UFCW National Health & Welfare Fund

Dear Mrs [redacted] , We are in receipt of your complaint submitted to the Revdex.com and trust fund governed by the federal Employee Retirement Income Security Act (ERISA)Pursuant to federal law, the Fund is required to adhere to the provisions of its plan documentsThe Fund's policy for filing of claims is within months of the service date and within days of receiving written notification of an adverse benefit determinationThe claim in question was denied on June 14, as the Fund's Consent to Lien from mailed on 5/21/was not returnedNo response to this denial or the status of this claim was received until July 18, 2013, in which you contacted our office to obtain another copy of the Form that was ultimately received on August 26, 2013.As such, the request for reconsideration of this claim at this late date was denied for failure to submit within the timely filing periodThe Fund's procedures for Claims Review and Appeals are summarized below, should you disagree with this denial of benefitsClaims Review and Appeal Procedures You may file a request for review of an adverse benefit determination by appealing to the Claims Review Committee of the Board of Trustees of the UFCW National Health and Welfare Fund in writing, within days after receiving written notice of the Fund's actionSend your appeal to the Fund office and address it to the CommitteeThe Committee may refer an appeal to the BoardThe full Claims Review and Appeals Procedure is set forth in the member's Summary Plan DescriptionSincerely, [redacted] Office Manager

I am rejecting this response because: they are lying I have returned papers back to themThe first were before July and I know this because we moved out of town in July and I took care of the paperwork before we leftLater I was receiving bills for the 33,so I then contacted the insurance company They sent me a new forms to fill out at my new address I never heard from them again and figured it was taken care ofWe were trying to buy a house and this bill came upI again contacted the insurance company....apparently they sent my denial letter to an old address when they had my current address Which takes me past the "days" I have to appeal How convenient!

Dear Mrs [redacted] ,We are in receipt of your complaint submitted to the Revdex.com and trust fund governed by the federal Employee Retirement Income Security Act (ERISA)Pursuant to federal law, the Fund is required to adhere to the provisions of its plan documents.The Fund's policy for filing of claims is within months of the service date and within days of receiving written notification of an adverse benefit determinationThe claim in question was denied on June 14, as the Fund's Consent to Lien from mailed on 5/21/was not returnedNo response to this denial or the status of this claim was received until July 18, 2013, in which you contacted our office to obtain another copy of the Form that was ultimately received on August 26, 2013.As such, the request for reconsideration of this claim at this late date was denied for failure to submit within the timely filing period.The Fund's procedures for Claims Review and Appeals are summarized below, should you disagree with this denial of benefits.Claims Review and Appeal ProceduresYou may file a request for review of an adverse benefit determination by appealing to the Claims Review Committee of the Board of Trustees of the UFCW National Health and Welfare Fund in writing, within days after receiving written notice of the Fund's actionSend your appeal to the Fund office and address it to the CommitteeThe Committee may refer an appeal to the Board.The full Claims Review and Appeals Procedure is set forth in the member's Summary Plan Description.Sincerely, [redacted] ***Office Manager

I don't have anyI sent it to them =/

Dear Mrs. [redacted],We are in receipt of your complaint submitted to the Revdex.com and trust fund governed by the federal Employee Retirement Income Security Act (ERISA). Pursuant to federal law, the Fund is required to adhere to the provisions of its plan documents.The Fund's policy for...

filing of claims is within 12 months of the service date and within 180 days of receiving written notification of an adverse benefit determination. The claim in question was denied on June 14, 2012 as the Fund's Consent to Lien from mailed on 5/21/2012 was not returned. No response to this denial or the status of this claim was received until July 18, 2013, in which you contacted our office to obtain another copy of the Form that was ultimately received on August 26, 2013.As such, the request for reconsideration of this claim at this late date was denied for failure to submit within the timely filing period.The Fund's procedures for Claims Review and Appeals are summarized below, should you disagree with this denial of benefits.Claims Review and Appeal ProceduresYou may file a request for review of an adverse benefit determination by appealing to the Claims Review Committee of the Board of Trustees of the UFCW National Health and Welfare Fund in writing, within 180 days after receiving written notice of the Fund's action. Send your appeal to the Fund office and address it to the Committee. The Committee may refer an appeal to the Board.The full Claims Review and Appeals Procedure is set forth in the member's Summary Plan Description.Sincerely,[redacted]Office Manager

Dear Mrs. [redacted],
We are in receipt of your complaint submitted to the Revdex.com and trust fund governed by the federal Employee Retirement Income Security Act (ERISA). Pursuant to federal law, the Fund is required to adhere to the provisions of its plan documents.
The...

Fund's policy for filing of claims is within 12 months of the service date and within 180 days of receiving written notification of an adverse benefit determination. The claim in question was denied on June 14, 2012 as the Fund's Consent to Lien from mailed on 5/21/2012 was not returned. No response to this denial or the status of this claim was received until July 18, 2013, in which you contacted our office to obtain another copy of the Form that was ultimately received on August 26, 2013.As such, the request for reconsideration of this claim at this late date was denied for failure to submit within the timely filing period.
The Fund's procedures for Claims Review and Appeals are summarized below, should you disagree with this denial of benefits.
Claims Review and Appeal Procedures
You may file a request for review of an adverse benefit determination by appealing to the Claims Review Committee of the Board of Trustees of the UFCW National Health and Welfare Fund in writing, within 180 days after receiving written notice of the Fund's action. Send your appeal to the Fund office and address it to the Committee. The Committee may refer an appeal to the Board.
The full Claims Review and Appeals Procedure is set forth in the member's Summary Plan Description.
Sincerely,
[redacted]
Office Manager

I am rejecting this response because: they are lying.  I have returned 3 papers back to them. The first 2 were before July 2012 and I know this because we moved out of town in July and I took care of the paperwork before we left. Later I was receiving bills for the 33,000.00 so I then contacted the insurance company.  They sent me a new forms to fill out at my new address.  I never heard from them again and figured it was taken care of. We were trying to buy a house and this bill came up. I again contacted the insurance company....apparently they sent my denial letter to an old address when they had my current address.  Which takes me past the "180 days" I have to appeal.  How convenient!

Review: My husband paid over $500 a month for health insurance from National health and welfare fund. When we actually needed them to pay a medical bill they did not and will not pay. Their reason....they didn't receive additional paperwork that I personally filled out and sent back 3 times. They claim to have not received them...how convenient! It happened April of 2012 I started receiving bills about a year later. That's when I got ahold of the insurance company. They sent me new forms to fill out. They are claiming those were the only paperwork the received and that it was too late! We can't buy a house because of this. This is a big bill we have a few little ones they didn't pay either. Do not get health insurance from them.Desired Settlement: I would like them to pay the bills

Business

Response:

Dear Mrs. [redacted],We are in receipt of your complaint submitted to the Revdex.com and trust fund governed by the federal Employee Retirement Income Security Act (ERISA). Pursuant to federal law, the Fund is required to adhere to the provisions of its plan documents.The Fund's policy for filing of claims is within 12 months of the service date and within 180 days of receiving written notification of an adverse benefit determination. The claim in question was denied on June 14, 2012 as the Fund's Consent to Lien from mailed on 5/21/2012 was not returned. No response to this denial or the status of this claim was received until July 18, 2013, in which you contacted our office to obtain another copy of the Form that was ultimately received on August 26, 2013.As such, the request for reconsideration of this claim at this late date was denied for failure to submit within the timely filing period.The Fund's procedures for Claims Review and Appeals are summarized below, should you disagree with this denial of benefits.Claims Review and Appeal ProceduresYou may file a request for review of an adverse benefit determination by appealing to the Claims Review Committee of the Board of Trustees of the UFCW National Health and Welfare Fund in writing, within 180 days after receiving written notice of the Fund's action. Send your appeal to the Fund office and address it to the Committee. The Committee may refer an appeal to the Board.The full Claims Review and Appeals Procedure is set forth in the member's Summary Plan Description.Sincerely,[redacted]Office Manager

Consumer

Response:

I am rejecting this response because: they are lying. I have returned 3 papers back to them. The first 2 were before July 2012 and I know this because we moved out of town in July and I took care of the paperwork before we left. Later I was receiving bills for the 33,000.00 so I then contacted the insurance company. They sent me a new forms to fill out at my new address. I never heard from them again and figured it was taken care of. We were trying to buy a house and this bill came up. I again contacted the insurance company....apparently they sent my denial letter to an old address when they had my current address. Which takes me past the "180 days" I have to appeal. How convenient!

Consumer

Response:

I don't have any. I sent it to them =/