Coventry Health Care, Inc.

Review: Coverage was cancelled for my son [redacted] in July 2014 and they still took a payment from my account.

He cancelled the coverage in July 2014 but they took the payment out of my bank account for August 2014. This caused and overdraft fee and my account to be overdrawn. I contacted the company and told them I don't want his information just the money put back in my account. The representative was very RUDE. I asked to speak to his supervisor and he said "NO" and hung up on me.Desired Settlement: full refund plus overdraft fees and an apology for their RUDE employee.

Business

Response:

September 30, 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 withdrawal of funds the month following termination.Our research into this matter revealed that the policy was not termed timely due to a processing error so the policy was corrected and termed for July 31, 2014. A refund was requested for the amount of $179.22 on September 23, 2014. Once the refund is processed it can take 3-5 business days depending on the bank. [redacted] should receive the refund this week. Additionally, [redacted] indicated that because of the money that was withdrawn in August, she had over drafted her bank account. If she can send me a copy of her bank statement (with a running balance) showing the Coventry draft and subsequent fees, I will be happy to look into the matter of reimbursement of those fees to her.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 March 12, 2014 I went on healthcare marketplace in search of health insurance and found one with Coventry but after finding out my doctor did not accept it I called Coventry and spoke with an agent John C[redacted] who found me the insurance I wanted. I was told by him that the premium would be $162.69 a month. On 3-17-14 I called the number given by him to pay my monthly premium and was given a different price of $130.28. Confused, I informed the person that was not the price and told it was, so I paid and given a confirmation number. After completing paying I asked for the info on the insurance I had paid for and it was for the insurance from the marketplace I did not want. The person informed me I would need to cancel that insurance and once that was done the money paid would go on the insurance and all I would need to do is pay the balance. After canceling the insurance I called back to pay the balance and informed there was no other insurance shown on their computer. I was told to speak with the agent and after calling on numerous times and being told he was not in or on another line, I emailed him twice with no response. I called numerous times and placed on hold and then disconnected. I called again and asked for a supervisor on 3-25-14 and spoke with Andrew thiel who stated my policy was placed in the computer and he gave me the transaction # to give them if they didn' t find it. When I called again I was told it was not there and I would not be able to get my money back. I was told someone would contact me and no one has. I don't know if I have any insurance nor can I get my medication of which I will be out of the end of this month and my money has been taken without any explanations.

Product_Or_Service: 3-17-14

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

I would like the health insurance that was written up for me by the agent John C[redacted]. To pay the difference needed so I can have insurance and get my medication which I need and have to have. I have no other option because the deadline for insurance is today 3-31-14.

Business

Response:

August 21, 2014Dear Sir or Madam:The Regulatory Compliance Department of Coventry Health Care of Missouri, Inc. (“Coventry Health Care”) writes this letter as its response to the consumer complaint filed by [redacted] regarding billing issues for her insurance policy.Our investigation into this matter shows that [redacted]’s application for a policy was received by the Marketplace on April 22, 2014 with an effective date of April 1, 2014. Because the member made an initial payment of $130,28 to an older policy ([redacted]) instead of the new policy ([redacted]) with a monthly premium of $162.69, the new policy was terminated for non-payment of the premium by the Marketplace on May 24, 2014 with an effective termination date of March 31, 2014 (as if never in force). As part of the investigation, the premium payment of $130.28 was moved from the older policy ([redacted]) to the new policy ([redacted]). Then on May 24, 2014, the member made a payment for the difference due of $32.41. Once the payment of $130.28 posted to the policy, the premiums due generated for May and June. Therefore, on June 4, 2014, **. [redacted]'s policy was reinstated with an effective date back to April 1, 2014.Coventry Health Carc 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,

Review: The company has not updated my coverage to add a new dependent. I've spoken to customer service on three different occasions. The claims department has no record of adding my son. The new enrollment department shows him as added but they are not billing me for the change in coverage. In the meantime my son does not have insurance. Rhonda from customer service told me she can't see how to fix the problem. When I asked her to let me speak to a supervisor to try and get this matter resolved she told me no one was available. I waited on hold with her for 20 minutes for a supervisor and when one was finally available, named Lisa, Rhonda placed me on hold. When she finally came back on the line she told me Lisa asked her to write some notes in the system. She did not let me talk to the supervisor like I had asked. When I questioned Rhonda and told her I needed to actually talk to her supervisor she told me she was gone to lunch and unavailable then she asked me to hold and transferred me to the health insurance marketplace. I have been given the run around from every department I've spoken with and would really just like to get this matter resolved so that my son has health insurance.Desired Settlement: Update my insurance and billing information correctly.

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 the addition of her newborn dependent, [redacted] to her CoventryOne® policy purchased on the Federally Funded Marketplace for an effective date of April 28, 2014. The request was received by CHC Carolinas on July 7, 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. An [redacted] Company

Review: I signed up with this healthcare company on March 31, 2014. I received a bill 3 weeks later that payment should be made on March 26 and then another letter that my plan had been cancelled for non-payment. I called and they stated they made a mistake on my start date, they would fix it and I should call back to get a payment plan set up when they had worked this out in about a week. I called back in a week and to set up a plan, this was in May by this time and they told me I would have to pay for April coverage, I explained I would not pay for coverage I did not have when they made a mistake. The rep. talked to supervisior and assured me I would be starting coverage in May and pay only from May on thru the year. I made a payment on May 5 2014 of 88.93, my premium and was told I would be receiving my insurance cards. On 5-13-14 I still have not received any insurance cards and received another letter that on May 31, a $177 premium would be withdrawn from my account for May and June coverage. I called and explained I did not have any cards and that the previous representative told me I would not be charged for this mistake in April. This representative hung up on me. I called the Healthcare market place to cancel my policy and they did this and told me I would also have to cancel my plan and payment plans with Coventry. I called Coventry again and talked to the billing department she said she would put me on hold to figure out what was going on and she hung up on me as well. I did attempt to call back and waited on hold for 45 mins. At this time, I called my bank to have the payment made on May 5th stopped. My bank is charging me a $35 stop payment fee. I do not feel that I should have to pay this fee considering the very poor service and customer service I received from this company causing me stress and to ultimately cancel my healthcare plan.Desired Settlement: I would Coventry to refund me $35 for my cancellation process resulting from they hanging up on me in customer service.

Business

Response:

May 29, 2014Dear [redacted]:Your letter of May 19, 2014 to Coventry Health Care of Iowa, Inc. (Coventry) was received in our office, and referred to my attention for review and response. [redacted] was covered under Coventry effective April 1, 2014 through the Health Insurance Exchange (Marketplace). [redacted]’s policy terminated effective May 28, 2014.On March 31, 2014, [redacted] enrolled for coverage through the marketplace with an anticipated effective date of May 1, 2014. The Marketplace notified Coventry that [redacted]’s policy effective date is April 1, 2014.Individuals who enroll for coverage on the Marketplace after the 15th day of the month are prospectively effective the first of the following month. Examples are provided below:• An individual applying for coverage on the Marketplace on March 14, 2014, the effective date of the policy would be April 1, 2014.• An individual applying for coverage on the Marketplace on March 28, 2014, the effective date of the policy would be May 1, 2014.However, the Marketplace was not enrolling members based on the example above or as listed on the www.healthcare.gov website. Below is an example of how the Marketplace was enrolling members:• An individual applying for coverage on the Marketplace on April 14, 2014, the effective date of the policy would be April 1, 2014.• An individual applying for coverage on the Marketplace on April 28, 2014, the effective date of the policy would be May 1, 2014.On May 5, 2014, [redacted]’s $88.83 made her initial binder payment and her policy was reinstated. Coventry attempted to draft $177.66 in premium from [redacted]’s bank account to bring her current. [redacted] was under the impression she did not have to pay for April’s premium and she contacted her bank and issued a stop payment of $177.66. On May 15, 2014, Coventry was notified by the Marketplace that [redacted] terminated her policy.Resolution 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] advised she contacted the Marketplace to cancel her coverage. [redacted]’s policy terminated effective May 28, 2014. On May 29, 2014, [redacted] was contacted and asked to submit a copy of her bank statement reflecting the stop payment fee of $35.00. Once the requested information is received a refund request will be initiated.Coventry apologizes for any inconvenience this has caused [redacted]. However, as stated above, the change must come through the Marketplace as Coventry is unable to change the effective date based on the Exchange rules and regulations.If you require additional information, please feel free to contact me at ###-###-####.Sincerely,

Review: November of 2013 I received in the mail a notification that my insurance didn't meet the minimum Obamacare requirements. The letter stated my policy was to be cancelled effective December 31 and I'd need to secure a different plan. I went ahead and purchased health insurance though my employer. I checked my bank statement in January 2014 and discovered I was still being charged for the old (supposed to be canceled) policy. I immediately began trying to call Coventry Health and could not get through. I called four times spending almost an hour on hold each time. I then tried to use the website to cancel my policy, but couldn't (still can't) find the option. I then used their contact form (January 22, 2014) to attempt to reach them and never heard back. I then called my bank to block payment (which they screwed up). Now I am into the second month (totaling $450.34) of a policy that I didn't sign up for and am unable to cancel. I have the original letter of cancellation, a digital video recording of me using their contact form and submitting my issue on the site (thought I'd need it), as well as the bank statements to show the withdrawals. I would like my $450.34 that was stolen returned into my checking account.Desired Settlement: I would like the $450.34 returned.

Business

Response:

February 17, 2014

Dear **. [redacted]:

This letter is in response to your request for Coventry Health Care of Virginia, Inc. to respond to a complaint submitted by [redacted] regarding termination of his CoventryOne policy which was effective January 1, 2011. **. [redacted] is also requesting a refund for the premium paid for January and February 2014. The request was received by Coventry Health Care of Virginia, Inc. on February 7, 2014.

Coventry Health Care of Virginia, Inc. does not have a signed authorization release form from **. [redacted] indicating that the Revdex.com is representing him in this matter. We will respond directly to **. [redacted].

Please contact me if you have any further questions involving this issue. I can be reached at ###-###-####-[redacted] between the hours of 8:00 a.m. and 5:00 p.m. Monday through Friday.

Sincerely,

Review: I’m A federal employee We have open season on November 2014 I went and talk to the health insurance advisor one of my question was for the gym membership She replied yes It is covered 100% percent at no cost. Ok for me that is one of the most attractive benefits,, I was enrolled at the gym membership and one day attending to the gym they said that my membership was not covered anymore. I called the insurance and they said that effective January 2015 THE GYM membership was going to be offered at a discount only. Unfortunallly we don’t have options to stay with the insurance till November 2015 I believe I was misinformed, MISLEAD INFORMATION JUST TO GRAB ME FOR THE INSURANCE IN addition they lied on their brochure which is available online. Please don’t let no one take this scam.

http://[redacted].pdf

[redacted] a frustrated customerDesired Settlement: WANT TO BE HONERS A GYM MEMEBRSHIP UNTIL NOVEMEBRER 2014 FOR A NEW OPEN SEASOR SO I can change the insurace

Business

Response:

Dear

Review: Coventry has denied me my coverage for my visit to my cardiologist. My primary doctor has sent me to see the cardiologist and Coventry is alleging that I have a pre-existing condition. Aside from receving absolutely no help from your agent who sold me the coverage, I'm beyond frustrated with lack of service from the point that I signed up for your horrid excuse of an insurance company. First and foremost, there was NEVER an explanation on pre-existing conditions. Second of all, I don't believe that it's even legal to deny payment to my cardiologist due to a pre-existing condition. These visits were in 2014, I started the insurance in 2013, there should not be any kind of denial of payment resulting in me paying out of pocket.Desired Settlement: I have received a bill from a 3rd party stating that I owe $140 for my visit. I refuse to pay this when I had an insurance to cover this AND a referral from my primary doctor for my visit.

Business

Response:

Dear

I have NEVER seen such a slipshod operationCoventry Health Care offers NO real care, no response and no customer service."We've cleared the path for you to control your own healthcare" boasts the banner, on Coventry's websiteThey're also busy clearing the path for you to pay for and PROVIDE your own health careEventually, they'll send you a "DIY Surgery Kit" -- you'll do the cutting and suturing - but you'll have to pay THEM, because "hidden costs"It has always been a painful struggle to get any response via emailThey don't cover anything, and phone encounters have been a nauseating 3-ring circus of non-communicative exchanges with incompetent "customer service" representativesI signed with Coventry for a child's health care"Oh, yes - children are our priority" began the mantraThey started early, giving me the one step forward, two steps back treatmentThat should have been a red flagWe won't cover A, but if you go to B, they'll refer you to us to cover C, and then you can file for ABut we don't cover A, so file for A and see what happens, cause we love paperworkThe list of "covered" providersOn a list of 20, were no longer accepting Coventry as a carrier(Golly, wonder why?) Of course Coventry reps wanted to argue with me on this, even after I'd gotten the info directly from the providerAnd mysteriously, providers who did accept Coventry coverage -- Coventry didn't have listedRight hand, left hand - who's minding the store?
Last strawI called to transfer coverage for my move to another state"You'll get a call back to confirm that within 2-days." Of course I had no call from themAfter a week, I called backNo one had any record of that conversationI was put on a minute holdI called backThis representative insisted I'd have to wait for paper mail - no one could email me any information - it just wasn't doneThey email me junk times a week, but this question couldn't possibly be confirmed via emailI asked to speak with a supervisor and was suddenly, magically disconnectedWhat a shockThe new address is in a state that Coventry supposedly coversWhat, like they've been covering me? No thanksCoventry provides no response, no straight answers, returned phone calls or any kind of information - EVERIt's been a nightmare trying to find out what, if anything, they cover - and when claims will be processedThe answers: "nothing" and "wait and see"Final act of bad faith: On August 23, I went into a CVS pharmacy to get a monthly prescription filledThe PHARMACIST - not a Coventry Customer Service agent - told me my insurance policy had been terminated the day beforeNo notice from CoventryI paid my premium August They had NO trouble taking the moneyProviding consistent coverage, however, is apparently a big challenge for themSo I'm terminatedfineGood riddance to bad rubbishCoventry is a bad joke

Review: I called the health care marketplace on May 5, 2014 to cancel my plan through Coventry Health Insurance. I was told then that everything was handled and my account had no extra balances due. On June 2nd of 2014 they had deducted my premium from my account in the amount of $119.00, which over drew my account and shorted me on my rent money. I called and spoke with a rep and they told me that they say the account had been terminated effective May 8th and because there had been errors in the notice they received the account just sat there. I was told at that point that the Recon team needed to handle the issue and to check back with them in a week. I called back a week later and another rep told me that the recon team did not have a time parameter that they needed to work in and it could take up to 30 days to resolve my problem and then I could possibly receive a refund. I called 1 week later because I still had not heard anything and was told that on June 30th they were going to deduct another 119.00. I asked why they would do that if they know the account had been canceled and I had been requesting refund from June 2nd. She told me to email the complaint department and to fax them a form canceling the direct withdraw (which I never set up with them). I filled out the forms, emailed them and called my bank to put a stop payment on it. On June 30th they withdrew the 119.00 again despite my efforts to stop it. I called today to add to the notes of my account that they would need to refund the additional 119.00 making the total now $238.00. There were very rude this time when I called and told me that it was my fault for not stopping the payment and that I should have followed up after I canceled my plan. I was very upset at this as I did everything I was supposed to do to handle this issue. I was told again that the recon team worked on things as they see fit and that I just needed to wait for them to call me. I am again short on my rent for the second month in a row. I also have two children that this effects. I don't know what else to do to get refund, and for them to stop charging me. I was disrespected and am not being treated as a client, which I paid for their services on time each month and never disputed anything prior to this happening. They way they are handling this issue is upsetting, and has caused a very stressful chain of events to occur. There is no ownership of the problem and no one seems interested to get it resolved.Desired Settlement: I am asking that Coventry refunds the money they took out of my account on June 2nd of $119.99 and June 30th in the amount of 119.00 each making the total $239.98. My bank has generously returned the over draft fees and the stop payment fee. When they took out the money on June 2nd I had to transfer money in the amount of 56.00 to my checking account from my savings account because they over drafted my account. Now my savings account is negative.

Business

Response:

July 9, 2014Dear [redacted]:Coventry Health and Life Insurance Company (Coventry) received the above referenced consumer complaint in our office on July 01, 2014. We appreciate the opportunity to respond.[redacted], a CoventryOne member, has filed a complaint regarding a termination.The file to terminate the policy was received from the Marketplace on 05/07/2014 to terminate the policy as of 05/22/2014. The file however, had an error on it that caused the change to never load into our systems. This is why the policy stayed active.The file was processed manually so the policy is terminated as of 05/22/2014. A refund has been requested for the excess funds that have been paid by the member. That is $34.84 for the remaining days in May after the 22nd, $119.99 for June, and $119.99 for July. This is a total refund of $274.82. Because all of the payments were paid electronically, the refunds should be sent to the member as an electronic credit to their bank account. This will take approximately 7-10 business days.We trust this information has addressed the issues raised in this complaint.Respectfully,Brandy H[redacted] Appeals Department Coventry Health Care

Review: On 2/10/14 I faxed a voluntary termination form to Coventry Healthcare with the request for policy termination on 2/28/14. My fax call report showed that all papers were faxed and there were no problems with the transmission. Two months later on April 7th I noticed a debit from my bank account from Coventry Healthcare. I immediately called and was told that they never received the fax. So on April 8th I redid all paperwork and re-faxed to number ###-###-####. Called company to make sure fax was received..was told that the last page was not received.Told the lady (melanie..I think) that I have the fax report sheet and that yes all papers went through fine. Once she opened my account she then admitted to me that all paperwork was received on time..including the original fax!

So I spoke with [redacted] and the amount of 398.26 was approved to return to my bank account..seeing as how they took out two months worth of payments when they were not authorized to do so. My log number for my case is [redacted] and I was told it would take 7 to 10 business days and this was April 9th, 2014.

I have called two other times just to see why I have not received my money back in my account yet and was told that its processing and they could not tell me when it would be returned to my account. Now its May 13th, 2014 and have yet to get my money back and Coventry Healthcare is not working with me nor are they concerned that I have other bills and I need my money back. I would like some other compensation besides what I am owed. Due to the fact that they had the original fax and proceeded to hit my account two more times for payment and just the blatant lying this company has done with telling me they had not received all my paperwork when in fact they did..twice! so appalled my their customer service and business practices that I feel this company needs to be investigated further. Thanks [redacted]Desired Settlement: My money I am owed (398.26) plus some extra for the company lying about not receiving paperwork and it taking over 30 days to return money that they ILLEGALLY removed from my account. They were not authorized and they had all the paperwork to prove that they were not authorized. This company has very questionable business practices.

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 as of February 28, 2014 and refund her premium payment in the amount of $398.26. 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 am filing a complaint because my premium is still being deducted from my bank account - illegally. I received a termination letter from [redacted] that states my policy will terminate Jan. 1st 2014. Well, I am still being charged for this policy.

I never signed or agreed to renew my policy.

I never signed or agreed to a new policy.

I called early December to verify the cancellation and was told there was nothing I needed to do and my policy will automatically cancel as the termination letter clearly states.

One of their operators (which will transfer me to their billing department and I will be on hold indefinitely) said my policy is most likely still active because of a new law - well, I was never notified of any new law. From what I have read, the law gives insurers an option to offer customers tailored or catastrophic plans - I never signed or agreed to any new plan, I never signed or agreed to keep my original plan.

You can talk to someone instantly to start a new policy and give them your payment information but you are hard-pressed to talk to someone to cancel a policy and stop them from taking your money.

153.28 that was withdrawn from my bank account on 01/06/2014 needs to be refunded back into my bank account and my policy needs to be canceled ASAP.

I have tried the past two weeks to reach someone over the phone at Coventry One over the phone, but am placed on hold indefinitely - this is rediculous. I have also faxed and mailed letters to various Coventry One offices - no response.Desired Settlement: My policy to be canceled, just as my termination letter clearly states and 153.28 that was withdrawn from my bank account on 01/06/2014 to be refunded.

Business

Response:

January 30, 2014

Dear **. [redacted]:

I am writing in response to a complaint filed with your office dated 1/21/14. The complaint involves our former member, [redacted], who was enrolled in an Individual PPO plan effective 9/2/13 to 12/31/13. **. [redacted] writes that although he cancelled his policy effective 12/31/13, the health plan continues to deduct premium from his bank account and he is requesting a full refund of any January premium.

Our records indicate that **. [redacted] along with other individual policyholders were advised that their 2013 plans were not ACA-compliant, that individual policies would terminate upon the first renewal occurring on or after January 1, 2014, and that, at the time of renewal, policyholders would be provided with ACA-compliant plan options available to them.

Although **. [redacted]'s plan would have been automatically canceled August 31, 2014 for being non-compliant, he did contact the health plan on 12/5/13 to decline any new coverage for 2014 and cancel his current plan. It appears this initial cancellation request was not forwarded to Enrollment appropriately and he wasn't cancelled until 1/31/14 (per his later phone call to the health plan on 1/7/14).

We apologize for this oversight. His policy has now been back dated to 12/31 and an expedited refund has been requested which should appear in the member's account within 1-5 business days depending on the bank.

Should you require more information or have any questions, please feel free to contact me.

Sincerely,

Review: Ref: First Health Plan Part D - ID #[redacted]. In February 2013 I signed up for a RX drug plan for $24.40 a month, with automatic payments coming out of my checking account. On January 10th, 2014 a payment of $41.60 was deducted from my account., I called the company and wanted to know what was going on. They said that a notice went out to all customers in October of 2013. stating the increase. I don't know if they sent the notice, but I do not recall receiving such a notice. If I did receive such a notice, I would have shopped for a new program,, as the increase from 24.40 to 41.60 was a 70% increase, which I felt was highway robbery. I am on a fixed income, and the additional charge was excessive, as I discovered there a many cheaper policies available. I spoke to a supervisor, who said I could apply for help in payment of premiums, by calling a state agency, which I did, but I will not know if I qualify or if the help would sufficiently reduce my premium. I will not more about this about the 22nd of January. I also told them to cancel my automatic payments, and that I wanted to see a monthly bill. I also asked them to Email confirmation that they will no longer automatically take any payments out of my account. As of this writing, I have not received the Email. Because of the regulations, that I could only change a program once a year, which means I have to pay the higher fee for 10 more months.Desired Settlement: I would like my previous payment for 2014 to remain at 24.40 per month, or release me from this agreement,. without penalty, so that I can seek another policy, I don't know the legality of switching programs mid stream, but I am sure something can be done.

Business

Response:

January 27, 2014

Dear [redacted]:

This letter is in response to your written inquiry received January 21, 2014. In that correspondence you asked about the following:

Member, [redacted], contacted the Revdex.com regarding his concern over the 2014 premium for his First Health Part D (PDP) Plan and concern over the notification regarding this premium change.

We will contact **. [redacted] separately via a letter to address his concerns regarding the premium change.

Please note the resolution that will be provided to **. [redacted] has not been included in this letter in an effort to keep our member’s personal and health information confidential.

We appreciate you contacting us, and trust the additional information that we have provided satisfactorily addresses your inquiry. Your inquiry provides us with valuable insight as we continuously seek opportunities to improve our member communication materials.

Should you have any further questions, please contact Customer Service at ###-###-####, 24 hours a day, seven days a week your local time. TTY/TDD users please call 711 Telecommunications Relay Services.

Sincerely,

First Health Part D Value Plus (PDP) Plan

Review: I began my health coverage with coventry one on july 18 of 2013 because of switching jobs and no knowing when I would get insurance through my new employer. I ended up recieving insurace through another provider through my employer before the initial start date for coventry one. I recieved a bill in august for a premium and called to have my account retro paid due to the fact that I had another insurance company that I was using for doctors visits and asked that I be refunded my money and my inurance with coventry one be cancelled. I was told that the only thing I would have to do is send them an email with proof of my other insurance and I would be refunded my money. I sent it and called a couple weekes later and was told I needed to send in more information. I sent the information and during the waiting period was charged for another month of insurance that I had attempted to cancel months before. I called again and was told to send more information. I eneded up calling about six times and was charged again for the month of october. Coventry one has stolen about $265.00 of money for a health insurance that was never used and un neccessary. every time I call I talk to someone new and am told that they will putioall through and I should get my refund. four months after the initial phone call I have no recieved a dime of the money that that took for cervice that was not only unnecessary but never used due to my employer insurance. all I want is my refund. im not even asking for the $80 in over draft fees that I have incurred through my bank because of their unlawful bank withdrawls. my member id number is [redacted]Desired Settlement: all I would like is my refund for the health insurance I tried to cancel and never needed. during the months that they charged me I used my employer health insurance for doctors visits.

Business

Response:

January 16, 2014

Dear **. [redacted]:

The Member is participating in the Coventry Health and Life Insurance Company (“CHL”) HealthAmerica One individual PPO health benefit plan.

The Member’s complaint concerns when the request of cancellation of Policy was made by the Member and the request for refund for 1 month premium payment in the amount of $224.35.

Below is a timeline of events leading up to the resolution of the member’s complaint.

July 17, 2013 5:43 PM - A new application was received.

July 19, 2013 10:35 AM -The initial credit card payment was declined due to a general decline of the card.

July 30, 2013- A credit card return letter was mailed to the member.

July 30, 2013- A recurring EFT letter was mailed.

July 30, 2013 - A welcome letter was mailed to the member.

August 23, 2013 3:19 PM- An adjusted pull letter was mailed to the member to notify them of the September 5, 2013 draft.

September 5, 2013 12:18 PM- [redacted] contacted billing and enrollment in regards to his policy. He stated that he was accepted however he was not billed and that he assumed he didn’t have the policy. He advised that he was drafted for the payment and that he would like to cancel and request a refund. The member stated that he had obtained other coverage since he took out this policy. The member was advised that we would need proof of other coverage in order to retro terminate his policy and a full payment could be refunded. He was advised that an adjusted pull letter was sent on August 23, 2013 and advised of the September 5, 2013 draft.

September 10, 2013 12:13 PM - [redacted] contacted billing and enrollment in order to obtain the email address he would be able to submit his proof of other coverage. He was provided with the email address to billing and enrollment.

September 10, 2013 12:58 PM - An email requesting to terminate as never in force was received. The document was not signed by the member, and an email was sent to advise the member that we would need a written request that includes the members name and signature.

October 7, 2013 11:45 AM - [redacted] contacted billing and enrollment in regards to retro terminating his policy. He stated that he was drafted and that he had submitted the information. The member was advised that an email was sent to advise of the needed information to retro terminate his policy. A request was forwarded to processing in regards to the retro termination request. A second email was sent to the member to advise on what information was required to retro terminate his coverage.

October 8, 2013 5:06 PM - [redacted] contacted billing and enrollment in regards to if we had received the information to retro terminate his policy and to obtain a refund. He stated that we drafted his account for October and that he would like a refund. He was advised that we received the proof of other coverage, however we needed a written request that advised of the effective date for the termination, the member’s signature, name, and case number.

October 16, 2013 12:02 PM - A written request was received by the member. The member requested to retro terminate as never in force. The policy was terminated for 10/31.

October 29, 2013 10:54 AM - [redacted] contacted billing and enrollment in regards to terminating his policy as never in force. A request was sent to processing to have the policy terminated as never in force. This was closed out in processing because the member was already terminated for 10/31.

November 20, 2013 - [redacted] contacted billing and enrollment in regards to the termination of his policy. He requested a refund and requested to speak with a supervisor. The information was sent for a supervisor review.

November 20, 2013 11:44 AM - [redacted] contacted billing and enrollment in regards to the termination of his policy. He stated that he wanted to terminate as never in force and for his funds to be refunded back to him. He was advised that the policy was not cancelled originally due to us not having a written request on file. A request was sent to processing to have the policy retro terminated.

ROOT CAUSE:

The member did not originally contact billing and enrollment until September 5, 2013 to terminate his policy. His original request did not include a handwritten request to terminate, which is why the policy originally wasn’t terminated.

The other issue is that processing did not terminate the policy back as never in force due to the policy already being terminated for October 31, 2013.

RESOLUTION:

The member’s policy has been terminated as never in force. An expedited refund in the amount of $224.35 has been requested.

If you have any questions or concerns regarding this matter I can be reached at ###-###-####.

Sincerely,

Review: November 3, 2013

Sir:

I am a South Dakota resident, living in Florida. I recently had my insurance rescinded by Coventry health care of Iowa. I believe this was not done in good faith, but in order to avoid paying a legitimate claim.

I purchased this insurance in January of this year (2013). It was a very high deductable policy as I thought I would soon be back to work with a company that provides insurance. Unfortunately in April of this year I went to the Dr and was told I had a hip problem. I had injections done but they were not successful in relieving the pain, I was advised to have a hip replacement.

In June 1 started the process by having the pre-ops done. I was notified 3 days before I was to go into surgery, that Coventry thought my condition was pre existing. They wanted all my records for the last 3 years. These were provided. Every time they found a Dr. mentioned, they requested more records. They took 15 business days with each set of records. This process took 4 months. The final result was they could not find any pre-exist problem with my hip.

They approved all the charges associated with my hip problem. This cost them nothing as my-deductable is $3500.00 so they were alt my out of pocket expenses.

The problem is that at the same time, they notified me that they were rescinding my insurance because I had not told them about a lab that was done 2 years ago. I was aware the lab was done but the Dr. said it was fine. The Doctor did not suggest any type of medication or life style change, so I had no idea I needed to report it. Their paper work stated that I needed to report everything to the best of my knowledge, which I believe I did.

They are now using this to cancel my insurance which I desperately need to have my hip fixed.

Please let me know if there is something you can do for me or what my next step is in making this right.

Thank youDesired Settlement: Please see attached

Business

Response:

December 4, 2013

Dear [redacted]

Your letter of December 2, 2013 to Coventry Health and Life Insurance Company, Inc. (Coventry) was referred to my attention for review and response.

On November 8, 2013, Coventry received an inquiry from the South Dakota Department of Labor and Regulation regarding the rescission of [redacted]’s policy. Coventry investigated [redacted]’s concern and it was identified her policy was rescinded based on undisclosed health history on her application. On November 26, 2013, Coventry provided a detailed response to the South Dakota Department

of Labor and Regulation.

Additionally, [redacted] has one hundred eighty (180) calendar days to file an appeal with Coventry. [redacted] has not exercised her right to an appeal at this time. If she chooses to file an appeal with Coventry it would need to be submitted prior to April 19,

2014.

If I may be of any further assistance, please feel free to contact me at ###-###-#### or toll-free at ###-###-####, ext. [redacted].

Sincerely,

Review: I contacted the insurance company to remove my daughter from the policy and the representative forwarded the form I needed to fill out, filled out the form with the representative still on the phone providing instructions on how to fill out and information to provide on the same, forwarded filled out form as instructed via fax and email. The representative informed me that the form would be processed within 7 business days. 18 days later I called Coventry again to follow up to find out that the form had not been processed. After speaking to several customer service representatives and being passed around to different supervisors, each and every single one of them gave me a different reason as to why the form had not been processed. Some supervisors and representatives promised that the issue was going to be taken care of. However days passed and passed and nothing had progressed. Called to find out status everyday to find out that in reality no one was working on my case, spoke to a very nasty, disrespectful, condescending, and unethical supervisor who told me that if I didn't pay the full premium for my daughter and myself, out health insurance policy was going to be cancelled. How after several requests could I get that response from a 'supervisor'. She also said that the promises and answers I had gotten previously from representatives/supervisors that the case was being resolved was all a lie because they weren't aware of procedures and their policy. How can you trash ALL other representatives like that? I then contacted the customer service department to inform of my compliant and issue, spoke to a supervisor who promised that if I forwarded the paperwork to her, she would get the form processed, the policy adjusted and the problem solved. I forwarded the information she requested and have sent several follow up emails, placed a couple of phone calls and left several voicemails to be at square one once again! I'm beyond frustrated with this issue and cannot believe that because of the incompetence of the people employed by Coventry I'm going to be left without health coverage. I hope that filing this complaint gets me somewhere where they have the authority to do something about this.Desired Settlement: Removal of my daughter from policy as of July 31, 2014 and billing of correct premium for my policy.

Business

Response:

September 26, 2014Dear Sirs:This letter is in response to the aforementioned Case Number [redacted] regarding [redacted]’s request to remove her daughter from the policy, Thank you for your patience throughout this process. Our goal is to resolve your concern in a fair and timely manner.Please be advised that after review of this grievance, we have confirmed the following: We received a request to remove the dependent as of September 24, 2014. Please allow 7–10 business days from that date for processing. Additionally, there is a current balance due of $1,288.48. We have not received payment since July, [redacted] is on paper billing, and it is the member’s responsibility to make payments timely. [redacted] must make a payment before the end of the month in order to avoid termination. Please find (enclosed) the termination process from the Certificate of Coverage. If you have any questions, please contact Customer Service at ###-###-####, Monday through Friday from 8:30 am until 5:30 pm or you may reach me directly at ###-###-####. If you are hearing impaired please call [redacted] Telecommunications Relay Service.Sincerely,Yanique MComplaint and Appeal Analyst Grievance & Appeals Dept

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:

The original form to remove my daughter from the policy was sent to Coventry on 8/7/2014. After following up several times via telephone, I got in touch with Tanisha G[redacted], a supervisor at Coventry, who asked me to send proof that the form was sent and proof of my daughter's new insurance. I sent this information to her and she confirmed receipt of the same. She promised that the form would be processed immediately so that I could make payment for the adjusted amount for my premium without my daughter. My premium should be for $265.37 and I am missing to pay for August and September. See attached emails to and from Tanisha G[redacted], Coventry change form to remove my daughter from the policy as well as proof of my daughter's new insurance. As I stated in the attached email to Ms. G[redacted], I am not refusing to pay; however, I am not going to pay the incorrect amount just because Coventry did not process the original request efficiently and timely. Please advise.

Regards,

Review: My policy with Coventry Health Care began on 1/26/2011. All my payments were made through my online banking account. For 23 months I had no issues with Coventry receiving my payments. In 12/2013 a letter was sent changing the payment address from P.O. Box in Illinois to Florida. The bank Coventry was changed to [redacted] at this time. On 12/18/2012 at 6:23pm I contacted Coventry member services to ask why my bill was double what it normally is. That stated that they were missing a payment at that time. I called my bank at that time to ask about this. They stated that this payment had cleared the bank & was sent to Coventry to prove they had received payment. I have bank statements verifying that the last 10 payments were received by Coventry on time. I made 12 phones calls & faxed two bank statements to Coventry between 12/2012 & 6/2013 trying to resolve this issue. Coventry has not applied one 2013 payment to my account & billed for July 1st after my policy had been cancelled on 6/28/2013 as of a phone call & written statement. They say there is a current balance of $117.86 they have to find. As proven by my bank statements there is zero balance owed. My bank guarantees all online payments have been received. As of 3/26/2013 they have been researching this missing payment with no solution. I have contacted member services four times since this date. Verification has been faxed to them showing all payments were received by Coventry.Desired Settlement: DesiredSettlementID: Other (requires explanation)

I would like my policy cancelled as of 6/30/2013 with a zero balance owed.

Consumer

Response:

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

From: [redacted] <[redacted]>

Date: Mon, Aug 19, 2013 at 6:57 PM

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]" <[email protected]>

The complaint listed below has now been settled to my satisfaction and has been closed by Coventry.

Thank you,

Review: My health policy ran through 12/31/13. Coventry One reset the policy on 12/1/13 by mistake. This caused me to be overcharged $77.77 for the December premium payment, which I have not been refunded. It also caused my deductible and yearly out of pocket to be reset a month early so the claims paid in December were incorrectly calculated showing I owed deductible which I did not because I had already paid it for the year. I have been contacting Coventry since December and they keep saying they will fix the claims and send me a refund but they never do.

Product_Or_Service: Health Insurance

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

I want them to send me the $77.77 refund, fix the claims for December showing my deductible correctly.

Business

Response:

September 9, 2014Dear [redacted]:Coventry Health and Life Insurance Company (Coventry) received the above referenced complaint in our office. We appreciate the opportunity to respond.A refund in the amount of $77.77 was returned to your account on September 4, 2014. We apologize for an inconvenience this has caused.We trust this information has addressed the issues raised in this complaint. If we may be of any further assistance, please feel free to contact me at ###-###-####.Respectfully,Brandy HAppeals Department Coventry HealthCare

Review: My family and I were forced by our President to take insurance we do not want and pay more than we can afford. We are with Coventry One and received a cancellation letter last fall and then a letter stating that our policy would change and our premium would go from $484 per month to $869 per month starting in Feb. of 2014. Our payments are taken directly from our bank account approx. the first week of every month. I spent hours trying to talk with someone at Coventry in Feb. and countless e-mails asking if they could split the increase over a couple payments monthly and they refused. On March 5th 2014 our wonderful President announced that anyone in our position can go back to our old plan and old premiums immediately until 2016! I called Coventry the next day and spoke with Charlotte and she stated they have gotten an e-mail and I would be going to my previous plan and premium and that they would be contacting me right away. Coventry then 2 days later took out the $869 and in April took another $869....to this day they have not contacted me like promised. This morning I called them and was told twice from a supervisor they would contact me soon?This is not the response I should be getting....

Product_Or_Service: health insurance

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

1. Refund for the March and April 2014....(difference only)2. Old plan re-instated3. A complete copy of our old plan and plan that we were placed on currently to be mailed in a hard copy form to my home address.

Business

Response:

May 30, 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 4-15-14. This letter is in response to the consumer complaint filed by [redacted] regarding the billing for his health insurance policy.Please note we received a MO Department of Insurance complaint (#[redacted]) regarding this matter on 5-15-14 and have been corresponding with Ms. Kathleen T[redacted] at that office concerning this complaint.[redacted] complains of wanting to return to his pre-2014 health insurance policy (which carried a lower premium) and of being unable to do so. Please note that on 10-1913 Coventry Health Care sent a letter to [redacted] advising him of the changes coming as of 1-1-14 and of his ability to renew his current plan early. We did not receive this back from the member suggesting he wanted to keep his old policy.Upon received of the instant complaint, a representative attempted to contact [redacted] by phone on 5-16-14, but there was no answer and no ability to leave a voice mail on that line. On 5-19-14, the same representative sent an email to [redacted] regarding the plan and premium discrepancy. She requested a working phone number to reach him as she was unable to reach him or leave a message at the number we have on file.On 5–19-14 we received a return email from [redacted] in which he listed his frustrations and refused contact that did not funnel through the Revdex.com, the Attorney General’s office, or the Missouri Department of Insurance. We contacted the MQ DOI on 5-19-14 to attempt to expedite this issue before the due date of this response. We assume the DOI has yet to hear back from the member regarding the options we provided.There are three options available to this member we are making available to remediate the situation:• If he wishes to return to his pre-ACA plan, he needs to be aware there will be an effective date change, premium change, and that his claims will have to be reprocessed to reflect the 12/l effective date.• Before we move the member back to the pre-ACA plan, we need confirmation from [redacted] of accepting the new rate of $521.44 for the plan 5000 80/50. There was an annual rate increase for this member's plan although this new rate is still less than the $869.00 quoted in his complaint. He would not be paying the $474,62 premium he previously had .• [redacted] has 3 options — (1)Agree to the effective date change and new premium, (2) Stay on the ACA plan he migrated to on 2/1, or (3) terminate his Coverage.Coventry Health Care hopes this explanation provides your office 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 [redacted], extension [redacted]. My fax number is [redacted], and my e-mail address is [redacted]Very truly yours,Neil M[redacted], B.A. Regulatory Compliance Analyst Coventry Health Care

Review: Due to the new Obama Care my insurance policy change is trippling which I do not blame on them. I am a military veteran though so I am just going to switch over to ** Health Coverage. I called in to cancel my policy and was on hold for 1/2 an hour waiting to talk to someone. Once I finally got through I was told, sorry our system is down and we can not help you right now. They asked me to try back in a couple of hours. Being on hold for 1/2 hour to be told they can not help me is unacceptable business behavior.Desired Settlement: cancel my policy

Business

Response:

May 16, 2014Dear [redacted]:Your letter of May 15, 2014 to Coventry Health Care of Iowa, Inc. (Coventry) was received in our office, and referred to my attention for review and response. **. [redacted]’s family coverage will terminate effective May 31, 2014.In his complaint to the Revdex.com, **. [redacted] advised that he experienced frustration with long hold times and system problems when he contacted Coventry regarding cancelling his coverage. Coventry has experienced a high level call volume after the first of the year regarding the Marketplace Applicants. On May 13, 2014, during **. [redacted]’s initial phone call, Coventry’s system was down. The representative did not have access to his policy, therefore **. [redacted] was asked to try calling later. Coventry understands **. [redacted]’s frustration and apologizes for any inconvenience this may have caused him.On May, 16, 2014, [redacted] contacted **. [redacted] to personally apologize for the inconvenience he experienced. Coventry looks for opportunities to improve the customer experience and his concerns will be addressed.If I may be of any further assistance, please feel free to contact me at ###-###-#### or toll-free at ###-###-####, ext. [redacted].Sincerely,

Review: I had a healthcare insurance plan with Coventry of GA. The monthly premium was $130.72. In late 2013 I received several mails from Coventry saying that due to the Affordable Care Act my plan was going to be terminated by 12/15/2013, and I was offered an alternative plan to enroll. I chose not to enroll in the new plan since I was going to apply for a family plan to replace this individual plan. So I assumed that they, I mean Coventry, would terminate my plan as they have stated in the mail. Then I noticed in both December 2013 and January 2014 I was charged the monthly premium. I called customer service line, was put on hold for about 50 minutes (this was the longest holding time I have ever experienced), finally got to speak to someone who told me that they didn't cancel my subscription. I asked to cancel my plan, then was told that the January premium would not be refunded.It doesn't make sense to me when they said they would cancel my plan, then they kept it without notifying me and charged a fortune.

Account_Number: [redacted]Desired Settlement: DesiredSettlementID: Refund

Refund the full monthly premium of January 2014 and half monthly premium of December 2013. Coventry has my old address on file. My new address is: [redacted]Please mail check to the address above.

Business

Response:

Coventry Health Care respectfully requests an extension of time in which to complete our investigation into this matter.

Thank you,

Business

Response:

January 24, 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 processes.

After a thorough review of the information submitted, a determination has been made to approve your cancellation request. However, policy cancellation occurs at the end of the desired month. Therefore, your policy was cancelled effective 12/31/13. We have requested an expedited refund of your January 2014 premium in the amount of $130.72.

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

Sincerely,