Via Benefits Reviews (143)
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 am so sorry it had to come to contacting Revdex.com. Thank you for your speedy response. The matter has beenresolved.
We have reviewed the claims and they have been approved for reimbursement. Please allow up to 10 business days for the
reimbursement to be received.
The participant’s options were discussed in detail during
the initial transition to individual coverage in 2014. At that time, the participant agreed to
forfeit their individual allocation. A
OneExchange representative will reach out to the participant directly to review
records indicate that Ms. D[redacted]'s reimbursements are being made via direct
deposit as of 7/31/2015. Should she have any problems going forward, she should
has worked diligently to resolve this matter. We are sorry we have not met Ms.
D[redacted]'s expectations; however, we are considering this matter closed. Thank you.
We are happy to reach out to the participant directly to advise of the issue that was identified and the resolution as well as assist with outstanding questions. We will reach out to the participant directly before end of business today.
I am rejecting this response because:There has been limited effort and results on the part of Tower Watson. You still have a good way to go. When a claim is denied the suggestion that, “some information is missing and please reapply,” you could indicate what information is missing. And 30 minutes on hold just to be told to refile with all information does not help. We are now about two and a half years behind. My claims for Blue Shield insurance alone would have exhausted these funds.
This issue has been escalated to a specialized team. This team has been in contact with the participant, contacting them on November 6, 2017. We will continue to keep the participant updated until resolution is reached.
We reached out to Ms. [redacted] on 5/2/2016. We continue to work towards resolution and will contact Ms. [redacted] directly with updates.
Our customer service department does not require Power of Attorney (POA) documentation to list a POA on the customer profile. Our customer service representatives will alert the caller of the documentation requirements of insurance carriers and other entities as necessary. We apologize...
for the confusion and will reach out to the customer to update their profile with their POA information. We consider this matter resolved.
I am rejecting this response because:RE: ID [redacted]Dear Lisa W[redacted],Thank you for contacting Towers Watson One Exchange and taking action on my behalf. Though I appreciate the company's apology, I do not yet feel they have fulfilled their obligation to me. I have received about one tenth of the reimbursement that is currently owed to me. Because I applied for my HRA in January (and should have begun receiving my information some time in March, a packet which contained reimbursement forms, so that I could not even apply for my HRA until mid-June when I received the forms and packet). By then I had paid my insurance premiums for July (April, May, June, and July), but I had to wait until I could get my bank statement to prove payment before I can send in the reimbursement forms. Since I am now owed reimbursement for four months of insurance premium payments, it is a complicated and lengthy process to apply for the rest of what I am owed. As a result, I will not be able to complete all the forms and the process required within the seven days you require for my response. Considering my past experience, I feel assured that this matter will not be resolved within that time. Therefore, I will contact you again after my paperwork is completed and the reimbursement delivered to me. My complaint will then be resolved to my satisfaction.Sincerely,Gail D[redacted]
mso-bidi-font-weight:bold">This issue has been assigned to a specialized team
that will remain in contact directly with the participant until resolution is
reached. This team reached out and spoke
with the participant on 4/28/17
After researching this issue, we have found that Mr. [redacted]'s claims have been processed and reimbursement has been sent to Mr. [redacted]. We trust this resolves this issue.
The participant provided us with an updated address on
11/22/2016. This update was provided
after the reimbursement was mailed to the previous address. I do not have record of multiple reissues and
mailings. We are reissuing the
reimbursement and mailing to the address we were...
provided on 11/22/2016.
Mr. [redacted] was reimbursed for March premiums on 4/22/2016. We consider this matter resolved.
OneExchange is a
private Medicare exchange that is contracted by a number of employers,
including General Dynamics and GE, to work with its retirees and their
spouses and dependents in transitioning from group health care coverage to
individual Medicare health plans. Many of these...
employers have also set up a
Health Reimbursement Account (HRA) for their retirees who are losing group
coverage to help offset the cost of the individual Medicare plan.
We are sorry for the
inconvenience this matter has caused Mr. D[redacted].
A letter was mailed to him on June 29, 2015 with detailed instructions
on how to set up his reimbursements. If
he is unclear, he should again contact us and we will be happy to assist him.
We are sorry that OneExchange did not meet your expectations and sincerely hope we will have able to assist you in a more satisfactory manner in the future. We have reviewed Mrs. [redacted]'s account and found that reimbursements are being sent as quickly as possible.
The participant’s funding allocation amount was corrected and backdated accordingly on 5/12/2016. The participant was contacted and made aware of resolution on 5/13/2016.
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me, if they do in fact resolve it.
Frankly, I'll believe it when I see it.
OneExchange is certainly NOT discriminating
Mr. J[redacted]. We very much want to assist him in getting his claims paid. Regardless of the size of the claim, there is
certain documentation required. As stated previously, On August 3, 2015, a representative from OneExchange
contacted Mr. J[redacted] to discuss his claims. In order for his claims to be
paid, we needed additional information. Our representative told him
specifically what he needed to submit (3 documents). Our representative also
told Mr. J[redacted] we can get his claim paid this week if he can provide the
documentation that was discussed. Mr. J[redacted] felt that was an inconvenience
and told our representative he did not want to send us anything else.
Again, we will gladly process the claims
provided Mr. J[redacted] submits the documentation needed.
We are considering this matter closed
at this time.