International Benefit Administrator

Review: On April [redacted] 2014 a [redacted] called my place of business and was offering a health plan with 0$ copayment 0$ deductible , dental, and vision. A group plan with a $99.00 membership to NCE ( National Congress of Employers ) with a monthly charge of $714.00 for coverage of myself, my husband and my two sons. I needed insurance so jumped on it. Come to find this plan has nothing to do with Obama Care, I now have doctor bills in the thousands, they will not pay for my sons rehab because they are investigating pre-existing condition! I feel strongly they should tell people they are not under Obama Care!!!!! I was under the assumption all health care was Obama Care. This is also a limited medical plan, which I was not informed about! How do they get away with this under the new health care reform?Desired Settlement: To let the consumer know this does not fall under the new health care reform!

Change the Store Policy

Review: In Feb 2014 I went online to find affordable health INS.I filled out forms,this lady called me,her name was [redacted] .said she would be my agent,,I explained to her I needed health ins and wanted to hear what she had available..HER first statement was that this was affordable and many ..many people were buying this policy...She expalined that it was a NO deductible...pd 80% dr visits ..unlimited dr visits..pd prior health issues..and prescription card pd 80%..I am excited to find this good a policy and she said yes,its affordable and many buying it..So I gave her Bank acct which $341 came out monthly since FEb...My son also heard me and he wanted to talk to her to..she told him same thing and he said MOM this is great ins...lets get this..So he also gave bank acct and pd $341 ,,but later after seeing dr for preexisting issues stopped paymnt on it because he was getting bills from drs that ins wasnt payin it.So in May of 2014 I had to see a colon specailist,..I received a statement that the office call was $1375 and I was going to be out of pocket $1195,,,I,You can imagine was very upset ,,so I calle d my ins Agent which I cud NEVER reach so I was switched to someone that informed me I was payin $341 a month for A DISCOUNT INS CARD,so after thinking I had ins and seen a specailist for my colon ..I will be receiving a $15,000 to GOD knows how much for a colonoscopy,AFTER much ADO......I am now faced with being without Ins..and health issues...I just want them stopped from doing this to others ...If at anytime they had said this is a DISCOUNT card ,,NOONE pays $341 a month for a discount card DUH but I did...without knowing,,the prescription card never worked but we dont take many meds so that wasnt a big deal to us..I appreciate your concern and your help in this matter ,,,Sincerely [redacted]Desired Settlement: All I wnat from this company is a FULL refund and refund for my son also....and them to be stopped from doing this to others...Thank You....

Review: My health insurance ended on June [redacted] and IBA made a data entry error when submitting my COBRA election and said I was covered until 7/**/15. This is a major issue because I had severe medical issues that went unattended because I was not allowed to enroll in COBRA therefore had no health insurance. This is against the law. It got resolved today, July **, 2015 and now COBRA says I have to pay the entire month premium even though I was told I wasn't going to be covered at all. IBA has made a severe error and is costing me money and my health.Desired Settlement: I want IBA and COBRA to pro-rate my month premium for July coverage.

Business

Response:

IBA has spoken with and taken care of this members complaint. IBA does not handle the administration of Cobrafor this member. We utilize a company called Benefit Strategies for our Cobra Admin. Benefit Strategies originally sentout a letter to the member with a term date of 7/*/15. In which case her medical would have run through July as she stated...The actual term date should have been 6/**/15 and Cobra to begin on 7/*/15. Benefit Strategies did send a second letter stating this.As the member states in her complaint, this has been taken care of.I have also copied email between myself and member (please see below)We have agreed upon resolution and it has been done.You will also see that this member states in her email that she enjoyed working with and has not had trouble with IBA over the past 5 years.Thank you. [redacted]

Consumer

Response:

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,

Review: I had giving the NBLA a payment of 3,058 dollars for them to pay on my medical and they told me not to worry that I of being cover with the expense under their plan I had use my unemployment checks sending to them for the plan that I

was on under, I just got bill for the amount of 3,528.00 by the University of Pennsylvania Hospital. I am no longer collecting unemployment anymore. I don't know how a company can just take peoples like that and run off with it not taking care of the bill. they never paid the bill from this date and 11/2011-10/2012. I had told the bill collector that I can't afford paying that kind of money to them when International benefits Administrators. it prove that they didn't paying on the bill they affiliate with the company of the national better living associates, they been riding people off by misleading people of false advertisement, it needs to be Investigated.Desired Settlement: they need to face up their mistakes with people money because they lives depends on it I feels as though they need to take full responsibility of their actions, it shouldn't haven take a poor person to pay for a bill that is not their responsibility, should had been taken care of, I just want them to paid this bill in full. if not then I willingly to resolved in small claims courts.

Business

Response:

[redacted]

I have received your fax of the complaint ID number [redacted]

Response:

International Benefits Administrators (IBA) is only the adminstrator of the plan. We adjudicate the claims based on the Summary Plan Booklet / Certificate of coverage. IBA does NOT sell or have anything to do with the selling and or explaining of the coverage to a new member. IBA does not bill or collect any premiums from this member as we are NOT the insurance carrier. IBA adjudicates the claims for this plan and the claim in question from University of Pennsylvania for $3,528 was denied due to benefit maximum being met. This plan only covers 2 (two) DXL visits per year and the $3,528 bill from Pennsylvania hospital was a DXL charge, the third one. Based on her plan, this claim was denied.

Again, IBA adjudicated the claims correctly as the administrator. If this member is not pleased with the cost of the plan, the coverage that she purchased (limited medical plan) or the sales person involved, this must be taken up with the Sales organization, which is NOT affiliated with IBA. Thank you. Please let me know if you require any additional information.

Consumer

Response:

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:

my Question to you is they going to pay

they entire bill that they to the University Pennsylvania Hospital and to the bill collector

they are also asking for their money as well.if not please contact me ASAP. Thank you

case #[redacted]

Sincerely,

Business

Response:

My initial response indicated how we adjudicated the claim and therefore there is no additional payments going out to the provider.

Again, IBA is hired by the insurance carrier to adjudicate claims based on the certificate of coverage. IBA does not collect premiums, we do not sell this product we only handle the service once a member purchases the coverage.

Consumer

Response:

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:

Hi, [redacted] I did received your email last night and I read email, here's my response back to you, I did contact the Lawyer and he said to me it's going to cost Courts fees plus his fee up front, that's Why you haven't heard from me is because I still don't have the money yet but I will I be using my tax money. to take them to Court this April the University Penn Hospital had bill Collectors calling at my house asking for their money plus they put a Judge ment [redacted] against me on my home. bad credit report from the hospital bill since this issue haven't been resolved. Please contact me ASAP. Thank you

Sincerely,

Review: I retired in Feb. 2013 I needed health insurance; in order get my medicine which is blood pressure and chosethol medicine. I am 64 years old female, I checked around and found this company; which is called NCE. my insurance started on April *,2013, on they took out 119.95 from my social security check I called the company and ask them if I can use the insurance on April *, 2013, they said it is ok to use the insurance. now in 09/**/2013 they are telling me that I should not have use the Insurance until May of 2013 30 thirty days after April *,20013, which is may.so now I owe the doctor office $417 dollars, they said I had 3 office visit 1 ER,one I Physical and on wellness visit. I called on April *, ask them if I could use the doctor and they said yes. it is not fair to the elderly. I cannot get Medicare I am 64 not 65 one more year they are wrong, I called them and that is what they said I used the insurance two early not true I called them on the day the card arrived which was April I paid 119.95 every month since April,2013 now I cannot go to my doctor until I pay of $417. they should may me back or give me credit. 7 months I am paying the premium for what the elderly loses all the time. please help there phone no. is ###-###-#### claim no.[redacted]Desired Settlement: pay the bill for the doctor or adjust the premium which is $119.95 times 7 is 839.95 take out the doctor bill. I started April **, 2013 until 9/**/2013 I was [redacted] wrong information as to when I was able to see the doctor, I would not have gone on April *, 2013 I would have waited until may, if there calls are monitored they should check back to when I called so many times before I accepted the insurance. seniors are not stupid people it is the insurance company.

Business

Response:

Dear [redacted]

I read the complaint