Gallagher Student Health and Special Risk

Revdex.com: I have resolved the issue after further escalation utilizing management at the University at [redacted] 's SBI officeI do not require further actionI find the response from Gallagher Student Health non encompassing and fails to mention my many pleas for assistance and failure to accommodateThe business practice is predatory and I personally feel that the extent of action required to satisfy a simple waiver and document insurance is purposefully made to be prohibitive to increase their revenuesThese revenues come at a cost of forcing healthcare upon some students who have healthcare.I would like to further reiterate that I understood that pro-rating of my insurance would be necessaryI tried to communicate this to Gallagher many times and received no sufficient answer on the processOnly after consulting with the University at [redacted] 's polite administrative staff was I able to come to a resolutionFurthermore, I find Gallagher Student Health to not be fully realizing the true administrative costs of their business including supervisory management and adequate training for their employees on comprehensive topicsI very humbly request this be considered in future investigations into this maliciously predatory company Regards, [redacted]

Greetings,I do not see a waiver submitted for a student [redacted] in our system I will respond to this, however,in general terms based on the information provided If you wish please provide the student's name as it was listed on the waive so I can pull up the form.To address the complaint at hand first we must explain the [redacted] Waiver Criteria Please follow this link to the [redacted] "Health Insurance Waiver Checklist" This document outlines the insurance requirement for the school: [redacted] This document clearly states that students must have covered access to: Other Health Care Providers in Routine/Non-Emergency Situations.As stated in the complaint the plan submitted on the waiver request offers coverage for emergent/urgent care only while outside of the plan's coverage area Thus the plan is not acceptable and the student must enroll in the Student Health Insurance Plan.As I stated above if you can provide information that will allow me to find the waiver in question I can research furtherBest, [redacted] VP, Client/Customer Service & EnrollmentGallagher Student Health & Special Risk

Gallagher Student Health does not control the student accounts and placement of the insurance fee The coverage was terminated via file from the school and the school manages billing students for the insurance

.Not only did this student not complete the online waiver form as required by her school she completed an enrollment form! The deadline to waive the insurance passed months ago which is why we will not accept a waiver This student will remain enrolled in the insurance policy Per Massachusetts law students must complete an online waiver form if they have their own insurance and want to waive the school's plan

Gallagher Student health does not bill students.? The school does.? All Gallagher does is collect waiver data and pass it to the school and the school removes the charge from the student account.? Since I do not see the student's name provided I cannot look at the waiver in question.? However,? if the waiver was approved as stated in this misdirected complaint it is the school's job to remove the insurance fee from the student account

Revdex.com: I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # [redacted] Please add your rejection comments below.? I talked to school about canceling the policy, but I was told that school doesn't have any control and that I have to talk to Gallagher directlyGallagher is correct that I didn't waive the coverage in the start of 2015-school year, and that's exactly the point I am raising hereEven if I wanted to waive, I couldn't because the open enrollment for [redacted] doesn't start until NovemberSo students have no choice but to enroll in the student health insurance provided through GallagherWhen the open enrollment period begins, most students will choose not to enroll, despite the fact that more affordable coverage is available through [redacted] ***, because Gallagher doesn't allow students to opt out and make them pay for the entire school year ending in AugustIf students enroll in a different health insurance through [redacted] ***, students will have to carry two health insurances until AugustIn order to avoid having two health insurances, students will not enroll during the open enrollment period even though more affordable coverage is availableWhen a new school year begins in August, students face the same problem: school requires a health insurance, but the only option is through Gallagher because the open enrollment is not until NovemberI believe this is a malpractice depriving students of the opportunity to enroll in more affordable, government-sponsored health insuranceGallagher might argue that it is not preventing students from enrolling in [redacted] ***Technically, that's a true statementBut if they do, they will be paying for two health insurances from January through August because of Gallagher's unwillingness to let students opt out at the end of calendar yearMost students are hard pressed financially, and the burden of having to pay for two insurances will discourage them from taking advantage of more affordable health insurance through [redacted] ***If Gallagher is truly interested in helping students rather than making money off them, it should not compel students to buy the insurance for the entire school year, but rather on semester-to-semester basisThat way, students can opt out at the end of a calendar year and get a different insurance for the following year if they want toFor the above reasons, Gallagher's practice interferes with government's health insurance programFurthermore, public policy demands that consumers be given an unobstructed choice, especially when buying a product concerning their well-being Regards, [redacted] ? ?

Gallagher Student Health acts as an agent of University at [redacted] to collect and review student health insurance waivers to determine if the student coverage is active and meets the criteria set forth by the school The criteria is as follows: Coverage is considered comparable if it provides students with access to a range of services in and around the area where they attend schoolServices include, but are not limited to, preventive and primary care, emergency care, surgical care, inpatient and outpatient hospitalization, lab work, diagnostic x-rays, physical therapy and chiropractic care, prescription drugs, mental health and substance abuse treatmentStudents should be able to seek these services from providers who are considered In-Network or PreferredIf your current plan is an HMO, it is very likely that coverage is limited, or not available, outside of the HMO’s service areaPlans that only provide emergency services in the campus area, that are purchased on a short term basis, that are international or travel insurance plans, or that are out-of-area/out-of-state Medicaid plans are not considered comparableCoverage must be in place from August 22, through August 21, to assure access to care for the duration of the academic year.On October 1, Mr [redacted] submitted his online waiver [redacted] and Gallagher Student Health send multiple notifications notifying students to submit an online waiver or they will be enrolled in the Student Health Insurance plan If you do not waive by a certain date indicated by the school they enroll students into the Student Health Insurance Plan This is what happened with Mr [redacted] On 8/24/and 9/1/when Mr [redacted] called he had not yet waived he did not waive until 10/1/ Since he waived with the same insurance as the school's insurance we asked him for documentation stating he was not waiving the school's insurance with the school's insurance We did not receive anything On October 4, we requested documentation from the student We did not receive anything As a result of this complaint we checked with [redacted] and learned the insurance coverage was not active until October 1, 2017....most likely the reason why a waiver was not filed until that date Since insurance coverage must be in place from August 22, to be considered comparable the waiver was denied.If the student's insurance coverage was active prior to that date Mr [redacted] can return to the waiver and upload supporting documentation that supports the coverage dates Additionally, now that coverage is in place Mr [redacted] can submit a written request to cancel the student health insurance Visit gallagherstudent.com and navigate to the University at [redacted] page Click on the "Customer Service" link and complete the online for and ask for a "NY request to Term Coverage" formBased on my review of this issue Gallagher Student Health as managed Mr [redacted] 's waiver properly against the school's waiver requirements

Gallagher Student Health acts as an agent of University at [redacted] to collect and review student health insurance waivers to determine if the student coverage is active and meets the criteria set forth by the school.? The criteria is as follows:? Coverage is considered comparable if it provides students with access to a range of services in and around the area where they attend schoolServices include, but are not limited to, preventive and primary care, emergency care, surgical care, inpatient and outpatient hospitalization, lab work, diagnostic x-rays, physical therapy and chiropractic care, prescription drugs, mental health and substance abuse treatmentStudents should be able to seek these services from providers who are considered In-Network or PreferredIf your current plan is an HMO, it is very likely that coverage is limited, or not available, outside of the HMO’s service areaPlans that only provide emergency services in the campus area, that are purchased on a short term basis, that are international or travel insurance plans, or that are out-of-area/out-of-state Medicaid plans are not considered comparableCoverage must be in place from August 22, through August 21, to assure access to care for the duration of the academic year.On October 1, Mr [redacted] submitted his online waiver.? [redacted] and Gallagher Student Health send multiple notifications notifying students to submit an online waiver or they will be enrolled in the Student Health Insurance plan.? If you do not waive by a certain date indicated by the school they enroll students into the Student Health Insurance Plan.? This is what happened with Mr [redacted] .? On 8/24/and 9/1/when Mr [redacted] called he had not yet waived.? he did not waive until 10/1/2017.? Since he waived with the same insurance as the school's insurance we asked him for documentation stating he was not waiving the school's insurance with the school's insurance.? We did not receive anything.? On October 4, we requested documentation from the student.? We did not receive anything.? As a result of this complaint we checked with [redacted] and learned the insurance coverage was not active until October 1, 2017....most likely the reason why a waiver was not filed until that date.? Since insurance coverage must be in place from August 22, to be considered comparable the waiver was denied.If the student's insurance coverage was active prior to that date Mr [redacted] can return to the waiver and upload supporting documentation that supports the coverage dates.? Additionally, now that coverage is in place Mr [redacted] can submit a written request to cancel the student health insurance.? Visit gallagherstudent.com and navigate to the University at [redacted] page.? Click on the "Customer Service" link and complete the online for and ask for a "NY request to Term Coverage" form.? Based on my review of this issue Gallagher Student Health as managed Mr [redacted] 's waiver properly against the school's waiver requirements.? ? ?

Revdex.com: I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # [redacted] Please add your rejection comments below.? [Please take the time to read the information that I sent you.] Regards, [redacted] ? ?

Student submitted waiver and additional information was requested in order to verify active coverage in the plan declared on the formAdditionally, the student provided incorrect information on the waiver form related to the type of insurance she had There are specific instructions on how to provide supporting documentation by uploading it to the denied waiver These instructions are provided on the same email that informed the student that the waiver was denied The student did not follow these instructions and instead sent a fax to our general business unit that is not equip to manage these documents....hence the specific instructions provided Also, it is a statistical impossibility that someone has tried to contact us and not had successWe respond to all emails in hours and we have an abandoned phone call percentage close to 2% Students that call us and do not want to wait can simply enter their number and we call them back, usually within minutes Nonetheless it appears the school has made an administrative exception for this student and the coverage has been cancelled

Revdex.com:
I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ***Please add your rejection comments belowThere is no changed to my student accountI checked on December 6,and I also asked a college representative to check for me
Regards,
*** ***

.Not only did this student not complete the online waiver form as required by her school she completed an enrollment form! The deadline to waive the insurance passed months ago which is why we will not accept a waiver. This student will remain enrolled in the insurance policy. Per
Massachusetts law students must complete an online waiver form if they have their own insurance and want to waive the school's plan

Revdex.com:
I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ***Please add your rejection comments below.
I talked to school about canceling the policy, but I was told that school doesn't have any control and that I have to talk to Gallagher directlyGallagher is correct that I didn't waive the coverage in the start of 2015-school year, and that's exactly the point I am raising hereEven if I wanted to waive, I couldn't because the open enrollment for *** *** doesn't start until NovemberSo students have no choice but to enroll in the student health insurance provided through GallagherWhen the open enrollment period begins, most students will choose not to enroll, despite the fact that more affordable coverage is available through *** ***, because Gallagher doesn't allow students to opt out and make them pay for the entire school year ending in AugustIf students enroll in a different health insurance through *** ***, students will have to carry two health insurances until AugustIn order to avoid having two health insurances, students will not enroll during the open enrollment period even though more affordable coverage is availableWhen a new school year begins in August, students face the same problem: school requires a health insurance, but the only option is through Gallagher because the open enrollment is not until NovemberI believe this is a malpractice depriving students of the opportunity to enroll in more affordable, government-sponsored health insuranceGallagher might argue that it is not preventing students from enrolling in *** ***Technically, that's a true statementBut if they do, they will be paying for two health insurances from January through August because of Gallagher's unwillingness to let students opt out at the end of calendar yearMost students are hard pressed financially, and the burden of having to pay for two insurances will discourage them from taking advantage of more affordable health insurance through *** ***If Gallagher is truly interested in helping students rather than making money off them, it should not compel students to buy the insurance for the entire school year, but rather on semester-to-semester basisThat way, students can opt out at the end of a calendar year and get a different insurance for the following year if they want toFor the above reasons, Gallagher's practice interferes with government's health insurance programFurthermore, public policy demands that consumers be given an unobstructed choice, especially when buying a product concerning their well-being
Regards,
*** ***

It is the policy of the school and also a requirement of the insurance carrier that students who do not show proof of active insurance coverage are enrolled in the Student Plan for the policy year This information was in the materials that were sent to students regarding the
school's insurance requirement This requirement is the standard process (and best practice) for hundreds of Colleges and Universities nation-wide Unlike a group plan where an individual pays monthly these plans are paid for in advance for the year and once coverage is in place it cannot be cancelled Therefore a refund is not due to this studentThis was explained to the student ion December of yet in the summer/fall of he still failed to waive...coverage was placedand now wants to get out of the plan

Greetings,I do not see a waiver submitted for a student *** *** in our system I will respond to this, however,in general terms based on the information provided If you wish please provide the student's name as it was listed on the waive so I can pull up the form.To address the
complaint at hand first we must explain the *** Waiver Criteria Please follow this link to the *** "Health Insurance Waiver Checklist" This document outlines the insurance requirement for the school: ***This document clearly states that students must have covered access to: Other Health Care Providers in Routine/Non-Emergency Situations.As stated in the complaint the plan submitted on the waiver request offers coverage for emergent/urgent care only while outside of the plan's coverage area Thus the plan is not acceptable and the student must enroll in the Student Health Insurance Plan.As I stated above if you can provide information that will allow me to find the waiver in question I can research further. Best,*** ***VP, Client/Customer Service & EnrollmentGallagher Student Health & Special Risk

Revdex.com:
I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ***Please add your rejection comments below.
[Please take the time to read the information that I sent you.]
Regards,
*** ***

It is the policy of the school and also a requirement of the insurance carrier that students who do not show proof of active insurance coverage are enrolled in the Student Plan for the policy year This information was in the materials that were sent to students regarding the
school's insurance requirement This requirement is the standard process (and best practice) for hundreds of Colleges and Universities nation-wide Unlike a group plan where an individual pays monthly these plans are paid for in advance for the year and once coverage is in place it cannot be cancelled Therefore a refund is not due to this studentThis was explained to the student ion December of yet in the summer/fall of he still failed to waive...coverage was placedand now wants to get out of the plan

Greetings,As I stated in my last response ***'s plan clearly does not meet the specifications outlined by the school Looking at the historical data the plan should have been denied last year as well Regardless, we cannot knowingly approve a plan that does not offer the adequate coverage just because someone approved in error in the past This denial will stand and is appropriate based on the schools requirements which I provided in my previous response If your plan does meet the requirements please return to the waiver and upload written verification from *** that this coverage if offered Best,***

Revdex.com:
I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ***Please add your rejection comments below.
I didn't know that I could enroll in the middle of yearI still think it's not fair to let students opt out when they happened to get another insurance (e.g., through their spouse, employment, or open enrollment)For example, students or their spouses could get a job that provides insurance benefits in the middle of school yearIn that case, students and their family members are nevertheless stuck with student health insurance and obligated to pay for something they don't needStudent health insurance costs about $for the student and additional $for each dependentIt's not cheapI don't think it's fair to make students and their families bear that much burden even when more affordable options are available. Another problems is that Gallagher doesn't disclose on its enrollment page any of this information (about students not being able to cancel until the end of school year, students being able to enroll in other health insurance through a special circumstance enrollment when their student plan ends, etc.)I was told about it only after I tried to cancel the policy and complainedI suggest that Gallagher disclose the information CONSPICUOUSLY on its enrollment page to let students know that they cannot opt out and are required to pay for the entire school year even if they get another insuranceMost students think that student health insurance is an option that is made available to them by school when they are not able to satisfy school's insurance requirement and that they can cancel it when they acquire insurance through their own
Regards,
*** ***

Students who are enrolled in the student health insurance plan have the opportunity to enroll for insurance through their state exchanges when there student plans ends It is clearly stated in the ACA website under as "Enrollment with Special Circumstances" in the insurance world we call those qualifying events Unfortunately for Mr*** actively securing a second insurance policy while the student policy was still in effect is not in line with the cancellation provisions of the student plan Mr*** was told this prior to him securing the other plan....and he still went out and bought the other plan.The structural design of student plans and waiver provisions have been thoroughly vetted through state DOIs nationwide and is accepted as fair and appropriate In fact, the provisions are designed with the best interest of the student in mind This is how student plans are structured nationwide by any insurance company that deals with student health insurance The student now has double coverage because he actively went out and purchased another insurance policy after being informed that the student plan cannot be cancelled The policy is very clear and implying that Gallagher Student Health is conducting fraudulent activity in any sense is not only incorrect but in this case is is blatantly disingenuous