Southwest Service Life Insurance Company

I would like to retract my complaint, case #***Southwest Service Life has been very accommodatingIn regard to the original complaint, we understand that a sales rep that said he also sells SW Service Life product misrepresented them to us and gave us faulty information in regard to both SW
Service Life and his own companyWe are continuing our relationship with SW Service Life and have no issues with their resolution

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,
*** ***

We are grateful for this opportunity to respond to Ms***’s complaintWe understand Ms***’s “Desired Settlement,” to be as follows:We want a refund of our money, as well as a letter stating that we should not be penalized by the government at the end of the month because of their
negligence from May until September 2016.First, we are processing a full refund of money we have received from Mrand Ms***They will receive the refund check on or before October 19.Second, there are a couple of details that we hope will help clarify Ms***’s statement of her problem that she “bought health insurance from Southwest in March of … [but] did not get cards etcuntil May 2016.”Indeed, Mrand Ms*** applied for our health insurance policy on April 9, 2016, requesting coverage for themselves and their three children (each of whom are under age 26)They were assisted in doing so by *** *** ***, an independent insurance agent of their choosingThe application they signed electronically stated that the “insurance will not take effect unless this Application has been accepted and approved by the Company and until the Effective Date of the Policy.” We received their application at our home office on April 12, 2016.After we receive any application for health insurance, a key part of our underwriting process is speaking with the applicants to make sure their responses on the application’s health questionnaire are correctWe contract with *** *** *** to make these verification callsWe do not issue a health insurance policy until we or *** have personally verified the information on the applicationAlong with the submission of the application from the ***’s agent, we received instructions that the ***s would be available for the verification call from *** *** *** on Friday, April 15, 2016, between 12-p.m.Accordingly, *** called them at 12:p.mon April 15, During that call, Mr***s asked *** to postpone the interview because he had some questions he needed to ask his agent first*** arranged with Mr*** to call later that afternoon.That afternoon, and over the next ten business days, *** initiated nine more attempts to conduct the verification interviewOn April 28, 2016, we contacted Agent *** and informed him that the ***’s application was on hold and the policy would not be issued until the information in the application was verifiedWe alerted the agent that unless we could conduct a telephonic verification interview within ten days, we would have to decline the application and refund any deposit we receivedThat evening, Mr*** called *** and completed the application-verification telephone interview.Apptical sent their results to us on May 5, 2016, five business days after the interviewThe verified application was then processed through our Underwriting DepartmentThe application for coverage was accepted, and on May 13, 2016, we issued the policy, and mailed the complete policy form along with insurance ID cards to the *** family.One final note: Our health insurance policies do not provide Minimum Essential CoveragePut another way, our company issues health policies that are granted exceptions, by law, from the requirements of the Affordable Care ActWe make this clear both on the application and on the front page of the policy.So, when an applicant signs our application for coverage, they acknowledge that the policy for which they apply “…is not Minimum Essential Coverage (MEC) under the Patient Protection and Affordable Care Act of 2010.” After an application is approved and the newly issued policy is sent to the new insured family, at the top of the first page of the policy, in boldface, underlined type, is the following notice:This Policy is not comprehensive health insurance, [or] minimum essential coverage under the Patient Protection and Affordable Care Act of 2010…In short, our health insurance policies provide “excepted benefits,” i.ebenefits that are exempt from the requirements of federal health insurance lawsIt is for this reason that our company does not issue IRS Form 1095-B Health Coverage information reports.We regret that we are unable to meet the ***’s health insurance needsIn issuing health insurance to Texans for more than years, we work hard to provide the best possible coverage for the lowest possible premiumWe are sorry for any frustrations the ***s have felt toward our companyWe hope the refund of their money helps them in some way

Thank you, for giving our company a chance to respond to your issue. After researching your concernsthoroughly we found in our records where our company faxed verifications of benefits to your Doctor'soffice explaining your policy's benefits.Our company relayed to your Doctor office that your policy...

had a $100.00 benefit for your office call. Inyour letter you stated that your Doctor's office told you our company had$100.00 co-pay and we wouldpay the remainder. We can only surmise they misunderstood are misread the verification of benefitsform we faxed them on 07 /27 /16 and 08/23/16.Our company was able to get you a $120.00 discount from our network provider, off your Doctors totalbill. And we paid $100.00 due you from your policy's outpatient benefits. We paid your claim and sentyou an Explanation of Policy Benefits (EOB) on 08/30/2016.Mrs Again we want to thank you for giving us an opportunity to respond to this situation. And wewant to thank you, for being a policyholder with our company since 2013.We hope we can continue to server you in the future.