Coventry Health Care, Inc.

Dear...

Ms. [redacted],
Please see our response to complaint #[redacted] for [redacted] that was received by us on February 23, 2015.
During our investigation, it was determined that Ms. [redacted] is not set up to have recurring EFT drafts for her premiums for 2015.  The premium collected on February 19, 2015, was a debit card transaction that had been requested through the Health Insurance Marketplace at the time of her active renewal.  The initial payment request was made in December and would have been for the premium for January 2015, but a hold was placed on it.  The hold was lifted in February causing the transaction to process.  Ms. [redacted] had already paid the premiums for January and February at the time of processing so the payment was applied to her March premium.
If a refund is issued, the amount would be removed from her March premium.  She would then owe the exact same amount of the refund back to Coventry.  Due to this, we are unable to determine a benefit to issuing a refund at this time.  However, if Ms. [redacted] was charged any overdraft or NSF fees due to the unexpected transaction, we may be able to reimburse her.  Requests for reimbursement of any fees applied would need to include bank statements that show the rolling total of her bank account as well as the dates that any fees that were applied and their amounts. 
We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address Ms. [redacted]’s concerns.  If there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted].
Regards,
Chris B[redacted]
Executive Resolution Team

Complaint: [redacted]
I am rejecting this response because:
 
I had contacted Revdex.com previously because my insurance company cancelled my health insurance without notifying me. After sometime and many hour long phone calls spent mostly on hold with Coventry and after the Revdex.com contacted them they agreed they were in the wrong and said they would reinstate my policy. I informed them I no longer wanted their policy as I had by this time, obtained another one. I received a letter in the mail this saturday 12/13 that they were ach withdrawing $1,098 from my bank account for payment for 3 months of coverage. I contacted them immediately but nobody there will do anything to help and my bank is unable to stop the pending withdrawal. Below is the original complaint: Sent Via: Email (ODR) From: Revdex.com serving Metro Washington DC & Eastern Pennsylvania To: [redacted] [redacted]. Subject: Message received from the business about your complaint Date Sent: 11/21/2014 8:24:30 AM Attachments: Click here for printer friendly version [redacted] Berlin MD [redacted] Dear [redacted] : This message is in regard to your complaint submitted on 11/10/2014 10:25:18 AM against Coventry Health Care, Inc.. Your complaint was assigned ID [redacted]. The business has sent the Revdex.com a message regarding this complaint, and we are passing it on to you. The contents of this message are below or attached. Please respond to this message in written form within 10 days. The text of your complaint may be publicly posted on Revdex.coms Web site (Revdex.com reserves the right to not post in accordance with Revdex.com policy). Please do not include any personally identifiable information when you tell us about your problem or in your desired outcome. By submitting your complaint, you are representing that it is a truthful account of your experience with the business. Revdex.com may edit your complaint to protect privacy rights and to remove inappropriate language. Regards, [redacted] The Revdex.com MESSAGE FROM BUSINESS: Dear [redacted], Thank you for allowing us to address the concerns reported in complaint #[redacted] for [redacted] that was received by us on November 10, 2014, regarding the termination of his policy. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you. We reached out to our Enrollment department for assistance during our investigation. We confirmed that [redacted]’s policy has been reinstated. [redacted] will still need to pay premiums for each month of coverage, but he will otherwise be able to remain covered on his current policy until December 31, 2014. [redacted] can contact the Enrollment department at ###-###-#### to make the payments or to cancel prior to December 31, if he does not wish to continue coverage for that long. We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address [redacted]’s concerns. If you have any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted]. Regards, Chris B[redacted] Executive Resolution Team
 
return my $1,098.96 immediately
Regards,
[redacted]

I received a letter from Coventry Health Care stating that I had verbally authorized Coventry to debit my bank account on Jan 10-2016 AM.
In the letter they list the following items:
Payment date - Oct 31 1926 , which happens to be my birthday
Payment Amount-$74.50
Bank Routing No.- [redacted]4366, this has some no's that are the same but not in that order.
Bank Routing Number- **SSN**, Not Even Close
Payment Reference **SSN**, don't know what that is.
The letter further states that if any of the information is incorrect, I should contact them and correct it.
I have never had any conversations with Coventry, in fact i've never heard of them. I will contact my Bank, my Senator, and my State Attorney General. To report this incident!.
EMPTOR CAVETE

September 30, 2014
Dear [redacted]:The Member is participating in the Coventry Health and Life Insurance Company (“CHL”) HealthAmerica One individual off exchange HMO health benefit plan.The Member’s complaint concerns premium payments refund due to premium payments drafted from the Member’s bank account for 11 months in error. The member is requesting a refund of premium payments.The member’s request for back premium is denied and will continue to be denied. He did not follow the terms of his contract with Coventry which state the following:The Subscriber may terminate Coverage for himself/herself and any enrolled Dependents under the Group Contract for any reason immediately (same day) upon thirty (30) days prior written notice (including facsimile or e-mail) to Us after the first 30 days of Your Contract. Such terminations will be effective at 11:59 p.m. on the termination date provided by the Subscriber in the notice to Us. Retroactive termination will be permitted up to a sixty (60) day time frame provided proof in writing is supplied that other insurance was in effect during that time frame. ([redacted]12/11)• The first documented termination notification was received on 05/05/14.• As a business rule applied to all cases, according to his contract, we will retro-terminate back 60 days.• If the member has proof, that can be validated, of a written termination notification prior to 05/05/14, we will be glad to reconsider the termination date.I have included a copy of the Member’s contract language for your review.We trust the above information is fully responsive to your request. Should you have any questions or concerns regarding this complaint, please do not hesitate to contact me at ###-###-####.Sincerely,Emily M
Complaint and Appeal Consultant

August 21, 2014Dear [redacted];The Appeals Department of Coventry Health Care of Virginia, Inc. ("Coventry Health Care") writes this letter in response to your request dated August 8, 2014 and received at our office on that day, This letter is in response to the consumer complaint...

filed by [redacted] regarding termination of her 09/01/2014 policy and refund of her premium.Coventry is unable to process any changes to a policy that was initiated through the Marketplace per the Exchange rules and regulations that we as an insurance Company must follow, [redacted] has requested these changes through the Marketplace. On 08/06/2014, [redacted] contacted the Marketplace to discuss her case. It was escalated to a dedicated Caseworker and a Case ID Was generated.
On 08/27/2014 the Health Insurance Marketplace Caseworker informed Coventry of the pending retro-termination date request, which is still in process and advised that the policy slated to begin on 09/01/2014 is now cancelled. No further action is required from Coventry.
If you have any questions, please contact the Customer Service Department at ###-###-####.
Sincerely,Appeals Department

October 27, 2014
Dear [redacted]:
I am writing in response to the additional concerns expressed by the Consumer, [redacted], regarding his Revdex.com case, Specifically, [redacted] indicated he rejected Coventry Health Care's original response because: 1) no one from either Coventry or the Marketplace had contacted him to resolve his issue; and 2) Coventry, not the Marketplace, had Collected his premium payments. He understands that he had enrolled in his coverage through the Marketplace, but states he had paid his premiums to Coventry.
At noon on October 17th, we coordinated a three-way conference call with the Marketplace, [redacted] and us. The parties spoke to Marketplace representative, Shanna P[redacted], to discuss a retro-termination of [redacted] 's Coventry policy as never-in-force during 2014, Ms. P[redacted] took the retro-termination request; she informed the parties that she would send the request over to the Marketplace's Escalation Department. The Marketplace would then contact [redacted] with a decision on his request within approximately 30 days from the date of the three-way conference call.
Though it might seem to our customers that we as Carriers should be able to make changes to health insurance policies ourselves, certain changes (such as changes in effective and termination dates) must be done through the federal Marketplace. The structure of the Affordable Care Act requires that these types of changes occur only through the federal level. [redacted] should hopefully hear from the Marketplace on his request by some time mid-November. However, should you require additional information or have any questions, please contact our Customer Service Department for more information.Sincerely,Linda LRegional Director Regulatory Compliance

[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:
Regards,
[redacted]
Ok you probably notified my employer, but you didnt notify you personell offering. On November 2014 a representative gave us a brochure indicating a free gym membership and one of the questions asked was about the gym memebrship I asked her and she said that this service will continued as previously How can a company like yours Coventry cannot fing the 2014 brochure?  is that strange. So you dont keep records (minutes, meetings). Youre intentions were to get as many mebers as possible because coventry was being purchase by another insurance carrier. I can find the brochure for you as needed but  I will so I can display your unethical practices and the lie behind it. I will not stoped until you guys paid what I was offered.   I will look for the brochure.
 
Kind regards,  
[redacted]

Dear Ms....

[redacted],
Please see our response to complaint #[redacted] for [redacted] that was received by us on February 25, 2015.
We reached out to our Billing and Enrollment department for assistance during our investigation.  They confirmed that the statement on the bills is correct and the due date for premiums is the last day of the month prior to the coverage period.  Ms. [redacted] is receiving an Advanced Premium Tax Credit which means that she is allowed a grace period for making the payments but to avoid disruptions in coverage and claim processing the payments should be made on time.  The due date statement on the bills will not be changed.
In reviewing Ms. [redacted]’s payment history, it was noted that she has not made her $11.94 premium payment for February or March.  As she is in the second month of her grace period at this time, claims for dates of service from March will be denied. 
We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address Ms. [redacted]’s concerns.  If there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted].
Regards,
Chris B[redacted]
Executive Resolution Team

April 17, 2014
Dear **. [redacted]:
Coventry Health Care of Kansas, Inc. (Coventry) received the above referenced consumer complaint in our office on April 7, 2014. We appreciate the opportunity to respond.We regret to inform you that we are unable to release information...

regarding this case without the consumers written authorization. Please be assured that this complaint is being investigated and further response will be sent to the consumer directly.we may be of any further assistance, please feel free to contact me by telephone at ###-###-#### or [redacted] ext. [redacted] or email at [redacted].Respectfully,

July 14, 2014
Dear **. [redacted]:The Member is participating in the Coventry Health and Life...

Insurance Comp any (“CHL”) HealthAmerica One individual HMO Health Care Reform health benefit plan.[redacted] (the “Member”) has filed a complaint. The Member’s complaint concerns poor customer service provided by CHL. The Member states that she requested and has not received an explanation as to when her automatic debit premium payment would be processed and also requested a detailed policy premium for her daughter and herself and has yet to receive anything from CHL.Below is a timeline of events leading up to the resolution of the Member’s complaint.07/02/2013- The Member called to update address.12/11 /2013- The Member called to get a breakdown of premium.05/01/2014- The Member called to see if she can get the breakdown of premium mailed to her.06/13/2014- The Member called about her recurring payment and stated her premium is incorrect. CHL representative advised renewal came and premium changed. Member wanted to speak to a supervisor.ROOT CAUSE:The Member requested a letter of premium breakdown, however it was sent to an email on file and not home address.RESOLUTION:We have provided the information being requested as well as a payment history. Member’s premium changed effective May 1, 2014 due to renewal. A migration letter was sent out advising so and the CHL has provided all documentations requested by the Member.We apologize for any inconvenience this may have caused the Member.If you have any questions or concerns regarding this matter I can be reached at ###-###-####.Sincerely,

July 17, 2014
Dear [redacted]:This letter is in response to your request for Coventry Health Care of the Carolinas, Inc. (“CHC Carolinas”) to respond to [redacted] regarding her request for a refund of her June 2014 premium payment in the amount of $491.00. The request was received...

by CHC Carolinas on July 16, 2014.CHC Carolinas does not have a signed authorization release form from [redacted] indicating that the Revdex.com is representing her in this matter, however will contact [redacted] within three business days. We will inform [redacted] that if she wishes to exercise her right to a grievance, CHC Carolinas will respond to the complaint in writing within 30 calendar days of receipt of her request.I trust that I have addressed this matter sufficiently. However, please contact me if you have any further questions involving this issue. I can be reached at ###-###-####, extension [redacted], Monday through Friday from 8:00 a.m. until 5:00 p.m.Sincerely,Melody *. C[redacted] Complaint and Appeal Analyst Coventry Health Care of the Carolinas, Inc

[A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me. 
Regards,
[redacted]

face="Calibri">Dear [redacted],
Please see our response to complaint #[redacted] for [redacted] that was received by us on March 26, 2015.
During our review, it was determined that [redacted]’s policy was active from May 01, 2014 to December 02, 2014 , which is a total of seven months and two days of coverage.  However, Coventry had only collected a total of six months’ worth of premiums as there was a bank rejection for the month of June’s premium.  This is why the owed premium of $172.86 was collected on December 01, 2014. This means the member is caught up and nothing is owed to the member.
In addition, [redacted] requested to terminate the policy through the Marketplace in November. The subsequent file received from the Marketplace on November 18, 2014, contained a termination date of December 02, 2014, which is why the plan was terminated December 02, 2014. Therefore, [redacted] currently owes $11.15 of premium for the two days of coverage for the month of December. If this termination date is incorrect and [redacted] does not wish to pay the $11.15, he may contact the Marketplace at [redacted] to request a termination date of November 30, 2014.
We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address [redacted]’s concerns.  If there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted].
Regards,
Julian C[redacted]
Executive Resolution 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 Administratively Resolved]
 Complaint: [redacted]
I am rejecting this response because:
The address for my wife [redacted] is still incorrect in the system. Also, to clarify, she has never received an insurance card. (Presumably these have all been sent to the incorrect address, jeopardizing our privacy by sharing this personal information with strangers.) The only reason she was able to visit the doctor now is because we signed her up for a separate online account and printed out the card, but her doctor is requesting the actual card on her next visit.
I will be keeping this open until we receive a physical card for [redacted] at the correct address.
Regards,
[redacted]

[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: I'm rejecting this answer because: Coventry raised their rates, being an insurance for people with very limited resources,the Withdrawn amount from my account, is the salary of a week and a half of work.I paid for the month of January according to this subject, two companies: Coventry and [redacted].I think I must have a reimburse from Coventry,since I had another insurance company  [redacted],with  rates according Obama care Policy.
Regards,
[redacted]

[A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me. 
Thanks!
[redacted]

July 2, 2014
Dear [redacted]:The Regulatory Compliance Department of Coventry Health Care of Missouri, Inc. (“Coventry Health Care”) writes this letter in response to the consumer complaint received by Coventry Health Care on June 24, 2014 which was filed by [redacted]...

regarding overcharges to his account.A review of our records shows **. [redacted]’s overcharges were a result of an incorrect renewal rate being entered into the system. That error was found and corrected. Thereafter, on June 6, 2014 (prior to Coventry Health Care’s receipt of the instant complaint), three EFT transfers were deposited to **. [redacted]’s account in the amounts of $395.11, $395.11 and $109.78, for a total of $900. This should resolve all of the outstanding overcharges.Coventry Health Care hopes this explanation provides the Revdex.com with the necessary information to complete the investigation of this matter. If you have any further questions or concerns, please feel free to contact me at ###-###-####, extension [redacted]. My fax number is ###-###-####, and my e-mail address is [email protected] truly yours,

September 19, 2014Dear [redacted]:This letter is in response to your request for Coventry Health Care of the Carolinas, Inc. (“CHC Carolinas”) to respond to [redacted] regarding maternity coverage for her CoventryOne® policy purchased on the Federally Funded Marketplace for an effective date of April 1, 2014. The request was received by CHC Carolinas on August 12, 2014.CHC Carolinas responded in writing directly to [redacted] by letter dated today.I trust that I have addressed this matter sufficiently. However, please contact me if you have any further questions involving this issue. I can be reached at ###-###-####, extension [redacted], Monday through Friday from 8:00 a.m. until 5:00 p.m.Sincerely,Melody CComplaint and Appeal Analyst

Dear [redacted],
Please see our response below to the additional concerns reported in complaint #[redacted] for [redacted] that were received by us on November 24, 2014. 
In our previous response, we were not stating that a qualifying event was not experienced or that one would be required to make a plan change midyear for an individual policy.  However, that was the reason provided to us by Mr. E[redacted]’s assistant, Adrianna, as to why the plan change process was never completed.  The letter that was sent as Coventry’s response to the previous Revdex.com complaint was fully reviewed prior to our initial response, so a copy is not needed. 
The adjusted pull letters are generated with predetermined text, which does not change whether the adjusted pull process is occurring due to a nonstandard draft amount or a nonstandard draft date.  We were not previously notified by our Enrollment department that an adjusted pull letter was sent in September.  It has been confirmed that one was sent on September 4, 2014, as the scheduled draft for September had been cancelled, so it had to be set up as an adjusted pull. 
We have verified that [redacted]’s policy has been fully terminated on both the enrollment and benefit sides of the system.  We will not be attempting to collect any further premiums or fees from him at this time. 
We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address [redacted]’s concerns.  Our standard process is to offer the e-mail address for the Executive Resolution Team, but if he has additional concerns regarding this matter, he may call me directly at ###-###-####.
Regards,
Chris B[redacted]
Executive Resolution Team

Hello,
Thank you for your inquiry, regarding complaint #[redacted] for [redacted]. Our Executive Resolution Team researched your concerns, and I would like share the results of the review with you.
We verified that [redacted] was sent the refund for $406.17 on November 21, 2014, to...

his home address on file. I sincerely apologize about how long it took for you to receive this money back and for the administrative hassles you encountered trying to retrieve this money.We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address [redacted]'s concerns. If you have any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted].
Thank you,
Ashley S,Complaint and Appeal ConsultantExecutive Resolution Team