Partners in Health Care, Inc.

In regards to *** ***:
The member is requesting the $enrollment fee back and she is stating that we lied to her about our program I have attached the system notes from her account She called into cancel the program on June 18th, then at point the program was explained to her, and the member still wanted to cancel At that point our customer service staff made her inactive and also explained the refund policy to the member The member then began yelling at our staff and hung up On June 23rd, the call center manager called her back and went over all of her concerns again The member then expressed her concern about the penalties for the Affordable Health Care Act After this conversation the call center manager then spoke with the president of Partners In Health Care, and as a courtesy Partners In Health Care refunded the member's monthly fee as a courtesy...the enrollment fee however is a non-refundable fee
I have also attached the member's voice verification from when the program was sold to the member In this, it clearly states that what she is purchasing is a medical discount program not an insurance plan, the member agrees at this point Then it is clearly stated as well, "and as per the government, that this is not classified as insurance." At no point was the member ever lied to, and there is no place that anyone ever told her that this was an insurance plan

I was mislead about their services and lost $I would just like to get my money backI was never told that this was not insurance that I was purchasingI asked if it covered doctors, hospitals and so forth and was told yes it wouldWhen I received the packet I learned it was just a discount programWhen I contacted them they were rude and told me it was past the days of enrollment and I could not get my money backHow are you supposed to review your package and have a chance to return it and get your money back when it takes longer than 7-days to receive it?

[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 is satisfactory to me. 
Regards,
 
[redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
Since then, I have cancelled my plan and gotten a full refund through my bank.  I was smooth talked into buying my plan thinking it was health insurance which it surely is not.  I have cancelled my plan and received a full refund from my bank and NOT FROM PIHC.  Please do not let these people talk you in to buying their "Health Plan".  THey call it a discount medical plan.  It is NOT HEALTH INSURANCE, which is what I was under the impression I was purchasing.  
[To assist us in bringing this matter to a close, we would like to know your view on the matter.]
Regards,
[redacted]

Dear [redacted],
We have reviewed the file on the complaint and also requested a statement from the Marketing Agency, United Health Choice.  In their statement they deny representing themselves with Partners In Health Care, which they are not authorized to do.  They also deny...

playing games with the effective date as stated in the complaint.  Our finds however notes that there was no verification call made and recorded so it is our determination to side with the complainant and provide a complete refund.  There was a check mailed 3/19/14 for the full amount, check number 5016 and should arrive within 3-5 business days. 
Based on all of the notes provided in our enrollment software we do not see any where that there was a lack of communicate with the member or where any shady practice was involved.  In his statement he mentions we are a discount plan not insurance.  If there is fault on our behalf it was not following through with this member after transferring him to the marketing organization.  We have now instituted a policy with all CS reps to make follow up notes in 123 so they are reminded 3 days later to make sure all member's requests are handled immediately.
Sincerely,
[redacted]

Revdex.com:
I have...

reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
[To assist us in bringing this matter to a close, we would like to know your view on the matter.]
Regards,
[redacted]
 
 I did receive $159.00 back but was charged the enrollment fee of $99.00 which I believe should be refunded . I only enrolled in there program because I was told it was ins. and the person that called me told me he was sorry that I was lied to ( therefore admitting  they lied ) so basically I have to pay for enrolling in their lie . I understand they are saying the call back recording told us it was not ins.( which we did not understand until we got the packet on 6/18/2014 and called right away.The man that called believed we were told it was ins. and said he was going to have to let the salesman go because they did not want them to sell policies with a lie.

[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 is satisfactory to me.
I want to thank you again for helping me get my complaint resolvedwith Partners in Health Care. It looks like they have credited mycharge card and I am grateful to you for following through and most ofall for your honesty and tenacity in getting this conflict resolved.Sincerely,
 
[redacted]

Ms. [redacted]'s refund was processed on June 16th, 2014, at the time the complaint was responded to.  We issued two different types of refunds, ACH and credit card and the individual that processed Ms [redacted]'s refund processed it as an
ACH rather than credit card.  This has been...

corrected and the attached scan show that the refund has been made.  It was an internal error and one that systems have been put in place to insure that it does not happen again.
We apologize for an inconvenience this may have caused the consumer.
 
Sincerely,
 
 
[redacted]

This is our response to the complaint filed by [redacted]:
First, I would like to have proof of where Ms [redacted] found a listing that claimed that Advantage Health "which is listed as being an Aetna product".  This is completely a false statement, we do have a contract with Aetna...

for their program named "MY Life Values" which is not insurance nor do we claim that any insured benefits are provided.  [redacted] the selling rep has been with Health Center for 5 months and we have never had anyone make the claims about his presentation that Ms. [redacted] is making.  I am also positive that [redacted] never told Ms. [redacted] that Aetna also provide dental and vision because they don't.  We do provide for those services but Aetna has nothing to do with it at all.  In our Recorded Verification we state that this is not insurance that what you are purchasing is called the Advantage Health Discount Program, do you understand that, of which she answered to the positive.  When she called our office and talked to Veronica, Veronica offered to play the voice recording for her and she refused to listen.  I am also positive, because we monitor our reps that he never referred to our plan as a policy, because it is not. 
We also split Ms [redacted]'s payments because she couldn't afford everything immediately, which we don't do, but did in trying to help her out.  I do not see any legitimacy in her complaint but will refund her the $159.00 and in the verification it clearly states that the application fee is non-refundable which she agreed to.  Please advise if this is acceptable.
 
[redacted]

To whom it may concern:
                This is
in response to the Revdex.com complaint number [redacted].  This member signed up with the Advantage
Health Savings...

Program on April 4th, 2014 and her first payment was
drafted per her request on April 11th, 2014. 
The member’s first complaint is
that Partners in Health Care deducted money from her account without hearing
anything from our customer service staff. 
Partners in Health Care drafted the member’s account on April 11th,
2014 per her request.  The member then
stated that she had not heard anything from Partners in Health Care.  Partners in Health Care prints the welcome
letters and handbooks once per week on Wednesdays, they get placed in the first
class mail on the following day.  After
this happens, each new member goes onto a master list that our customer service
staff receives on the following Wednesday. 
At this point our customer service staff receives this master list of
all of our new members, then we engage all of our new members for what is
called a welcome call.  We contact the
member, go over the handbook page by page with them, answer all of their
questions, get them enrolled in the different facets of our program from our
Consult A Doctor program to, taking them to the My Life Values Website, to getting
a detailed list of their prescriptions. 
At no point is this ever referred to as “insurance”, it is clearly
stated by the customer service staff as well as printed on our cards, welcome
letter, and also on our handbooks that this is a medical savings program.  The member called in on April 24th,
2014 prior to receiving her welcome call, and she spoke with [redacted], where she
asked [redacted] about the program.  [redacted]
initially started to explain the program to her, then the member stated that
she wanted to cancel.   [redacted] explained
the differences between our program and insurance, the member stated that she
wished to cancel and that she would like a full refund.  [redacted] explained our refund policy to her and
at that point the conversation ended.
Now as far as the member stating
what she was promised.  During her
initial sale there was a voice verification that was done, we would be happy to
play for the member at any time that she requests.  It clearly states in the verification “What
you are purchasing is classified as Advantage Health Discount Medical Plan, as
your representative has already discussed with you.”  She does agree this statement.
Our refund policy which is clearly
stated in the voice verification, in our handbook, as well as by our customer
service staff states that she has ten days from the date of enrollment to
cancel to receive the first months payment back and that the enrollment fee is
non-refundable.  Anything after the first
ten days, all that we request is that you give a simple ten day notice prior to
your next billing date to cancel, at which point you will remain active until
the end of your billing cycle.  Now
understanding that each case is different and we look at each case
specifically, this member had all of the afore mentioned information and
everything was clearly explained to her. 
[redacted]
President
Partner In Health Care

I am trying to contact this office with no luck I want to cancel this savings plan because when I took it out they said it was health insurance. I sent my books and cards back certified mail only to have them returned to me in the same envelope. I don't want this savings insurance and don't want them taking any money out of m,y account I would also like to have my money returned to my account.

Dear [redacted],
This person was enrolled by one of our affiliates and here is there answer to this complaint of which we have on file:
"All of our agents state that we are calling from an enrollment center not the national registry of health insurance.  We explain to our...

customers the savings that they could obtain by using the medical savings plan such as prescription discounts as well as help with repricing hospital bills thru the mediation department.  We never tell people that they would have a co payment like the complaint states, we explain that they could save money by using the discount plan.  This is not insurance as we state on the verification tape which every customer that we enroll has to do.  Every one of our customers goes thru the verification process and we are very specific about the fact that this is NOT INSURANCE.  We also state that this is not to replace any major Medical insurance that the customer may have.  We have already spoke to the customer and have agreed to give them a refund even though they are out of the 10 day period that would qualify them for a full refund.  The customer is satisfied with the refund.
Should you need any additional information please do not hesitate to call me.
 
Sincerely,
 
[redacted]

[redacted] enrolled in the Advantage Health Savings Program on May 30th, 2014 and
became active on June 23n:1, 2104 due to a postdated payment. Upon receiving this complaint
we had the enrollment agency contact the member and explain our program. At this point the
member...

agreed to stay on with the Advantage Health Savings Program and withdraw the Revdex.com
complaint (refer to system notes).
[redacted]
President
Partners