C&R Restaurant Service

Community is required to follow the [redacted] guidelines for effective and termination dates? A termination file was received from [redacted] with a date of September 30, ? [redacted] can contact the [redacted] at 1-800-318-and request a Special Enrollment Period (SEP) to have policy retro activated to 09/01/? Community does not make the decision of eligibility for Special Enrollment Period? Thank you

We contacted the member via phone and explained the reason for high volume calls and apologized for delay in responding.? We are also sending a letter of explanation.? The subscriber was given an id number and they indicated they will use our online services for what is needed

A check for $was issued on 06/21/2017. Please contact healthcare.gov for further assistance. thank you

subscriber was contacted and a resolution was reached

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID *** and have determined that this proposed action would not resolve my complaint
Based on the conference call on September 19, the date (September 30) was set by you, Community Health Choice, not by *** can only send a request without day and formalize the termination notice then sent back to youYou set up a loop to avoid the responsibility to solve the problem
Regards,*** ***

Member was terminated due to non-payment after a new file was received from CMS adding the newborn to the policyThe new dependent was added with a retro date of 1/17/in MarchMember then owed the difference in premiums from January through MarchInvoices were sent out with new premium
rate and the past due amountPolicy had no APTC and was termed after the day grace period. Since this is a public forum we are unable to provide additional information containing PHI. We value all of our members and have reviewed this file to ensure invoices were sent with updated information

Community does not have the ability to override a file submitted by ***. We are bound by the regulatory guidelines set by *** regarding when we are able to reinstate, retro term or change any dates. The file sent to us had a term date of September 30, we are unable to override that date unless *** tells us you have qualified for a Special Enrollment Period (SEP). Community does not make that determination.

We contacted the member via phone and explained the reason for high volume calls and apologized for delay in responding. We are also sending a letter of explanation. The subscriber was given an id number and they indicated they will use our online services for what is needed

Community is required to follow the *** guidelines for effective and termination dates A termination file was received from *** with a date of September 30, *** *** can contact the *** at 1-800-318-and request a Special Enrollment Period (SEP) to
have policy retro activated to 09/01/ Community does not make the decision of eligibility for Special Enrollment Period Thank you

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

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint Hi, can you please address our question about removing our non-payment status? We have proof that we paid you for the retroactive fees within the day grace periodPlease advise.
Regards,

A check for $was issued on 06/21/2017. Please contact healthcare.gov for further assistance. thank you