Delta Dental of Wisconsin

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.I...

received a letter as previously indicated, stating my husbands policy will renew as of 01/01/2016. Thus however contradicts the statement that the policy would renew as of 4/1/2016. I do not feel it is fair as I have been advised by telephone by a representative of Delta Dental in September 2015, that in order to cancel the policy a statement in writing must be made to cancel said policy.
I have followed their procedure as previously advised to me. There are two dates of renewal given as well as two contradictions in terms of policy on cancellation. Please advise as this appears to be another attempt to collect on a consumer that is disabled and will incur more financial burden that had been thrice attempted with mitigation. 
[To assist us in bringing this matter to a close, we would like to know your view on the matter.]
Regards,

In response to Mr. [redacted]'s comments, Delta Dental's decision
to uphold our previous determination is strictly contractual.Delta Dental is regulated by the Wisconsin Office of the
Commissioner of Insurance (OCI) and is required to administer according to the
policy contract document.Delta Dental considers the matter closed.

Delta
Dental of Washington (DDWA) has reviewed the complaint referenced by Case ID
[redacted]. The complaint was filed by a subscriber to a DDWA dental benefits
plan.Because of confidentiality requirements of the Health
Insurance Portability and Accountability Act of 1996, 42 U.S.C. S 1320d-9
(2010), we are not at liberty to discuss this issue with you without a signed
release from the subscriber. However, Delta Dental of Washington places an
extremely high value on the patient's experience with us. We have researched
and reviewed all available information. We will address this complaint directly
with the member shortly, by letter.We appreciate your
bringing this to our attention, and providing us with the opportunity to work
with our customer.If I can be of further
assistance with regard to this case, please do not hesitate to contact me at
###-###-####, extension [redacted].

See attached. Mr. [redacted] may end his policy coverage effective 12/31/2015 or upon the one-year renewal on 3/31/2016. Delta Dental will assume the 3/31/2016 date unless Mr. [redacted] contacts us to provide other direction.

The terms of Ms. [redacted]'s policy clearly state that it is a one-year contract with automatic renewal. At Ms. [redacted]'s request, her policy is being cancelled mid-term, effective September 30, 2014. We believe that this resolution is satisfactory to Ms. [redacted] and this issue is closed.

[A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me. 
However,If I do not receive my refund within the two weeks I have indicated in my  previous letter, then I will do my next move.Kindly understand the situation you put us through, you gave us stubs without directions/proper guidelines in filling up your payment stubs. I am hoping for your swift response in processing my refund.
Regards,
[redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve...

my complaint.  For your reference, details of the offer I reviewed appear below.
The response I received from the Revdex.com if Wisconsin simply says:                           "The details of this issue were forwarded to Delta Dental of Washington for response.  DDWI will follow up to ensure it has been received."I have been given 10 days to state whether or not I am satisfied with this response.  I am not satisfied with being on a 10 day clock when I have not received any true response from (1) Delta Dental of Washington, or (2) Revdex.com of Wisconsin.Please start the 10 day clock only after the Revdex.com of Wisconsin forwards to me an actual response from Delta Dental of Washington. I have attached a copy of my original complaint.
Regards,
Albert [redacted]

Our response to this complaint will require the
release of the consumer's Protected Health Information (PHI). We have contacted
the complainant requesting that they sign a HIPAA authorization form permitting
us to release the information required to respond. We take Revdex.com complaints
seriously and...

will diligently work in attempting to resolve this matter.Upon
receipt of the signed HIPAA release, we will be in touch with a response to
this complaint. In the meantime, if any assistance is needed regarding this case,
please do not hesitate to contact me at ###-###-####, extension [redacted] or [redacted]

Dear Ms. [redacted]:A copy of the Revdex.com
complaint for Joan B. [redacted] has been forwarded to me for review.Ms. [redacted] received a call back from a
Delta Dental Supervisor as requested, and Ms. [redacted] has agreed to accept an
offer which will allow her to change policies with Delta...

Dental without
penalty. A new policy application has been mailed to Ms. [redacted] and she was
advised this application needs to be completed and returned to Delta Dental of
Wisconsin by June 30, 2016 in order for this policy change offer to remain
valid.If you should have any further questions or require
additional information, please contact me at [redacted]

Delta Dental of Wisconsin is a claims administrator for the individual policieswritten by Delta Dental of Colorado. Delta Dental has record of several callsfrom [redacted] requesting cancellation of her policy. Ms. [redacted]’s policyhas been terminated July 31, 2015.Tell us why here...

The policy was purchased on DeltaDentalCoversMe.com. The policy contract is presented for review and the purchaser must check a box stating they have read and understand the terms and condition and want to continue with the purchase. The policy has a ten-day free look. Delta Dental was not contacted...

during the ten-day period. Mr. [redacted]’s policy has been terminated as of July 31, 2016, which is the end of his contract period.

Review: Delta Dental refuses to close our policy after repeated efforts. They claim we must pay them until 01/01/2014 on one policy and through 02/28/2014 on the other. This is a copy of one of the email they received. May 28, 2014 [email protected] Please cancel Immediately!

Policy Holder: XXX XXXXX

ID: [redacted]89

Payer ID: WDENC

Reason: I would love to continue with you but I can "NO" longer afford to pay the monthly premium and support a family. Sorry but time are very tough for some people.

Please confirm receipt of this email.

Thank you

XXX XXXX

Their reply was one of money hungry people. I was told that I could not cancel and must pay them. I believe they practice this on all their customers. They wouldn't disclose that you could even cancel! After 100 phone calls someone finally told me I could cancel if I was active military going overseas. That was what they said!!! Here is what I found on their delta dental talks website.

http://www.deltadentalks.com/IndividualOptions/FAQsIndProd/

Q: How can I cancel my policy?

A: You can cancel your policy by sending written notice to Delta Dental at least 30 days prior to your requested termination date. Terminations will always be the last day of the month. For instance, if you request a May 31 termination date, your written request must be received at Delta Dental on or before April 30.

With that being said; I am being strong-armed, black-mailed and muscled for money.... This is a FEDERAL CRIME.... I believe they practice this on a regular basis.Desired Settlement: Contract Is Terminated as of May 28, 2014 as written...

Business

Response:

Mr. [redacted] purchased an Enhanced policy effective January 1, 2013. This was a one year contract and automatically

renewed on January 1, 2014. Please refer to page 2 of the attached Policy, “When does my

coverage start?” and “How do I renew my coverage?” The inability to pay is not

a Qualifying Event. The website Mr. [redacted] notes in his complaint, www.deltadentalks.com is for

plans administered by Delta Dental of Kansas. The correct website is

DeltaDentalCoversMe.com.

Review: Hi,

My credit card was charged on 10/29/12 for $362.64 by Delta Dental/Delta Dental Covers Me. I've tried contacting them several times over the course of the year to remove the charge but according to them "once charged, it can't be undone" even though recently I found this not to be true. I am unable to even utilize the service because I'm in another state completely before the plan even activated.

The credit card was expired on 5/31/12 and Delta shouldn't have been able to charge the card however due to the fact that they had a successfully charged the card a year earlier they utilized a method of what my credit card company called something like "same transaction ID" which allows them to keep taking money. The only reason I found out that they were charging the card is because I kept getting emails like the one below:

"Dear [redacted], Our records indicate that your debit or credit card is set to expire within the next 60 days. In order to continue paying for your dental plan by debit or credit card, you must update your information at www.DeltaDentalCoversMe.com."

I had never even received a email that they had charged my credit card and the reason I missed the charge on my bill is because I had a delta flight charge the day before.

A bit after May of 2012 I had to call because the emails kept coming in and they don't allow you to remove the credit card via their website. When talking to them on the phone they responded back that they needed it in writing which I said why not inform people about this on your website, why call and then go well since the card is expired nothing should be charged. I wasn't going to write a letter and it wasn't until 6 months later I was told it could have been done by email. So with the expired credit card I figured it ended. Since every purchase and subscription I've had been requesting the new information until I could utilize services I just allowed the emails to keep coming in.

Forward to 4/25/2013 I noticed I was still getting these emails that stated that I need to update my credit card. I called them up and said please stop emailing me as I no longer have any services with you in which they informed me that they had charged my credit card. After several calls and emails I got nothing along the lines of anything could be done. So I wrote up a dispute to my credit card company which eventually came back that since so much time had passed all they could do is flag my accounts as being a subject of fraud. Which means I have to go through hoops and get a flag on my credit report about fraud because they charged something that should have never gone through in the first place.

A few weeks ago I contacted them some more and kept talking to customer service and escalating to a supervisor who informed me that okay we'll cancel today which means I can get my money back for two months, Sept and October of this year. Something that was first told not possible to do but now that they will allow it, is nowhere near close to cover the entire $362.64. I've repeatedly called to get nowhere some more to which I finally got the supervisor today named Amanda who informed me that they can cancel and refund me anything after 10/31/13 which means I would get no money back. This company is nothing but a headache who took money from me.

At this point I'm asking for help in making sure all my money comes back at this point, not a penny less.

Thank you!Desired Settlement: Full refund of $362.64 since I could never once utilize their services due to me being in another state which I even proved to them.

Business

Response:

Since we did not receive updated contact information from Mr. [redacted] about his change of address, we did not know that he had moved to the state of Florida and is ineligible for coverage with this policy. We are issuing a refund at this time for the ineligible months of coverage.

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID [redacted] and find that this resolution is satisfactory to me as long as the refund is in full for the total of $362.64 which is the original amount charged to the credit card.

Review: Last Fall (2012) I called Delta Dental for information regarding dental insurance as I was soon age 65, on Medicare, and as under my husband's employee status (he's now deceased & it continued with Delta while on Cobra) we'd had Delta for a minimum of 12 yrs.+ and had been using my current dentist for approx. 20+ yrs.. At the time of my call I was given 2 options - the "Enhanced" and the "Classic" options and was sent information as to their coverage.

Earlier this year (2013) I again called Delta to confirm these prices and was told that they had a new, 3rd, option - the "Clear" plan. They again sent me the information on all 3 plans and I decided to go with the "Clear" Plan @ $40/mo. I was told to send in on March 1st so it would begin April 1st (as my Cobra was discontinued) - no waiting period since I'd had Delta previously. I sent in my Application along with a voided check on 3/1/13.

I do not know exactly when I received the "Welcome" package with my "Declaration" (they dated it March 8 but I could have received 5 or 10 days later) and I saw "Payments of $43/mo. will be charged on the 27th of each month. About that same time I also received a bank statement showing that $43 was deducted on March 12th (for the April coverage). I'd called Delta and asked why no one called or notified me of the $3 increase in monthly premium. They apologized and said that I must have been "caught" between the original papers sent me and the actual changes. I could discontinue coverage if I wish. I was upset to say the least but it was a bit too late after finally deciding on an insurance coverage.

Aug. 5th I went to MY dentist for a routine cleaning/x-ray that I've been using for 20+ yrs. and they submitted the claim to Delta. 2 weeks later I get the EOB from Delta telling me of my co-pay (which I knew) but that they would not cover my dentist bill as he is "out-of-network".

I called Delta earlier this week (8/26 I believe) and complained. I was told I SHOULD HAVE checked to see what dentists are in my network (this surprised me since Delta had been our insurer for over a decade). Delta said that my dentist would have been (partially) covered under the other 2 plans but not the "Clear" plan I'd chose. I asked why Delta, who also had my info in their files didn't send me a "list" of those they covered as a considerate business? I could change to one of the other 2 options but not until my contract was up at the end of a year. I was told I could go on their website and see who were in the network. (I didn't have access to high-speed until end-June and dial-up often would "freeze" when I'd go to sites hence the change for me after 14 yrs.).

Then I decided to check out the website. I checked for the dentists in my area (Tomahawk) - there was no "option" to choose from so it kept coming up that the 4 other dentists were IN network - not mine. How can that be if they'll accept him on the other 2 plans (with a slightly different payout)??

I called Delta again and this time I asked questions (like a new prospective purchaser) and all was the same as when I'd first called last Fall & earlier this year. Yes they mentioned IN & OUT of network but nothing about specific dentists in my area after giving my zip code. After a while I was asked if I wanted to talk to a supervisor and I said yes. It was arranged that a supervisor would call me tomorrow (yesterday, 8/29/2013).

The Supervisor called (I can't remember what her name was) and it was a repeat that nothing could be done until the end of my contract (ie switching to the other plan). After much rehashing of the same stuff - NADA! They can't make changes now as they're audited and that is their stance - no change!

Because of their non-contact to me I am now paying $3/mo. ($36/yr. additional to what I signed up for) more for no insurance ($516/yr.) unless I go to another strange, new dentist. Oh yeah, I was suppose to have received a postcard in my "Welcome" package ... hmmmm, surprisingly that wasn't there either.

I feel, no I know, that I've been scammed 100% and I've been wasting money like there's no tomorrow.

Beware new purchasers! - they're even being advertised with AARP (check out the difference in pricing).Desired Settlement: I don't know what to say here .....

It would have been nice if they could have, when they send the application, an FYI of "network" dentists in my immediate area of those included with EACH choice since my dentist especially since mine was only "allowed" in the 2 I hadn't chosen (why would that have been in 2 instead of the 3 is mindboggling). Who wants to change a provider (health or dental) after 2+ decades? And to not give the consumer a heads-up on that "Exclusion" is a ridiculous policy - do they expect everyone of their customers to have computer access?? When you think of it - it really tends to be a no-brainer to think that would be good policy.

If it were possible to switch to the other plan I would like to NOW not at the end of the contract.

If I could be reimbursed for what I've already paid in that would be nice as they HAVE NOT PAID OUT 1 penny on me so far - just ripped me off.

I should have quit when they were negligent in forewarning m of the increased premium change before my Declaration was sent me, the bank statement where they'd already removed the money (heaven help that they wait a while before taking my money out of the bank) - I just felt when I called to question them that it would have been even more convoluted to halt everything then, as in the refunding money back to the bank, paperwork, etc. My bad! It got worse later when I visited my dentist!!! NO COVERAGE!!!!!

Addendum:

After finalizing this complaint you would not let me list (this is an approx. date) 3/12/2013 for the "1st Contact on this issue" section in your "Review & Submit" as it is BEFORE the date of coverage so I had to list this week as the 1st contact (but it was not actually the first contact made).

Business

Response:

I called Mrs. [redacted] to speak with her about her experience with the Clear Plan policy benefits. Mrs. [redacted] was not aware that her dentist was not in the Delta Dental network and that the Clear Plan only provided benefit to in-network dentists. There are 4 network dentists in her community that are able to provide covered services to Mrs. [redacted]; however, she does not want to change her dentist at this time. Delta Dental is allowing Mrs. [redacted] to move to the Classic Plan, which allows reimbursement for services provided by out-of-network dentists. This change will become effective on October 1, 2013. The premium payment for the new policy is $36.74 per month and this policy has a monthly contract. Since Mrs. [redacted] had continuous comprehensive dental coverage, no waiting periods will apply in the Classic Plan.

Consumer

Response:

[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.]

I have reviewed the response made by the business in reference to complaint ID [redacted] and find that this resolution is satisfactory to me.

I am "Accepting" Delta Dental's response to my complaint #[redacted] .................

Yes, I did talk with Delta Dental yesterday late morning and, after much discussion, the current 1 yr. contract of the "Clear" plan @ $43/mo. will be canceled effective end-Sept. 2013 and on Oct. 1, 2013 I will then be covered under Delta Dental's "Classic" plan ($36.74/mo) which is a month-to-month contract. As stated in the Business Reply from Delta Dental - they are aware that I have had dental coverage, by Delta Dental, for over a 12 yr. time frame so I am also aware that the "waiting period" is a non-issue for myself.

I'm glad that this has been responded to as fast as it has - within less than 1 wk., especially since we've just ended a 4-day Labor Day weekend.

I did suggest to Delta Dental that I firmly believed in the future it would be a gesture of goodwill, especially in the smaller rural areas such as mine, for Delta Dental to take the time to include in any mailings to potential customers who are requesting Plan information (ie first timers who have fewer dentists in their immediate city/town/area) to also receive a listing of those dentists that ARE covered and possibly, like in my situation, including a "Note" to customers to call Delta Dental further information about any dentists who are out-of-network and are still allowed reimbursement for services. Since I've been treated by my same dentist for about 20 yrs. I'd rather stay with my current dentist who I know, has all of my records, x-rays vs who I don't know let alone if stand behind their work as mine does.

Thanking you,

Review: I purchased dental insurance from Delta back in April of 2015, but now being told it will not cover a crown for a split tooth until one year after purchase. I cannot eat on one-side of my mouth due to split tooth.Desired Settlement: I want a refund of my monthly payments since Delta engaged in deceitful marketing of providing dental insurance.

Business

Response:

The Shared Enhanced Plan policy waspurchased by Mr. [redacted] via the website on 03/09/2015 with an effective dateof 04/01/2015. The policy is for one year with the first opportunity to cancelon 03/31/2016. One claim for Mr. [redacted] has been processed and paid.This plan has a one year waitingperiod for crowns which is defined in the Summary of Benefits portion of thepolicy. Before completing the purchase of his policy, Mr. [redacted] was presentedwith the policy contract and then required to check the box that stated he readand understood the policy. The policy includesa 10-day free look period with a notice stating “If you’re notsatisfied with this policy you can return it anytime within 10 days of the dayyou received it. We’ll void the policy and refund your premiums.” Delta Dental of Wisconsin has canceled Mr. [redacted]’s policy effective 08/31/2015with no refund in premium payment. Tell us why here...

Consumer

Response:

I set up dental insurance independently through Delta Dental. I had their coverage previously through my employer, and apparently it is a completely different company when individuals are involved -- and it is truly awful. Payments were promptly taken, but I never received any information via email or mail. Nothing except an email that said "thanks for signing up."When I needed my membership ID I had to call, wait a half hour on hold and ask for it. I'm told that to not automatically renew, I have to send a letter in writing. If these have become common business practices, something is wrong.

Review: They will not cancel my coverage.Desired Settlement: to Cancel my Dental coverage.07774679932

Business

Response:

Mr. [redacted]'s policy has been cancelled 3/31/2016.

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below.

Be very careful on this company's website! It seems straight forward to simply search for their covered providers, however, it is actually quite deceiving. We searched our address and it came up with our local dentist as a covered provider. After going in for our appointments, we were caught off guard when we were presented with $50 copays. Upon a further look into the website, Delta Dental has a small line indicating if the provider is PPO. This is remarkably deceiving as one would think that if it is a covered provider, you would be safe to go to that provider. Needless to say, we will be terminating service with this company in the upcoming week.

Review: I have been in contact with this company for 2 1/2 months now trying to cancel our coverage and it has not happened, even with me doing all the things they require. They have withdrawn months worth of coverage that was not needed or wanted and I have not been given a refund.Desired Settlement: I want a refund of $256.80

Business

Response:

Delta Dental of Wisconsin is a claims administrator for the individual policieswritten by Delta Dental of Colorado. Delta Dental has record of several callsfrom [redacted] requesting cancellation of her policy. Ms. [redacted]’s policyhas been terminated July 31, 2015.Tell us why here...

Review: my mother went on line after talking to a deltal dental rep , he told her the policy she took out was effective immediatly aug 1, but failed to state that only certain dentist were in the network , so when I went to my family dentist , aug 20 I was told the policy did not cover my family dentist , so we have tried to cancel the policy and recieve a refund of 180.00 for 6 mo. with several phone calls , a letter written , and e mails . the only thing we are told is its a contract and nonthing can be done , this is a service on line not explained by phone rep or web site at all about stipulations . a service which took 180.00 and is no service to me . but , also will not help in anyway to resolve the problem. your help in the situation is appreciated. respecfully yours [redacted]Desired Settlement: hopefully I want a cancellation and refund of 180.00 for less than 30 days service , which is no service to me as a customer

Business

Response:

The policy was purchased on DeltaDentalCoversMe.com. The policy contract is presented for review and the purchaser must check a box stating they have read and understand the terms and condition and want to continue with the purchase. The policy has a ten-day free look. Delta Dental was not contacted during the ten-day period. Mr. [redacted]’s policy has been terminated as of July 31, 2016, which is the end of his contract period.