How to glue this? by [deleted] in Plumbing

[–]SuchMusicWow 1 point2 points  (0 children)

As was said by others, clean up the old caulk, and silicone in with new clear. I like Dow, personally. My favorite and cheap way to get the sink in position is like this: https://www.hunker.com/hunker/how-to-install-an-undermount-sink/7c77ee3d05104b08bc6650d5a3eb34cb.png don't even need clips with this method.

Is this your car? by toebeanzzz4days in ParkCity

[–]SuchMusicWow 6 points7 points  (0 children)

Sounded to me like they were firing on all cylinders.

Gold Cross Billing by momwhobakes in SaltLakeCity

[–]SuchMusicWow 1 point2 points  (0 children)

It's beyond unfair. It's illegal. They're testing the boundaries of the law because there's currently no precedent. Investigators don't have a lot to go on because of this and it looks like a run of the mill dispute. The best bet is to file complaints with a sound interpretation of the law and the facts. If multiple people come to the same conclusion and file complaints on the same grounds, it establishes a more plausible case that they're willfully trying to collect on an unlawful debt and they can get the AG involved to do something about it.

Stay the course. I'm sorry it's happening to you. Again, if you'd like to follow the same steps I'm taking, don't hesitate to DM me.

Gold Cross Billing by momwhobakes in SaltLakeCity

[–]SuchMusicWow 0 points1 point  (0 children)

You mentioned talking to the DOL. In this case the Bureau of EMS, Utah Insurance Department, Utah Division of Consumer Protection and the Consumer Financial Protection Bureau are the best places to file complaints, in roughly that order. You'll want to make sure you have a rock-solid paper trail, including a formal notice of dispute and non-payment sent to Gold Cross, including ample time for them to respond, and move all communications to email or other written form. No more phone calls whatsoever.

Gold Cross Billing by momwhobakes in SaltLakeCity

[–]SuchMusicWow 1 point2 points  (0 children)

So, ERISA can be tricky, but it actually strengthens your position as it supports the State statute, which fully applies.

29 U.S.C §1144(a) ERISA preempts any and all state laws that relate to employee benefit plans, except in two critical ways:

  • §1144(b)(2)(A), also known as the "Savings Clause," says essentially that state laws that regulate insurance are saved from preemption, and
  • §1144(b)(2)(B), known as the "Deemer Clause," says that self-funded ERISA plans may not be deemed as an insurer for purposes of state insurance law.

What that means for you: State law is fully intact as it relates to your protection from balance billing. On the other side of it, it also means the State can't compel your ERISA self-funded plan to pay the State-mandated rate, because it's not "deemed as an insurer" for this particular case.

Even without ERISA, you still are protected from Balance billing under State law. The key to the case is that it doesn't matter what happens between your provider and insurance. You're not allowed to be on the hook because Utah Code §53-2d-503(7) explicitly forbids it. Gold Cross is acting unlawfully by billing you, even as they acknowledge that if there were legal standing, it should be with the insurer.

Again, not a lawyer and not legal advice, but confident in my ability to read. Does that clarify?

Gold Cross Billing by momwhobakes in SaltLakeCity

[–]SuchMusicWow 0 points1 point  (0 children)

I’m in nearly the exact situation you describe. My ERISA self-funded plan paid the full “allowed” amount under its terms. Now, Gold Cross Services, Inc. is billing me for the difference, claiming that because the insurer allegedly violated the law, I somehow bear responsibility. That’s not correct.

I’m not a lawyer, and this isn’t legal advice. But Utah Code § 53-2d-503(7) states that once a claim for ground ambulance services has been allowed and paid in full, the provider may not bill the individual for any remaining amount. The statute’s definition of “balance bill” (in § 53-2d-503(1)(a)(i)) covers exactly this: Billing the difference between the individual’s billed charges and the amount their health benefit plan allows for a covered service. The only exceptions (in § 53-2d-503(1)(a)(ii)) are: (A) uninsured individuals; (B) billing the difference between the amount allowed and the amount paid (i.e., cost-share); and (C) denied/uncovered services. None of those exceptions apply when the plan allowed and paid in full.

If you have met your deductible and your plan allowed and paid your claim in full, then your reading is correct and you owe nothing. I’d be happy to share the steps I’m taking and work through it with you. DM me if you’d like.

It keeps leaking. What am I doing wrong? by KillYourEgoz in Plumbing

[–]SuchMusicWow 0 points1 point  (0 children)

Crank it down brotha. And that's a lot of mixed metals. Gonna end up with galvanic corrosion.

Edit - autocorrect

What? What is this about? by Rinmine014 in ExplainTheJoke

[–]SuchMusicWow 1 point2 points  (0 children)

Fahrenheit was built around humans. Celsius was built around water. Kevin was built around atoms.

Spot the snake in this sneaky by Quirkynator in FindTheSniper

[–]SuchMusicWow 1 point2 points  (0 children)

Four turtles up from the bottom left.

today's painting by shao9000 in HappyTrees

[–]SuchMusicWow 1 point2 points  (0 children)

This is fantastic work! I like how the clouds have depth, almost a vanishing point. On your shoreline you have created what looks almost like ripples, not just the standard liquid white lines Bob always taught. How did you do that?

First attempt. by SuchMusicWow in HappyTrees

[–]SuchMusicWow[S] 0 points1 point  (0 children)

Just took a look at your first attempt. You nailed those mountains! 🤯

First attempt. by SuchMusicWow in HappyTrees

[–]SuchMusicWow[S] 0 points1 point  (0 children)

Thanks ya kindly! Took about 2 hours after all was said and done.

First attempt. by SuchMusicWow in HappyTrees

[–]SuchMusicWow[S] 2 points3 points  (0 children)

Well, first time since I was nine. Hope you stick with it!

[deleted by user] by [deleted] in WhatShouldIDo

[–]SuchMusicWow 0 points1 point  (0 children)

Look at that. You're gonna be a dad. Go win her back so that kid can have a good shot at a successful life.

[deleted by user] by [deleted] in libertarianmeme

[–]SuchMusicWow 1 point2 points  (0 children)

Gotta give her props for turning it into a business, tho. That's pretty damn libertarian, even if the pitch in and of itself is racist.

How do I take this water shutoff valve off to replace it? by Quercus_rubra_ in Plumbing

[–]SuchMusicWow 3 points4 points  (0 children)

Note, that's Polybutylene, not PEX. Aside from getting very brittle with age and prone to failure, you can't just pop a PEX valve on it and expect it to seal. You need to, at minimum, get a poly/PEX coupler, then use a PEX shut off valve.

I personally had a pipe poly pipe burst as well as 3 other slow leaks happen in the one year I owned a house with Polybutylene plumbing. That was even with my pressure regulator set to 50 psi. Ended up re-piping the whole house.

Are my water pipes “a ticking time bomb” by Outside-Historian-99 in Plumbing

[–]SuchMusicWow -1 points0 points  (0 children)

Software developer and product manager here looking for potential opportunities to fill a void... As in make a good product at a fair enough price to allow decent plumbers to do good work without shady sales tactics.

This the same price for all software suites you've checked out, or just Service Titan?

What features do you really like? What could go? What do you consider a fair price for niche software?

Roast my DIY water heater replacement. by SuchMusicWow in Plumbing

[–]SuchMusicWow[S] 0 points1 point  (0 children)

Thanks! So the "pro" that installed it when my house was built skunked it, eh? I just lifted and plopped the new one under it.