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HMO drops pregnant woman

Gina Hunter is afraid that being a few days late on a monthly bill will cost her a lot more than a late fee.

The New Port Richey woman and her family lost their health coverage from Physicians Healthcare Plans in April when she missed the deadline for the month's $370 premium.

The panic? She is 7{ months pregnant with her third child.

While the Tampa-based HMO has reinstated her two children _ Matria, 18, and Dakota, 3 _ she and her husband, Jay, remain without coverage. And she fears that her pregnancy and Jay's pre-existing heart condition will keep her from regaining coverage at prices she can afford.

"It's my fault for being late, but I don't think I should be crucified," said Hunter, 40, who runs the Spotlight Ballroom Dance Company with her husband in New Port Richey.

"I feel like I've been pushed up against a wall."

The HMO said it is acting within the law and the terms of its contract with the Hunters.

While conceding that appears to be true, the state Department of Insurance said the case is not that simple.

"I would hate to think that my relationship with my insurance company was so fragile that if my payment was just outside the grace period, that they would adopt an inflexible and inhuman position and drop me while my wife was seven months pregnant," said Dan McLaughlin, the department's press secretary.

"There's a bit of a sense of moral outrage," McLaughlin said. "We don't too often see cases like this."

Marta Arrington, who directs the department's Consumer Services Division, said she is working with the HMO to get Hunter's family reinstated. One possibility, she said, might be to obtain coverage through the Hunters' business.

Arrington said Hunter's April payment to the HMO was postmarked April 18 and logged in as having arrived on April 20. That's 10 days beyond the standard grace period, and five days beyond the extra time the HMO allows for mail delivery, Arrington said.

The cancellation letter was postmarked April 17.

Hunter said in her three years with the HMO, she has made a late payment only one other time.

Chris O'Connor, the HMO's vice president of operations, said a meeting will be held Monday morning to review the grievance Hunter has filed, but he offered no speculation as to the possible outcome.

"At this point I really don't want to venture a guess," he said. "We'll evaluate every aspect of this situation."

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