Health Alliance Medical Plans

Initial Business Response / [redacted] (1000, 7, 2015/05/18) */ The initial address provided to Health Alliance by the FFM did not contain an apartment number Mr [redacted] is responsible for ensuring the FFM has the correct address on file On 4/7, Health Alliance did receive from the FFM an updated address, after his termination due to non-payment Mr [redacted] did not set up auto draw on his account Invoices were sent each month for the next month's premiumThere is also a statement on each invoice that states you will be terminated for non-payment if not paid within the grace period Mr [redacted] grace period was thirty (30) days and he was given this timeframe to pay

The complainant is on an Illinois Marketplace individual planEnrollment and Disenrollment is completed by the FFMHealth Alliance did not receive any termination information on this member from the FFM to change her termination dateShe mentions cancelling her insurance online, there is not an option to do so with health Alliance as it would go through the FFMIt is likely she did so with the FFMShe stated in her call, in September, to the Health Alliance Representative that she did so on 8/31/The FFM usually does so in days and does not retro The member first contacted Health Alliance on September 27, 2016, and advised that she had other insurance and wanted to cancel her policy and back date itShe was advised at this time that she would need proof of other insurance otherwise her termination date would remain 9/15/ She told the Representative at that time that she did not have proof of other insuranceNo additional contact or information has come in since that time via the member or the FFMHer termination date continues to be September 15, She owed premium through that date but as of November 1, she has paid in fullTell us why here

Initial Business Response / [redacted] (1000, 5, 2015/08/17) */ We listened to the 5/08/recorded call/ conversation between Ms [redacted] and the Health Alliance Customer Service RepresentativeThere was no mention of requesting to terminating policy We also listened to the 8/10/recorded call/ conversation between Ms [redacted] and the Health Alliance Customer Service RepresentativeOn this call, Ms [redacted] did inquire about terminating her policyThe Health Alliance Customer Service Representative (CSR) appropriately directed Ms [redacted] to the Marketplace; the CSR provided her with the contact information As of today, 8/17/15, Health Alliance has not received a Marketplace termination request

Initial Business Response / [redacted] (1000, 5, 2016/03/30) */ After reviewing the complainant's account and the phone calls she made, Health Alliance concurs with her that a refund of $is owed for the month she determined she didn't need or want the planThe fact that she hadn't received her refund yet was brought to our attention with her phone call 03/28/to our customer service department.The refund check should go in the mail by Friday this week and she should allow mail timeWe apologize for any delays or confusion

[redacted] was enrolled in a Health Alliance plan in In October Mr [redacted] went out to the FFM and made an active selection for plan year His selection was a plan type change On 10/24/Health Alliance received a BAR file that included this change When a member makes a plan type change Health Alliance follows the same process they would for a new member This process would include sending the member a binder letter This member was sent a binder letter on 11/09/17, which states if he didn’t make his first payment in time his plan would be cancelledAs this member was an existing member when we didn’t receive his payment for January, he went into the day grace periodAfter the grace period expired and no payment was received he was terminated for non-payment, thus creating a balance owed for January Since the member made the plan type change in October, he should have been termed never effective for 1/1/ (when Health Alliance didn’t receive the binder payment).Health Alliance has corrected this Mr [redacted] has been termed never effective (01/01/18) because Health Alliance didn’t receive his binder paymentOnce billing runs again, around April 16th, the member will receive a new bill showing a $balance