Long Term Disablity change to Cigna, need help

[Anonymous]

Has anyone else been contacted by Met-Life and Cigna about this change? I received two letters last week and a phone call from a claims rep that is transistioning my file. I have now been on LTD for 3 years after a very bad multiple car crash breaking many bones a partialy paralyzing my lower half. My question for anyone that did receive a call is did they schedule you for an IME yet. Cigna is scheduling mine for the 3rd week of January and is reviewing all Met-Life files per the rep within 6 mos of 2011. Anyone else that has info much appreciated since I have no way to reach out to anyone else.

 

[Anonymous]

Yes, contacted by mail but no call yet. I was with Shering and moved over to Merck Legacy.

The letter from Met-Life said a claim rep would be calling to schedule an IME and other items as Cigna takes over in 2011. Good luck to you as I have no idea what this all means. Met-Life has been good.

 

[Anonymous]

Has anyone else been contacted by Met-Life and Cigna about this change? I received two letters last week and a phone call from a claims rep that is transistioning my file. I have now been on LTD for 3 years after a very bad multiple car crash breaking many bones a partialy paralyzing my lower half. My question for anyone that did receive a call is did they schedule you for an IME yet. Cigna is scheduling mine for the 3rd week of January and is reviewing all Met-Life files per the rep within 6 mos of 2011. Anyone else that has info much appreciated since I have no way to reach out to anyone else.

My attorney notified me of a corespondence last week from Met life that Long Term Disablity moves to Cigna Jan 2011. He said Cigna is a horrible nightmare to deal with and constantly audits files and ask for independent medical exams. Also they have a team of private investigators that monitor activity when going to appointments. I have been on disability for 7 yrs and had to deal with this crap with another company Merck had. Met life has been no problem and reviews the case every two years for legitimacy which is fine. With my condition I cannot even drive, or walk. I wish those of you in this same predictment good luck as we are in the same boat.

 

[Anonymous]

I noticed the LTD claims administrator change from the annual election of benefits notice that was recently mailed by Merck. A top ERISA attorney has advised having horrible experience with Cigna. Did this factor into Merck's decision? I'm afraid this is another fine example of one of the company's health and welfare benefits failing to execute their fiduciary obligations. I'd really like to know why, who and how this LTD claims administrator change was made. Have LTD recipients skyrocketed at Merck? Bring it on since I'm sure the public will be interested in knowing. Be well.

 

[Anonymous]

Anyone who has had to deal with ERISA governed benefits knows it's a badly broken system. Maybe Cigna will help us get ERISA fixed. I have a few senators serving on committees that just might have a renewed interest. Thanks Merck!

 

[Anonymous]

I signed up for the CIGNA - program and its very expensive. I hope if I ever need to use it I can get what I paid for. Right now I could use the money I spend each month, but I stay with it because I dont have a care system in place if something happens. I hope I am not wasting this money!

 

[Anonymous]

I signed up for the CIGNA - program and its very expensive. I hope if I ever need to use it I can get what I paid for. Right now I could use the money I spend each month, but I stay with it because I dont have a care system in place if something happens. I hope I am not wasting this money!

Don't count on it. Employer sponsored group LTD insurance is often a bitter disappointment for employees who have their claim denied when they are in most need of financial support and at their most vulnerable due to compromised health. It can be an extremely cruel ordeal for the claimant who thought they had an insurance benefit if their health circumstances prevented working. You can end up impoverished very quickly when the claims administrators start playing their delay games and use of supposed "independant medical exams" that are anything but independant. One other caveat - you used the phrase "care system in place" - are you confusing long term disability insurance with long term care insurance? They are two different animals.

 

[Anonymous]

I signed up for the CIGNA - program and its very expensive. I hope if I ever need to use it I can get what I paid for. Right now I could use the money I spend each month, but I stay with it because I dont have a care system in place if something happens. I hope I am not wasting this money!

I recently met with my financial advisor and he went over all the Merck benefits. LTD was discussed as I have several small children. He said that he does not have one client on LTD and he has been doing this for 12 yrs. I guess it is very rare, but when you need it you want the benefits to be there quickly. He said due to the small amount to up to 70% it was worth it it an event should occur.

 

[Anonymous]

Don't count on it. Employer sponsored group LTD insurance is often a bitter disappointment for employees who have their claim denied when they are in most need of financial support and at their most vulnerable due to compromised health. It can be an extremely cruel ordeal for the claimant who thought they had an insurance benefit if their health circumstances prevented working. You can end up impoverished very quickly when the claims administrators start playing their delay games and use of supposed "independant medical exams" that are anything but independant. One other caveat - you used the phrase "care system in place" - are you confusing long term disability insurance with long term care insurance? They are two different animals.

No family help available if needed is the "care system". No kids and an "ex" means your on your own. Sibs have their own lives and families to worry about, so an aid or assistance is what I may need if something happens to me. Just hope this would be worth the money I am putting out long term.

 

[Anonymous]

I recently met with my financial advisor and he went over all the Merck benefits. LTD was discussed as I have several small children. He said that he does not have one client on LTD and he has been doing this for 12 yrs. I guess it is very rare, but when you need it you want the benefits to be there quickly. He said due to the small amount to up to 70% it was worth it it an event should occur.

You might be surprised by how often people encounter a period of inability to work due to some health impairment. You should ask your financial advisor about the differences between your Merck group LTD vs buying an individual LTD insurance policy through your advisor. While the group benefit may be less costly, you generally give up any chance of a jury trial and must rely on judicial review to decide if Cigna behaved in an arbitrary and capricious manner in denying your benefit. This is extremely difficult to do but that is how ERISA lawsuits get handled. In this case, you truly do get what you pay for and when you don't pay as much, guess what? You don't get as much. I'd take the more expensive individual policy in a heartbeat. Individual LTD policies get denied far less often than group LTD claims. This should tell you something.

 

[Anonymous]

You might be surprised by how often people encounter a period of inability to work due to some health impairment. You should ask your financial advisor about the differences between your Merck group LTD vs buying an individual LTD insurance policy through your advisor. While the group benefit may be less costly, you generally give up any chance of a jury trial and must rely on judicial review to decide if Cigna behaved in an arbitrary and capricious manner in denying your benefit. This is extremely difficult to do but that is how ERISA lawsuits get handled. In this case, you truly do get what you pay for and when you don't pay as much, guess what? You don't get as much. I'd take the more expensive individual policy in a heartbeat. Individual LTD policies get denied far less often than group LTD claims. This should tell you something.

Why doesnt the group itself have more strength (like group health insurance) or the group source (Merck) step in to ensure the purchaser is treated fairly for all the thousand and thousands of dollars they put in?

 

[Anonymous]

You might be surprised by how often people encounter a period of inability to work due to some health impairment. You should ask your financial advisor about the differences between your Merck group LTD vs buying an individual LTD insurance policy through your advisor. While the group benefit may be less costly, you generally give up any chance of a jury trial and must rely on judicial review to decide if Cigna behaved in an arbitrary and capricious manner in denying your benefit. This is extremely difficult to do but that is how ERISA lawsuits get handled. In this case, you truly do get what you pay for and when you don't pay as much, guess what? You don't get as much. I'd take the more expensive individual policy in a heartbeat. Individual LTD policies get denied far less often than group LTD claims. This should tell you something.

I would believe that many do have time off work due to a disablity, but most often it is short term, not long term. Per my financial advisor less than 2% of the workforce is on LTD. Unsure of the stats, but he is the one that could benefit by selling the policy and said you don't need it and is comfortable with the group plan.

 

[Anonymous]

Yes, contacted by mail but no call yet. I was with Shering and moved over to Merck Legacy.

The letter from Met-Life said a claim rep would be calling to schedule an IME and other items as Cigna takes over in 2011. Good luck to you as I have no idea what this all means. Met-Life has been good.

I contacted an lawyer today that handles LTD cases since I am not repped for benefits. He confirmed Cigna not good and if benefits hould be denied after IME could take 9 mos to 1 yr to reinstate on appeal. He suggested getting rep ASAP to start getting paperwork for possible denial.

 

[Anonymous]

Why doesnt the group itself have more strength (like group health insurance) or the group source (Merck) step in to ensure the purchaser is treated fairly for all the thousand and thousands of dollars they put in?

You've raised a very good question. It comes down to the LTD claims administrator's focus and priority being cost containment ahead of the employee's very real disabling condition and need of support. It is a system of rationing and we all know how well that works in providing healthcare services. Patients lose every time. LTD claims administrators have a conflict of interest where they have sold Merck on their ability to limit Merck's LTD expense liability better than anyone else and as a result, valid LTD claims from Merck employees get denied or delayed to the point of the employee giving up fighting their claim denial. Despite having medical documentation and support, the LTD administrator will seek "independent" medical opinions that will dispute your medical doctors' statements regarding your disability. Given that your LTD claims administrator will be granted discretion in most states per ERISA law to approve or deny your claim based on THEIR review and opinion of your medical record, any possible opportunity to deny your claim will be taken. It's a terribly broken and tragically unfair system that routinely is used by insurers to deny very real and valid group disability claims from employees with disabling conditions. You have a right to sue but ERISA severely limits your right to only judicial review. You have no benefit of any punitive damages, no matter how long it takes to litigate for benefits, win a favorable court decision that you are entitled to LTD benefits, and the resultant delay in receiving them that the litigation process brings. Thus the insurer has no incentive whatsoever to approve your claim without first contesting it. It is a win-win for the insurer, and a partial win at best for the insured. A terminal diagnosis is about the only thing I can think of that is worse than having to fight a disability claim.

 

[Anonymous]

I would believe that many do have time off work due to a disablity, but most often it is short term, not long term. Per my financial advisor less than 2% of the workforce is on LTD. Unsure of the stats, but he is the one that could benefit by selling the policy and said you don't need it and is comfortable with the group plan.

I think what you've said is accurate. Insurance is all about risk management and a significant part of that equation is your tolerance for risk. Your financial advisor is supposed to know well what that is in order to best serve your interests. It is true that your advisor could benefit financially from selling you an individual LTD policy, but it is also true that this individual policy could benefit you financially more than your group LTD, should you become disabled. As long as you're comfortable with the level of risk assumed, that's all that matters. You might ask your employer for their LTD claims administrator's claims approval ratio and compare that with the claims approval ratio of an insurer selling individual LTD policies. Just know that if you unfortunately suffer a disability that prevents you from being able to work, submitting a claim for LTD benefits may not initially result in an approval of LTD benefits. In fact, it may never result in an approval of LTD benefits. I advise all of my clients to build a 2 year reserve of assets to be used in an emergency where one is unable to work and has no income. This is a reasonable time frame consistent with what you've mentioned and provides you with the peace of mind that you will not be reliant on some dubious LTD claims administrator to approve your claim. YOU get to approve your claim. Best of luck! LTD insurers can go to hell from my experience.

 

[Anonymous]

I think what you've said is accurate. Insurance is all about risk management and a significant part of that equation is your tolerance for risk. Your financial advisor is supposed to know well what that is in order to best serve your interests. It is true that your advisor could benefit financially from selling you an individual LTD policy, but it is also true that this individual policy could benefit you financially more than your group LTD, should you become disabled. As long as you're comfortable with the level of risk assumed, that's all that matters. You might ask your employer for their LTD claims administrator's claims approval ratio and compare that with the claims approval ratio of an insurer selling individual LTD policies. Just know that if you unfortunately suffer a disability that prevents you from being able to work, submitting a claim for LTD benefits may not initially result in an approval of LTD benefits. In fact, it may never result in an approval of LTD benefits. I advise all of my clients to build a 2 year reserve of assets to be used in an emergency where one is unable to work and has no income. This is a reasonable time frame consistent with what you've mentioned and provides you with the peace of mind that you will not be reliant on some dubious LTD claims administrator to approve your claim. YOU get to approve your claim. Best of luck! LTD insurers can go to hell from my experience.

I think I speak for many who would say to build a 2 year reserve is very difficult unless you are a just starting out in life or are at a very high salary meaning over 175K. But for someone middle aged who has this policy for a few years I now feel like I might have wasted thousands already. Its impossible to put a few years income aside. Ill be lucky if I can put 8K away a year for retirement with living expenses. A few years salary would mean you would need at least 100-150K surplus money. Who could do this unless you are in senior management. Impossible. I would now have to wonder if I should just chuck the whole policy before I might even waste more.

 

[Anonymous]

I think I speak for many who would say to build a 2 year reserve is very difficult unless you are a just starting out in life or are at a very high salary meaning over 175K. But for someone middle aged who has this policy for a few years I now feel like I might have wasted thousands already. Its impossible to put a few years income aside. Ill be lucky if I can put 8K away a year for retirement with living expenses. A few years salary would mean you would need at least 100-150K surplus money. Who could do this unless you are in senior management. Impossible. I would now have to wonder if I should just chuck the whole policy before I might even waste more.

I know you speak for many who would find it impossible to put away a 2 year reserve. Then it becomes a matter of developing some kind of alternative plan if possible such as increased spousal/family support, extreme downsizing, and tapping into retirement savings as an absolute last resort to name a few possible options. It is not fun but one should know and consider these difficult potential strategies. Also, keep in mind that if your disability is severe enough and you live in a part of the country where Administrative Law Judges are more reasonable at granting Social Security Disability Insurance claims, this may also be a source of support for you. It isn't a lot of money but should help prevent you from starving. I will agree that you very well might be better off investing your LTD premiums in a ROTH IRA that you could readily access without penalty in the event of a need. At least you could be sure that money will be there for you should you unfortunately have the need and hopefully you won't need it until retirement and you've experienced some nice growth over the years. I've seen and observed far too many clients experience devastation to their lives from denied LTD claims over the years I've been in the financial services industry.

 

[Anonymous]

I know you speak for many who would find it impossible to put away a 2 year reserve. Then it becomes a matter of developing some kind of alternative plan if possible such as increased spousal/family support, extreme downsizing, and tapping into retirement savings as an absolute last resort to name a few possible options. It is not fun but one should know and consider these difficult potential strategies. Also, keep in mind that if your disability is severe enough and you live in a part of the country where Administrative Law Judges are more reasonable at granting Social Security Disability Insurance claims, this may also be a source of support for you. It isn't a lot of money but should help prevent you from starving. I will agree that you very well might be better off investing your LTD premiums in a ROTH IRA that you could readily access without penalty in the event of a need. At least you could be sure that money will be there for you should you unfortunately have the need and hopefully you won't need it until retirement and you've experienced some nice growth over the years. I've seen and observed far too many clients experience devastation to their lives from denied LTD claims over the years I've been in the financial services industry.

Then why the hell are we using this plan. Seems to me if we are looked after Met-Life or some other company will really will pay a claim SHOULD be used. I cant beleive I am wasting all this money every month if this is the case. Can I roll this into a better company so I dont throw everything out the window? As far as Roth IRA, I though you could not add to that if you are putting money in a 401K.

 

[Anonymous]

Cigna is Satan. SP was self-insured via Cigna for STD and put me through the wash and spit me out, disabled, no benefits, no pay and placed the burden of proving their decision wrong. HR was no help and in fact, sided with them telling me to go and get an attorney. No company and no insurance wants to pay out and they will do anything and everything to make your life a living hell when you need help the most. It is hard to believe that such a powerful and rich company could treat an ill employee in the U.S. who has paid for the benefit with such complete disregard. Good luck to you and make sure you have examined all of your options and maintained your medical records with doctors as your advocates and a good disability attorney. There is nothing anymore that would surprise me. Clearly, "we" do not matter at all and there is absolutely no loyalty or kindness. I hope you find some support and get the benefits you deserve in your time of need.

 

[Anonymous]

Then why the hell are we using this plan. Seems to me if we are looked after Met-Life or some other company will really will pay a claim SHOULD be used. I cant beleive I am wasting all this money every month if this is the case. Can I roll this into a better company so I dont throw everything out the window? As far as Roth IRA, I though you could not add to that if you are putting money in a 401K.

Because most employees thankfully will never have to file a claim for LTD benefits and never experience the dirty little secrets associated with LTD claims. The insurer is happy to collect your premiums without need of ever paying a claim. However, for those unfortunate few employees who do face a work restricting impairment, your LTD claims administrator will look for any possible way to deny the claim. Some claims with resounding objective medical evidence of disability will be readily paid since the insurer will have no grounds for a benefit denial. Employees with less obvious or hidden disabling conditions such as chronic pain from fibromyalgia or degenerative spine diseases where there is less objective and more subjective medical documentation used to justify your LTD claim often face denial of benefits. Your question about why Merck is using a given LTD Claims Administrator is quite valid and I would encourage you to contact your company's internal LTD Plan (not claims) Administrator and ask them.

Maxing out your 401K contributions does not prevent you from also contributing to a ROTH IRA. However, there are adjusted gross income limits that may prevent or limit your ability to contribute to a ROTH IRA. In general, single filers earning up to $105,000 and joint filers earning up to $166,000 may contribute fully to a ROTH IRA. Contributions above these income limits are reduced and then completely phased out at $120,000 for single filers and $176,000 for joint filers. Hope this helps.