IBM Medicare "About Your Benefits" Reference Book

A while ago I mentioned a reference book that IBM sent out in the beginning of 2014.  It is called
"About Your Benefits: Post-Employment" and has a subtitle "Summary Plan Description".
 
A great deal of this book is about plan information for retirees who are under 65.  When IBM stopped providing group insurance to retirees who are Medicare eligible most of the plan description was no longer relevant. 
 
However, there is important information in this book that is easy to overlook.  There are descriptions of programs that are still available to people over 65:
 

• Life Planning Account which describes the benefits for people who retired by 12/31/2003
• Special Health Assistance Provision (SHAP) for people who retired pre-1997
• IBM Adoption Assistance Program 
• IBM Legal information (which describes your rights to appeal claims that you cannot resolve through Towers Watson)

 
Maybe you did the same thing I did when I first got this book. I tossed it aside and assumed it no longer applied to me.  I subsequently had some trouble with a Life Planning issue and decided to look into the details of the plan by going to netbenefits.com.  I ended up finding my answers in this book.   
 
Here is a link to the letter we got with the book and the front cover of the book.  https://drive.google.com/file/d/0B83wVKnNLtjtYmJJaHktdTdPWUU/view?usp=sharing .You can find the book in netbenefits.com but it's a whole lot easier to peruse the hardcopy version.  If you cannot find your copy ... I suggest you call the IBM Employee Center and get a new one.        

IBM Medicare Supplement Provider Refund Aggravation

We just received a refund check from the hospital for a claim I paid before my spouse's Medicare Supplemental plan agreed to pay it.  In a previous post, I said I'd do a happy dance when I got the check.  Well, it's a short lived happy dance.  Nonetheless, it is a victory.  Seems the complaint letter to the CEO of the hospital did inspire the billing department to get into action and correct the situation.
   
I thought I was on the path to a full blown resolution of the refund situation and the hospital check would be the final fix.  Unfortunately, a couple of days ago, that changed. We got a bill from my spouse's primary care provider group and there was no refund showing any where on the bill applied to the balance due (that was how they were going to refund our money).  In fact, their bill could not have been more of a mess.  I get the feeling the provider group change accounting systems in the beginning of 2015. 
       
This new bill showed a new account number and my spouse's name included a middle initial (something they had not done before).  In addition, the bill had a line item for a doctor visit in December 2014 which was not submitted to the 2014 cheapo Medicare Supplemental plan for payment.
 
I tried calling the group billing department at least five times but could not get an answer.  I decided to skip trying email and sent a letter with copies of an old bill, the new bill and information about the claim refund that is due.  I also told them to submit the December claim to the cheapo insurance. 
     
I have an hypothesis about all the machinations we've gone through to get our situation resolved.  It seems no matter what the organization: insurance companies, hospitals, doctor groups, governmental complaint agencies, corporations (ergo, Towers Watson) ... all these organizations are operationally incompetent and/or somehow short changing the customer.  My hypothesis is the layoffs, reorganizations, consolidations, outsourcing and the organizational push to be ever more efficient have produced enormous dysfunction. "Do more with less" ends up being "Do less with less and if  the customer gets shabby service so be it".  Where are the Watsons when we need them?

Update on 4/19/15:  Time to do an unreserved happy dance.  The last provider finally sent a refund check.  Wow.  It only took about 6 months to resolve this mess.  Amazing.