IHC Health Solutions

I received your reply that it appears from consumer that this is not resolved.
Yes, I'm fully aware of that. I refer you to the statements in the correspondence, that there is no HIPAA authorization on file to disclose consumer's insurance matters to Revdex.com. I also stated that upon completion of the review into the inquiry a separate detailed response will be sent directly to Ms. Messick.  
Respectfully yours,
Wendy P[redacted]
Compliance Specialist
Legal Department

I had insurance the last year with IHC Group, in September I was emailed and asked if I wanted to renew and I told them NO. On October 4 they debited my account $175 for the Life Insurance part. First call representative hung up on me, so I emailed the company and I also called and one representative told me no record of being taken out account and I would need to fax bank statement and I did. Then I was called and was told there was nothing they could do that I needed to contact the agent Elias A[redacted] at [redacted] and still no calls or resolve so I put a stop payment at my bank.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.The representative from company is not addressing why they drafted my account on July 1 for a premium on an account that was cancelled in March, claiming 'No account found.' So how did they all of a sudden locate my account now? I have no problem showing where they drafted my account $33.42 on July 1 but when I called in, reps claim they cannot give me any written confirmation that it will not happen again in the future. 
Regards,
[redacted]

Dear Conciliation  & Engagement Specialist:Reference is made to your correspondence dated May 25, 2016 regarding the above.Thank you for sending this matter to our attention. Please be advised the company takes these matters very serious. Correspondence has been sent...

to the complainant and we intend  to resolve this matter accordingly.Regards, Terri A. M[redacted]

[A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted] and find that this resolution would be satisfactory to me.  I will wait until for the business to perform this action and, if it does, will consider this complaint resolved.
Regards,
[redacted]
Addendum 06/072016: Contacting customer service today at [redacted]0, I was told I would receive a full refund of my $196.66 within 5 - 10 days from 06/01/2016
If funds are credited to my account in this timeframe, accept the business response. If the funds are not returned within said time I will refile my complaint

Revdex.com:I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below and in the attachments.These are copies of the emails I received from the [redacted]. The first ones are an itemized receipt for the dental insurance, from [redacted]. She also talked to me about the health insurance but never sent an itemized bill like the dental bill. The agent I talked to was [redacted] and I never heard anything from him again. The emails that follow are cancelations of the dental insurance.The only communication received from [redacted] was to go to a website. At the website were html documents I could not open. There was no itemized receipt sent to me for the health insurance. I made many attempts at calling the ###-###-#### phone number. I was put on hold or told it was another person who had to help me, they never did. I wrote [redacted] an email letter, dated Jan 5, 2015, to cancel the health insurance policy, included in the IHC email file above. I received no communications from the [redacted], or M [redacted]. I couldn't put the policy information on the email as I could not decode the html document. Mr [redacted] cancelled the dental insurance after I reached him on a phone call and he said he was canceling the insurance. After realizing, I had been paying for the IHC insurance for 4 months, I called the IHC customer service number on my credit card statement, in early April, and gave the person my information and was told I was not in their system. Then I started downloading html decoding programs and found one that worked on the html documents. As you can see on the IA [redacted] emails there is only the ###-###-#### phone number to call. There is no specific number to cancel it. I did not receive any information in the mail such as policies or insurance cards. One - no policy or id card from [redacted]. Very poor insurance agent service where there was no information. Two - How can a person cancel something when I was not supplied with my policy information or any invoice information as I was for the dental policy? They didn't email it to me. Three- Calling IHC in Arizona was useless as they couldn't identify my policy with my name, birthday, address, or social security number. 4- they, [redacted], are the only company that didn't inform me about ACA health care compliance. 5- after they got my credit card number they treated me like I didn't exist, and made it impossible to cancel. I was given the run around. This is the kind of sales practices that got the insurance industry saddled with lots of government regulations.  Regards,[redacted]

I would like to ad that, since I filed this, I reviewed my bill with my dentist's office. When I made...

the complaint I saw, per my bill, that this insurance company had paid for my preventive work. When I said that during my call to the company, they said they did pay this ($100) but they don't pay for work done subsequent to the prevention work and it was a six month waiting period. When reviewing this with the dental office, I found out that this current company did NOT pay that preventive work/ $100. It was my FORMER dental insurance company, [redacted], that paid it. So, while I was complaining about the fact they didn't cover my dental work, they lied to me about covering the preventive work. They didn't pay for that; my former insurance did. Therefore, I would like this company to pay my bill and cover the dental work I had done per the agreement. I was willing to forgo that and just ask for a refund of my insurance payments, but, since they lied to me while I was complaining to them (!!!), I want them to pay for what they contracted for; the coverage of the dental work I had done.

Dear Dispute Resolution Consultant:This is in response, on behalf of Standard Security Life Insurance Company of New York (“Standard Security”), to your correspondence dated August 10, 2014 and received August 11, 2015. According to our records Ms. [redacted] purchased a group short term...

medical expense insurance plan. The non-employer group policyholder is the Communicating for America, Inc., (the “Association”). The group policy is sitused in Washington, D.C. and is underwritten by Standard Security. The group policy is individually marketed to members of the Association and each enrollee receives an individual Certificate of Insurance (“Certificate”) itemizing their benefits, terms and conditions of the group short term medical expense insurance plan. IHC Health Solutions, Inc. is the third-party administrator (“TPA”). IHC Carrier Solutions provides legal non-TPA management functions. Ms. [redacted] coverage was effective December 1, 2014. Ms. [redacted] is requesting assistance as to payment of her claims.Please be advised that Ms. [redacted] also submitted filing with the Arizona Department of Insurance. The Arizona Department of Insurance informed Ms. [redacted] of the need to complete the insurance company’s appeal process. Ms. [redacted] has separately filed an appeal with the internal appeal department under cover of correspondence dated August 10, 2015. We similarly request that the Revdex.com allow for the completion of this process as well.Please be advised that the information contained herein is meant to be responsive to your inquiry on behalf of the insured. It is not meant to constitute or be construed as a waiver of any other defense available to the insuring carrier. The insuring carrier expressly reserves all rights to assert any provision, limitation or defense provided for under the Policy and/or applicable law. Should you have any further questions, please contact this office.

Again, the response will issue to consumer by December 4, 2015 (this complaint has arrived during reduced work week, the Thanksgiving holiday).
 
December 15, 2015Arizona Revdex.com Northern & Western Arizona 213 Grove AvenuePrescott, AZ 86301 RE:Dear Ms. [redacted]
In reply to the notification dated and received November 24, 2015 and our subsequent email exchange of Friday, December 11, 2015, regarding the above-captioned complainant ID, please be advised that the consumer has not executed a HIPAA release and authorization that names the Arizona Revdex.com as an authorized party to receive information as to the complainant’s insurance coverage.Therefore, please be generally advised of the timely issuance of insurance documents with schedule of benefits to its consumers for their use, information, and review prior to seeking care from a healthcare provider. The complaint has been investigated and a detailed response has issued via certified mail to the insured consumer.Please be advised that the information contained herein is meant to be responsive to your inquiry on behalf of the insured. It is not meant to constitute or be construed as a waiver of any other defense available to the insuring carrier. The insuring carrier expressly reserves all rights to assert any provision, limitation, or defense provided for under the Policy and/or applicable law.If anything further is required, please contact us. Sincerely,Wendy P[redacted]Wendy P[redacted]

[redacted]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID...

[redacted], and find that this resolution would be satisfactory to me.  I will wait until for the business to perform this action and, if it does, will consider this complaint resolved.
Regards,
[redacted]

In reply to the follow-up inquiry of Ms. [redacted] containing the image of the debit statement, I submit the below statements on behalf of Madison National Life Insurance Company (“Madison National”), NAIC #[redacted]. According to our records Ms. [redacted] purchased dental insurance coverage underwritten by Madison National. IHC Health Solutions, Inc. serves as the third-party administrator (“TPA”), and its affiliate, IHC Carrier Solutions provides legal non-TPA management functions.Ms. [redacted] provided an account number for payment of the initial dental premium, in the amount of $33.42, which was submitted to her bank for payment. Via email dated 03/02/2015, Ms. [redacted] invoked the 10-day right to return the policy for full refund of all premium. By correspondence dated 03/04/2015, we acknowledge receipt of the cancellation request and inform Ms. [redacted] that the premium refund may take up to three weeks and would be seen as a credit to her account. On 03/31/2015 the premium refund system attempted, unsuccessfully, to refund the $33.42 to Ms. [redacted]’s bank account. On 04/07/2015 Ms. [redacted]’s bank sent notification of a corrected bank account number to which the premium refund was able to be deposited. On 05/28/15 we received notice that Ms. [redacted]’s bank was unable to locate the account number from which the initial premium payment, $33.42; therefore, the initial premium payment had not been paid.During June 2015 the systems “communicated” to one another, which documented that in early April 2015 Ms. [redacted] received a premium refund to her account for $33.42 but the insurance company had never received the initial premium payment. Thus, the systems needed to correct this. Accordingly, the July 2015 withdrawal of the amount of $33.42 from Ms. [redacted]’s account. The below table summarizes the transactions:
 

  Transaction   Accepted/Declined Status
03/02/2015 Initial Premium Payment ($33.42) [redacted] to TPA Bank Declined Insurance Co. receives – premium payment ($0)
 
03/04/2015 Policy Cancelled Refund Process TPA to Boxley Boxley Bank Accepted (btw 03/31-04/07) Boxley receives (+$33.42)
         
Insurance Company is out (-$33.42)
         
07/01/2015 Recoup refund as premium payment never received TPA from [redacted] Accepted Insurance Company receives (+$33.42)
 
No further withdrawals will occur as there are no insurance coverage in effect. In consideration that the Insured has not provided a duly executed release and authorization naming the Arizona Revdex.com (“AZ Revdex.com”) as privileged to receive specific bank account information, copies of the transactions referenced herein, will issue directly to complainant—Ms. [redacted] to the address provided in her complaint to the AZ Revdex.com.Sincerely,[redacted]Compliance SpecialistLegal Department

They have not contacted me directly, the matter is not resolved.
[redacted]

I respond, on behalf of [redacted] Life Insurance Company of New York ("[redacted]"), to your correspondences dated April 15 and April 27, 2015. [redacted] was covered under a group short term medical expense insurance plan issued to group policyholder [redacted] ("CA"), which is sitused in Washington, D.C. The group policy is marketed individually to the members of CA. The individual receives their Certificate of Insurance (the "Certificate") containing the terms and conditions of their coverage. The policy is underwritten by [redacted] and is third-party administered ("TPA") by IHC Health Solutions, Inc. IHC Carrier Solutions is an affiliate of IHC Health Solutions that provides non­-TPA legal services.Mr. [redacted] acknowledged timely cancellation and refund of a dental care plan and premium; but alleges non-receipt of a policy from [redacted] and requests assistance regarding the refund of the premium for his health plan. We respond to these concerns in the manner itemized.Dental Plan[redacted] does not show record of an application for dental coverage, and therefore no issuance of a dental plan. That the dental coverage, as stated by [redacted], was canceled and was refunded on January 8, 2015 was not handled by [redacted] cannot speak to policy issuance or premium handling of another insurance carrier.Receipt of Medical PlanMr. [redacted] completed an application for short term medical expense coverage on December 29, 2014. [redacted] issued an approval of insurance welcome letter dated December 30,2014, copy attached, properly addressed to [redacted]. The welcome letter directed Mr. [redacted] to the website to print his "policy, or if applicable, your Certificate of Insurance, any state required endorsements and your identification cards." That Mr. [redacted] may not have printed these items is outside the scope of our knowledge. Medical Plan Premium[redacted] has no call log documenting the. alleged oral cancellation of coverage in January 2015. Under correspondence dated April16 , 2015, copy enclosed, [redacted] notified Mr. [redacted] of receipt of a dispute regarding the premium payment; in response [redacted] credited the April 2015 premium payment to his cred it card, copy enclosed, and coverage cancelled effective as of Apri l 9, 2015. Insofar as the return of the initial premium of$282.50 paid for the month of January 2015, the monthly premium of$262.50 paid for the months of February & March 2015 [redacted] properly retains those funds for the months of coverage provided under the terms of the Certificate issued.With regard to the concern that this group short term medical expense coverage was non-compliant with the "ACA Exchange mandate," please be informed that medical expense plans of limited duration, such as the coverage chosen and purchased by [redacted], are expressly excluded from the Affordable Care Act (the "ACA"). Short term limited duration plans are exempt from the ACA mark etreforms. The ACA Section 2791 (b) (5) states: The term 'individual health insurance coverage ' means health insurance coverage offered to individuals in the individual market, but does not include short-term limited duration insurance. [redacted] describes Individual Health Insurance as health insurance coverage offered to individuals in the individual market, but does not include short-term, limited duration insurance. [redacted] describes short-term, limited duration insurance as health insurance coverage provided pursuant to a contract with an issuer that has an expiration date specified in the contract that is less than 12 months after the original effective date of the contract.Mr. [redacted], may also request assistance from the [redacted] at [redacted].Please be advised that the information contained herein is meant to be responsive to your inquiry on behalf of the insured. It is not meant to constitute or be construed as a waiver of any other defense available to the insuring carrier. The insuring carrier expressly reserves all rights to assert any provision, limitation or defense provided for under the Policy and/or applicable law.If you have any further questions, please contact me at the address provided at P.O. Box address provided at the bottom of the first page. Sincerely, [redacted]Compliance SpecialistLegal Department

Please be advised that the insurance carrier did contact Ms. [redacted] directly. The insurance company, Standard Security Life Insurance Company of New York (NAIC #[redacted]) issued correspondence to Ms. [redacted] on 5/11/16 requesting additional information to further investigate her concern.Please be advised that the insurance carrier called Ms. [redacted] and left a voicemail on today’s date. We will also send a follow-up email to insured for the documentation requested in the  correspondence dated 5/11/16 that was sent to insured.

VIA Revdex.com PORTAL Member of The IHC Group March 31, 2016Arizona Revdex.com Northern & Western Arizona 213 Grove AvenuePrescott, AZ 86301 RE:Dear Dispute Resolution Consultant:In reply to the notification dated...

and received November 24, 2015 regarding the above-captioned complainant ID, please be advised that the consumer has not executed a HIPAA release and authorization that names the Arizona Revdex.com as an authorized party to receive information as to the complainant’s insurance coverage.Therefore, please be generally advised that the premiums are billed and collected per the insurance products purchased by a consumer. Upon completion of review and inquiry into the matters alleged a separate detailed response will issue directly to the consumer.Please be advised that the information contained herein is meant to be responsive to your inquiry on behalf of the insured. It is not meant to constitute or be construed as a waiver of any other defense available to the insuring carrier. The insuring carrier expressly reserves all rights to assert any provision, limitation or defense provided for under the Policy and/or applicable law.If anything further is required, please contact us. Sincerely,Wendy P[redacted]Wendy P[redacted] Compliance Specialist Legal DepartmentCc: Via Certified Mail [redacted]

[redacted]

I have reviewed the response made by the business in reference to complaint ID...

[redacted], and find that this resolution would be satisfactory to me.  I will wait until for the business to perform this action and, if it does, will consider this complaint resolved.

Regards,

Dear Conciliation  & Engagement Specialist:Reference is made to your correspondence dated May 25, 2016 regarding the above.Thank you for sending this matter to our attention. Please be advised the company takes these matters very serious. Correspondence has been sent...

to the complainant and we intend  to resolve this matter accordingly.Regards, Terri A. M[redacted]

This company should be shut down. Their primary responsibility is handling medical billing verification and claims.

The lost/misplaced/never received my medical history THREE times. I finally had to send the form with tracking information to be sure they received it. The "form" included all of my medical history.

*The day I mailed AND faxed the form, I was informed by an agent at IHC, "We do not have an email address you can send a scanned copy to - and - There is no supervisor you can speak with."

I have outstanding medical claims from April and June 2013 that are still not paid.

[redacted], LLC, Boca Raton, FL is the company I signed up for health insurance with - they farm out their verification and billing to IHC Health Solutions.

They have not contacted me directly, the matter is not resolved.

Horrible !!! Scam !!! . I purchase ihc solutions because I missed open enrollment I paid $215 never recieved insurance cards. I tried calling but you're unable to get in contact with any representative you have to "email" them. I emailed and was sent what was suppose to be my insurance card but it didn't have no information on it as far as ID number etc . I emailed them twice to cancel the insurance and refund me never got a response ( of course) . This company is a scam after all that I decided to read some reviews and many other people was saying the same thing how they couldn't get in contact, they tried cancelling and still was being charged . I made sure I changed my account numbers . This company is a bunch of bull . I will not suggest anyone to go through this company . I wish I followed my intuition something told me something wasn't right with this company !