(Reprinted with permission from Childrens Hospital of Cincinnati and the Ohio Speech Language Hearing Association)
Dear (Employer’s Human Resources Director/Union Representative),
This letter is in regards to our current inadequate health benefit coverage for pediatric speech, language and hearing services. This year, our plan only provides coverage for a maximum of 20 speech therapy benefits. My child’s speech and language disorder is severe and he/she requires ongoing intensive, individualized therapy to make progress. Last year, my child attended X number of speech therapy sessions and while he/she is making good progress, he/she is not age appropriate in his/her speech and language skills yet. I am bringing this to your attention because when I called the insurance plan to request more visits, the representative recommended that I contact you as you are responsible for negotiating the benefits package.
I realize that the cost of providing health benefits is of major concern to employers. Fortunately, the cost of expanding speech, language and hearing benefits is inexpensive. Cincinnati Children’s Hospital Medical Center expanded coverage for speech-language pathology services for its employees last year by increasing coverage to 30 visits per benefit period under its self-funded medical plan. After the addition of pediatric speech services, enrollment in this plan increased 192%. The impact of increasing these benefits on total claim expense was less than $0.05 per enrollee per month. Not only was the rider beneficial for families of children with speech pathology needs, it was also financially advantageous to the insurance company that gained a significant increase in member enrollment.
Under our current benefit plan, medically necessary services are being denied for the youngest beneficiaries – our children. I cannot emphasize enough how concerned I am that my child may not be able to reach his/her potential because of inadequate speech and language skills. Thank you for considering this issue. I will be contacting you soon to discuss the opportunity to improve our speech, language, and hearing benefits.
(Employee’s name, title)
*Disclaimer this letter is a sample only, and should not be construed as appropriate for each individual situation.