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Kristopher Robert Alderman

Kristopher Alderman’s Answers

49 total

  • What are my options now, I don't think Walmart want to pay for fixing my car?

    My car is currently at a Walmart store. I paid $112 for a battery and oil change. As the manager gave me my receipt, the other associate that was working on my car called him on a two way phone. The manager went out to the associate and my car, s...

    Kristopher’s Answer

    Wal-Mart had no right to keep your car after you paid for the services they provided. Under some circumstances, mechanics may assert a lien for unpaid services, but Wal-Mart didn't have any lien rights against the car since you paid the bill. It sounds like that problem has resolved, as they are no longer denying you access to the car.

    I would tell Wal-Mart to (1) transport the car to a local machanic that you choose and (2) pay for the mechnics' diagnosis and repair of the damage that Wal-Mart caused. If Wal-Mart won't agree to do this, I would do it myself and then sue Wal-mart for the cost to repair the car (assuming that Wal-Mart actually caused the damage).

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  • Can a employer in NY state change my cobra deductible with out notice?

    I was let go from my job a few months ago and the employer stated in writing that they would cover my cobra premiums for several months. I just found out today, that they changed my deductible and never notified me.

    Kristopher’s Answer

    Are you asking about the deductible (the amount you must pay each year before your insurance begins to cover costs) or the premium (the amount that you must pay each month to maintain coverage)?

    If you truly mean "deductible," that can be changed without notice, but it must be the same as the coverage offered to active employees. In other words, the employer can change the policy but can't single out COBRA participants for the change. The change in deductible would have to apply to all.

    If you are asking whether the premium can be changed without notice, the answer is no. You have to be given notice of the change in premium. But if the employer shows that the notice was sent to your last known address, it usually satisfies COBRA's notice requirements. However, if you sent the old premium amount and the increase was less than $50, then the employer must give you notice of the shortfall and an opportunity to correct it.

    The $50 amount should probably be revisited in today's market, where annual premium increases typical run more than $50. I suspect that the agency initially adopted the $50 number so that if you missed the notice and sent the old premium amount, you would still have a chance to correct it because premiums were not increasing by more than $50 per year. That is no longer the case, and the $50 amount should get some consideration.

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  • Are PRN employee entitled to benefits and are there any laws about PRN employee rights

    I am a PRN employee working 40 hours a week

    Kristopher’s Answer

    I am not aware of any laws about PRN employee rights. Frankly, I would literally be shocked to learn that Georgia had laws about PRN employee rights. Your entitlement to benefits is governed by the rules set by your employer. If you are working 40 hours every week and the company offers benefits to full time employees, there is a good chance that you qualify for benefits. But you have to look to the terms of your employee benefit plan. Assuming you work for a private company that offers benefits, the terms of the benefits plan should be written. That is likely to be the only law that governs your entitlement to benefits. Get a copy of that plan and you should have your answers.

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  • Insurer did not allow an office visit charge (for in-network provider) is this considered an adverse benefit determination?

    My group health plan will pay 75% of allowed charges for in-network provider. The local Blues Co. did not allow charge for 4 office visits (they did allow office visit charges for similar visits before these consecutive visits for several years a...

    Kristopher’s Answer

    This is considered an adverse benefit determination. And you can appeal it under ERISA. I understand your frustration in trying to figure out which affiliate you should contact. It's better to find something in writing and then hold the plan to it than to try to comply with whatever requirement the insurance company representative might make up on any given call.

    The plan document that describes the benefits available to you has a section that sets out the appeals procedures. That section should tell you how to address your appeal (the EOB should also have this information, but often does not). Follow the procedures in the plan document exactly. If the appeals section simply tells you to send an appeal to the "Claims Administrator" or "Plan Administrator" or some similarly named entity, check the definitions section to see who that is - likely it is either the insurance company or your employer. The plan document should have the address for both. Again, follow the appeals procedures exactly as they are written.

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  • Can a company without the authoriziation of the Union just stop paying into a employee retirement plan.

    Our Union #42 has allowed Hostess to stop paying into our pension fund now we are hard working people working without a pension plan. Most of us union members have gotten together to see what can be done about it. The union refuse to return our ph...

    Kristopher’s Answer

    The union's failure to communicate with you and other workers is certainly disconcerting. Unions are supposed to protect the workers, but the fact that the union seems to be failing you is not the end of the road. As the participant or beneficiary in a pension plan, you have rights that you can enforce without the assistance of the union.

    Unfortunately, without knowing a lot more it is hard to sugegst any course of action. Generally, speaking, you need to understand what has happened and why. As suggested in the previous answer, your best course may be too write directly to the employer or the administrator of the pension plan (which is identified in the documents that govern your pension plan).

    I strongly suggest consulting a lawyer to help you devise the first steps. Your situation appears to be governed by two complicated federal laws: one governing employee benefits and the other governing labor/management relations. If there are several workers who are in your position and of the same mind as you, you will likely find a lawyer who will be willing to meet with you to learn more about your case without a charge (initially) and you may be able to persuade the lawyer to take the case on a contingency basis if he believes there is merit and potential for financial recovery.

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  • Is It legal for an employer to cancel health benefits without any written or verbal notice prior to the cancellation?

    Is It legal for an employer to cancel health benefits without any written or verbal notice prior to the cancellation? I got a call today from the dentist saying we owed them money because my children both had appointments last week and they called...

    Kristopher’s Answer

    Whether the denial of benefits was unlawful (and perhaps also immoral) probably depends on a few other factors.

    First, the terms of your benefits should be spelled out in a plan document. The terms of those documents are binding on the employer; however, the employer may choose to eliminate or modify health benefits (by modifying the terms of the plan documents).

    Second, why were your benefits terminated? Were everyone's benefits terminated, or only yours? If only your benefits were terminated while others were allowed to keep their benefits, there is probably a greater chance that there was an error or unlawful conduct.

    Third, did you ever get notice of the termination (before or after) from your employer?

    Fourth, when did the terminations occur? Did they actually terminate on November 30, or did they terminate later but make the termination retroactive?

    There may be other factors to consider as well. The termination of benefits may very well be unlawful, but it is impossible to know based on the facts given. In some cases notice may be required, in other cases no notice would be necessary.

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  • I called my insurance provider and was told a lab test was covered, now they won't pay

    I gave them the CPT code and name of the test. Now they say it is experimental and they will not cover the test. I already had it done and paid for it. How can they do that?

    Kristopher’s Answer

    On those facts, you have a misrepresentation claim(i.e., saying one thing and then doing another). More details would be required to know whether that misrepresentation claim must be brought under ERISA, state law, or some other set of laws.

    Keep in mind that being able to state a claim and prove one are two very different things. The more documentation you have the better. For example, if you have a precertification number, you should be able to convince the insurer to pay simply by providing the number. On the other hand, if you only have your memory of a phone call that the insurer denies took place, you may never be able to prove what the insurer told you in advance.

    You should call the insurer, confront them with what they told you, and see how they react. based on the reaction, decide how to proceed.

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  • Healthe Insurance reimbursament for employees

    We offer health insurance to our employees sometimes when we hire employees the employee have already health ins thru their parents or spouse ,can we offer them to pay 1/2 of our monthly insurance cost if they stay on their current policy rathar t...

    Kristopher’s Answer

    One thing to consider is that you may run into problems if the other coverage is offered through the government, e.g., Medicare, Medicaid, TRICARE.

    This kind of tactic for dealing with high health insurance costs are relatively untested, but will become more common place until something is done to combat rising costs.

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  • My COBRA benefits were cancelled without notice . My wife is 9 months pregnant. Do I have any legal recourse?

    I screwed up and was more than 30 days late sending my October check. It was postmarked Nov.8th . I called and literally begged the company ( my ex-employer) but they said it cannot be reinstated.

    Kristopher’s Answer

    On those facts that you gave, you probably do not have any recourse. COBRA coverage generally may be terminated when payment is not made within 30 days after the first day of the period.

    However, more facts could be helpful. For example, the plan may provide for a longer period than 30 days. Also, if this was the first payment or if you recently elected COBRA, different rules will apply.

    Also, if your plan is insured (rather than self-funded) you may have a longer time period based on the provisions of the employer's contract with the insurance company.

    If I had access to the plan documents governing your benefits, I could quickly determine whether you have a case, but without reviewing those, it's just speculation.

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  • Do i need a laywer

    hurt on the job, denied workers comp.was verbally abused for several months after then company vehicle was taken away.forced me to resign as i do not have any way to make commute . when i was hired i was told to drive company van home it was ...

    Kristopher’s Answer

    It sounds as if you have two issues.

    First, your worker's comp claim was denied. It's impossible to know whether you have a good worker's comp claim. You would need to meet with a worker's comp lawyer and present the lawyer with all of the information to make that determination. It sounds as if you may already have some problems with the timeliness of an appeal, so you should do this right away.

    Second, your company vehicle was taken away. Unless you have a contract or some other extraordinary condition that entitles you to the company vehicle, you probably do not have any legal claim based on the denial of a company car.

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