CIGNA

Hello,
Thank you for this information.
I will be researching this issue and will follow up with the customer once a resolution has been met.
Thank you,
Nicole P[redacted]

Resolution letter sent overnight 3/28/2016 to customer via [redacted].  Charlene V[redacted]Executive Office Advocacy Team

Our resolution team has been in touch with the customer and worked through the concerns brought to our attention.  The customer was advised in a private conversation.

[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 as Answered]
 Complaint: [redacted]
I am rejecting this response because: Since I have filed this complaint I have received a letter and a phone call from 2 different companies that have been contracted by Cigna to "follow up" on ALL of my injures since November of 2015. These are over a year old and now they are trying to not cover them! I truly feel that this is them retaliating on me for me filing this complaint. Also they did not do anything but tell me my FSA card was back on which I was already aware of. They need to do something to fix this process and to make up for hassle and time I had to spend trying to figure this out for them! They also need to do some more training so that their employees know what they are doing. I would like my calls pulled and action to be taken!!
Regards,
[redacted]

Update on complaint #[redacted] - once more I'm receiving demands for payment and threatening letters from Cigna. Today a woman in Windsor, CT. called. It was a disaster. It took 5 minutes to get her to correct a typo: I put down Oct. instead of...

Nov. for the 1xst notification date that I was withdrawing from Cigna Medicare supplement beginning on Jan. 2017. The lady then informed me that their records say I withdrew from their program on March 2016, despite the fact the Cigna up a direct payment bank draft in Dec. to pay for my supplement thru Dec. 31,2016. This bank draft occurred on Dec. 25, 2016. The woman said that I needed to inform them of my withdrawal. I've been doing this since November that I would no longer be their customer as of Jan. 2017. Which I have done ad nausum. I contacted Medicare for the requirements for this change in insurance and Medicare approved my change to anthem. I told this lady all this over and over and over again. She wanted name on the last harassment letter for non-payment, but I mailed that back to the company so that they'd have a complete record of what was going on. And it's not my responsibility to keep track of their employees and what they do. I was so frustrated after going over and over this information for over 15 minutes that I told her to stop their letters, said good-bye and hung up. I want no further contact with this company! It obviously has a big problem with record keeping, since their records state that I withdrew in march, 2016. Please Revdex.com stop this company from continuing contact with me. I've done every thing Medicare told me to do in order to change supplement insurance. **No further contact by the business

Hello-
Thank you for forwarding this complaint to Cigna. This complaint is being reviewed and Cigna will work directly with the customer.
 
Tanya H[redacted]
Cigna
Executive Office of Complaint

A final determination has been sent to the customer today, April 4, 2014.

October 30, 2015Dear [redacted],We are writing in response to your follow-up inquiry regarding [redacted]’s Short Term Disability (STD) claim.[redacted] raised additional concerns regarding the overpayment on her STD claim, and that she felt pressured to make payment arrangements. We have further reviewed [redacted]’s situation and the concerns she has raised, and have waived the overpayment on her claim. We will notify [redacted] directly, and that trust this will resolve this matter to her satisfaction.Should you have any questions or would like to discuss this matter further, please feel free to contact me directly at ###-###-####. You may also contact CGI’s Consumer Advocacy department regarding any group disability, life or accident concerns at:Cigna Consumer Advocacy Attn: Meredith ** L[redacted] Phoenix, AZ [redacted] Email: [email protected] Fax: ###-###-####Sincerely,Brenda W.Manager, CGI Consumer Advocacy

We
are writing to acknowledge and respond to your correspondence dated
April 1, 2016, regarding Joey [redacted]’s claim for Long Term
Disability (LTD) benefits. Mr. [redacted] was covered under his employer
provided, fully-insured LTD policy [redacted], which was underwritten
by Life Insurance Company...

of North America ([redacted]) and issued in
Georgia.Mr.
[redacted] raised concerns regarding his most recent LTD claim experience
and claim decision. Please allow us this opportunity to address his
concerns and explain our decision. With
respect to Mr. [redacted] employer’s LTD policy [redacted], in order for
benefits to be payable, his medical records needed to support that
his health conditions caused a functional impairment that would
continuously meet the following definition of Disability/Disabled to
be eligible for benefits:Definition
of Disability/DisabledThe
Employee is considered Disabled if, solely because of Injury or
Sickness, he or she is:unable
to perform the material duties of his or her Regular Occupation; andunable
to earn 80% or more of his or her Indexed Earnings from working in
his or her Regular Occupation. After
Disability Benefits have been payable for 24 months, the Employee is
considered Disabled if, solely due to Injury or Sickness, he or she
is:1)
unable to perform the material duties of any occupation for which he
or she is, or may reasonably become, qualified based on education,
training or experience; and2)
unable to earn 60% or more of his or her Indexed Earnings.The
Insurance Company will require proof of earnings and continued
Disability.While
his LTD benefits were approved for a time, continued LTD benefits
were not payable to Mr. [redacted] beyond October 29, 2014, because he no
longer met the policy’s definition of Disability. Benefits were
subsequently paid through this date and then discontinued. According
to our records, this determination was also reviewed and upheld
through two separate administrative appeals. While we understand Mr.
[redacted] disagrees with our determination and paid for coverage under
policy [redacted], further LTD benefits would only be payable if a
continued functional impairment was supported. At this time, it has
been determined that Mr. [redacted] did not meet this definition of
Disability/Disabled beyond October 29, 2014 as required by his
employer’s policy. Based on our review, no further financial
compensation is due to Mr. [redacted] at this time. Should
you have any questions or would like to discuss this matter further,
please feel free to contact me directly at ###-###-####.Sincerely,Eric
F[redacted],Compliance
SpecialistCGI
Consumer Advocacy

Documents

Thank you for forwarding this complaint to Cigna. Cigna has reviewed this complaint and resolution letter has been sent to the customer on 10/04/2016.Charlene V[redacted]Executive Office Advocacy Team

Cigna is reviewing this matter and will respond with
additional information. 
 
We take patient confidentiality seriously
Protecting our customers’ personal health information is
critical. So much so, that the Health Insurance Portability and Accountability
Act (HIPAA)...

requires that we protect an individual’s private health information
(PHI). Because this matter requires that we look into personal information, we
need him to give us permission to share
our findings with the Revdex.com. [redacted] can grant this permission by signing
the attached Authorization for Use and Disclosure form.
 
Thanks,
Georgia

[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]
 Complaint: [redacted]
I am rejecting this response because:
Long Term Disability is something that we as employees pay into in case situations such as mine's occurs.  Secondly, there have been other employees in similar situations, and have received their STD and LTD. Thirdly, I received information from Cigna,  explaining to me when my employment disability will begin and the amount (please see attachment) and the company have now went backwards on their own words and policy.  According to the information that this company has rendered, they were willing to start the benefits, but was informed by my employer ([redacted]r) not to do so; this in itself is contrary , uncharacteristic, and even subordinate for prejudicial treatment.Fourthly, since this company (Cigna) has clearly stated that [redacted] is the primary reasons for Cigna's inaction concerning my STD and LTD: I feel that it is only fair to also file a claim with the Revdex.com against [redacted] for the twin reasons  or the matching of correspondence of  this complaint current complaint.  In the forthcoming complaint, I ask that the information rendered by Cigna in this grievance should not be closed for the necessity and pertinent impending. To close the gap in resolving the current issue, I believe that in the corrective stage and only in such stage of the forthcoming complaint should this current complaint be withdrawn,  freely by me.  Lastly, after speaking with Mr. P[redacted] on Wednesday July 1, 2015, the response was yet unclear and conflicting  in regards to STD and LTD. Thereafter, I informed him that I  have sought an attorney. Mr. P[redacted] stated that the Revdex.com would contact my attorney. However, the Revdex.com does not have my attorney's name or number so I do not know the nature of his remark. Nevertheless, I am enclosing the information here: [redacted] and [redacted] ###-###-####
Regards,
[redacted]

Hello,
 
This complaint has been received by Cigna's Executive Office of Complaints. Cigna will follow up with the customer directly for review.
 
Thank You,
 
Rafael P[redacted]

Hello,
We have confirmed with the customer that the matter adheres to Cigna's policies. There is no additional level of review available.  The customer is currently working with internal contacts here at Cigna to ensure resolution.
 
Thank you,
[redacted]

This complaint was received on 8/29/2014.  A response will be sent to the customer regarding these concerns.
 
Thank you,
 
Kelly M[redacted]

This issue jhas been resolved. A message has been left for the customer if there are any other issues.
Tanya H[redacted]
Executive Office Advocacy Team

[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 as Answered]
 Complaint: [redacted]
I am rejecting this response because:  Cigna informed me I could use a credit card to pay for my premium prior to signing up for their service last year, allowed me to pay my premium multiple times by credit card then took away that option.  They should continue allowing payment by credit card until I can change insurers which is not allowed until the end of year enrollment.  
Regards,
[redacted]

Good Afternoon,Thank you for forwarding this information to Cigna. Cigna is reviewing the complaint, and an acknowledgement letter was sent to the customer on February 21, 2017.Protecting our customers’ personal health information is critical.  So much so, that the Health Insurance Portability...

and Accountability Act (HIPAA) requires that we protect an individual’s private health information (PHI). Because your inquiry requires that I look into your information, I need her  to give me permission to share my findings with the Revdex.com. Janice Minchenberg can grant this permission by signing an Authorization for Use and Disclosure form.  Rae B[redacted]Executive Office Advocacy Team

Please be advised that this case is still under review. Upon review a response will be sent to the customer.
Thanks.