Coventry Health Care, Inc.

Dear [redacted]...

[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 backdating his termination date to September 30, 2014. Our Executive Resolution Team researched your concerns and we would like to share the results of the review with you.
We reached out to our Enrollment department for assistance during our investigation. A phone call was located from September 9, 2014, requesting termination of his policy.  The termination date has been changed to September 30, 2014, in line with that request, and the representative he spoke with has been educated on handling verbal termination requests.  A refund was issued to him on November 18, 2014, in the amount of $408.94, for the premiums paid for October and November.
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]@aetna.com.
Regards,
Chris B[redacted]
Executive Resolution Team

Review: I have been a member of Coventry One Health for a year. This month while reviewing my bank account Coventry debited my account in the of $506.00, I spoke with four different employees in billing and two supervisors. Each time I was told I was mailed a letter to choose a plan ( which I did not receive). So I was placed in a new plan with out my consent. The manager on duty also hung up on me 3 times pretending that they couldn't here me.Desired Settlement: DesiredSettlementID: Refund

Refund for the amount that was charged to my account and placed in my old plan.

Business

Response:

September 18, 2014Dear [redacted]:The Member is participating in the Coventry Health and Life Insurance Company (“CHL”) HealthAmerica One individual HMO ACA health benefit plan.[redacted] (the “member”) has filed a complaint. The Member’s complaint concerns termination of his old Plan. The Member was placed on a new Plan and $506.00 premium payment was deducted electronically from his bank account. The Member is requesting reimbursement in the amount of $506.Upon review, the member received his migration letter advising him of his new monthly premium. A letter dated October 10, 2013 was sent to the member by HealthAmerica informing the member that his insurance health plan will be affected and the member’s policy will terminate effective December 31, 2013 due to the ACA (copy of letter attached).Further, HealthAmerica is required to switch all members as of their renewal dates to an ACA compliant plan as of January 1, 2014 per the Affordable Care Act.Please note that if the member did not enroll in one of the available plans described in the letter dated June 27, 2014 (copy attached), the member would automatically be enrolled into the HMO ACA plan listed as Option One in the letter dated June 27, 2014.(copy attached).Also, you will see in the attached call log the member advised the representative that he understood that he would be unable to change his plan until open enrollment. I have attached a copy of the call logs between the Member and the Plan.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.Sincerely,Emily MComplaint and Appeal Consultant

Review: I have an issues where my medicaid didn't show do to me moving from [redacted] co to [redacted] city at that time I had to pay for insurance with the marketplace I got Coventry one of VA . At the time I was told by Coventry I had to pay 200 monthly but they would give me 60 days to pay per another rep that wasn't the case they gave me 30 days and canceled my policy. 5/31 I called back in after going to doctor 7/14 was adv since wrong information was given they would get me an new policy and that I should call medicaid cause I had an case worker and service I should be getting. I contacted medicaid was advised was to have coverage since 4/1 and now going through an battle between market place and Coventry one to getting a refund for the amount 489.00 for coverage from 4/1-5/31 the amount of services paid. Per coventry unless market place can cancel my policy back to 3/31 they will be able to onlyDesired Settlement: would like refund for policy paid.

Business

Response:

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

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: [redacted]

I am rejecting this response because: I still have not gotten my refund company states they dont know how to refund my 489.00 they owe me.I also having issues with marketplace working with them to submit my refund

Regards,

Business

Response:

September 15, 2014Dear [redacted]:The Appeals Department of Coventry Health Care of Virginia, Inc. (“Coventry Health Care”) writes this letter in response to the rejection of Coventry Health Care’s initial response of the complaint filed by [redacted] regarding termination of her 09/01/2014 policy and refund of her premium.[redacted] rejected the initial response because she has not received her refund of $489.00 from Coventry Health Care and that she is having difficulty working with the Marketplace to secure her refund. The policy slated to begin on 09/01/2014 was successfully terminated.As stated in the previous letter, 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.On 09/12/2014, a regional Health Insurance Marketplace Caseworker informed Coventry of the following:Regional offices [CMS] nor Issuers [Coventry Health Care] are involved in the appeals process. Once the consumer files an appeal with the Marketplace, the Marketplace will respond within 90 days with next steps. The appeals process and appeals determination is solely between the consumer and the Marketplace.The determination on whether [redacted] will receive a refund is processed through the Marketplace. The Marketplace Appeals process is still ongoing in this case. No further action is required or allowed by Coventry.If you have any questions, please contact the Customer Service Department at [redacted].Sincerely,Appeals Department

Review: Coventry made unauthorized payment from my bank account and they have made no attempts to remedy the problem in a timely mannerDesired Settlement: money to be credited back to my bank account immediately

Business

Response:

June 30,2014Dear [redacted]:The Appeals Department of Coventry Health Care of Georgia, Inc. ("Coventry Health Care") writes this letter in response to your request dated March 12,2014 and received at our office on that day. This letter is in response to the consumer complaint filed by [redacted] regarding what she considered to be an unauthorized payment from her account.Coventry's records show that the payment that was received on 02/27/14 went towards March's premium payment. T he member did not draft for the month of March, but her draft continued in April. Therefore the member is neither ahead nor behind in payments.If you have any questions, please contact the Customer Service Department at ###-###-####.Sincerely,Appeals Department

Review: I had a health insurance policy in place with Coventry for years. Due to the Health Care Act I had to change policies as mine did not meet the government requirements. My insurance was switched to another plan that cost me almost $200 more each month. When I spoke to the customer service department they recommended that I switch to a government plan so I could benefit from the tax benefit. So we switched to that plan. The next month I was charged $298 instead of the $148 and called. When I called them never changed my billing to the government plan. They then stated they were going to apply the $298 premium to my new government plan and that I did not need to pay anything. Then came the next month and the same thing occurred. Again, I called and they said the payments would be applied to the new plan. The next month the same thing happened. So, my old, old plan was expired. My government plan was terminated due to non payment (because their accounting department did not apply the premium to my government plan so it was cancelled due to non payment. I have been on the phone for over 40 hours trying to straighten this out. Currently, I have NO health insurance because now they all have lapsed and they will not reinstate me and I cannot get on my new insurance until January 1 (I thought I could just start from the beginning and try an entirely new plan) . In the meantime, there is a credit somewhere in their system for almost $600 that is due to me and now they cannot seem to find that credit. I have numerous case numbers with them, I have escalated this to numerous supervisors in numerous departments but I have not received any resolve to this issue. I have faxed bank statement in to prove that I did not receive my refund. I never hear back from anyone when they say they will call back. Last Monday I was going to stay on the phone until resovled. I spent a little over 6 hours on hold and being transferred and talking to numerous people and did not receive a resolution. Instead, at the end I faxed another banks statement and was told to call back in 4-5 days to see what the other department found out. I called today and spent 2 hours on the phone with no explanation. I am again awaiting a call back from a supervisor.

Here is what I want: my $600 refund and a health insurance plan reinstated so I do not have to go uninsured for the rest of 2014. I will then get a new plan for 2015. I even offered to pay for the plan and figure out the refund later but they said they could not do this. HELP! I do not know what else to do.Desired Settlement: Here is what I want: my $600 refund and a health insurance plan reinstated so I do not have to go uninsured for the rest of 2014. I will then get a new plan for 2015. I even offered to pay for the plan and figure out the refund later but they said they could not do this. HELP! I do not know what else to do.

Business

Response:

Dear

Review: I submitted notice on November 5th to switch my current health police to a new plan with an effective date of Dec. 1st 2013 with a renewal rate of 70.82. When I called Coventry One mid November they said they received the fax and that my policy would reflect the new premium amount. However I was billed 87.82 which was not correct. I then called Coventry One to cancel the policy and then received notice that I was being billed the 87.82 plus a 20.00 late fee for non payment. The policy has been canceled and no payment should be due from me.

Account_Number: [redacted]Desired Settlement: DesiredSettlementID: Other (requires explanation)

I would like them to show that I owe them a 0.00 balance since the policy was canceled. I have already received the funds back from my bank. However they are still sending me notice that I owe them 107.82 when in fact I do not.

Business

Response:

January 22, 2014

Dear **. [redacted]:

Thank you for giving Coventry Health Care of Georgia the opportunity to review your Revdex.com complaint. We appreciate your feedback in regards to our Customer Service process.

After a thorough review based on the information submitted, a determination has been made to retro terminate your CoventryOne policy back to 11/30/13 showing no payment responsibility. They account was updated reflecting zero $0.00 balance and no premium payment owed.

If you have any questions, please contact the Customer Service Department at ###-###-####.

Sincerely,

Appeals Department

Review: I contacted Coventry Health because they automatically debited my bank account earlier than my payment date. When I spoke with someone there they told me that they changed the date that payments were due. I was never informed of this change. I told the supervisor I spoke with that I wanted to remove the automatic withdrawal from my account. This month they have still taken an automatic withdrawal from my account and when I contacted them this month, they have refused to stop the payment or refund my money unless I provide proof of other health insurance. Everytime I ask to speak with a supervisor Im told there is not a supervisor available. They have not done everything they can to help me with my complaint. In fact they have done nothing but give me a hard time about something as simple as speaking with a supervisor.

Product_Or_Service: health insuranceDesired Settlement: DesiredSettlementID: Refund

I would like my money put back into my account. I want to cancel my policy with them.

Business

Response:

Attached please find a copy of the response Coventry Health Care sent to the Complainant regarding this matter. If you have any questions, please do not hesitate to contact me.

Thank you,

Review: I have been told since the beginning of August they will remove the red flag for late payment within 5-7 days, supervisors say 24-48 hrs

I have broke my back and after that was in a car wreck that left me with broken ribs. I was put on a high powered pain medication that I am being taken off slowly in order to not cause withdrawal or seizer. I have paid my premium and this entire month have tried to get the red flag removed from my account in order to get this medicine. They transfer me to [redacted] to get my medicine and ended up sending me to a broker who sells insurance named [redacted] Insurance. Every time I call back the representative has a different story of what is going on with my account. I have names and confirmation numbers. They are inhumane, not caring about the effects or what could happen to me. I have a son who is having to see me withdrawal and could possibly see me have a seizer. I have had to tell him that if mommy is doing this, which are the symptoms of seizer, to call 911. This us undue stress on my child and myself.Desired Settlement: I expect that they do what they are stating they will do in a timely fashion. I believe that because I have had to deal with this an entire month even though my premium is paid they should pay my premium for a month and something beyond that to account for my time every day on the phone dealing with something they are responsible to do as a job.

Business

Response:

Coventry Health Care respectfully requests an extension of time to respond to the above-referenced Complaint.

Thank you,

Deborah F[redacted]

Review: I applied for Health Insurance through ObamaCare Marketplace on Saturday, March 29, 2014 before the deadline on March 31st. Then I realized I can get health insurance through my job, so I tried to call on the SAME DAY, Saturday, May 29, 2014 to terminate the plan BEFORE THE MAY 31ST OBAMACARE DEADLINE and BEFORE they took my first automatic payment out on April 1,2014. HOWEVER, I was unable to get through the phone lines because the phone lines were so busy from people calling trying to beat the Obamacare deadline. I tried multiple times every single day, but the lines were still always busy, and I was unable to get a voicemail, also. Because of this, I couldn't terminate my plan before the deadline in order to get a refund. This was NOT my fault that I could not get through to anyone in order to terminate my plan before they took my money out of my account. Because of this, they took out my 1st monthly payment (which I tried to stop) of $87.12 because I was unable to terminate my plan in time. If only I were able to get through the phone line on the same day to terminate my plan, this problem would not have evolved. I tried to avoid this before it happened.

I contacted Coventry Health Care, & after being on hold for an hour a very rude woman informed me I had to terminate the plan with Obamacare Marketplace before Coventry could refund me any money. Finally I had gotten through to someone on the phone line,& I was finally able to get my plan terminated through Marketplace. The next step was to call Coventry back to inform them. I did, and after being on hold 45min-1hour, a completely different lady heard my entire store & was ALSO rude and said I'm entitled to a refund and a refund will be issued in 3-5 business days. I never got a refund. I called them back on a different day, and after being on hold for an hour, now this time they said they can't issue me a refund. She, too, was very rude and acted like she didn't want to work there. I called and spoke with someone else, and they informed me they CAN issue me a refund (after being on hold for an extremely long time), I have to send them a letter informing them of the situation, my information, and proof that I have insurance through someone else. I faxed all of that information, and when they finally received it, a different woman with a big attitude, told me it'll be 7-10 business days before I get a refund, but it WON'T be for the full amount of $87.12. This is NOT what I was told in the beginning. I told her it was NOT my fault that nobody would answer the phone in time so that I can terminate the plan before it was too late. It was not my fault that Marketplace AND Coventry held up the process until it was too late to get a refund. It was not my fault. And because it wasn't my fault, I should get the full refund that I've been asking for since March 2014. I asked if I can speak to a supervisor, she simply said no. I asked why not, she said he's busy doing other things at the moment. I asked for a number to the refund department she said they don't have numbers for other departments except theirs. I said that doesn't make any sense that out of that entire building, you're the only person I can talk to. That doesn't even sound right. I demanded to speak to a supervisor but she refused to put any supervisor on the phone. I told her to give my contact information to a supervisor, she said she can, but she also mentioned, with an extremely big attitude, he won't call back today & that it'll be 3-5 days. It's been way more than 3-5 days and I still haven't received a call from anyone from Coventry. After this, I contaced Obamacare's Marketplace, and they were so nice, and helpful, unlike Coventry Health Care. I filed an appeal through Marketplace so that I could get a refund, however, Marketplace informed me since Coventry is the one that took my money, they are the only one's who can give me my money back, because Marketplace didn't take my money. She was nice about it, but I am still upset that Coventry is very helpless, rude, not understanding, don't know their information,& doesn't show concern at all. Coventry acts like they do not want to be at work and were so unprofessional and didn't care about the quality of their work. I've been dealing with Coventry since March 29th, & it is now May 13th. I've been getting the run-a-round about if and how to get my money back. Nobody from Coventry has helped me yet. If only I was able to get in contact with someone before March 31st, I wouldn't have to worry about having my money taken out of my account and getting a refund. But no. Because nobody wanted to answer their phone at Marketplace and Coventry, I was unable to get this resolved befor it had gotten out of hand. And because of that, I am now overwhelmed with stress and worries of trying to get my money back from Coventry health. Basically, what I am saying, is, if this was handled before they automatically took out my money, it would have been resolved and no money would have been taken out. They wouldn't have had a problem with it. However, because Marketplace and Coventry Health couldn't answer their phone call from me before the 31st, it is THEIR fault that I couldn't get this resolved before the deadline, thus, making it difficult to get a refund. Remember I said THEIR FAULT, NOT MINE. Because it was their fault I couldn't get through in time, I feel I am entitled to a refund. Thank you for your help. I really appreciate this.Desired Settlement: All I want is my $87.12 refund and I will never bother with Coventry Health Care Insurance again. I also ask that they do something about their rude and terrible customer service.

Business

Response:

May 30, 2014Dear [redacted]This letter is in response to your request for Coventry Health Care of the Carolinas, Inc. (“CHC Carolinas”) to respond to a complaint submitted by **. [redacted] regarding the request to terminate her policy purchased on the Federally Funded Marketplace exchange for an effective date of April 1, 2014 and refund her premium payment in the amount of $87.12. The request was received by CHC Carolinas on May 15, 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 we 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.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,

Review: I have made numerous phone calls to Conventry Health Care with hold times in excess of an hour, trying to find out why a medical claim was denied. After calling with no success, I decided to file a written a appeal regarding a denied claim. Per their process they are to respond to confirm receipt of the written appeal within 3 days. I had not received confirmation of receipt of the appeal, so I contacted the number located in their process, I was told they could ot help me and referred to a number where the hold time was in excess of an hour. I am still unable to get a reason for the denial of the claim or an acknowledgement of the appeal.Desired Settlement: I would like to get an explaination as to why the benefits claim was denied and an acknowledgement of the appeal.

Business

Response:

May 30, 2014Dear [redacted]This letter is in response to your request for Coventry Health Care of the Carolinas, Inc. (“CHC Carolinas”) to respond to a complaint submitted by **. [redacted] regarding a claims payment determination for date of service February 19, 2014. The request was received by CHC Carolinas on May 26, 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 we 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.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,

Review: Insurance company tried to retroactively collect additional money after claim was settled and completed.

Spoke with customer service representative about a claim/EOB for services provided and paid for approx 19 months ago. First representative did not inform me that there were any contract changes with providers on their end and told me I had to call the third party provider. After spending over 3 hours tracking down the provider and speaking with their very friendly and courteous staff of the imaging I discovered that Coventry attempted to retroactively change the billing. A little irritated that I had already wasted over 3 hours tracking it to this point the third party informed me that I had already paid the initial value and would receive another bill and that it if had issues with the billing I should return to Coventry. Called Coventry again to finally be told that they denied and reprocessed the claim. Upon further investigation on I have discovered that they are outside the 18 month mark for auditing their billing in GA and am considering legal recourse for the bill and time lost.

This all came to light well over a year after the policy was cancelled and I am currently insured under another provider.Desired Settlement: For Coventry to honor the original charge and close all of the account relating to me.

No additional charges from any third parties going forward.

Business

Response:

Dear

Review: I have tried to run my debt card 4-5 times for payment of premium and has been "rejected by my bank". The funds have been in my account the entire time and my bank confirms there was no attempt to collect. I've called the company 2-3 times only to be on hold for 30+ minutes. I did get through one time and the man manually ran my debt card, which also did not go through. He explained if this didn't work I would need to mail a check, which I did 3 weeks ago and was cashed my my bank. Yesterday I get a letter from Coventry stating my insurance has been cancelled due to non-payment. I've spent close to 3 hours of my time trying to get this fixed. Oh did I mention they also don't reply to emails? By far the worst service I've experienced with any company in any field.

Product_Or_Service: health insurance

Account_Number: Termination # [redacted]Desired Settlement: DesiredSettlementID: Refund

I do still want the coverage but now want compensation for my unnecessary wasted time which is now at 3 hours. All I want is to pay from the website with my debt card and be done with it. This is getting laughable at how incompetent this company is.

Business

Response:

October 1, 2014

Dear Sir or Madam:The Regulatory Compliance Department of Coventry Health Care of Missouri, Inc. (“Coventry Health Care”) writes this letter in response to the consumer complaint transferred from the Missouri Revdex.com and filed by Seth Cobb regarding payment issues for his policy. This matter was also brought to the attention of the Missouri Department of Insurance.After research, the problem with the member’s payments was discovered and, by working with the member, the matter was resolved. A letter to this effect was forwarded to the Missouri Department of Insurance on August 4, 2014.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 [redacted]Very truly yours,Neil MRegulatory Compliance Analyst

Review: I have been trying to cancel my coverage of med insurance for over three months now and get the run around,in feb I moved and it took over two weeks to get them to change my address, in doing so Coventry One changed my insurance policy, I have been trying since march to get Coventry One to cancel my policy, only to be told I have to pay the policy to get them to cancel my policy. I have received bills each month,March,April,May I am stressed every day I call each week trying to get them to cancel the policy, I have not made a payment since feb, I just want Coventry One to cancel Me I call and am told if I want to be canceled I have to pay them back payments tree months or they will send it to collection, I want out yet week after week im on the phone with them only to be given the run around. Again I have not made a payment since feb told them I want to be canceled, fax a cancel letter in, called the numbers they told me to call, called market place and canceled with them in april 23 and again on may 23, I don't know were to turn to get this resolved I just want to be canceled and this bill of three months to be cleared away. I informed them I have med insurance else were. I have never had such bad service as Coventry One has dished out, you call up first thing in the morning and you are on hold a half hour only to be passed around from department to department and still they don't help you. I have been trying calling faxing to cancel my coverage and get the three month payment cleared and still have not been canceled.. THIS IS TRULY A BAD COMPANY (HELP)

Product_Or_Service: Med Insurance

Account_Number: [redacted]Desired Settlement: DesiredSettlementID: Other (requires explanation)

I would like to be canceled, and the tree months march, april, may payment cleared I was not insured by them and I didn't want to be covered by Coventry One I want OUT and the bill cleared they gave me the run around every time I called, they are under trained in how to handle my coverage after three months of being given the run around on may 23 being told by the Market Place I should have call them first to cancel my coverage, three months and

Business

Response:

June 10, 2014Dear [redacted]:This letter is in response to your request for Coventry Health Care of the Carolinas, Inc. (“CHC Carolinas”) to respond to [redacted]’s request to terminate his CoventryOne® policy purchased on the Marketplace for a termination date of February 28, 2014. The request was received by CHC Carolinas on May 30, 2014.CHC Carolinas does not have a signed authorization release form from [redacted] indicating that the Revdex.com is representing him in this matter. However, CHC Carolinas has responded directly to [redacted] regarding his complaint in writing on June 10, 2014.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,

Review: I have been trying to cancel my health insurance for two weeks. Each time I fax over the requested documents they tell me they need to change or add something to my fax. I am on my third fax to cancel my insurance policy and still have not received a refund of the full amount of the debit they made to my checking account. I asked to speak to a supervisor and was told none are available and it would take me 24-48 hours to hear back from one. I believe either their customer service is extremely flawed or they are running a scam in order to avoid reimbursment of my policy.Desired Settlement: I want a full refund of my policy that was withdrawn from my checking account. I cancelled my policy before the initial draft of my account.

Business

Response:

Dear [redacted]

Attached please find Coventry Health Care, Inc.'s reponse to Complaint #[redacted]

Thank you,

Review: I cancelled a healthcare plan with Coventry One before the plan was supposed to begin, on 9/1/2014. Unfortunately, I keep receiving mail from them.

About 3 weeks ago, I cancelled a health insurance policy with Coventry Health Care, which was supposed to begin on 9/1/2014. I was told that the policy would be cancelled. However, I am receiving membership information and health insurance cards. I do not wish to receive this policy. The membership number for this account [redacted] and the group number is [redacted].Desired Settlement: I do not wish to receive this policy. I want the company to cancel it immediately, and to no longer send me mail.

Consumer

Response:

-------- Forwarded message ----------

From: Revdex.com of Metro Washington DC <[email protected]>

Date: Mon, Sep 15, 2014 at 4:17 PM

Subject: Fwd: You have a new message from the Revdex.com of Metro Washington DC & Eastern Pennsylvania in regards to your complaint #[redacted].

To: [redacted] <[redacted]>

---------- Forwarded message ----------

From: [redacted] <[redacted]>

Date: Mon, Sep 15, 2014 at 11:28 AM

Subject: Re: You have a new message from the Revdex.com of Metro Washington DC & Eastern Pennsylvania in regards to your complaint #[redacted].

To: [email protected]

Hello,

Review: I have been trying since May 2014 to get Coventry to acknowledge my new subsidy amount from Healthcare.gov. and am still being overcharged.

I've called weekly since my new subsidy amount was approved and have been given a constant runaround. I've opened an escalation with Healthcare.gov only to receive yet another letter stating Coventry will take money out of my account at the wrong amount. Conference calls with all parties involved have proven fruitless - I'm at the end of my rope. The stress from this process is causing me to have an increased number of seizures.Desired Settlement: I want this fixed immediately. I don't want to cancel my policy because of my doctor's network.

Business

Response:

September 23, 2014Dear Sir or Madam, The Regulatory Compliance Department of Coventry Health Care of Missouri, Inc. (“Coventry Health Care”) writes this letter in response to your request received by our office on July 18, 2014. This letter is in response to the consumer complaint filed by [redacted] regarding a needed correction in the subsidy on her policy.This member is currently enrolled in a fully insured, non-grandfathered, PPO, individual health insurance plan with Coventry Health Care as of January 1, 2014 through the on-exchange Marketplace. The member's instant complaint is regarding a change in premium and subsidy she believes should have been effective since May, Coventry Health Care received a file from the Marketplace on May 17 to change the member’s premium amount to $60,52. Unfortunately, this file contained an error which did not allow it to process the change automatically in our system as intended. We identified the issue on July 7, and manually adjusted the member's premium to $60.52 effective as of July 1 as listed in the Marketplace file. The member's billing was adjusted to correctly Show the amount due in response to this change in premium, and a payment history is attached. The member's premium is now current through September 30.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 [redacted].Very truly yours,Neil MRegulatory Compliance Analyst

Review: On May 2014 I was told by Leslie who works in customer service that insurance company was denying service do to my healthcare bills. On April 30, 2014 my insurance policy was terminated without any notification. On March 2014, I made a payment of $128.00 to cover March/April billing cycle. I received an letter in the mail that I owe $4.88. I made an payment on May 12, 2014 for $66.44, and June 13, 2014 for $66.44. I made a payment through expedite mailing service through [redacted] for $71.13 which included the $4.88. I spoke to Esther B[redacted] from the marketplace that stated to me the insurance company suppose to give me an 30 days notice before cancellation. I then spoke Steven in billing department that told me if I pay the $71.13 I can be re-instated. I spoke with Tiffany on July 8, 2014 which she informed me that basically the money I sent in May/ June will not be returned even though I didn't receive any services. She stated that they do not have to give any kind of notice they can cancel at any time. She stated that the only money will be return is July payment which I have not received. I believe when Leslie told that the insurance does not want to high health bill on client they find anyway to terminated them from service. I believe that I have been a victim discrimination. I have all my statement of payments if needed. Lashonda in appealing office stated that I can appeal however, it will be denied due them not wanting to service me. I have so many healthcare concerns and I cannot afford my medication to scheme by an insurance company.Desired Settlement: I would like to receive my money from May/ June, and July or for them to give my health insurance

Business

Response:

August 1, 2014Dear Sir or Madam:The Regulatory Compliance Department of Coventry Health Care of Missouri, Inc. (“Coventry Health Care”) writes this letter in response to the consumer complaint filed by [redacted] regarding billing issues for her policy.After investigation, a review of our records shows that the member made four payments to the policy. A payment of $66.44 posted to the policy on January 23, a payment of $128 posted to the policy on March 7, a payment of $66.44 posted to the policy on May 12, and a payment of $66.44 posted to the policy on June 13. The problem with this account appears to be the inconsistency and lateness of payments as well as the outstanding balance. The most recent payment to the policy was refunded on July 22 because the policy was considered to be terminated. However, after consideration, the decision was made to reinstate the policy. One of Coventry’s managers, Jason R[redacted], called the member to review the above and to procure payment. He was not able to reach the member, however he did leave a detailed message to give him a call back including his extension. Mr. R[redacted] advised the member that her policy is reopened but she still owes $4.88 (the difference she paid in March). He additionally advised her that she will owe for July and August ($132.88) once the bill has been adjusted. It is strongly suggested that the member contact Mr. R[redacted] as soon as possible and that she make arrangements to ensure that this (and future) payments are made on a timely basis.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 [redacted]Very truly yours,Neil MB.A. Regulatory Compliance Analyst Coventry Health Care

Review: I’m attempting to obtain a refund for the amount of $249.98 that was debited from my account on Monday, June 24, 2014 by Coventry Health Care.

Near the end of April I signed up for a silver insurance plan with Coventry through the healthcare marketplace website because I was laid off on April 18, 2014 and my insurance was ending on April 30. I didn't make a premium payment at the time because I was still trying to decide if I really wanted that plan. Then on April 30, I cancelled the silver plan and instead signed up for a bronze plan. I also entered my bank account information to pay the May premium payment in order to avoid a lapse in coverage. The following week I got a letter from Coventry stating that I needed to pay the monthly premium payment for the silver plan. I called and explained that I canceled the silver plan and instead I selected a bronze plan and made a payment on the healthcare marketplace website. However, the Coventry rep couldn’t find any record that I selected the bronze plan in their system. She could only see that I cancelled the silver plan. I then called the healthcare marketplace to find out why Coventry couldn't find my new (bronze) plan in their system and was told that it would take about 12 days for this to be updated in Coventry’s system. I also asked the healthcare marketplace rep about the payment I made because it was never debited from my bank account. And I was told that the payment page doesn’t work which, I couldn’t understand because I entered my account information on the site. I was told that I had to make a payment directly to the insurance company.

So I waited for a bill and insurance card from Coventry, but I never got it. I called them numerous times and they weren’t able to find my bronze plan info. I called the healthcare marketplace and was told that they would “escalate” the issue so that this could be taken care of. I called back a week later and mentioned the escalation, but was told by the rep that she couldn’t find an escalation on my account in the system, but she would initiate one. I was frustrated because I already thought the issue had been escalated when it wasn’t. I called back a week later to verify that it was escalated and this time it was confirmed.

On May 27, I started a new job and my new health insurance was to start on June 1. So I called the healthcare marketplace 4 or 5 times on May 31 to terminate the Coventry insurance plan and was told that the system was down and they didn’t know when it would be back up. I called on the evening of June 1 and the system was up and running again. I explained to the rep that I needed to cancel my bronze plan because my new health insurance was starting that day (June 1). At this point, I still hadn’t received an insurance card or bill from Coventry. And every time I called Coventry, no one could find information about the bronze plan. So I told the marketplace rep that I wanted to have the plan terminated as of April 30.

I thought the issue was resolved until I noticed a debit from my checking account in the amount of $249.98 by Coventry on Monday, June 24. I called them to explain the situation from the beginning and to request a refund of the $249.98. I was told that a request was submitted, but that the insurance was still active. I called the healthcare marketplace and was told that the insurance was cancelled as of June 30. I didn’t understand why since I specifically told the rep on June 1 that my health insurance from my new job started on June 1. I called on Friday, June 27 to follow up on my refund request, but the call was (conveniently) disconnected. When I called back I got the message that the office was closed. I called again on Monday, June 30 and was on hold for about 45 minutes. Once I got someone on the line I inquired about my refund request and was told that I couldn’t get a refund unless my plan was back dated to April 30 by the healthcare marketplace. I called the healthcare marketplace and was told by the rep that they couldn’t back date the plan, but she wanted to talk to her supervisor to see what could be done. She put me on hold and periodically came on the line to let me know that she was still waiting for a supervisor, but it was very busy because it was the end of the month. After an hour of being on hold, she told me that there was nothing that could be done because they couldn’t back date the plan. In my desperation to get this resolved, I found an email address on Coventry One’s website for the Special Investigation Unit ([redacted]) and sent them a copy of my complaint on June 30. I wasn’t sure if they could help me, but I decided the email them anyway. And I followed up on July 2 with no response so far.

UPDATE: I finally received the bill and insurance card the day after I sent the first email on June 30, but I have no use for them since I now have insurance through my job.Desired Settlement: All that I ask is that my money ($249.98) be refunded because I never received any coverage from Coventry Health Care.

Business

Response:

July 9, 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 her request to cancel her CoventryOne® policy purchased on the Federally Funded Marketplace for an effective date of May 1, 2014 and refund her premium payment in the amount of $249.98. The request was received by CHC Carolinas on July 5, 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 3141935, Monday through Friday from 8:00 a.m. until 5:00 p.m.Sincerely,

Consumer

Response:

-------- Forwarded message ----------

From: [redacted] <[redacted]>

Date: Tue, Jul 15, 2014 at 11:56 AM

Subject: Completed HIPAA Form - Complaint ID [redacted]

To: "[redacted]" <[redacted]>

**. [redacted]:

Please find attached the completed and signed HIPPA form.

Thanks.

Sent from my [redacted]

Review: I have been in correspondence Coventry Health Care of Georgia since August 2013 in order to terminate my policy; the reason for request of termination is due to gaining health insurance through my employer with an effective date of 01 August 2013. Since, they have continued to charge my bank account for the policy premium, and in December nearly doubled the premium amount. I have sent them the cover sheet of my new policy with [redacted], a written request for termination, and everything else they have asked for, and still they continue to charge my bank account for the the monthly premium.My wife and I have spoken to a Coventry representative several times since December 2013, and each time they have informed us my policy has been terminated and a refund check accounting for all premiums charged since 01 August 2013 will be issued. Earlier this morning I spoke with a Coventry representative to ensure everything was good to go, and he assured me the policy was terminated 01 May 2014 and the premium would not be taken out of my account. However, my wife and I just checked our bank statement and the premium was taken out again on 05 May 2014.

Product_Or_Service: Health Insurance

Account_Number: [redacted]Desired Settlement: DesiredSettlementID: Refund

I would like my policy terminated with the effective termination date 31 July 2013, and all premiums taken out since that date be refunded in full.

Business

Response:

June 17, 2014Dear [redacted]:Thank you for giving Coventry Health Care of Georgia the opportunity to review your Revdex.com complaint regarding the termination for coverage and the refund of premium payments deducted from your bank account. We appreciate your feedback in regards to our Customer Service process.After a thorough review, our records show that your coverage was termed on 9/30/13. Coventry collected premiums for $2331.29 for the month of October 2013 through April 2014 in error. The premium rate for each month has been corrected. The total premium amount for your spouse from October through June 2014 should be $1,637.02. The adjustment was made and you will be refunded $694.27 within 3-5 business days. (See Attachment A)We apologize for any inconvenience this may have caused.If you have any questions, please contact the Customer Service Department at ###-###-####.Sincerely,

Review: I didn't get my refund in amount of $631.92 from Coventry health care.

I have chosen Coventry health care insurance on the Marketplace. I made my first premium payment for the January on December 15 2013. I canceled that coverage on January 15 2013 on the Marketplace website but Coventry was again charging me with the premium for the next month (February). I contacted them the same day they withdraw Money for the February premium. I had a conference call with Coventry representative (supervisor) and Marketplace Representative, where we came to result that they will send me refund but that never happened. I try to call Coventry few more times but they claim that my insurance is still active and have me going around from one representative to another but could never reach supervisor any more. I also contacted Marketplace two more times and they say there is nothing they can do because it is canceled and they did their part.

member id 907490187-01Desired Settlement: Refund in the amount of $ 631.92

Business

Response:

April 17, 2014Dear **. [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,