Leon FL Lawyers | Sonja P Mathews -- eLawyers

10-000987 GEORGE AND ASHLEA YEARWOOD vs DEPARTMENT OF MANAGEMENT SERVICES (2010)

Division of Administrative Hearings, Florida Filed: Feb. 25, 2010

The issues in this case are whether the criteria for approval of the prescription drug Norditropin exist under the Specialty Guideline Management Program; and whether Petitioner's son's growth hormone deficiency has been established by sufficient medical evidence.Petitioners did not meet burden of proof regarding requested medical services.

09-005872 ARTURO PUETO vs DEPARTMENT OF MANAGEMENT SERVICES, DIVISION OF STATE GROUP INSURANCE (2009)

Division of Administrative Hearings, Florida Filed: Oct. 22, 2009

Whether the Department of Management Services properly denied medical insurance reimbursement to Petitioner, a covered dependent of a state employee insured by the State Employees' Preferred Provider Organization health plan, for Genotropin recombinant growth hormone prescribed for the treatment of long- term growth failure associated with idiopathic short stature.Petitioner did not meet the criteria for insurance coverage of growth hormone treatment for idiopathic short stature.

09-002298 JUSTINA MULLENNIX vs DEPARTMENT OF MANAGEMENT SERVICES, DIVISION OF STATE GROUP INSURANCE (2009)

Division of Administrative Hearings, Florida Filed: Apr. 29, 2009

The issue to be resolved in this proceeding concerns whether the Petitioner, as beneficiary of her deceased father's State of Florida life insurance policy, is entitled to a benefit of $10,000 or $2,500, and is related to how notice of a change in coverage amount and premium was provided to the decedent.Petitioner did not show that she or the decedent retiree had informed Respondent of a change of address. Respondent has a seperate database from the Division of Retirement. Therefore, Respondent's notice to the last-known address was appropriate.

09-002135 JONATHAN ADAMS, PH.D. vs DEPARTMENT OF MANAGEMENT SERVICES, DIVISION OF STATE GROUP INSURANCE (2009)

Division of Administrative Hearings, Florida Filed: Apr. 21, 2009

On April 21, 2009, the Department of Management Services, Division of State Group Insurance (DSGI), referred this matter to the Division of Administrative Hearings (DOAH). The referral included Petitioner’s letter requesting a formal hearing concerning the denial of an insurance claim as well as a Motion to Dismiss filed by Respondent.Request for hearing that was not timely filed should be dismissed.

08-005613 ALTA Y. JONES vs DEPARTMENT OF MANAGEMENT SERVICES, DIVISION OF STATE GROUP INSURANCE (2008)

Division of Administrative Hearings, Florida Filed: Nov. 10, 2008

The issues in the case are whether the Respondent erred in 2006 when a life insurance program applicable to retired state employees was amended to provide for two levels of benefits with separate premiums, and, if so, whether the beneficiary of a retired, now deceased, state employee should receive a different life insurance benefit than was paid.The life insurance benefit due to Petitioner was $2,500. The insured employee did not select a premium to provide higher benefit.

08-003690 HENRY T. SWANN, III vs DEPARTMENT OF MANAGEMENT SERVICES, DIVISION OF STATE GROUP INSURANCE (2008)

Division of Administrative Hearings, Florida Filed: Jul. 28, 2008

The issue is whether Petitioner is eligible to receive disability income payments under the State Group Disability Income Self-insurance Plan (DISP).Petitioner is not eligible for benefits under the State Group Disability Income Self-insurance Plan.

07-002352 TERRY RHINES vs DEPARTMENT OF MANAGEMENT SERVICES, DIVISION OF STATE GROUP INSURANCE (2007)

Division of Administrative Hearings, Florida Filed: May 29, 2007

Whether Petitioner is entitled to any reimbursement of insurance premiums because he was mis-informed or inadequately informed concerning his opportunities to sign-up for the Spouse Program within the State of Florida’s Group Insurance Program.Petitioner was not inadequately informed or mis-informed by his personnel liason so as to be entitled to State health insurance premium, even though active military service was discussed as to circumstances.

06-003360 DONNA DANZIS vs DEPARTMENT OF MANAGEMENT SERVICES, DIVISION OF STATE GROUP INSURANCE (2006)

Division of Administrative Hearings, Florida Filed: Sep. 08, 2006

The issue to be resolved in this proceeding concerns whether the Petitioner Donna Danzis is a retired state employee and is entitled to reinstatement of her policy of State Life Insurance Plan.Petitioner failed to prove that she properly notified her former employer within 31 days after termination of her employment and before she was approved for disability retirement in order to remain in the State Life Insurance Plan.

05-001851 ANNA LEIGH MILLER, A MINOR, BY AND THROUGH HER PARENTS AND NATURAL GUARDIANS, LEIGH LASSITER MILLER AND THOMAS B. MILLER, AND LEIGH LASSITER MILLER AND THOMAS B. MILLER, INDIVIDUALLY vs DEPARTMENT OF MANAGEMENT SERVICES, DIVISION OF STATE GROUP INSURANCE (2005)

Division of Administrative Hearings, Florida Filed: May 20, 2005

Whether the Dynamic Orthotic Cranioplasty band prescribed to treat Petitioner Anna Leigh Miller's deformational plagiocephaly in 2004 was a covered benefit under the 2004 State Employees' PPO Plan.A Dynamic Orthotic Cranioplasty band to treat deformational plagiocephaly is excluded from coverage under the state employee health insurance plan, inasmuch as it constitutes "cosmetic" treatment.

04-002370 ANDRES GIL vs DEPARTMENT OF MANAGEMENT SERVICES (2004)

Division of Administrative Hearings, Florida Filed: Jul. 08, 2004

The issue is whether the Dynamic Orthotic Cranioplasty band and related services to correct cranial asymmetry in a one-year- old child are covered benefits under the State of Florida State Employees' self-insured health plan.Repondent proved that DOCB and treatment of deformational plagiocephaly is experimental or under investigation, and thus ineligible for payment under the Florida self-insured health insurance plan.

Sonja P Mathews