Health Republic Insurance of New York

Dear Sir/Madam:Thank you for your inquiry in connection with the captioned complaint ID. Health Republic Insurance of New York (“Health Republic”) hereby responds to complaint ID [redacted], received by the Revdex.com (“Revdex.com”), which Revdex.com relayed to us on July **, 2015.The member...

enrolled with Health Republic, through the New York State of Health (“Exchange”), effective, May *, 2014. The member resided in New York State until late 2014; thereby, terminating his policy with Health Republic as of December **, 2014. However, the member indicates that he subsequently received three (3) monthly billing invoices from Health Republic during plan year 2015. Additionally, since the member was previously signed up for re-occurring ACH payments, the member states his billing invoices resulted in three monthly (3) ACH premium payments being deducted towards his plan year 2015 coverage. The member contacted Health Republic to inquire about his termination date. The member was informed due to enrollment through the Exchange, he would need to contact the Exchange directly in order to terminate his policy and to stop the re-occurring ACH payments. Upon terminating his policy, through the Exchange, to March **, 2015, the member filed an app eal to the Exchange requesting a December **, 2014 termination date. The member requests that the Exchange terminate his policy with Health Republic to December **, 2014; and process a refund of his three (3) plan year 2015 ACH premium payments. Health Republic can advise that we did not receive notification that the member was moving outside of New York prior to the beginning of plan year 2015. Accordingly, we could not terminate his policy until we received a directive doing so. With respect to our deduction of ACH premium payments, Health Republic can advise that as the member was enrolled in re-occurring ACH payments, we proceeded to deduct his monthly premium payments as they became due via automatic ACH until we received a directive to terminate the member’s policy.We have terminated the member’s policy with Health Republic, through a directive of the Exchange, effective, December **, 2014. Therefore, we have processed a refund of the three (3) premium payments deducted from his account against his plan year 2015 coverage, in the amount of $607.08. The refund will be processed within 72 hours. However, should the member fail to receive same, he is directed to contact our customer service during regular business hours.Health Republic apologizes to the member for the inconvenience experienced.

This is in response to the member complaint filed under ID# [redacted] regarding status of claims for services received in November 2015.  Health Republic Insurance of New York ceased operations on November **, 2015.  The organization is currently in wind down of its operations with the full...

cooperation and involvement of its regulators.  At this time, claim payment processing is on hold as we coordinate with our regulators during this wind down phase.  We expect additional guidance to be made available in the near future regarding payment status of outstanding claims.  Sincerely,Health Republic Insurance of New York

[redacted] 
[redacted]Dear Sir/Madam:Thank you for your inquiry in connection with the captioned 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, February *, 2015. The member terminated his policy, through the Exchange, in May 2015. The member avers the Exchange then informed him that Health Republic would waive the remaining balance outstanding against his account. Having completed our investigation, Health Republic can advise that the member filed several claims in May 2015; however, the member was not then paid through to May **, 2015. In order to access the full benefits of his policy for the requisite period, the member is required to cover the remaining balance outstanding against his account. The member was contacted on June **, 2015. Health Republic can now confirm that he has remitted a premium payment, which removed his outstanding balance. Therefore, the complainant’s coverage period now reflects as active from February *, 2015 through to May **, 2015. Health Republic apologizes to the member for the inconvenience experienced. Respectfully, [redacted]

[redacted]
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Dear [redacted]:
Thank you for your correspondence, dated, July **, 2014, in connection with the captioned complaint. According to the complainant her matter has not been fully resolved for the following reasons:
1. Health Republic denied claims from facility that is In-Network (INN):
All claims that have been submitted by the complainant will be processed within the limitations of her contract of insurance; and as at the date of this complaint and the answer concomitant therewith, there are several claims that are in the processing stream. Unfortunately, Health Republic cannot commit to a date for completion but can assure the complainant, that any and all claims that are properly within network will be covered.
Health Republic will continue to monitor this matter.
2. Health Republic is not processing claims in accordance with the PPACA:
The Patient Protection and Affordable Care Act (PPACA), provides that a new born is entitled to a 48 hour hospital stay following child birth (96 hours in the case of a caesarean birth). The PPACA, however, makes provision for a special enrollment period if the plan is advised by the primary holder within 30 days of the birth of the child. The Law then requires a retroactive effective date back to the date of birth of the child. As such, Health Republic is acting in strict accordance with the law in New York State.
As advised in our first response, Health Republic is working closely with the Exchange, and is mindful of the legal and ethical constraints; and as such the newborns coverage effective date has been modified to coincide with the date of birth, February **, 2014.
We trust the complainant will allow the implemented and established process to run its course, if however, he is dissatisfied with our determination then he is invited to appeal the decision in the manner that is contractual stipulated.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is not explained as to why it took 3 months and contacti g the Revdex.com before finally sending out my daughter's ID card.
Sincerely,
[redacted]

Dear Sir/Madam:Thank you for your inquiry in connection with the captioned complaint ID. Health Republic Insurance of New York (“Health Republic”) hereby responds to complaint ID [redacted], received by the Revdex.com (“Revdex.com”), which Revdex.com relayed to us on July **, 2015.The member enrolled...

with Health Republic, through the New York State of Health (“Exchange”), effective, May *, 2014. The member resided in New York State until late 2014; thereby, terminating his policy with Health Republic as of December **, 2014. However, the member indicates that he subsequently received three (3) monthly billing invoices from Health Republic during plan year 2015. Additionally, since the member was previously signed up for re-occurring ACH payments, the member states his billing invoices resulted in three monthly (3) ACH premium payments being deducted towards his plan year 2015 coverage. The member contacted Health Republic to inquire about his termination date. The member was informed due to enrollment through the Exchange, he would need to contact the Exchange directly in order to terminate his policy and to stop the re-occurring ACH payments. Upon terminating his policy, through the Exchange, to March **, 2015, the member filed an app eal to the Exchange requesting a December **, 2014 termination date. The member requests that the Exchange terminate his policy with Health Republic to December **, 2014; and process a refund of his three (3) plan year 2015 ACH premium payments. Health Republic can advise that we did not receive notification that the member was moving outside of New York prior to the beginning of plan year 2015. Accordingly, we could not terminate his policy until we received a directive doing so. With respect to our deduction of ACH premium payments, Health Republic can advise that as the member was enrolled in re-occurring ACH payments, we proceeded to deduct his monthly premium payments as they became due via automatic ACH until we received a directive to terminate the member’s policy.We have terminated the member’s policy with Health Republic, through a directive of the Exchange, effective, December **, 2014. Therefore, we have processed a refund of the three (3) premium payments deducted from his account against his plan year 2015 coverage, in the amount of $607.08. The refund will be processed within 72 hours. However, should the member fail to receive same, he is directed to contact our customer service during regular business hours.Health Republic apologizes to the member for the inconvenience experienced.

To: The Revdex.com (Revdex.com) - This is in response to the inquiry filed under complaint #[redacted].  Health Republic Insurance of New York ("Health Republic") has conducted a review of the member's account status and confirmed her coverage during 2015.  The member's account...

eligibility has been updated and communicated to the New York State of Health (NYSOH).  NYSOH has confirmed that a corrected [redacted] was sent to the member on April **, 2016.  We trust this matter has now been resolved and apologize for any inconvenience to the member.  Thank you. Sincerely,[redacted]Health Republic Insurance of New York

Revdex.com:
At this time, I have not been contacted by Health Republic Insurance of NY regarding complaint ID [redacted].
Sincerely,
[redacted]

[redacted]
[redacted]
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[redacted]Dear Sir/Madam:Thank you for your inquiry in connection with the captioned 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, February *, 2015. The member terminated his policy, through the Exchange, in May 2015. The member avers the Exchange then informed him that Health Republic would waive the remaining balance outstanding against his account. Having completed our investigation, Health Republic can advise that the member filed several claims in May 2015; however, the member was not then paid through to May **, 2015. In order to access the full benefits of his policy for the requisite period, the member is required to cover the remaining balance outstanding against his account. The member was contacted on June **, 2015. Health Republic can now confirm that he has remitted a premium payment, which removed his outstanding balance. Therefore, the complainant’s coverage period now reflects as active from February *, 2015 through to May **, 2015. Health Republic apologizes to the member for the inconvenience experienced. Respectfully, [redacted]
[redacted]
[redacted]

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

Freelancers Health Service Corporation, d/b/a Health Republic Insurance of New York (the “Respondent”) hereby responds to the complaint filed by [redacted], (the “Complainant”)...

received by the Revdex.com (“Revdex.com”), which Revdex.com relayed to the Respondent on April **, 2014.
COMPLAINT FACTS
1. According to the complaint, Health Republic debited the Complainant’s account on March **, 2014, in the amount of $436.56. The Complainant maintains that he did not authorize automatic deductions from his account;
2. The Complainant has asserted that the amount deducted by Health Republic was excessive, in that, the Complainant’s monthly premium for March is $218.45, and the amount debited from Complainant’s account was twice the amount that ought to have been taken;
3. The Complainant avers that as a direct result of Health Republic’s actions, his account went into overdraft, thereby triggering the interest which accrues when the facility is utilized. The Complainant alleges that as at the date that he registered his complaint, his overdraft fees were $233.00;
4. The Complainant has spoken with several member services representatives to resolve his complaint, all without avail;
5. The Complainant has been assured of a call back by a Supervisor, the Complainant has yet to receive this call; and
6. As a result of the matters raised in paragraphs 1 through 5 hereof, 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 April **, 2014 Respondent received the Complaint from [redacted] ([redacted], [redacted]).
2. 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 [redacted], 2014, through to termination on March **, 2014;
3. On April **, 2014, Health Republic’s Billing and Enrollment Team confirmed that member was showing a net due amount of $218.45, representing the amount that was wrongfully deducted from the member’s account for April, 2014;
4. Health Republic’s Billing Department also confirmed that on March **, 2014, the Complainant’s account was debited in the amount of $436.56, which was allocated against the Complainant’s invoice for March and April, 2014;
5. Based on the foregoing, Health Republic determined that the Complainant’s account ought not to have been debited for the month of April, 2014, and consequently initiated the refund process. On April **, 2014, the Billing Department confirmed that the Complainant was issued a refund for April in the amount of $218.45;
6. Regarding the overdraft fees: between, April **, 2014 through to April **, 2014, Health Republic made a total of five (5) requests directed to the Complainant, urging him to furnish proof in the form of redacted Bank Statements to support the claim. Health Republic remains ready and willing to consider said claim, upon receipt of required documentation

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]

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]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory, however, due to the past experience with the mention business, at this time I cannot say that the matter has been resolved until I receive my funds that I have worked very hard to earn them. Yesterday, I was reached by this business and I was promised that I should expect to receive funds within 5-7 business days. Now I'm waiting for their factual response.
Sincerely,
[redacted]

Revdex.com:
At this time, I have not been contacted by Health Republic Insurance of NY regarding complaint ID [redacted].
Sincerely,
[redacted]-[redacted]

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

[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]

[redacted]...

[redacted]
Dear [redacted]:
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 (“Revdex.com”), which Revdex.com relayed to the Respondent on June *, 2014.
COMPLAINT FACTS
1. According to the Complainant, she applied for a Health Republic policy of insurance sometime in or about November or December, 2013, for coverage effective, January *, 2014;
2. Due to financial constraints, the Complainant was unable to make her binder payment effectuating coverage for January *, 2014. Accordingly, the Complainant received a letter, sometime in February, 2014, from Health Republic, notifying her of the cancellation of her policy due to non-payment, and also advising that the Complainant had the ability to re-enroll before the end of “open enrollment”;
3. Acting on the contents of the aforementioned letter, the Complainant enrolled once again for a policy of insurance with Health Republic in advance of the deadline ushering in the end of “open enrollment” so as to avoid the penalty associated with foregoing insurance under the PPACA (Patient Protection and Affordable Care Act);
4. Sometime in March, 2014, the Complainant received a letter from Health Republic, informing her that she had an outstanding balance for January and February, notwithstanding that her policy was cancelled for non-payment for those months; and
5. After several attempts to resolve her billing and enrollment issues with Health Republic, 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 June *, 2014, Respondent received the Complaint from Dispute Resolution Services (Revdex.com).
2. On June **, 2014, Respondent began its internal review and escalated this Complaint with Respondent’s Enrollment Specialist team, which confirmed the contents of the Complaint herein;
3. Based on the foregoing, the Respondent promptly advised its Enrollment Specialist team to effect the necessary changes to the Complainant’s record, in order to reflect an effective date of March *, 2014; further, to modify the Complainant’s billing record so that it coincides with the changes made to enrollment;
4. Health Republic can confirm that the Complainant’s matter was satisfactorily remediated on June **, 2014; and
5. The Complainant currently has an outstanding account for June, 2014. Should the Complainant have any other concerns she is invited to contact our member services Department at our toll free number ###-###-####.

To - 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.   
Thank you.
 
Sincerely,
Stacey B[redacted]
Health Republic Insurance of New York Inc.

At this time, I have been contacted directly by Health Republic Insurance of NY regarding complaint ID [redacted], however my complaint has NOT been resolved...

because:
[Your Answer Here]i was contacted by Caliber Home Loans & have been told that the issues with my account access have been fixed but I will not be able to verify this until August [redacted] 2014 when my next bill becomes available for payment online. Until that time I have no way of verifying if my complaint has been resolved.
 
In order for the Revdex.com to appropriately process your response, you MUST answer the question above.
Sincerely,
[redacted]