Health Republic Insurance of New York

***
Dear *** ***:
Freelancers Health Service Corporation, d/b/a Health Republic Insurance of New York (the “Respondent”) hereby responds to the
complaint filed by *** ***, (the “Complainant”) received by the *** *** *** (“Revdex.com”), which Revdex.com relayed to the Respondent on April **,
COMPLAINT FACTS
According to the complaint, the Complainant became eligible for coverage through his employer, and elected to terminate his coverage with Health Republic;
On February **, 2014, the Complainant contacted a Customer Service Representative (“CSR”) of Health Republic, and was instructed to send a fax registering his intention to cancel his policyThe Complainant acted in accordance with the instructions of the CSR and faxed in a notice to cancel his policy;
On March **, 2014, having heard nothing further from Health Republic, the Complainant again contacted member services and was informed by a CSR that his cancellation could not be located and that an investigation would be conducted to resolve the issue;
On March **, 2014, after Health Republic failed to follow up with the Complainant, the Complainant again reached out and was informed by another CSR that as he enrolled through the Exchange, termination of his policy must also be effected with the ExchangeThe Complainant acted on the advice of the CSR and cancelled with the Exchange;
On March **, 2014, the Complainant discovered that Health Republic debited his bank account for March, and presumably April, 2014;and
As a result of the matters raised in paragraphs through hereof, the Complainant filed this complaint with the *** *** *** (“Revdex.com”)
RESPONSE
The following is a timeline with references to supporting documentation describing the matter and the steps Respondent took to ensure satisfactory resolution and communication thereof
On April **, Respondent received the Complaint from *** *** (***, *** *** ***)
On April **, 2014, Respondent began its internal review and escalated this Complaint with Respondent’s Enrollment Specialist team, which confirmed that member enrolled in the Essential Care Bronze plan, effective January **, 2014, through to termination on March **, 2014;
On April **, 2014, Health Republic’s Billing and Enrollment Team confirmed that the Complainant’s account had been paid in full through to April **, 2014, due to Health Republic’s ACH schedule of debiting a member’s account for the upcoming months premium on the **day of the penultimate monthConsequently, when the member’s termination arrived from the Exchange on March **, 2014, the ACH deduction for April was already triggered in Health Republic’s system;
On April **, 2014, having determined that the member’s plan ought to have been terminated on February **, 2014, Health Republic processed the member’s refund for the premium payment mentioned in paragraph hereof;
Further, on April **, 2014, member services reached out to the Exchange to request a term date corresponding with the Complainant’s original and unchanged intention to terminate his policy effective February **, 2014;
On April **, 2014, Complainant’s refund for the month of March, 2014, was processed; and
On May **, 2014, Heath Republic confirmed that the refunds for the months of March and April, 2014, were accessible by the Complainant

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID# ***, and have determined that my complaint has NOT been resolved because:
[Your Answer Here]
I would like to keep this complaint open for the months of July and AugustI have been told for months this has been resolvedYet, here I amI have been told the issue has been solved but until months pass without an issue, I am not willing to believe themPlease keep this complaint open until I receive both the July and August bills to confirm the issue is resolvedThank you
In order for the Revdex.com to appropriately process your response, you MUST answer the question above
Sincerely,
*** ***

May **, The Revdex.com VIA WEB: http://newyork.Revdex.com.org/respond ** *** *** *** * *** *** *** *** * * *** Re: Member Complaint Revdex.com Complaint ID: *** Dear Sir/Madam: Thank you for your inquiry in connection with the above referenced complaint IDHealth Republic
Insurance of New York (“Health Republic”) hereby responds to complaint ID ***, received on May *, by the Revdex.com (“Revdex.com”)The member enrolled with Health Republic, through the *** *** *** ** *** (“***”), effective, February *, She then contacted Health Republic in January to make a one-time premium payment towards her coverageThe member was then informed that Health Republic was unable to deduct a payment from her savings accountThe member indicates that she was later charged a fee of $Based on further review, we have confirmed that members may utilize a savings account for ACH paymentsHowever, the charge the member incurred was due to an invalid account numberHealth Republic has cancelled the member’s most recently billed $void payment fee for June 2015; and has sent her an updated invoice with her current outstanding balanceThe member has since been contacted and advised of these correctionsHealth Republic apologizes to the member for the inconvenience experiencedRespectfully, *** *** *** ***, *** *** *** Health Republic Insurance of New York

Good Afternoon,
Health Republic Insurance of New York (HRINY) recently received the above mention case and reached out to the Complainant to gather more information in effort to come to a resolution to his satisfaction. The member notified me via email to confirm that
the issue in his complaint has already been addressed and resolved by HRINY. Is it possible to have the complaint withdrawn, since the issue was resolved prior to us receiving the complaint? Please see the attached email from the Complainant confirming that the issue was resolved
Thank You,
*** ***
*** ***
*** ***
Health Republic Insurance of New York
** *** *** * *** *** * *** *** ** ***
***

I'm happy with the fact that I will not have to pay any dues until the month of JulyHowever, I want the facts states correctly if my complaint should go publicThe facts are Health Repulic created two address in my favor that in no shape or form should of happenedThey had a mailing address for me and a living addressI have ONLY ONE address and have been there for yearsIn there response it was mentioned that the complaintent had provided the incorrect infomation upon signing up on the websiteThat is NOT SO!! First of I never signed up on the website. An individual had signed me upSomeone botched up my info. It had taken me from Nov - March * of to resolve that issureFor several months I had been told from numerous representive that they had the correct info and that was a lieThey never had my address correctAny documentation they mailed had been going to the WRONG address due to there errounous errorThat is unacceptableIf my complaint goes live the facts need to be stated correctly !!! Thasts all I want the truth to be knownThank you

To - The Revdex.com:
This is in response to the inquiry filed under Complaint# *** Health Republic Insurance of New York ("Health Republic") is currently in wind down of operations and working closely with our regulators At this time, claims processing remains
on hold during the wind down review Please continue to refer to our website for updates on payment of claims as it becomes available Sincerely,
*** ***
Health Republic Insurance of New York

To - The Revdex.com: This is in response to the inquiry filed under Complaint# [redacted].  Health Republic Insurance of New York ("Health Republic") is currently in wind down of operations and working closely with our regulators.  At this time, claims processing remains on...

hold during the wind down review.  Please continue to refer to our website for updates on payment of claims as it becomes available.  Sincerely,[redacted]Health Republic Insurance of New York

To:  The Revdex.com (Revdex.com)This is in response to the inquiry filed under complaint #[redacted].  Health Republic is currently in wind down of operations and working closely with our regulators.  At this time, claims processing remains in a hold status during the wind down...

review.  Please continue to refer to our website for updates on payment of claims as it becomes available.  Thank you.Sincerely,[redacted]Health Republic Insurance of New York

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID# [redacted], and have determined that my complaint has NOT been resolved because:

[Your Answer Here]
 I was told my ach info was correct by [redacted]. This is an internal issue with the company. I was also told MULTIPLE times my ach info was deleted from my account, and yet, EVERY month they still send it and then charge me. I will not agree this issue is corrected until AT THE MINIMUM two months goes by without them trying to access my account and then turning around and billing me. If they truly believe, my info is wrong (which it is not) why do they keep trying to use it?
 
 
 
In order for the Revdex.com to appropriately process your response, you MUST answer the question above.
Sincerely,
[redacted]

May **, 2015 The Revdex.com VIA WEB: http://newyork.Revdex.com.org/respond [redacted]...

[redacted] Re: Member Complaint Revdex.com Complaint ID: [redacted] Dear Sir/Madam: Thank you for your inquiry in connection with the above referenced complaint ID. Health Republic Insurance of New York (“Health Republic”) hereby responds to complaint ID [redacted], received on May *, 2015 by the Revdex.com (“Revdex.com”). The member enrolled with Health Republic, through the [redacted] (“[redacted]”), effective, February *, 2015. She then contacted Health Republic in January 2015 to make a one-time premium payment towards her coverage. The member was then informed that Health Republic was unable to deduct a payment from her savings account. The member indicates that she was later charged a fee of $2.50. Based on further review, we have confirmed that members may utilize a savings account for ACH payments. However, the charge the member incurred was due to an invalid account number. Health Republic has cancelled the member’s most recently billed $2.50 void payment fee for June 2015; and has sent her an updated invoice with her current outstanding balance. The member has since been contacted and advised of these corrections. Health Republic apologizes to the member for the inconvenience experienced. Respectfully, [redacted], [redacted] Health Republic Insurance of New York

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 and the matter has been resolved.
Sincerely, [redacted]...

[redacted]
[redacted] Dear Sir/Madam: Thank you for your inquiry in connection with the above referenced complaint ID. Health...

Republic Insurance of New York (“Health Republic”) hereby responds to complaint ID [redacted], received on June **, 2015 by the Revdex.com (“Revdex.com”). The member enrolled with Health Republic, through the New York State of Health (“Exchange”), effective, January *, 2014. The member states she was eligible to receive an Advanced account to reflect the receipt and Premium Tax Credit (“subsidy”) for plan year 2014. The member requests an update of her allocation of a subsidy during plan year 2014. Since enrollment and enrollment changes are done directly with New York State of Health, we can confirm that the Exchange has knowledge of the member’s subsidy issue and is working diligently to ensure that her account is updated to reflect the receipt of an apportioned subsidy from January *, 2014 through November **, 2014. After we receive the correct transaction file, we will reconcile the member’s account; and reprocess all of her eligible claims. Health Republic apologizes to the member for the inconvenience experienced. Respectfully, [redacted]
[redacted]

Thank you for your correspondence concerning premium payments remitted for health insurance coverage. Health Republic Insurance of New York (“Health Republic”) hereby responds to the complaint filed by the member via the Revdex.com (“Revdex.com”), which the Revdex.com relayed to Health Republic on...

January **, 2016. Health Republic can confirm that a refund of premium payments totaling $500.49 was issued to the member by check on January **, 2016, to the Riverhead address listed on file. If the member fails to receive the refund check within (15) business days, they are advised to contact [redacted] referencing the captioned Revdex.com case number. Respectfully, Member Solutions Health Republic Insurance of New York

Revdex.com:At this time, my complaint, ID [redacted] regarding Health Republic Insurance of New York has been resolved.
(By clicking "OK", your complaint will be closed as...

Resolved.)
Sincerely,[redacted]

[redacted]
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Dear [redacted]...

[redacted]:
Thank you for your inquiry in connection with the captioned complaint, Freelancers Health Service Corporation, d/b/a Health Republic Insurance of New York (“Health Republic”) hereby responds to the complaint ID [redacted], received by the Revdex.com (“Revdex.com”), which Revdex.com relayed to the Respondent on October **, 2014.
COMPLAINT SUMMARY
1. According to the Complainant, he subscribed through New York State of Health (the “Exchange”) with Health Republic for a policy of insurance. According to the complainant at no point did he enroll for Health Republic’s automatic recurring ACH program, by which premium payments are deducted from a participants account every month to satisfy any and all due and payable balances ; 
2. The complainant states that sometime in May, 2014, became aware that unbeknownst to him, he had been registered for the recurring ACH program, at which point the complainant contacted Health Republic to confirm his ACH status, and after validating same, recanting his consent and thereafter cancelling the authority of Health Republic to deduct any further payments on his account. According to the complainant, he was assured by a representative of Health Republic that he was no longer a participant in the program;
3. Despite the foregoing, Health Republic deducted a further premium payment from the complainant’s account in June, 2014, and when the complainant called to query the deduction, he was informed that he was still enrolled in recurring ACH, and further, that the only means by which a refund could be processed was to terminate the policy through the Exchange;
4. According to the complainant he contacted the Exchange and terminated his coverage, but the Exchange failed to process his termination correctly, instead filing an appeal with the Department of Health (“DOH”) which is still pending, with no substantive steps being taken to address his overall concerns;
5. According to the complainant, though the Exchange failed in its mandate, the greater part of the blame for his present predicament lies with Health Republic, for: enrolling him in recurring ACH without his authority, failing to terminate the recurring ACH after having assured him that it was so terminated, deducting payments form his account without his consent and/or knowledge; failing to honor its word issued by an authorized representative; and for failing to issue a refund when it became clear that one was owed;
6. After attempts to resolve this matter without avail, the complainant filed this complaint with the Revdex.com (“Revdex.com”).
RESPONSE
The following is a timeline with references to supporting documentation describing the matter and the steps Respondent took to ensure satisfactory resolution and communication thereof.
1. On October **, 2014 Respondent received the Complaint from the Dispute Resolution Services Department of the Revdex.com;
2. On October **, 2014, Respondent began its internal review and escalated this Complaint with Respondent’s Enrollment Specialist team (“team”);
3. The team confirmed that, on December **, 2014, the complainant registered himself for recurring ACH via Health Republic’s website. Consequently, Health Republic had the requisite authority to deduct payments from the complainant’s account using this means;
4. On June **, 2014, the complainant called Health Republic to verify that he was enrolled for recurring ACH, the complainant was informed that he has been enrolled since, December **, 2013, at which point the complainant directed the cancellation of the program. The complainant was led to believe that no further steps were required to cancel the recurring ACH, and as such, he took no further action with respect to this matter;
5. Health Republic can advise that it’s policy for terminating recurring ACH, is to have the participant send a request in writing; 
6. As the recurring ACH was not cancelled in accordance with Health Republic guidelines, the complainant’s account was deducted for a further premium payment allocated against the month of July, 2014;
7. Health Republic recognizes that the complainant expressed an interest to terminate his policy as well as to cancel recurring ACH as of July **, 2014, as such; it has coordinated with the Exchange to rectify the complainant’s enrollment record to reflect termination as of July *, 2014, thus voiding the balance outstanding for the month of July;
8. In view of the foregoing, the complainant is entitled to a refund for the month of July, which has been authorized by Health Republic. 
9. Health Republic apologizes for the inconvenience caused to the complainant; and
10. Based on the contents of the foregoing, we believe the Complainant’s matter has been satisfactorily addressed.

Revdex.com:First of all, I would like to thank you for assisting me in this matter. I was calling and calling and getting no actions. To my frustration and angst, I wrote to you and to my State Senator for help.I think three months to fix this simple problem is rediculously long for a reputable health insurance company. I feel I should receive some due compensation for my three months of utter frustration.
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me and the matter has been resolved.
Sincerely,
[redacted]

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 and the matter has been resolved.Sincerely, [redacted]

[redacted]
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[redacted] Dear Sir/Madam: Thank you for your inquiry in connection with the above referenced complaint ID. Health...

Republic Insurance of New York (“Health Republic”) hereby responds to complaint ID [redacted], received on May *, 2015, from the Revdex.com (“Revdex.com”). The member enrolled with Health Republic, through the New York State of Health (“Exchange”), effective, January *, 2014. The member states she requested termination of the policy in January 2014 due to relocation of the complainant’s residence from Buffalo, New York to New Jersey. Since enrollment and enrollment changes are done directly with New York State of Health we included review of their call history in our investigation. Neither Health Republic nor New York State of Health have record of phone calls from the member. However, Health Republic confirms that the complainant’s policy has been terminated retroactively to January **, 2014 and any outstanding balances have been removed from the policy. Health Republic apologizes to the member for the inconvenience experienced. Respectfully, [redacted]
[redacted] Health Republic Insurance of New York

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID# [redacted], and have determined that my complaint has NOT been resolved because:

[Your Answer Here]
 I would like to keep this complaint open for the months of July and August. I have been told for 5 months this has been resolved. Yet, here I am. I have been told the issue has been solved but until 2 months pass without an issue, I am not willing to believe them. Please keep this complaint open until I receive both the July and August bills to confirm the issue is resolved. Thank you.
 
 
 
In order for the Revdex.com to appropriately process your response, you MUST answer the question above.
Sincerely,
[redacted]

[redacted]
[redacted]
[redacted]
[redacted]
[redacted]
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Dear [redacted]:
Freelancers Health Service Corporation, d/b/a Health Republic Insurance of New York (the “Respondent”) hereby responds to the complaint filed by [redacted], (the “member”) received by the Revdex.com (“Revdex.com”), which Revdex.com relayed to the Respondent on June **, 2014.
COMPLAINT SUMMARY
1. According to the member, he is a subscriber holding a policy of health insurance with Health Republic. He asserts that on an unspecified date during the current year, he made a payment against his policy using his checking account and received confirmation that the transaction was successful;
2. The member avers that at some point his Financial Institution (“Bank”) contacted him and informed him that his Debit/Credit card (“card”)was compromised as a result of a security breach unrelated to his transaction with Health Republic, and therefore his card was deactivated by the Bank;
3. The member asserts that as a result of the foregoing matters, Health Republic refused to accept any further payments from his checking account, though he is unclear how the foregoing detailed incident would affect his checking account status as a form of legal tender to satisfy his monthly premium obligations with Health Republic;
4. The member thereafter contacted Health Republic and made two (2) payments against his policy by telephone, which the member was assured were allocated against his policy;
5. According to the member, he was informed by Health Republic that there was a glitch in the system that was preventing it from accepting his checking account but that within a month, the situation would be remedied. Subsequent events have proven this statement misleading and/or false, as his checking account has yet to be readmitted as an acceptable form of tender by Health Republic;
6. Moreover, the member asserts that he checked his account status on-line only to find that his payments have hitherto failed to be applied against his policy; and
7. As a result of the matters raised in paragraphs 1 through 6 hereof, the member filed this complaint with the Revdex.com (“Revdex.com”).
RESPONSE
The following is a timeline describing the matter and the steps Respondent took to ensure satisfactory resolution and communication thereof.
1. On June **, 2014, after receiving this complaint from the Revdex.com, the matter was referred for investigation with the Respondent’s Billing and Enrollment Specialist team (“team”), who confirmed that on April *, 2014, the member’s premium payment against his policy was voided with an indicator notation, “account invalid”;
2. As a result of the foregoing, Health Republic’s system triggered an account restriction against the member’s account, thereby effectively preventing any further premium payments being deducted using the account number of record;
3. On June **, 2014, Health Republic removed the restriction against the member’s account, and advised him to verify his account before attempting to utilize it to satisfy his premium payments. The member was also advised that he was at liberty to use another account to satisfy his monthly obligations with Health Republic; and
4. Based on the contents of the foregoing, the Complainant’s matter has been satisfactorily addressed. However, should the member have any other concerns, it is suggested that he reach out to our Customer Service Department at our toll free number [redacted].
Respectfully,
[redacted]
[redacted]