Kentucky Health Cooperative, Inc.

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.
Per my initial request, I would still like a formal apology from the corporate office of Kentucky Health Cooperative and suggest that my calls to their call center be reviewed for quality control purposes. 
Thanks for the refund. 
Regards,
[redacted]

From day one (1/1/2015) when I am suppose to have coverage from this health insurance, I do not. I have called every other day at least about my pharmacy not being able to fill my prescription, which I need badly. I had left of $ .20 from my original payment (12/19/2014) and went to Walmart and made it on 1/3/2015. I was told it would be posted and benefits available by Monday, 1/5/2014. But the pharmacy stated I was still not in the system. I called again and after talking to two persons, the latter treating me with much indifference stated that my last 20 cent payment was received and posted on the 6th however it would be the 8th before I could get medication. This is ridiculous!!! The affordable health care act works if the insurance companies would not make it so difficult! Isn't it enough that before insurance was made available for everyone by President Obama, that many people DIED! They died from lack of care. Now there are some who still don't care. I am not sure what my next move is---another company?? I need medical care now. May God have mercy on this country.

This Obamacare company a total scam. The doctors listed under their provider directory do not accept KHC insurance although the representative I contacted insists they do. They disconnected with "computer problems" when I called and were utterly unhelpful. Doctors won't accept because they will not pay the agreed amount and take almost a year to pay.

This Company is horrible. They charged me $696 monthly and then they received a fax. Dec 24th KYnect and DCBS sent a fax to Ky Health Cooperative. They never responded after over 40 hours on the phone. Between Walgreen and Kroeger Pharmacy as well. Do not use this company. They will take your money and not provide your benefits.

Kentucky Health Cooperative is an insurance company for second class citizens...of a third world country.

It has a reduced to bare bones formulary. It does not pay physicians on time or ever. It is a disgrace to the Commonwealth of Kentucky. I know of many prominent clinics and physicians who refuse to take this insurance now because of slow or no payment of benefits.

I don't want to list my personal experience for fear of retribution from this company. But as an example, I have a hospital bill of 5,000 dollars from an in network provider. KYC claims that I only owe 1k, but the hospital bills me over and over and it's been a YEAR. KYC refuses to call the hospital to clear up the bill, saying "we don't make phone calls".

Formulary is deceptively worthless. I have had to buy out of pocket many common medicines and I have a GOLD PLAN. It is implemented by a third party provider Pro Care pharmacy, who could care less about getting you the right prescription.

Run away from this company as fast as you can. It's worth it to purchase insurance from a reputable company instead of third class "cooporative".

A refund for the requested amount of $417.36 as Ms. [redacted] requested was processed and sent on May 21, 2015

February 19, 2016, The Kentucky Health Cooperative (KYHC) has received your letter dated 1/27/2016.  You referenced a previously submitted complaint, however KYHC did not receive a complaint previously.  We have reviewed the complaint in question and can offer the following...

information:  KYHC keeps an accurate log of all customer service contacts.   Pursuant to that record, there were multiple calls from the complainant to our customer service center throughout 2015 regarding premium payments and clarification of the correct Advance Payment Tax Credit (APTC) issued by the Kentucky Health Benefits Exchange (KHBE), typically referred to as “Kynect”.  The member called multiple times during August, however never requested a cancellation.  However the member called to make payments on the account and to dispute the amount of APTC, and was referred to KHBE as that is their determination.  Member first requested cancellation on September 28, and KYHC requested a termination date of 8/31/15 from KHBE, as they also handle enrollment and termination requests.  No premium refund was made until November 30, 2015.   However, member still had a balance due of $136.88 from August.  Member continues to carry a balance from August 2015 and no refund is currently due.  On January 15, 2016, the Kentucky Health Cooperative was placed into liquidation at the request of the Kentucky Department of Insurance.  If the member feels that this issue has not been resolved, the member will need to file a proof of claim form with KYHC.  The form is available on the DOI and KYHC websites (insurance.ky.gov and mykyhc.org). Sincerely, [redacted] ­Vice President of Government Relations and Compliance Kentucky Health Cooperative, Inc. 9700 Ormsby Station Road, Suite 100 Louisville, KY 40223

We have had problems with Kentucky Health Cooperative from day 1. It took about 3 months after initial premium was payed to start our coverage. Now I am having trouble with claims from over 3 months ago. I have the silver plan which includes no charge on well visits and immunizations. I have 9 month old twins and now have $2600 in bills for well visits and immunizations that Kentucky Health Cooperative has failed to pay. I contacted Kentucky Health Cooperative with the problem over a month ago and there is still no resolution. The problem has been escalated to supervisors twice. Their supervisors refuse to contact me back. I am waiting one more day before filing a complaint with the Revdex.com. Be advised if you are thinking about signing up with this company for insurance. BTW I work in pharmacy and let me tell you I am not the only one having trouble. Multiple times we have encountered problems where patients have paid their premiums but Kentucky Health Cooperative has the patient as inactive. This issue seems to happen frequently the first week of every month. I know of one business who dealt with this for 2 months and then switched their coverage to another company. Not a bad idea. Buyer beware. I can make one good statement about this company... They are an insurance company who sometimes provides service and payments.

Absolutely terrible, KYHC cancelled mine and my sons policy after a payment was a few days late(this is in Jan 2015); they kept receiving my payments (depositing them into their account at >$400 per payment) while they refused to pay for a doctors visit. They didn't advise of cancelling the policy until mid to late March. I called their call center, total waste of time and very unprofessional. They offered to refund some but not all the payments that were made, while the payments covered aforementioned doctors visit; which is basically fraud. Stay far far away from this group, there's no telling how many other people have been denied service after paying for the services.

This individual also filed a complaint with the KY Department of Insurance which we also responded to. Based on our response, the DOI considered the issue to be satisfactorily resolved and as you can see from the notes below communicated that to the individual. We also consider this issue resolved...

and closedSays they pay their premium, but their bills aren't being paid and she was told she isn't covered but her husband is. She had filed a DOI complaint, but KYHC told her it was a fault through Kynect. She wants: I would like KHC to refund our premium payment, AND send us a letter explaining why our coverage was terminated so that we will not be fined by the IRS for lack of coverage. I would like for Kynect to send us a letter explaining the mistakes made regarding our premium amount and payment assistance which greatly impacted our cancellation. 6/9/15 [redacted]:  This was originally a DOI complaint under [redacted].  Which contains the following notes: 4/28/15 [redacted]:  CGI IT has been asked to assist.  KHBE Issuer Portal says that both shoudl have coverage in 2015 however we only have one. 4/29/15 [redacted]:  Members have been termed for non payment.  Payment Report attached.  Both members were enrolled in PID 304 Mar-Dec 2014 and Jan - Dec 2015. 5/20/15 [redacted]: DOI has sent letter to the member stating their file is closed. I have sent a request to enrollment to review the account and submit a refund request if a refund is due to the member.6/23/15 - [redacted]: Can I get an update on this. Received an e-mail from the Revdex.com late yesterday saying they still haven't heard from us on this and that unresponsiveness will continue to negatively impact our Revdex.com rating. Thanks,6/23/15 [redacted]:  This was handled by responding to the DOI.  The information below was found in that ticket.4/28/15 [redacted]:  CGI IT has been asked to assist.  KHBE Issuer Portal says that both shoudl have coverage in 2015 however we only have one.4/29/15 [redacted]:  Members have been termed for non payment.  Payment Report attached.  Both members were enrolled in PID 304 Mar-Dec 2014 and Jan - Dec 2015.5/20/15 [redacted]: DOI has sent letter to the member stating their file is closed.

Refund being processed and should be mailed soon