ComplaintsforSouthwest Service Administrators, Inc
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Complaint Details
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Initial Complaint
02/13/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Unanswered
Southwest Service Administrators provides me with my health insurance. I was off work due to a surgery that was work related and lost my insurance due to the amount of time I was out. I started working again in October, 2023 and started paying union dues again which covers my benefits. I called this business to inquire about my coverage and was told that I would be ok making doctor ************ again and that my insurance would be active again. My wife started receiving medical bills for the month or November and they were not covered by insurance because it said that we were not covered for November. I spoke with this business February 6th, 2024 and was told that we were not covered so we will be responsible for the medical bills. Because the person I spoke to was no help, I requested a call back from a supervisor and was told one would call me in 24 to 48 hours. After not receiving a call, I called them again on February 8th to request a call from a supervisor and was told one would call me. It is now February 13th and I have gotten no call, nor any help regarding my situation.Initial Complaint
12/06/2023
- Complaint Type:
- Customer Service Issues
- Status:
- Answered
I have been disabled since June of 2023. I am a driver with **** This company has a policy they won't call you. So I have had to run around and get all paperwork several times due to the fact they won't call if there's a problem with paperwork. They want dates of disabilities and when those are provided by the doctor they change what they need. We have only received two checks in six months. They refuse to let us speak to a manager. They have put me in financial ruin. *** is contracted through this company for disability and we can not get anyone to help me. My car is about to be reprocessed. And I am so sick. I have made so many calls. Faxes. Emails. And they just keep giving me the runaround. I am now on long term disability and this companies policies almost bankrupt me from them not paying. I have all the doctors documentation yet I am still told to wait 8 to 10 days for a check. I haven't received my entitled check for three months.Business response
01/16/2024
The issue presented in this complaint has been fully resolved as of December 19, 2023. The claimant cashed the final disability claim check that was overnighted to him via UPS.
There were difficulties encountered when his disability checks were mailed to his new international address in ****** that was changed after his initial disability claim was filed. Checks were overnighted to the claimant on three occasions when it was discovered he did not receive other checks that were processed and mailed regular mail through USPS.
Please update this complaint to reflect the full resolution status and to no longer show as unanswered.
Please let us know if you have any questions regarding this email response.
*****************
Account Manager
Southwest Service Administrators, Inc.
P: ************ W: **********************Initial Complaint
12/13/2022
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
I have called and requested an Insurance ID card 3 times and still have not received one and it has been almost 1 year. They keep telling me they will send it out but I have not received one yet and I need it to schedule a doctors appointment. They dont give me the option to pay for fed x where I can track the shipping or have it on their app so I can just pull it up. At this point I dont know what else to do I need my insurance card.Initial Complaint
02/23/2022
- Complaint Type:
- Order Issues
- Status:
- Answered
The business decided to conduct an "audit" and removed all *** employees family members from their health insurance plan through *********** Blue Shield. No information was sent to *** employess. Family members discovered the cancellation of insurance while at the doctor's ******* Southwest Services Adminstrators takes no action in adding family members to the insurance again. Even after all documents were faxed to them to add family again, Southwest Services Administrators claimed they never recieved the documents. Again, the "audit" was done under fraudulent practices and zero notice as given to *** employees and their families.Business response
03/11/2022
Southwest Service Administrators is the contract administrator of the Teamsters Western Region and Local 177 *********** Plan, a federally governed welfare benefit plan. The Plan is provided to eligible employees of employers bound by labor agreements to contribute to the Trust underlying the Plan. *** is one of those employers. The Plan is not a business with customersit is rather a self-insured health benefit plan with participants and dependent beneficiaries as defined by federal law.
In recent months, the Plan undertook a review of underlying documents to verify that claimed dependents were, in fact, properly included under the benefits the Plan provides. On five separate occasions, notice of the review was provided to participants. Since the complainants address was the one to which these notices were sent we are hard pressed to understand the zero notice claim. We can say that necessary documents proving dependent status were provided to this office on March 1st, and that BCBSAZ and the other benefit provision vendors are now being provided with the eligibility update.
We note that participants in the Plan have appeal rights to the Plan Trustees under the governing federal law (ERISA), but that the complainant did not apparently utilize that avenuethe proper ***** voice her concerns.
We trust that this response satisfactorily resolves any issues posed.
Please confirm receipt as the deadline stated on the letter is today.
Thank you,
***************************
Administrative Assistant
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Customer Complaints Summary
4 total complaints in the last 3 years.
2 complaints closed in the last 12 months.