Executive Health Group Inc

In response to the letter from Executive Health Group, I will stipulate to the numerous calls in the "early stages" of the plan due to my wife obtaining health care for our daughter alsoSince my daughter has "Pre-existing issues" we were told once again by MR*** that her pre-existing issues were covered, so as a result of what HE stated, we purchased the plan her as wellTo also come to learn, all of her claims were denied due to "PRE-EXISTING"Since MR *** has sold my wife and daughter both a plan that COVERED PRE-EXISITING, we told a friend and had her contact MR *** as wellWell this caused us great embarassment because MR *** told her that her pre-existing issues were covered but she as well recived denial claims with an excuse of nonpayment due to her pre-existing issuesThis is a close dear friend of ours and to have three people told all the same thing and non of it to be true is an outrage to say the least and extremely misleading to make a saleBy the way her name is CHERYL *** from Bellwood Pa, she too will be filing a complaint with your firmNow onto the statement Executive makes that we did not contact them, I traced my fax machine and cell phone records, since the beginning of when these issues started I can list and provide the following as proof and are listed as:ALL OF THE CALLS WENT TO PHONE NUMBER ###-###-#### AND CAN BE PROVIDED UPON REQUEST!!1-6- 3:18PM MIN MESSAGE1-6- 1:PM MIN CONVERSATION1-6- 8:AM MIN CONVERSATION1-29-6:PM MIN MESSAGE1-30- 9:AM MIN CONVERSATION***3-4-11:AM I left message from my cell phone that if we could not get assistance in resolving all of the denials I was going to file a complaint***3-4- wife left message 10:am3-9-10:am min conversation all denials were faxed to MR *** THIS DATE3-10-12:pm min message left and after this date no calls were ever returnedWe cancalled the insurance and obtained a major medical plan in April 2015.Now I find it hard to digest that Executive Health Group has no records of our calls but yet we do and can fax or bring to any hearingI attempted to get MR *** to assist or respond dated July 2nd I faxed a letter to him at fax number ###-###-#### and have fax receipt to prove I gave him days to respond, he never responded to me or my wife.I then see where he mis-represents himself as a customer and places a review on his own web site for Executive Health Group which I found to be misleading as wellI printed a copy of this if needed upon requestHis review leads anyone to believe that he is a customer by what he wrote when he is the one who sells the insurance???I do not feel that our request is an outrageous oneWe want our money back or the denied claims paid which ever is cheaperIt is bad enough we are stuck paying these after being told they were covered no to mention the embarrassment they placed upon us when we send them our close friend as customer and hers is also denied for the same reason, different customers, all same denials!In closing, I do not tend to let this issue be ignoredI am attempting to resolve this matter and have prove we tried before coming to this pointI have many other steps I plan to take, I was hoping to get it resolved before I take the next step.MRS*** from Bellwood Pa will be in contact with your firm in the upcoming week.Thank you and we await your response.Sincerely,*** * *** * *** * ***

We have resolved this issue with the client.

Review: My wife and I made contact to Executive Health Group and spoke to [redacted] to obtain a health care plan that took care of "PRE_EXISITING TYPE 2 DIABETIC". My wife was in need of a health plan coverage and prescription plan. MR [redacted] sold my wife a health plan and advised several times that she would be covered for tretments with her current condition. October 2014 my wife took the plan at $330.00 per month. 2 months later we received in the mail several denial forms from Central United Life that they were denying the claim based upon "Pre-existing". We have tried to contact MR [redacted] to help resolve the matter to no avail. We are requesting our money back since we feel we were mis-represented. He further advised that this was a major medical plan to only find out is was nothing more than a supplement insurance plan. His web site under the Executive Health Group shows him even placing a review posing as a customer that the company saved him a ton of money on his health care plan and are easy to deal with. HE is the very person selling the insurance planDesired Settlement: We are seeking a refund in order that we can use that money to pay for the denied claims, otherwise Executive Health Group can pay thre claims which ever is cheaper, the refund or the denied claims

Business

Response:

To whom it may concern: ¦I am responding to a complaint filed in the name of [redacted] of Altoona, PA.First off, there are several inaccuracies and half-truths about what he has stated, which I will address specifically.1) Mr. [redacted] is not our client, his wife [redacted] is our client.2) Mr. [redacted] has not, to our knowledge, made contact with any employee in our office, nor has he contacted us in order to either raise or resolve any issues.3) [redacted], [redacted]'s wife first became our client when she purchased a policy on 4-1-14 for her and her daughter [redacted]. After only one month, she allowed her policy to lapse through non-payment of premium. Mr. [redacted] claimed that "October 2014, my wife took the pian at $330/month. Two months later we received in the mail several denial forms..." The FACT is that [redacted] did not have any coverage in force with Central United Life between 5-16-14 until 1-1-2015, thus making their claim completely false.4) On 12-8-14, she contacted out office in order to purchase the very same policy for her and her daughter [redacted]. That policy took effect on 1-1-15.5) The policy that [redacted] purchased was a private, limited benefit policy through Central United Life company from Houston, TX, It was disclosed to [redacted] that the policy would provide coverage for her immediately for her medical needs, but that there would be a standard 12-month waiting period to cover anything that is pre-existing. This was also clearly written into the policy that she received in the mail on or about 12-20-14.6) [redacted] contacted our office with several questions over the course of a few months, beginning February of 2015, and her questions were answered in a prompt and professional manner,7) [redacted] knows the office number and the business cell phone of her agent, Mr. [redacted]. Upon checking phone records, no calls were made on behalf of the [redacted]s to either of those numbers raising any concerns about the coverage past March 13, 2015. It is a total falsehood to imply that there was anything less than an available channel open for communication or a reluctance on the part of EHG to assist [redacted] in resolving any coverage questions.S) At the time of purchase of the plan, [redacted] requested if a major medical plan was a betterpurchase option and subsequently was given a quote for a major medical plan through the ACA. [redacted] was quoted a Bronze Level 1 plan with a premium of over $600/month and a deductible of $6000 annually each for [redacted] and [redacted]. [redacted] explained that that premium would not be affordable for her.9) [redacted] opted to buy a "private" health plan which does not, by law, have to adhere to the same benefits structure as an ACA plan, thus the pre-existing clause. At no time was [redacted] ever told that she was purchasing a major medical plan. To imply that she was told that it was a major10) Medical plan is an outright falsehood. Ironically, if she had purchased a major medical plan, at! of the claims that haven't been paid thus far, would have still been the out-of-pocket responsibility of the [redacted]s until their annual deductible was met.11| As a point of order, the agent/broker has very limited involvement in settling a medical claim as those are the domain of the insurance company and involve an agreement directly between the insurer and the policy holder.In summation, there was absolutely no misrepresentation made on behalf of EHG to [redacted] and that, for whatever reason, Mr. [redacted], for his own disingenuous reasons, is attempting to smear the name of a reputable company who made a good-faith effort to provide his wife and daughter with a measure of affordable insurance protection.At the very least, Mr. [redacted]’s efforts to represent EHG in an extreme negative bad light, are actionable and rife with misrepresentations and downright falsehoods on his part. We would request that he cease and desist with his smear campaign and pursue a more rational avenue to get his wife's medical expenses revisited for coverage with the true target of his dissatisfaction, the claims department of Central United Life.EHG, Inc

Consumer

Response:

In response to the letter from Executive Health Group, I will stipulate to the numerous calls in the "early stages" of the plan due to my wife obtaining health care for our daughter also. Since my daughter has "Pre-existing issues" we were told once again by MR. [redacted] that her pre-existing issues were covered, so as a result of what HE stated, we purchased the plan her as well. To also come to learn, all of her claims were denied due to "PRE-EXISTING". Since MR [redacted] has sold my wife and daughter both a plan that COVERED PRE-EXISITING, we told a friend and had her contact MR [redacted] as well. Well this caused us great embarassment because MR [redacted] told her that her pre-existing issues were covered but she as well recived denial claims with an excuse of nonpayment due to her pre-existing issues. This is a close dear friend of ours and to have three people told all the same thing and non of it to be true is an outrage to say the least and extremely misleading to make a sale. By the way her name is CHERYL [redacted] from Bellwood Pa, she too will be filing a complaint with your firm. Now onto the statement Executive makes that we did not contact them, I traced my fax machine and cell phone records, since the beginning of when these issues started I can list and provide the following as proof and are listed as:ALL OF THE CALLS WENT TO PHONE NUMBER ###-###-#### AND CAN BE PROVIDED UPON REQUEST!!1-6-2015 3:18PM 3 MIN MESSAGE1-6-2015 1:48 PM 8 MIN CONVERSATION1-6-2015 8:30 AM 14 MIN CONVERSATION1-29-2015 6:12 PM 2 MIN MESSAGE1-30-2015 9:45 AM 11 MIN CONVERSATION[redacted]3-4-2015 11:29 AM I left message from my cell phone that if we could not get assistance in resolving all of the denials I was going to file a complaint[redacted]3-4-2015 wife left message 10:47 am3-9-2015 10:48 am 6 min conversation all denials were faxed to MR [redacted] THIS DATE3-10-2015 12:20 pm 1 min message left and after this date no calls were ever returnedWe cancalled the insurance and obtained a major medical plan in April 2015.Now I find it hard to digest that Executive Health Group has no records of our calls but yet we do and can fax or bring to any hearingI attempted to get MR [redacted] to assist or respond dated July 2nd 2015 I faxed a letter to him at fax number ###-###-#### and have fax receipt to prove I gave him 5 days to respond, he never responded to me or my wife.I then see where he mis-represents himself as a customer and places a review on his own web site for Executive Health Group which I found to be misleading as well. I printed a copy of this if needed upon request. His review leads anyone to believe that he is a customer by what he wrote when he is the one who sells the insurance???I do not feel that our request is an outrageous one. We want our money back or the denied claims paid which ever is cheaper. It is bad enough we are stuck paying these after being told they were covered no to mention the embarrassment they placed upon us when we send them our close friend as customer and hers is also denied for the same reason, 3 different customers, all same denials!In closing, I do not tend to let this issue be ignored. I am attempting to resolve this matter and have prove we tried before coming to this point. I have many other steps I plan to take, I was hoping to get it resolved before I take the next step.MRS. [redacted] from Bellwood Pa will be in contact with your firm in the upcoming week.Thank you and we await your response.Sincerely,[redacted]

Review: [redacted] contacted me by phone regarding insurance through Assurant Health. After reviewing the insurance compared to my business group plan through Aetna, I discovered by business group plan had better coverage. I contacted [redacted] prior to 2014 indicating that there was a difference in coverage and she told me that she would get back to me. I NEVER heard back from her. I called back a couple of times and left a message for her to contact me, I still never heard back from her. So, on January 3, 2014, I sent her an email requesting that the Assurant coverage be cancelled immediately. No emails or calls were returned. My wife contacted them last week and was told that [redacted] would contact us back. STILL no phone call. My wife called back today and spoke with a man who FINALLY gave us a phone number to cancel the policy. Here it is January 20, 2014, almost a whole month of failed communication.Desired Settlement: A complete and full refund of the ENTIRE purchase amount. The insurance was NEVER used, my repeated efforts to cancel the coverage were ignored.

Business

Response:

We have resolved this issue with the client.