Prominence Health Plan

My Prominence health insurance policy was wrongfully terminated for non-payment, although I am paid up through 8/31/I have been trying to work with Prominence to reinstate my insurance, but they refuseI have submitted proof, both in my canceled checks and a printout from Prominence's own website verifying I am paid through 8/31/I never came close to exhausting the day grace period I have through the Marketplace due to my APTC qualification They also never sent me notice of the terminationThe only reason I found out was because my broker happened to be looking up information for another client and saw my policy had terminated, so she called me I have spoken to the Marketplace and they agree it was a wrongful termination, but the most they can do is escalate a claim and expedite an appealI was informed this could take months I am a year old woman with health issues (I also submitted a letter from my PCP stating this situation is jeopardizing my health and my ability to obtain and maintain maximum function) and I am a full-time caregiver for my husband with Alzheimer's disease This is the first year Prominence has been in the Marketplace, so I believe they don't understand the rulesHowever, I have sent them links to the healthcare.gov website, where it clearly states the rules for the day grace periodThey simply won't take the time to research and realize they have made a mistake This has taken a toll on me; I am stressed out and exhausted and don't know where to turn

Prominence customer service is awful I waited over minutes for an operator When she came on, I was told the (Obamacare) forms would not be sent out until "early February" It's my understanding that all tax forms are to be sent out BEFORE February I got my form from Medicare in the second week of January So much for the benefits of privatization!

Prominence could not get my information correct between them and the Marketplace. Sure, some of this could of been the Marketplace's fault but in the end my biggest complaint is towards Prominence.
I paid every months premium and got a letter of determination from them for 'non payment'
After taking my step son off insurance over a month ago, they still did not have the new information and I was being charged for myself and him.
For 4 months I did not know if I had insurance or not from the information I was getting between the Marketplace and Prominence BUT I was still paying my expensive premium!
And in the end Prominence (Shawna) has the tenacity to start blaming ME! She totally turned it around started saying things like my payments were sporadic (B.S.) and that I had too much information going on with the Marketplace.
Good bye Prominence. Thanks for the headache, wasted time and money I did not have in the first place!
([redacted], their sister partner, were helpful BTW, but did not seem like a team)

My Prominence health insurance policy was wrongfully terminated for non-payment, although I am paid up through 8/31/16. I have been trying to work with Prominence to reinstate my insurance, but they refuse. I have submitted proof, both in my canceled checks and a printout from Prominence's own website verifying I am paid through 8/31/16. I never came close to exhausting the 90 day grace period I have through the Marketplace due to my APTC qualification.
They also never sent me notice of the termination. The only reason I found out was because my broker happened to be looking up information for another client and saw my policy had terminated, so she called me.
I have spoken to the Marketplace and they agree it was a wrongful termination, but the most they can do is escalate a claim and expedite an appeal. I was informed this could take months.
I am a 55 year old woman with health issues (I also submitted a letter from my PCP stating this situation is jeopardizing my health and my ability to obtain and maintain maximum function) and I am a full-time caregiver for my husband with Alzheimer's disease.
This is the first year Prominence has been in the Marketplace, so I believe they don't understand the rules. However, I have sent them links to the healthcare.gov website, where it clearly states the rules for the 90 day grace period. They simply won't take the time to research and realize they have made a mistake.
This has taken a toll on me; I am stressed out and exhausted and don't know where to turn.

This company loses payments that you mail in for your premium, then acts like you are lying about sending in payment until they miraculously find it. Once they post the payment, they unlawfully cancel your policy (90 day grace period permitted by law). Then, after countless call and hours you still can't get a manager to talk to you about the matter. They don't mind breaking the law, they don't care about resolving issues with their customers, their website does not have accurate information for patients, etc. Incompetent business, I retired after being a hospital CFO for over 15 years, this is most ridiculous thing I have seen. In 2017, do not buy insurance with Prominence Health Plans.Product_Or_Service: Health Insurance PolicyDesired SettlementPolicy reinstated, contact by management and online account to be accurate.Business Response On 8/8/16, the member reached out to Prominence Health Plan staff because his coverage had been terminated and he had a doctor's appointment that same day; his enrollment was corrected immediately. At approximately 2:29pm on 8/8/16, [redacted] (Manager of Enrollment), spoke with the member regarding the situation, and apologized for the inconvenience the error had caused. It was explained to the member that the issue was caused due to the timeliness of his payment submission. The system was already processing a non-payment termination when his payments were received, however, the termination file had already been generated. He was further advised that his policy had been corrected/reinstated earlier in the day and that it takes approximately 24 hours for the online account to update and reflect the current information.

My Prominence health insurance policy was wrongfully terminated for non-payment, although I am paid up through 8/31/16. I have been trying to work with Prominence to reinstate my insurance, but they refuse. I have submitted proof, both in my canceled checks and a printout from Prominence's own website verifying I am paid through 8/31/16. I never came close to exhausting the 90 day grace period I have through the Marketplace due to my APTC qualification.
They also never sent me notice of the termination. The only reason I found out was because my broker happened to be looking up information for another client and saw my policy had terminated, so she called me.
I have spoken to the Marketplace and they agree it was a wrongful termination, but the most they can do is escalate a claim and expedite an appeal. I was informed this could take months.
I am a 55 year old woman with health issues (I also submitted a letter from my PCP stating this situation is jeopardizing my health and my ability to obtain and maintain maximum function) and I am a full-time caregiver for my husband with Alzheimer's disease.
This is the first year Prominence has been in the Marketplace, so I believe they don't understand the rules. However, I have sent them links to the healthcare.gov website, where it clearly states the rules for the 90 day grace period. They simply won't take the time to research and realize they have made a mistake.
This has taken a toll on me; I am stressed out and exhausted and don't know where to turn.
","neg-1

They are sending too much junk mail about their plans. Three this week so far! I have asked them to stop but the crap keeps coming. Prominence Health has been bombarding me with postcards and letters regarding their health plans,the regular plans and the medicare plans. I am not interested in their product and I want the junk mail harassment to stop. I have requested this via the phone numbers (which are different on each piece of mail) but still it continues. Please help get me off their list!!Desired SettlementI want the mail to stop, and they better not start calling me on the phone.Business Response We have contacted [redacted] to apologize. We have requested our vendor remove her name from the mailing lists we have purchased.Consumer Response (The consumer indicated he/she DID NOT accept the response from the business.)I would have said yes, but I would like some assurance that this will not happen again next year. Is it possible for me to be permanently removed from their mailing lists?Final Business Response yes, we have already requested that she is removed from the mailing lists we purchase from a vendor for these mailings.Final Consumer Response (The consumer indicated he/she ACCEPTED the response from the business.)Please note, I am still receiving mail from them as of 13 November 2015. But I will accept their assurance that it will not happen next year and that I have been removed from all their mailing lists for both medicare and regular health plans, now and in the future.

Prominence customer service is awful. I waited over 10 minutes for an operator. When she came on, I was told the 1095 (Obamacare) forms would not be sent out until "early February". It's my understanding that all tax forms are to be sent out BEFORE February 1. I got my form from Medicare in the second week of January. So much for the benefits of privatization!","neg-2

Prominence could not get my information correct between them and the Marketplace. Sure, some of this could of been the Marketplace's fault but in the end my biggest complaint is towards Prominence.
I paid every months premium and got a letter of determination from them for 'non payment'
After taking my step son off insurance over a month ago, they still did not have the new information and I was being charged for myself and him.
For 4 months I did not know if I had insurance or not from the information I was getting between the Marketplace and Prominence BUT I was still paying my expensive premium!
And in the end Prominence (Shawna) has the tenacity to start blaming ME! She totally turned it around started saying things like my payments were sporadic (B.S.) and that I had too much information going on with the Marketplace.
Good bye Prominence. Thanks for the headache, wasted time and money I did not have in the first place!
([redacted], their sister partner, were helpful BTW, but did not seem like a team)","neg-3

Saint Mary's owes me for over-payment of services, $564.43. I have talked to numerous representatives on the phone, trying to fix this problem, for 60 days now. I also made a trip down to the hospital billing department. My husband had a head X-Ray on 2/7/14 and an MRI on 3/19/14. The original issue was that no facility claim was ever received for the x-ray on 2/7/14. I was told that the problem was fixed finally on 6/4/14, that after all my efforts, all the claims had been received and I would get my refund in 4-6 weeks. It has been 6 weeks and 1 day, so I called the billing department again, and was told that all the claims are not in yet. The "biller" would look into it and call me back. I named everyone I'd talked to in the past 60 days, and the representative (yes, I got her name) told me that nobody with any of those names, works there. The billing department phone # is: [redacted]. Account # is: [redacted]. The amount originally paid was: $1,338.40. In the course of trying to get my money back, I also had to have my husband sign a HIPPA waiver, which I had to submit twice, because it got misplaced after the first submission. Am I going to have to get an attorney?Account_Number: [redacted]Desired SettlementI would like a full refund of $564.43, the total amount of the over-payment. And, I will not wait another 4 to 6 weeks. It has been 4 months and I would like immediate re-payment of my funds.Business Response The refund requested by this member is due from Saint Mary's Medical Center not Prominence Health Plan (formerly Saint Mary's Health Plan) Our records show, based on the information provided, that she should have a refund from the hospital of $439.49. All other charges were applied to her deductible.