit the ambulance company to recouping costs only from insurance companies. She said that measure could be ready for approval by the next board meeting in two weeks.

Port Jefferson is not the only area with the idea of using insurance companies to offset taxpayer dollars. The Commack Volunteer Ambulance Corps argued recently that billing private insurance companies for patient care would ultimately save taxpayer dollars for constituents. At an August work session in Smithtown, Tom Lowenberg of the Commack VAC said insurance reimbursements are a resource utilized typically at private ambulance companies, but not as much by volunteer groups.