ComplaintsforApple Insurance & Financial Services, Inc.

• Initial Complaint

  04/04/2023

  Complaint Type:

  Sales and Advertising Issues

  Status:

  Unanswered

  More info

  For the year is 2021 in 2023, I signed up with Apple insurance to provide me with Florida blue healthcare coverage. ***********************, who was my representative had asked me to give her information so she can see what my best plan was. Part of that information was that I had informed her that I was retired with a law enforcement pension. She advised me that she spoke with her supervisor, and he said that I dont need to use my yearly pension as income. This put me under a fixed amount which provided me the cheapest option for health insurance. After filing my taxes, I was informed that for the year 2022 I owe $8000. this was all due to the fact that me and my wife had an income above the satisfied yearly range for health insurance. After having a four-way conversation with my accountant, *****, ******, and manager, ***, I discovered that my pension does count as income. ***, the manager, at Apple insurance, admitted over the phone that *********************** made a mistake and that she would be placed in training so it wont happen again. I feel that it is unfair that I wasnt given the proper information from the beginning. I could have signed up for health insurance under my wifes plan for a lot less. Now Im in a situation where I have to pay the money and the business profited from their mistake.

  Business response

  04/19/2023

  Thank you for bringing this to our attention, we understand your frustration.  After reviewing the case fully, I can certainly understand Mr. ********* frustration with a tax bill imposed by the *** when he reconciled his Advance Premium Tax Credit ( APTC aka Subsidy).  The reconciliation of the tax credit and the confirmation of the income ultimately is based on information reported to the Marketplace based on income,age, resident  zip code and  household  tax members eligibility. ** policy years 2021 and 2022 spouses and dependents  were bound by the *** law which prohibited household members to obtain an APTC if the spouse had employer coverage that was affordable. On March 16,2022 the agent was informed by Mr. **************; that his accountant told him to change his income at zero dollars for the year 2022, even though the original Marketplace application had reported income earned. Mr. ********* asked the agent to submit, on his behalf, a statement to the Marketplace claiming that his income was now zero. Both of these conversations were via text.   We instruct agents to advise clients to check with an accountant prior to submitting an application on the Marketplace. ** this case the accountant instructed the client to keep his income at zero thereby causing the issue.

  Customer response

  04/19/2023

   
  Complaint: 19892905
  
  I am rejecting this response because: Apple insurance agent, *********************** advised me to fill out the letter just as I did, and coached me through the process. I did not give her the permission to falsify information. It is a shame that a company would take advantage of a retired law enforcement officer to benefit themselves.  This statement is completely false, and I will not let this rest until a refund is given.

  
  Sincerely,
  
  *****************************

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