Blue Cross California

Review: I received a "notice of grace period" from Anthem Blue Cross regarding my Life Insurance Policy back in September. There was no payment slip, or address included with this letter mind you. I have been trying to class their Customer Service team to make a payment for weeks. When I would call, even during business hours, I would hear "not open" or their self-serve menu would not allow me to make a payment. I called today, and finally got through only to learn my account has been CANCELED! I have been with this company for over 8 years, and they didn't even try to rectify the situation. All I got was a "we're sorry, but you had until.... to pay." I tried to pay! Their system is never working correctly. I always pay two months, or more at a time via check. I have YEARS of proof, and because of their faulty "self-serve" my policy has been canceled. I demand that they either reinstate my policy, or issue me a refund of all funds paid over the years.Desired Settlement: At this point, I would like them to either reinstate my policy as it was, no changes, increases, and caring same balance. Or a complete refund of all monies paid over the years.

Consumer

Response:

Review: 9795236

I am rejecting this response because:

Review: I had to switch medical providers due to distance in 2012, and my new medical provider (UCLA Health) required me to submit to $911.41 worth of preventative-care biometric-screening labs that Anthem BCBS had assured me is covered as preventive. When the provider misbilled the charges as non-preventive/"medical diagnosis," thereby reducing my Healthcare Reimbursement Account, Anthem assured me that if the provider resubmitted the claim as preventive, the funds would be restored, as all preventive care is covered by traditional coverage. After almost a year of requesting, pleading, and reminding the provider to resubmit the charges, they finally agreed to do so after I finally filed a Revdex.com complaint with them. When they did resubmit, Anthem denied coverage and gave the reason that the preventive tests were tied to an annual exam, and only one such exam is covered per year. (My prior provider had run some tests earlier in the year.)At no point did Anthem warn me of such a restriction, nor is such a restriction to be found anywhere in the plan materials. In fact, because the laboratory (Quest Diagnostics) my prior provider worked with earlier in 2012 also miscoded most of these annual exam labs ($165.77) as medical instead of preventive, those ALSO reduced my account, and Anthem's repeated promises to follow up with the laboratory - several Anthem representatives have promised to follow up to resolve this, and none have - went unfulfilled even with full cooperation of the physician.In short, Anthem used every reason, from supposedly miscoded billing to novel restrictions not found in plan materials, to deny my preventive claim. Anthem has acted in bad faith repeatedly as I have attempted to resolve the issue.Desired Settlement: I would like Anthem to refund the amount of the preventive care, including the $929.52 that was wrongly deducted from my Healthcare Reimbusement Account as well as the $141.57 that I had to pay out of pocket to the provider after my account was depleted, for a total of $1,071.09. I can provide a full accounting of all charges if helpful.

Business

Response:

We can not locate Cory Fryling as an Anthem Blue Cross member. The number he referenced is not an Anthem health plan ID number. Please have him provide his Anthem Blue Cross ID number so we may locate and research his issue.

Consumer

Response:

Review: 9748137

I am providing additional information for this complaint as requested by Anthem in their initial response.

Review: I tried to cancel my policy on 12/2/2013 on the phone and online, but there is no option for talking to an operator, or canceling a policy. I sent a change form specifying a cancellation of policy on 4/11/2014,on which they received a return receipt on 4/13/2014, but got a bill again 4/18/2014.Desired Settlement: To clear my records on the amount they think I owe them, cancel my policy, and stop billing.

Business

Response:

We cannot identify this member due to lack of information. Please provide member health plan ID number.

Business

Response:

The health plan has initiated an appeal regarding this member's complaint. He will receive a written response within 30 calendar days.

Consumer

Response:

Review: 10017553

I am rejecting this response because:

Appeal my health plan how exactly?

Why 30 days?

Are you refusing to cancel my plan so you can send me an even larger bill in the next 30 days?

I wanted my plan canceled back in December.

I'll take a response both here, and in writing.

Regards,

Review: Multiple billings for the same billing period including initial payment and subsequent payments. Letters saying I haven't paid when I have bank statements that say I do. Going to have the bank over turn the DOUBLE payments, but that does not make this right, it keeps happening. I paid my initial payment several times before they acknowledged it and every bill since I have had to spend valuable time dealing with the matter on the phone. For the most recent bill I was asked if I could fax the bank information, I am not going to spend my time and money fixing a problem caused by Anthem Blue Cross, especially when this issue arises with every bill they send.Desired Settlement: Prove to the Revdex.com that going forward payments processed by the bank will always be acknowledged in your database.

Business

Response:

The health plan has initiated an appeal for this member. He will receive a written response from the health plan within 30 calendar days.

Business

Response:

The issue will be researched and a health plan response will be sent within 30 calendar days.

Consumer

Response:

Review: 10017160

I am rejecting this response because:

I am going to keep rejecting this response because this needs to stay open until they actually come up with something besides "give us 30 days". Also note that they have not responded to a complaint I filed internally with the company asking them to call me.

Review: I received a bill for something that I was told that I had already paid for. After spending more than hour going in circles through Anthem's phone menu system I reached someone in the billing department who then hung up on me. The problem is that my pediatric dental charge has been doubled with no explanation and I would like to know why, especially when I was told that it was already paid.Desired Settlement: First someone needs to actually call me. A competent customer service agent can reach me anytime at 323-854-1298. I want to know why I am receiving 2 bills and why the amount is apparently doubled, especially when I was told that I had paid in full. I'm not going to waste any more of my time trying to call Anthem myself. So call me. CALL ME! Tell me why I have an extra bill. Its simple. It shouldn't be this hard but I think Anthem's customer service may actually be worse than Time Warner

Business

Response:

A grievance has been iniated by the health plan for this member. They will receive a response from the health plan within 30 calendar days.

Consumer

Response:

Review: 9913911

I am rejecting this response because:

30 days?!?! What are these deadbeats doing? This is just as bad as what I went through yesterday. Handle it now!

Regards,

Business

Response:

Per the member's EOC, appeals/grievances are resolved within 30 calendar days.

Review: I submitted a complaint against Anthem Blue Cross on Thursday 09/04/14 regarding my request for the premium refund. I asked them to refund fully in 7 business days or they have to pay the interest and any cost related on top of the amount they owed me since 06/01/2014 (According to their policy, they will refund any overpaid premium within 30 days of the termination of the plan and my health plan was terminated as of 05/01/14) Up to today, it has been the 8th business day from the day I submitted my complaint but Anthem did not comply with the request. I want Anthem's respond in writing, either by regular mail, email or fax. I do not want Anthem's representative to contact me by phone, especially at my work. Last Thursday, somebody from Anthem from Anthem left a message for me at my work. The message gave me the phone number and extension number, the group number but when I called back the next day, Debbie (the person who answered the phone) could not track down who was the person and I couldn't leave any voice or email message to that person. So, no more phone contact.Desired Settlement: If I do not receive the full refund as requested, I will complain further until Anthem pays back my money.

Business

Response:

The member was sent a response by the health plan on Augus 20, 2014. We advised her additional information was needed before wwe can research further. As of now, that information has not been received.

Consumer

Response:

Review: 10223515

I am rejecting this response because: I already sent Anthem my response late August 2014 after I received their response. Anthem voluntarily applied my overpaid premium of May 2014 to a policy that I have never requested or authorized since the group plan was already terminated on May 01 2014. Anthem even applied the overpaid premium of May 2014 from my coworker to my terminated policy! Whether I have my other health coverage or not is not Anthem's responsibility or interest. I have active health insurance right now with my husband's policy but I reserve the right to provide the proof to Anthem. If Anthem still refused to resolve the issue as requested., I had no choice but bring them to the small claim court.

Regards,

Business

Response:

This member's next level of appeal is to the State of California Department of Managed Health Care.

Review: A claim was filed on my behalf by a provider over 3 months ago and it has been ignored by Anthem Blue Cross. I have made numerous calls to Anthem Blue Cross customer service over the past 2 months with absolutely no help from the representatives. Each representative looks up my claim and says the same thing, that because of the Affordable Care Act, they are just swamped with extra work and are behind on claims. But I do believe there is a time limit on how long they can hold a claim without processing it. On 5/21 I filed a grievance, and was told it would be resolved within 30 days, and I would be notified of the resolution. Big surprise, I was never contacted again. On 6/24 I called in and asked about the outcome of my grievance. I was told they could see where I had called one in, but nothing had ever been done with it. I called my insurance agent for help, and when she called she was told that since I had filed a grievance they would not speak with her as an agent. I called back 6/24 and asked for a manager as my agent suggested. The first representative would not connect me with a manager. After continuing to ask, he transferred me to another rep I had spoken with. She would not connect me with a manager either, until I had to raise my voice and tell her I insisted on speaking with one that day. It took me 30 minutes that day to get a manager. The manager said she knew someone that would get my claim processed within 24 hours. She guaranteed 100% it would be done by the following day. She called me back 6/25 and told me they were having difficulties with their system and while they still were not able to process my claim, they would keep trying. It has been over 100 days and nothing has been done. No payment, no declining, no decisions whatsoever. In the meantime, I have a provider demanding payment for their services. Customer service is lacking, and I honestly believe Anthem is practicing in bad faith delaying the processing of this claim in hopes I will give up.Desired Settlement: I would like the insurance services to be provided that I have been paying for. I want my claim to be processed.

Business

Response:

The health plan has initiated a grievance for this member. She will receive a written response from the health plan within 30 calendar days.

Business

Response:

The health plan will respond within 30 calendar days.

Consumer

Response:

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]

Review: 10106466

I am rejecting this response because: When I wasn't getting any help from Anthem in getting my claim processed, I called the Department of Managed Health Care to see what recourse I had, if any. They told me I first had to file a grievance with with my insurance company and give them 30 days to resolve it. If I didn't get any results, my next step would be to file a complaint with them, which I just completed. I took the proper steps, filed a grievance with Anthem which gave them 30 days to respond, and nothing was done with it. I don't see the logic in taking 2 steps backwards and giving them another 30 days to do what should have been done earlier, or at the latest after I had filed a grievance. At some point the delaying has to stop and a simple claim needs to be processed and a provider has to be paid.

Regards,

Michele Lilley

Review: I called and ask to cancel my plans when I got a new job, Anthem only cancelled part of it and continued to charge me. I had duplicated plans on Anthem without knowing it until I started looking at my bank records and seeing that I had been getting charged double for dental and life. I've been trying to ask for a refund and to cancel all remaining accounts. No one will respond to my messages or claims. The website is a total mess, I somehow have multiple user accounts all with different things going on. I try calling and no one ever answers. If someone does answer they give me another number to call- where no one has ever answered. I've just paid my bank to start refusing all requests from Anthem. At this point they have taken hundreds of dollars from me for plans I cancelled and I don't see how I can ever get the problem fixed, Anthem is like a black hole, I am really upset and can't find a way to get any of this fixed.Desired Settlement: I called to cancel all of my plans associated with Anthem in Nov 2012 as I was moving to a group plan with a new employer. My medical was discontinued on 11/15/2012. I would like to be refunded for every payment towards the dental and life plans that I requested to end. The end date for those plans should have also been 11/15/2012. I also need to have those plans cancelled immediately so that I do not continue to be charged for them.

Business

Response:

Please have the member provide the health plan ID number that he alleges was not canceled.

Consumer

Response:

Review: 9865909

I am rejecting this response because:

Review: Twice now I've submitted a claim to Express Scripts which is a contractor of Anthem (I'm not sure which party is the source of the issue, but Anthem should be responsible for the actions of their contractors) and have been told that I haven't met my deductible yet. I had, in fact, met my deductible in both cases. In the most recent case, they also told me that the medicine wasn't covered when, in fact, it was covered. I spent over 2 hours on various calls with various parties trying to resolve this issue. This is ridiculous. I need my medicine on a timely basis and if I can't get it it constitutes a denial of service.Desired Settlement: 1. I'd like to ensure that my most recent proscription is reimbursed as they (finally) agreed that it would be. 2. I'd like to create a record of the dishonest tactics being employed here, as they seem to be a matter of policy.

Business

Response:

We are unable to locate this member. Please have her provider her health plan identificaion number.

Review: I believe that Anthem Blue Cross deliberately made it very difficult to cancel a plan I did not order, one that was also embellished unnecessarily to increase my premium.I was unable to get through to an agent to help me cancel my plan until today (Feb 18th) and have been trying since the first of the year.Additionally, the agent I spoke with said that they were required by the new rules under the Affordable Care Act to add pediatric dental coverage, despite the fact that I have no children. When I spoke to an agent at CoveredCA, they claimed that this was untrue. I have checked www.healthexchange.ca.gov and confirmed that pediatric dental is not required.My billing with Anthem is set up to automatically withdraw from my account. For Feb they withdrew $239 for a premium I didn't sign up for, plus an additional $6 for pediatric dental.I have never used medical care while I have been a customer of Anthem. How they decided I needed a more expensive plan and pediatric dental coverage, I am not sure.Desired Settlement: I would like a refund of the $239 + $6 that Anthem charged for me for February of 2014. I never requested this plan and, according to the agent at Covered CA, was never required to have pediatric dental. I was deliberately put through long hold periods, under or mis-informed agents at Anthem, and ignored when I tried to straighten my situation out.

Business

Response:

We are unable to locate this member. Please have the member provider their health plan ID number. Thank you.

Review: Hi Our company changed health insurance from Blue Shield to Anthem Blue Cross in 2013. We paid deductible of $2,763.64 under Blue Shield. I tried to carry over the deductible from Blue Shield to Blue Cross.I collected all the detailed documents and faxed to Blue Cross on 8/27/13, and was confirmed by Blue Cross it was received on 8/29/13. I was told it will take 30 days to process.A month later, I received a letter and ask if the payments we paid were in-network.I called again on 10/24/13, and talked to [redacted], told him that the payments were for medicine, and it should be in-network. [redacted] promised to put some comment and re-initiate processing. [redacted] told me it will take another 30 days to complete.I called on 1/3/14, but was told the medicine deductible can NOT be carried over. If the medicine expense can count as deductible, it should be able to carry over.We received a check of $992.38 on 1/28/14 (not cashed yet). I e-mailed to our company's health insurance broker for help. After many e-mails with Anthem Blue Cross, here is their statement:"When we credit a members account we refund and or adjust rx /medical claims by the process date, medical deductible was removed in the amount of $1,435.28 + rx refund 992.38 = 2427.66."It looks like they credited a portion and refunded portion. They are unwilling to provide to me any additional details.We paid deductible of $2,763.64, it should be "carried over" to the Anthem Blue Cross according to Blue Shield/Blue Cross policy. They are trying to cheap on us, denying refund first, short paying the deductible, and delaying payment.I want fight for the principle of fairness, and insist full refund of deductible of $2,763.64 we paid. Anthem Blue Cross has to perform their part of the contract, instead bullying their customer.Thanks you very much for your attention and help.Best regards,[redacted]12/12/14Desired Settlement: Full refund of deductible of $2,763.64 we paid.

Business

Response:

A grievance has been initiated by the health plan. The member will receive a response from the health plan within 30 calendar days.

Review: I have set up "auto-pay" THREE times now with this company, each time they say it has gone through and up to date, then all of a sudden they say I was never enrolled in "auto-pay" confirmation numbers are useless becuase they always say they do not recognize the numbers I give them. Further more, I was charged $531.39 on 9/8/14 for my monthly dues wich made me current. Now today when I went for my infant sons doctor appointment they say my insurance was cancelled. After dealing with Anthem Blue Cross of CA they tell me they terminated my insurance due to failure of payment!! Also they fail to recognize my payment that my bank paid to them via check on 9/8/14! This company is out of controll!!! Please HELP!!Desired Settlement: For my insurance coverage to be reinstated as of today October 1, 2014.

Business

Response:

An appeal was initiated on this member's behalf on 10/2/14. He will receive a response from the health plan within 30 calendar days.

Business

Response:

This member is no longer w/Anthem Blue Cross. We have responded to his issues.

Review: This letter was sent to you in July, 2013 and we have NOT recieved ANY reply as of yet. Please respond and refund our OVERPAYMENT of our PREMIUMS. Thanks, [redacted] Anthem Blue Cross. ATTENTION: Anthem Billing DepartmentJuly 31, 2013Re: Subscriber Name: [redacted]ID No: 09[redacted]3Referring to: Part D Plan Bill for $76.80 Period Covering: June 1, 2013 to July 1, 2013This is a request for a REFUND or CREDIT for $76.80 from Anthem due to the fact that I have paid for the month of 06-01-2013 to 07-01-2013 TWICE. Attached is the proof that Anthem cashed BOTH our checks for the month of June. 1)For the billing cycle covering 06-01-2013 to 07-01-2013 (June) I sent check #1381 for $76.80 to Anthem and you cashed it on 06-17-2013 (see attached)2)On the next billing cycle, I received a bill stating that we had NOT paid for the cycle covering June and therefore, you billed me for 2 cycles or two times the monthly bill of $76.80 totaling: 2 x $76.80 = $153.603)In order not to get late charges until this matter was resolved, I paid the above bill of $153.80 with check # 1399 which was cashed by Anthem on 06-21-13. (see attached)4)I believe the error occurred as a result of the fact that instead of putting the ID number of 096A51733 on the check, I wrote the BILL ENTITY No: [redacted]IPlease correct this error and either send me a refund check of $76.80 or credit me the amount on my next bill. Please contact me through mail.Desired Settlement: Refund of $76.80

Business

Response:

The health plan will initiate a 30 day appeal regarding this member's complaint. She will receive a response from the health plan within 30 calendar days. Thank you.

Review: I received coupons for junk food from Anthem Blue Cross in May of this year. There was no date on the letter, no address and no way to opt out of receiving further coupons. I have tried for years to stop junk mail and now am getting it from my health insurance carrier. My boss pays a FORTUNE for my insurance every month, and now they are making even more money off me by working with marketing firms to send coupons to their client base. This is a way to get around not being able to give my contact information directly to marketing agencies.If Anthem would have sent healthy diet or exercise tips, or ways to live a healthier life I would not have minded, but included in the coupons were ones for ice cream (2 kinds), oil and mayonnaise. I called Anthem and told them I wanted to be taken off their coupon mailing list. The operator had no idea what I was talking about.Desired Settlement: I would like Anthem Blue Cross to stop sending coupons to me, and when they send any further correspondence I would very much like a date and contact information on the letter.

Business

Response:

This member's grievance was initiated on 6/4/13 when she complained directly to the health plan

Review: Blue Cross miscalculated and paid much less in my hospital bill. I have emailed countless times, and called on 5/31, 6/23, 8/6, 9/5, 9/29 regarding the following 2 claims on 4/3/2014. Every time, I was told Blue Cross will correct the mistake but never did. It has been more than 7 months, caused hospital to send me final notice that they will forward bill to collection agency, so I have to pay the Blue Cross share to avoid ruining my credit. Blue Cross now owes me $898.5 !!Blue Cross supervisor [redacted] (x35488) told me he will handle this in high priority, and will call me back regarding the status, but he never did ! ----------------------------------------------------------2 claims need to be paid:1. 4/3/2014 Claim Number: 20[redacted]173 for Saddleback - my copay should be 20%, not 50% - need to issue refund check of $898.5 to me instead of paying Saddleback.2. 4/3/2014 Claim Number: 20[redacted]173 for AFFILIATED PATHOLOGISTS M - my biopsy was approved and told everything was within network, so BlueCross should cover, not deny.Desired Settlement: 2 claims need to be paid:1. 4/3/2014 Claim Number: 20[redacted]173 for Saddleback - my copay should be 20%, not 50% - need to issue refund check of $898.5 to me instead of paying Saddleback.2. 4/3/2014 Claim Number: 20[redacted]73 for AFFILIATED PATHOLOGISTS M - my biopsy was approved and told everything was within network, so BlueCross should cover, not deny.

Business

Response:

The health plan has initiated an appeal for this member. They will receive a response within 30 calendar days.

Business

Response:

The member's issue is not resolved as it is in the grievance process. She will receive a resolution letter when the grievance is completed.

Consumer

Response:

Review: 10308493I am rejecting this response because it's not resolved. In your letter saying if I don't respond within 7 days or the complaint will be closed as assumed resolved. Regards,[redacted]

Review: Anthem Reps said that I received a letter from them regarding the new affordable health plans, what plan was comparable to the plan I have now. According to this supposed letter I was to call only if I did NOT want the plan and that I would automatically be enrolled in the new plan. If I knew about this I would have called! My plan was $150 the new plan that they automatically enrolled me on is over $400!!! How is that comparable?!? I have called their number every day now since the money was automatically withdrawn from my bank account (another thing I did not approve). I have been hung up on, transferred multiple times to the wrong department, sent to wrong numbers, put on waiting list, sent to numbers that no longer work within company, sent emails,etc and have had no response. In all since I have started trying to contact them I have sat on hold for a total of 15 hour which has ended up as a dead end. All I want is my money back so I can pay my mortgage. I am very disappointed in the way that I have been treated, I expected more from this company considering that I have been a loyal customer to them for many years. All I want is my money back!Desired Settlement: I would like the $410 that was withdrawn from my bank account without consent refunded immediately.

Business

Response:

The health plan cannot identify this member. Please have the member provide her health plan ID number.

Review: On numerous occasions, I have called Anthem Blue Cross to speak to customer service about my membership. I can usually be assisted within 30 minutes. Most of the time the customer service rep has no answer for me. Today, Sept 12, 2013, I called Blue Cross at 3PM, was on hold for 49 minutes, a rep came on, took my information, said she would be right back and 47 minutes later, I hung up. I called again and it took 18 minutes to have someone answer. There are never 'supervisors' available, no one knows what they are doing and this is one of the multi-billion dollar companies with inept customer service, just like ATT, Verizon and the other monopolies. I finally received help at 5:35 by someone by the name of Sonia after being transferred, put on hold, then I gave an extension number to see if that would get me to a human being and finally, Sonia answered; I spoke to her once before in April of this year. Customer service, hold and wait time is absurd and a waste of time. Something needs to be done with this as it us unfair to the consumer, their customers. They jack up the prices constantly, offer fewer benefits and the service only gets worse. 3 1/2 hours wasted trying to get help today...and they ask me to watch my language when they finally answer. Excuse me, I've waited for hours listening to the orchestra play it's damn loop stating someone will be with me shortly. PLEASE HELP.Dr Linda SalvinDesired Settlement: That it be brought to the attention of Blue Cross how poorly their respond to their customers. Something has to be done.

Business

Response:

The health plan has initiated a 30-day grievance for this member. She will receive a response regarding her complaint within 30 calendar days.

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID 9716990, and find that this resolution is satisfactory to me.

Regards,

Review: I sent Anthem an application for health care coverage. I have tried to pay for the first month of health care coverage twice and Anthem does not admit to receiving any payment from [email protected] MeDec 16, 2013Anthem does accept checks, cashiers checks and money orders for your initial payment. NOTE: Please do not send cash by mail.Please complete the following steps: Make your check, cashiers check, or money order payable to Anthem Provide the full amount of your first months premium - $16.96 Include this identification number on the check or money order: VA[redacted]39 Print a copy of the confirmation page and include it when mailing your payment. Mail the payment to P.O. Box 9[redacted],Oxnard, CA 93031-9041.The payment must be received and processed by your effective date.If the payment is not received by this date, your application for coverage will be canceled and you will have to reapply for coverage.Please allow for a minimum of 5 days for mail time to ensure the payment is received by the due date.CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, isfor the sole use of the intended recipient(s) and may contain confidentialand privileged information or otherwise be protected by law. Anyunauthorized review, use, disclosure or distribution is prohibited. If youare not the intended recipient, please contact the sender by reply e-mailand destroy all copies of the original message.I mailed Anthem a check from a Post Office in Petersburg on 18 December 2014. I received a letter from Anthem dated 27 December that said they have not received my payment. I spoke with a representative at this number ###-###-#### on 10 January and gave her the information to charge my bank card for $16.96 once. And I told her after the transaction that I had mailed a check for that amount on 18 December. I just checked my bank account via online banking. And there is no transaction for $16.96 from 18 December to today.Desired Settlement: I have ordered health care coverage from an insurance company before 23 December. I sent the full payment for my first first months premium ($16.96) as instructed. And called Anthem and asked the representative I talked with to take the payment using my bank card.I have trying to pay my bill before or on all deadlines twice.I want my health care coverage to begin on 1 January 2014 as advertised.

Business

Response:

We are unable to identify this member. Please have him provider his health plan member ID number. Thank you.

Business

Response:

Because of Health Plan Protection, we need the member's health plan ID number to review his complaint.

Consumer

Response:

Review: 9873664

I am rejecting this response because: this is a delaying tacit on the part of Anthem.

MESSAGE FROM BUSINESS:

Because of Health Plan Protection, we need the member's health plan ID number to review his complaint.

Today is 15 January 2014. Today I need to have paid for one month of health insurance for the policy to begin on 1 February 2014.

WELCOME TO THE MARKETPLACE: Find health coverage that meets your needs and budget

Enroll by January 15 for coverage starting February 1

On 18 December 2013 I sent a check to Anthem for $16.96 and on 10 January 2014 I called Anthem and gave their representative my bank card information and my permission to charge $16.96 to that card once. Anthem has not provided the health care coverage that I have tried to pay for twice.

My plans & programs

HealthKeepers, Inc(Anthem BCBS) Anthem HealthKeepers Silver DirectAccess - cbau

Status: Initial enrollment

Review: ANTHEM has become unresponsive in 1) answering the phone 2) returning calls and 3) having payment systems that work (online and tele-based). I've been calling ANTHEM daily for the last 2 weeks - every day - and EVERY teleprompt regarding "pay my bill" ends in a disconnection - or a message saying "sorry - we are having technical issues please try again later" .My policy is past due - and ANTHEM's inability to ACCEPT PAYMENT is unacceptable. Its getting to the point of ridiculousness - where i'm wasting HOURS every day "on hold" for a system that DOES NOT WORK. To the point where my cordless handset's battery DIES before I actually reach someone. I'm on HOLD as I type this - now for 90 minutes - because I pretend to be a NEW CUSTOMER ... hoping that gets a response. Unacceptable customer service - and unacceptable / broken process. [redacted]###-###-####Desired Settlement: PHONE CALL RESPONSE FROM ANTHEM. They need to FIX THEIR PROBLEMS so people can pay their bills.

Business

Response:

The health plan has initiated an appeal for this member. The member will receive a response from the health plan within 30 calendar days.

Review: I wanted health insurance for my family of 4. They automatically forced 2 of my family members into Anthem BC. A bait-and-switch to something other than what I had applied for.It is common sense that one would want ALL family members to be covered. When NOT offering what the customer had applied to, they should FIRST provide the SWITCHED offer for the customer to review. Automatically forcing 2 of my 4 family members into Anthem BC is unethical. They had NO right to enter me into a forced contract after the bait-and-switch practice.Now they are forcing me to fill out yet another form with all kinds of detail to cancel the forced contract. This is NOT right.Desired Settlement: Cancel any pending policies and remove my Credit Card Information from their billing system to avoid accidental or intentional charging of my credit card.

Business

Response:

The member has been requested to put his complaint in writing to the health plan.

Consumer

Response:

Review: 9553041

I am rejecting this response because: Business has not started a review of their practice of automatically binding the applicant to a modified (switched) policy.

Regards

Business

Response:

The member's next level of appeal is to the California state regulator's office, either CDI or DMHC.