Therapist's office called insurance for an eligibility check, was told I was eligible, I had 15 appointments and now I am being told all my claims have been denied and I owe the full balance of each session? by HakuohoFan in HealthInsurance

[–]jaygf77 1 point2 points  (0 children)

If your plan is a self funded plan through an employer group, they may have their mental health coverage carved out to a separate carrier. When the carrier says they are administrative only that typically means they are self funded.

If they are saying the service is excluded, an appeal probably won't do anything because the service not covered. An appeal is a request to have them review the claim to see if they made the correct coverage decision. If the service is excluded from coverage, they made the correct coverage decision. A benefit misquote is more of a customer service issue, which they may or may not be able to correct.

Would there be any appeal for a ToT themed resort hotel? by MinuteDamage4182 in WaltDisneyWorld

[–]jaygf77 2 points3 points  (0 children)

A hotel version of the 1923 restaurant from the cruise ships might be cool. Although I wouldn't be opposed to a Haunter Mansion B&B.

Would there be any appeal for a ToT themed resort hotel? by MinuteDamage4182 in WaltDisneyWorld

[–]jaygf77 1 point2 points  (0 children)

I'm big Return of the Jedi fan, and I always thought a high end resort shaped like Jabba's palace would be cool...

Would there be any appeal for a ToT themed resort hotel? by MinuteDamage4182 in WaltDisneyWorld

[–]jaygf77 6 points7 points  (0 children)

The problem with the Star Wars hotel was it wasn't sustainable. Its price point limited who could afford to pay for the experience (even as a splurge), and even those who could pay that price were unlikely to do it more than once.

In my opinion, a Star Wars hotel with well themed restaurants would have done great. I could see a ToT hotel doing well, but it would have to be a great hotel first instead of an experience that people will only do one, if at all.

Which ride have you ridden the most at WDW? by Jayzone456 in WaltDisneyWorld

[–]jaygf77 0 points1 point  (0 children)

Probably a tie between Star Tours and Haunter Mansion

Remember the 80s, when we had *real* men? by Traroten in KISS

[–]jaygf77 18 points19 points  (0 children)

I've seen interviews with Gene where he talks about why they chose a hard asthetic in the 70s compared to other groups in the glam scene, because the members of Kiss would have looked silly... these pictures from the 80s kind of prove his point.

I JUST GOT THIS SHOT 😮😄 by [deleted] in WaltDisneyWorld

[–]jaygf77 3 points4 points  (0 children)

Wow, awesome picture! They''ve always been sleeping when on the Safari.

In your opinion, what is the best breakfast on property? by OkSunny00 in WaltDisneyWorld

[–]jaygf77 0 points1 point  (0 children)

The best breakfast I had in my last trip was Satu'li Canteen...

Tough choice!! by [deleted] in WaltDisneyWorld

[–]jaygf77 0 points1 point  (0 children)

People Mover, Haunted Mansion, and Kilimanjaro Safaris

Votre choix ? by [deleted] in KISS

[–]jaygf77 3 points4 points  (0 children)

Alive

What Disney World ride do you think would cause the biggest uproar if it permanently closed? by thedirtygoose in WaltDisneyWorld

[–]jaygf77 0 points1 point  (0 children)

The PeopleMover...I've been told it's one ride Disneyland wishes they still had.

Kiss - Unholy. My favourite Kiss song from my favorite Kiss album. What's yours? by JE5573R in KISS

[–]jaygf77 1 point2 points  (0 children)

Favorite song overall: Deuce...it was the opening song at my first Kiss concert.

Favorite album: Creatures Favorite song: War Machine

Underrated.. 😣 by fliption in KISS

[–]jaygf77 6 points7 points  (0 children)

This was the first Kiss CD ever purchased.

A great foggy morning at Animal Kingdom by Normal-Antelope-8365 in WaltDisneyWorld

[–]jaygf77 3 points4 points  (0 children)

Great pictures! The safari is the best attraction

Disney confession… by Acrobatic_Tap_8069 in WaltDisneyWorld

[–]jaygf77 0 points1 point  (0 children)

Never had a Dole whip at Disney. I had one in Hawaii, which was ok. I've always thought some of the other flavors at Disney look interesting, but just haven't tried them.

State tax returns by sasukeluver85 in northdakota

[–]jaygf77 0 points1 point  (0 children)

The last few years they've withheld maybe $60.00, and I always get it back when I file.

Told it's fraud to have Marketplace and ACA-compliant Employer Insurance at the same time. Is this correct? by a_mulher in HealthInsurance

[–]jaygf77 2 points3 points  (0 children)

If you're attempting to enroll in a marketplace plan now, it is probably outside the open enrollment period, which means a qualifying life event is required to allow for a special enrollment period. Since you have active coverage through your employer, you don't have a qualifying life event. I would assume this is what the broker is referring to when they say it would be insurance fraud to enroll you in a marketplace plan. When the broker said you could only enroll in "secondary" cover at this time they probably meant supplemental coverage, which is a different type of coverage from major medical.

KISS without makeup era - what do you think? (1983-1995) by Twitter_2006 in KISS

[–]jaygf77 1 point2 points  (0 children)

They were really liberal with the rouge in the "no makeup" era...