Smart Security, Inc.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me.
Regards,
*** ***

Good Morning, The parent was sent notification of a health plan change 09/02/stating the children would be covered under *** *** beginning October 1, 2015. This letter included information on plan options as well as contact information for *** for families to review
the provider list. Ms*** *** called the call center 09/23/to switch from *** *** to *** *** without dental which offers the same benefits with a deductible and higher co-payments. Ms*** *** called the *** *** call center 10/13/inquiring about the account balance. The Call Center Representative (CCR) noted that the CCR from 09/23/only updated the *** *** for one of the children and was willing to make the adjustment to update the second child but the parent hung up the phone prior to verifying the change. 10/14/Ms*** *** called the call center and stated she wants a letter from *** *** stating they made an error and did not grant coverage to both of her children so she could get employer sponsored insurance (ESI) since her children's doctors will not accept ***. The call center *** offered October coverage to both children but the parent stated she did not want it, she wants a letter so she can get ESI. 10/19/the parent called back again demanding the letter, she was told we can provide a cancellation letter but she stated she wanted a letter that stated *** *** made a mistake and cancelled her children's coverage. Ms*** *** spoke to several CCR including *** and was noted as being irate and upset that we were unable to provide the letter she requestedSeveral attempts were made to rectify this situation but none seemed to satisfy Ms*** ***. Once again if she is interested in health coverage for her children for the month of October we would be happy to grant it. ***

Good morning. The Florida Healthy Kids Corporation was able to resolve the issueThe parent indicated she was happy with the outcome. If you need specific details regarding the child's coverage, please ask the parent to complete the attached release of authorization form. Thank
you,*** *** ** *** *** Florida Healthy Kids Corporation *** Desk: ***
*** 850-320-

Complaint: [redacted]
I am rejecting this response because: on 06/26/17 I was informed that I would have to contact Florida Healthy Kid Care back in order to keep the policy in force. I did not contact FHKC back at any point therefore the policy should have been cancelled on 06/30/17, like previously requested. FHKC took it upon themselves to apply the credit towards the month of July. When I called on 07/18/17 the representative told me numerous times that the notes on 06/26/17 stated that I would HAVE TO CALL BACK TO KEEP THE POLICY IN FORCE. Why are the notes that you are sharing now not stating this exactly as the representative read them to me? I do not feel that FHKC truly tried to make attempts in contacting me before making this decision on my behalf (after I was told otherwise) due to the fact that my cell phone number was NEVER contacted.
Regards,
[redacted]

Your Level 2 Dispute is currently being reviewed.  The [redacted] Dispute Review Process consist of four levels of review.  You must complete all of the Dispute Review Resolution levels before you can request a [redacted] Grievance Committee review.
For more information about the entire [redacted] Dispute Review Process visit, [redacted], and insert [redacted] in the “Full Text Search” box.

Complaint: [redacted]
I am rejecting this response because:This explanation is completely inaccurate and not a true account of what has taken place between Florida Healthy Kids and myself.  On 8/17/15, I sent an email through the Florida Healthy Kids website informing them that I elected specific coverage for my children.  I called the center after several weeks when I saw no change had taken place.  When I called, I was assured that they had received my email on 8/17/15, understood the changes and that those changes would be made with a premium payment of $410.00 per month ($205.00) per child.  In September, 2015, I again called the center because I received a letter in the mail informing me that my premium payment was late and that my coverage would be cancelled.  When I called the center, I was again assured that my children would have October coverage and that their website would be updated to reflect those changes.  On October 13, 2015, I took my daughter to her pediatrician and was told that she had no coverage.  The Florida Healthy Kids website showed both my children covered under "[redacted]" for the month of October 2015 and showed a balance in my account for $616.00.  On that same date, I called Florida Healthy Kids (in the doctor's office) and was told that there was an insufficient payment in premium and that my childrens' coverage was terminated for the month of October 2015.  The operator indicated that my children could be reinstated "AFTER AN INVESTIGATION WAS CONDUCTED" as to why an error was made within "24-48 HOURS" and that I would receive a telephone call on my status.  The "new insurance coverage" was mentioned; however, my comment to the operator was questioning why "[redacted] WOULD PROVIDE A HEALTH INURANCE COVERAGE THAT NO DOCTORS ARE ACCEPTING.?"  I never COMMITTED or indicated that I did not want the coverage.  I called the center on October 15, 2015, AFTER NOT RECEIVING A CALL BACK WITHIN 24-48 HOURS...and was told that my case was still under investigation and that someone would call me back.  At this point, I asked to speak with a [redacted].  After being on hold for 45 minutes, I spoke with a [redacted] by the name of "[redacted]"  and informed her that I was requesting they provide me with a letter stating ..."THAT BECAUSE OF AN ERROR THROUGH NO FAULT OF MINE, MY CHILDREN WERE DROPPED FROM COVERAGE FOR THE MONTH OF OCTOBER 2015."  "[redacted]" informed me that they would reach out to their corporate department and that would take 24-48 hours.  When I asked her who her [redacted] was, she informed me that, "they are not allowed to disclose that information and that she could only give me the name "[redacted]."  I asked her to have [redacted] call me back and she informed me that "[redacted]" would call me back within 24-48 hours.  When "[redacted]" did not call me back, I again called on October 19, 2015 to inquire as to the status of my account and the requested letter.  I was again informed that [redacted] was on another call but that he would call me back.  I called again that afternoon on or about 3:15 p.m. to inquire as why "[redacted]" had not returned my call.  I asked them to put me on hold and that I would wait to speak with [redacted].   [redacted] then asked me to explain to him the issue.  I explained everything to him in detail and he then informed me that he would put in a request to "corporate" regarding the letter I requested.  [redacted] promised to call me back personally and inform me of a status within 24 hours.On October 19, 2015, I called Florida Healthy Kids once again to inquire as to why [redacted] did not call me back with  a status as promised within 24 hours and was told that he was in a meeting and that he would call me back when he got out of such meeting.  On October 19, 2015 at about 2:30 p.m., I called Florida Healthy Kids to speak to "[redacted]"  and was told he was still in a meeting.  I informed them that I would wait on hold to speak to him.  I expressed my frustration once again to the representative and asked her why it has taken them over 2 months to fix this error when I requested my election on August 17, 2015 via email through my online account.  She expressed surprise and put me on hold to check my account.  When she came back on the line, she ADMITTED that "yes", they did make an error, however, the letter that I am requesting is still not going to be issued and that the "only" letter they could provide me was one that stated "my children were dropped for non-payment.".  I then demanded to speak with "[redacted]" and that I would hold.  I was put on hold for approximately 76 minutes and was transferred to another [redacted] rep who promised to call me back on October 20, 2015 to give me a status.  On October 20, 2015, I received a call on my cell phone from the [redacted] rep informing me that she was told that the letter I was requesting could not be provided.  I then asked her what reason was given and she said "I don't know specifically."  I then told her to have a [redacted] call me back with an explanation.  I have still not been told:1.   Why, from the date of my initial email on August 17, 2015 to today's date, my account has not been corrected to reflect the correct changes to my account;2.   Why, their website portal has not been updated to reflect the correct information for coverage;3.   Why, it has taken over 2 months and an obvious and ridiculous amount of telephone calls to customer service to correct "THEIR" error; and4.   Why, they are refusing to acknowledge in writing that they made an error and dropped my children from coverage for the month of October 2015?I have printed copies of the website pages showing the inaccuracy of the information and my balance.   I am sure they have all of these conversations recorded and can attest to these fact and true and correct to the best of my recollection and knowledge.In closing, I also received a letter yesterday, October 19, 2015, dated October 14, 2015 STILL reflecting inaccurate information on my coverage elections. 
Regards,
[redacted]

As per the parents request a letter was sent to her home address today.

Florida Healthy Kids policy prohibits can the cancellation of coverage once the coverage month has begun.  If the parent wanted to cancel January 2017 coverage they would have had to cancel by December 31, 2016.  Coverage will end for all children January 31, 2017.  Any additional...

disputes can be sent in writing to [redacted].

We have confirmed that no claims have been received by the health and dental plans for July 2017, so we are retro-voiding July 2017 coverage and refunding the premium payment.  The parent should receive the refund within two weeks.  If any claims are received with a July date of service, they will be denied due to non-coverage.

This issue has been reviewed prior and the complainant was
sent a response to both her Level 1 and Level 2 disputes.  Florida Healthy
Kids Corporation's position remains the same. 
The Florida Healthy Kids Corporation’s internal policy
implemented 05/2015 does not allow for...

consideration of coverage cancellation
after the 7th day of the coverage month.  The complainant requested cancellation of
January 2016 coverage on January 8, 2016. After reviewing the facts related to the
dispute, our [redacted] staff have confirmed that coverage was properly
ended January 31, 2016 and the complainant was not due a refund of January 2016
premium.  We did however refund the
January 8, 2016 payment for February coverage.

Complaint: [redacted]
I am rejecting this response because:I would like specification as to what the contents of the letter state.  I have made 3 phone calls to Ms. [redacted] today with no response as to same.
Regards,
[redacted]-[redacted]

We processed the request for retro-enrollment and sent the request to the [redacted] program for coverage last week.  We will ask that someone from the [redacted] program call you immediately to confirm coverage.  Please note that we do currently show sufficient funds on your account for November - January coverage at the current premium rate (premium payments are due one month in advance of the coverage month).  Thank you.

Someone will be contacting you shortly regarding your complaint.  If you have not received a response by the COB Monday please email me at [redacted]. 
Florida
Healthy Kids Corporation
[redacted]
[redacted]
[redacted]...

Complaint: [redacted]
I am rejecting this response because:I made a complaint 10/3/17 about this issue. I received a call on 10/5/17 regarding that initial complaint miraculously they were able to expedite my application. They stated that my [redacted] would have coverage for the month of October and that as soon as my payment POSTED on my account that the system would update her insurance information while I received her insurance cards in the mail. My payment posted by the next business day. It is now 10/11/17 and there is no insurance information. In addition, the only messages that I have in my inbox are letters stating that I still have "missing income information". In the box where her insurance details should be there is a message to call an 800 number. [[redacted]] I called and was connected with a representative. I explained my concerns and was advised that since I had made a late payment that I would have to way 7-10 business days for the payment to post on their end and for [redacted] to send me my insurance information. Until then, I have to pay out of pocket. I would then have to ask about POSSIBLY getting reimbursed for my what I've paid out of pocket. This is absolutely unacceptable. 1. I did not make a late payment. I made a payment minutes after being advised that the system would allow me to make a payment. 2. I was advised that she would have coverage for this month. SHE DOES NOT. My money was taken, I paid 4 months in advanced. WHY DO I HAVE TO PAY OUT OF POCKET to then POSSIBLY get reimbursed. MY [redacted] NEEDS TO GO TO HER APPOINTMENTS. I need her health insurance information so that I can make her appointments. This is RIDICULOUS. I am absolutely exhausted and will be seeking to take further actions if this does not get resolved soon. We are mid-October and she does NOT have coverage despite them accepting my payment AND telling me that she would. ALSO, nothing has been updated on their end as far as my income verification goes. It should have been updated on 10/5/17 when the [redacted] called me to tell me that it had been updated.My [redacted] needs COVERAGE for the month of October. I need her insurance information. Premiums have been paid for.
Regards,
Cynthia Tirado

We have reviewed call recordings and have determined that the parent is not eligible for a refund since she did not request cancellation timely.  Per the call recordings and other account actions, the following occurred:6/26/17 11:33 am  Parent called to request coverage to cancel the end...

of June.6/26/17 1:17 pm  Parent called back and stated she needed to do more research on other insurances before cancelling and will call back tomorrow.  Rep advised to call back asap.6/27/17 8:10 am  Rep left message for parent to confirm account cancellation.  Parent did not call back.7/6/17  FHKC sent an e-mail, made an auto-dialer call, and sent a letter regarding a late payment.7/18/17  Mom called requesting refund for July 2017.  She was advised request was not made timely.7/19/17  Account was cancelled due to non-payment.

[redacted] will provide retro-coverage for the child requested back to 10/1/17 once premium payment is made.  [redacted] will receive a call from us with payment directions.  Once payment is posted to the account, we will request [redacted] update coverage through one of their managed care...

plans.  Please contact us at [redacted] regarding your account if you need further information.  Thank you for choosing [redacted] for your child's health and dental care needs.

Complaint: [redacted]
I am rejecting this response because: Tell me where I have received the paper work describing the rules.  There is no information on-line, I received a letter in December describing things I need to do to renew but NO information about cancellation rules.  They purposely make it difficult for situations like this to suck money out of people to put in their pockets, absolutely unprofessional especially since I can prove have coverage in Jan. from another insurance agency.  Florida Healthy Kids have not incurred any costs for covering my children in Jan. and they need to do the right thing.
Regards,
[redacted]

If you would like to file a Level Two dispute please send it to [redacted].

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]
 Complaint: 11940915
I am rejecting this response because:Why was I not told on the phone when I insisted that I disagree with the answer that a "Level 2" complaint even existed?  How many levels of complaints are there?  Please provide me with a clear understanding of the timing, process and where I find these procedures.  
Regards,
William Stout