Father and Son

Employee Manager: [in his office] Your policy has changed, Mr. Archibald.

John Q. Archibald: [sitting in front of him] Changed to what?

Employee Manager: Yeah, we recently switched carriers from a PPO to a HMO. It's a less expensive policy, but unfortunately, there are some restrictions.

John Q. Archibald: What kind of restrictions?

Employee Manager: Here's how it works: Non-management part-time employees, such as yourself, only qualify for second tier catastrophic coverage.

John Q. Archibald: No, no. I'm not part-time. I'm full-time. It's just slow right now.

Employee Manager: Sure, but your coverage is based on hours worked and like I said, you only qualify for second tier. And that has a maximum payout limit of $20,000.

John Q. Archibald: [shocked] What? Wha- I-I mean-I mean, you guys have been taking money out of my paycheck every week. I've been paying into this policy for years.

Employee Manager: Right. And that's why we're gonna cover you for the full twenty.

John Q. Archibald: You can't be right. I mean, come on. Alright, let me get this straight: You're telling me that you have dropped me from full-time to part-time. You switched carriers. Now you're telling me I'm not fully covered? Even though I got a policy that says I am?

Employee Manager: It doesn't seem right, does it?

John Q. Archibald: No, it doesn't seem right. I mean, my son is sick. If I'm not covered, I've got a serious problem.

Employee Manager: I understand that, uh, but there's nothing I can do. Look, you can file for an appeal.

John Q. Archibald: Yeah?

Employee Manager: [hands John an appeal application] Here you go. That takes about seven working days.

Rebecca Payne: [in her office] No, no, no. This is an appeal. An appeal is for an already existing claim. What you needed to file was a grievance. You filed the wrong paperwork.

John Q. Archibald: [sitting in front of her] Wait a minute...

Rebecca Payne: You're gonna have to resubmit. It could take up to 30 days.

John Q. Archibald: [turns frustrated] Look, I don't have 30 days.

Rebecca Payne: I know you don't.

John Q. Archibald: And quite frankly, I'm getting sick of the runaround. Now what I need is my son's name...

Rebecca Payne: Mr. Archibald, your account is in access of $30,000. The hospital has been over backwards to help you out.

John Q. Archibald: Is that right?

Rebecca Payne: Yes! It is right. But there's a limit to our generosity. Once and for all, your insurance does not cover this.