ComplaintsforBenefit Resource LLC

• Initial Complaint

  09/27/2022

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  My previous employer changed insurance carriers and COBRA services in May 2022. However, I wasn’t registered until after I made my payment for June 2022 to BRI COBRA. I spoke with a BRI customer service rep in July 2022 regarding a refund for the June payment and they suggested that I submit a request in writing. I submitted a request in writing on June 7, 2022 for the refund. I didn't hear back so I called on July 18, 2022 and sent a follow up request in writing the same day. The only responses I received were their standard automated response that I would be contacted within 10 business days. I sent another follow up in writing on July 25, 2022 and again on August 2, 2022. I sent a 5th attempt on August 23, 2022 - to which I received the following response from a rep named Katy in the Participant Services group: ==================== Hello **, I am so incredibly sorry that you haven't heard back from anyone. I reached out to our internal team and I made sure you are on the refund list. Looks like some system issues but that is here nor there. All excuses aside, we are processing your refund ASAP. Unfortunately, it does take a few days but I truly made sure that you WILL get your refund. I'm so sorry! Thank you, ==================== I have since followed up on September 12, 2022 with no response, and again today September 27, 2022. I have attached a copy of my email communication.

  Business response

  10/03/2022

  Hello, I am terribly sorry to hear about the experience that ** had with his COBRA plan administered by BRI. In reviewing his account, I see that the refund for the month of June 2022 was made and mailed out to the address on file, on 9/23/22. It may take up to 10 business days to receive the refund check.  Thank you, Kyle P****** Benefit Resource, LLC 

  Business response

  10/12/2022

  Hello, I apologize for the delay in receiving your refund. I have reached out to our cobra team and was informed you have received your refund check after speaking with us today. Please let me know if I can help you any further.  Thanks so much  Kyle P******  Benefit Resource, LLC 

  Customer response

  10/13/2022

  Better Business Bureau:  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.   Regards,  ** ******* 

• Initial Complaint

  09/20/2022

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  I cancelled my COBRA policy effective 7/31/22, but was charged for the month of August 2022 through auto-pay. I contacted Customer Service on 8/25/22 and was assured that a refund would be processed within 5 business days. All communication with them for statue was on 8/25, 9/12/, 9/13 and 9/20 and I have still not received my refund as of 9/20/22. After being on hold for 2 1/2 hours each time, I'm promised a payment will come. As of today 9/20/22 they confirmed I'm owed the money but will not tell me when or why there has been a delay of 2 1/2 months. 

  Business response

  10/12/2022

  Hello,  I am terribly sorry to hear about the experience that ********* had with her COBRA plan administered by BRI. In reviewing her account, I see that the refund for the auto pay billing was made and direct deposited to the account we have on file, on 9/23/22.Please let me know if this was not received and I will do what I can to resolve this issue.    Thank you,  Kyle P******  Benefit Resource, LLC 

  Customer response

  10/15/2022

  Better Business Bureau:  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.   Regards,  ********* ****** 

• Initial Complaint

  08/26/2022

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  I switched jobs and had to use BRI Cobra for May and June 2022. I paid for May and didn't start actually being able to use my benefits until the last week and a half of May because of "processing". Finally I had insurance, it said my next payment was due June 1st so I paid my payment June 1st. In June I had a Dr apt on June 7th and they informed me that my insurance ended on May 31st. I called BRI multiple times, and my issue was "escalated" with no responses. I left a message with a supervisor, no one ever got back with me. Finally the end of June came and I still didn't have insurance. I called and spoke to customer service AGAIN on June 28th, I told her I wanted a refund since I never received my insurance. She had me email participate services and tell them I wanted to cancel as of June 1st and she was going to attach a note for a refund. On July 19th I FINALLY received an email back saying they canceled my insurance as requested and I'd be receiving a refund of $766.02 and that it would take 7-10 business days. After waiting over 10 business days I still hadn't received my refund. I emailed participate services on Aug 5th and let them know I still hadn't received my refund. No one got back to me so I called customer service AGAIN on Aug 12th, they escalated the the issue for the millionth time. Its now Aug 26th and I still have no refund, no call backs, literally no one from this company trying to help me. I called and talked to the operator and told her I do not want to speak to customer service that I wanted a manager. After waiting 30 min on hold the operator came back and offered for the manager to call me back or I could continue to wait on hold. I let her know I've been waiting for managers to call me back several times and they never do so I'd rather wait on hold. So I then continued to wait another 10 minutes and an automatic answering machine came on and made me leave a message for the manager to call me back. Still NOTHING!! I WANT MY MONEY!!

  Business response

  09/09/2022

  Hello,

  
  I am terribly sorry to hear about the experience that ********* had with her COBRA plan administered by BRI. In reviewing her account, I see that the first payment for the month of May 2022 was made by ********* on 5/6/22 and BRI sent a reinstatement request to the insurance carrier on 5/10/22. We received a confirmation email from the insurance carrier on 5/12/22 that *********’s coverage was activated on their end, which is normally the final step in the process. On BRI’s end, *********’s COBRA has been fully active since 5/10/22 when we notified the insurance carrier. Unfortunately, the insurance carrier did not complete the activation on their end even though a confirmation was sent to us. We reached out to the insurance carrier multiple times after ********* informed us of this error to assist with fixing the carrier’s mistake, until ********* decided to cancel her coverage backdated to 5/31/22.

  Regarding the refund for *********’s June premium, I do see the check having officially been processed by our accounting team on 9/6/22 and mailed out to the home address on file on 9/6/22.

  
  Thank you,
  David Stehler
  Benefit Resource, LLC

• Initial Complaint

  07/15/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I have communicated with Benefits Resource regarding denied claims for the past two years. I have sent over two dozen emails. I have called and talked to representatives, managers, and supervisors, and I've even had to contact the CEO due to the organization's nonexistent customer service. I have been submitting the same type of claim to the organization, and they continue to assign the claim to the wrong account, which resulted in me maxing out my credit cards because the organization is so disorganized that they don't know how their plan benefits work. I requested the claims department to provide me with a complete accounting of my claims and explain why my claims for reimbursement were denied. Unfortunately, I have yet to receive a response. The problems I have been subject to with this organization and the amount of time I spend writing letters, downloading my claim benefits, accounting for my claims, and then sending them the spreadsheet have been exhausting. I receive much-needed medical care, and they have made it virtually impossible by denying my claims and then making me jump through an endless number of hoops to get one reimbursement.

  Business response

  07/29/2022

  Hello,******* has 4 different plan types with us through her employer. The Medical FSA is what ******* contributes into with pretax payroll deductions, and this plan has a wide range of eligible expense types that can be accessed via claim submission for reimbursement or by using a benefit card that we issue to plan participants. The other 3 plans are employer funded Health Reimbursement Accounts, named HRA Copays, HRA In-Network and HRA Out-of-Network, which have different types of expenses eligible under each. The eligible expenses allowed under these HRAs are also all covered under the Medical FSA. If an expense is eligible under one of the HRAs (which do not overlap) and the FSA, the expense should pay out of the HRA first until the HRA is exhausted and then any remaining amount would pay from available FSA funds. Each of these HRA plans require the participant to submit a copy of their Explanation of Benefits (EOB) from insurance to prove that the expense qualifies under that plan.Here is the layout of each HRA plan as the employer has requested BRI to administer, related to Melissa’s coverage level:HRA Copay – Explanation of Benefits from insurance required - Copays are reimbursed as follows:$20 of a $30 (Primary Care) $20 of a $50 (Specialist) $100 of a $200 (Emergency Room) COVID testing will be reimbursed at 100%HRA In-Network - Explanation of Benefits from insurance required - For participants with the High Plan, out of pocket, In Network expenses will be reimbursed as follows: Participant must meet $500 in out of pocket, In Network, in-patient Deductible expenses before the plan reimburses up to $2,500.Out of pocket, In Network, out-patient Deductible expense are reimbursed up to $3,000.Out of pocket, In Network Co-Insurance expenses are reimbursed up to $1,500.HRA Out-of-Network - Explanation of Benefits from insurance required - For participants with the High Plan, out of pocket, Out of Network Co-Insurance expenses will be reimbursed as follows: Participant must meet $1,000 in Out-of-Pocket expenses before the plan reimburses up to $4,000.This is all outlined in each HRA’s Plan Highlights, available through plan participants’ online portals or via request through their employer.The most recent email that was sent to Melissa’s client contact on 7/22 is listed below:The claims supervisor, team lead and I reviewed Melissa’s claims and documentation to identify claims that could be applied to the overpayments due to submission of duplicate claims. See attached summary.A claim recently submitted for HRA out-of-network for 12/8/2021 date of service was submitted with EOB and reimbursed in the amount of $232.82, as a good faith gesture.Going forward, HRA claims must only be submitted for Eligible deductible, co-insurance or copay expenses. Any additional amount for out-of-network services are not reimbursable under the HRA. Note for ******* and all participants: For HRA expenses, the type of service selected should be Deductible as that will ensure the documentation will be reviewed carefully for HRA-eligibility (deductible, co-insurance or copay expenses). Indicating the type of service as any other will cause the claim to be entered as FSA.There are additional claims that could be considered for application to the overpayment balance or reallocated from FSA to HRA upon receipt of an EOB:8/18/2020, $200 9/3/2020, $200 9/1/2021, $250 (was paid from FSA, with EOB could be moved to HRA out-of-network) 9/8/2021, $2504/9-4/27/2022, $750 The attached documentation was for different provider and dates5/13/2022 $250Thank you in advance for agreeing to assist.When a claim is submitted without the EOB from insurance, it cannot reimburse from any of the three HRA plans but may qualify under the FSA. Later submitting the claim with an EOB can cause duplication errors if the dates or amounts are not exactly the same as the original submission, as well as possible human error in making adjustments that our system cannot process automatically.I hope this information is helpful in explaining the numerous plan designs and the need to submit the correct documentation in order for plans to pay out of the HRAs when eligible.Thank youDavid S******Benefit Resource, LLC

  Customer response

  08/08/2022

  Better Business Bureau: I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below. I submitted the requested EOB's on 6.18.22 and in the nature of BRI I have not received a response as of 8.8.22. I also submitted a question to their customer service portal on 8.1.22 and again have not received a reply. I also reject the comment regarding not receiving the proper documentation for each claim; however, I do understand now that they are using an automated system when receiving claims which account for the numerous errors. I hope this claim issue is resolved as soon as possible. Still, I am sure I will have to keep contacting them for the remainder of 2022 because it took two years, multiple messages to their customer service center, an email to their CEO and finally a complaint to the BBB to receive any response about the error that was made on their end back in 2020 - 2021 - 2022. This has been one of the worst customer service experiences of my entire life. Regards. 

  Business response

  08/24/2022

  Hello,There were 5 claim submissions uploaded into our system on 6/18/22. The details for each are as follows:1 - Date of service 10/11/21 - $972 - Date of service 11/11/21 - $2503 - Date of service 5/18/22 - $304 - Date of service 5/31/22 - $2005 - Date of service 6/1/22 - $501 - First entered under the prior plan year FSA (allowed with this plan design), and denied for not having any remaining funds in that account. The claim was then entered under the newer plan year FSA and denied for also funds being exhausted. This claim was not eligible with the HRA per the plan requirements. 2 - This claim was entered under the HRA Out of Network plan, because the EOB from insurance showed that $232.82 was a deductible expense. The remainder of the claim was entered under the FSA and denied for not having any remaining funds in that account. This $232.82 was reimbursed as a direct deposit on 7/17/22.3 - This claim was entered under the HRA Copay account on 6/22/22 and $20 was reimbursed, with the remaining $10 being the participant’s responsibility. Per the plan highlights, $20 of a $30 primary care copay will be paid from the HRA. The $10 portion was eligible under the FSA however the FSA was exhausted already.4 - This claim was entered under the HRA Copay plan on 6/22/22 and $100 was reimbursed while the remaining $100 the participant’s responsibility. Per the plan highlights, $100 of a $200 Emergency Room copay will be paid from the Copay HRA. There were no funds remaining in the FSA to reimburse the remaining $100.5 - This claim was entered under the HRA Copay plan on 6/23/22 and $20 was reimbursed, with the remaining $30 being the participant’s responsibility. Per the plan highlights, $20 of a $50 Specialist copay will be paid from the HRA Copay. There were again no funds in the FSA to pay the remaining $30 of that claim.There is nothing to correct nor any further action needed by ******* or BRI regarding these 5 submissions; what has been reimbursed are the allowed amounts that could be reimbursed under her plans. Her accounts have been audited numerous times dating back to 2020 and any errors have been corrected after each audit. If there are any new claims to submit for services rendered during the plan year effective dates, they may still be submitted to BRI no later than 10/31/22 for the plan year ending 7/31/22.Thank you,David S******Benefit Resource LLC

• Initial Complaint

  04/30/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I signed up for COBRA on 30 March 2022. I was told it would take up to 10 business dates for this payment to be received by *****. However, ***** never received my payment. I found out on 27 April 2022 that ***** had inactivated my account due to non-payment. Even with ***** reaching out directly to COBRA they met with road blocks. They had sent an email to BRI COBRA asking where these funds had been sent. When I spoke to ***** on 29 April 2022, they were very proactively trying to get this issue resolved. When I had called BRI COBRA, I was told that they could only confirm that they had sent a payment over to ***** Well obviously this was not the case. Their customer service is inept and as far as way from problem solving as earthly possible. This situation has caused me not to receive the medical care that I need.

  Business response

  05/02/2022

  Hello,This member’s COBRA account setup processed in a very timely fashion on our end, including the insurance carrier fulfilling their side of the activation according to what the carrier advised BRI.Timeline of events:3/29/22 – member registered online, elected coverage on BRI website3/30/22 – member paid online for initial monthly insurance coverage, to officially activate the COBRA plans with the insurance carrier(s)3/31/22 – BRI emailed **** Illinois with the reinstatement request4/26/22 – member called BRI to check on status. Ticket submitted internally to research the status with BCBS4/28/22 – Internal research found confirmation from BCBS received on 4/15/22 with an email stating “Upon checking, Melissa Jameson is showing active both for medical and dental effective 1/1/2022.”4/28/22 – BRI responded to **** asking for reconfirmation of coverage, just to be sure4/29/22 – BRI spoke with **** who advised the reinstatement is confirmed, same as the previous confirmation. **** provided BRI with case number ******** for confirmation on **** endThe fact that the insurance carrier did not advise the member after 4/15/22 that she was active in their system when she contacted them is not something BRI can fully assist with, and we have no visibility into the carrier’s system to see why the **** representative she spoke with gave her that incorrect information. As the above timeline confirms, the time between the member enrolling and submitting payment and BRI notifying the carrier was 1 business day. From there, the insurance carrier was able to confirm activation of her plans within 2 weeks, and we typically see a 7-10 business day turnaround, which falls in line with this timeline. What transpired between the member and the insurance carrier is a question that only the insurance carrier would be able to research and respond to.Thank you,David S******Benefit Resource LLC

• Initial Complaint

  03/22/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  The company through which my commuter benefit account was set up filed for bankruptcy and I left. I have been trying to get in touch with BRI via their website, phone and email and cannot get through to them. My benefits are in my parking account and they won't let me use them outside of some made up perimeter of my old company.

  Business response

  04/04/2022

  Hello,******* had both a Mass Transit and Parking Commuter Benefit Plan under her employer. The Mass Transit balance was fully exhausted as of 11/18/21, and the parking account balance has been $115.86 as of her last purchase at a parking vendor on 11/15/21. There have been no attempted parking purchases nor claim submissions for out-of-pocket parking expenses to reimburse since that date. As ******* mentioned, her employer filed for bankruptcy and officially terminated services with Benefit Resource, LLC as of 3/31/22. The client termination resulted in a deadline to use account funds by 3/31/22, and any remaining Commuter funds to be forfeited. Unfortunately, this means that Katrina, as well as any plan participants under this client, no longer have access to their Commuter accounts through Benefit Resource, LLC. Under IRS regulations for this benefit plan, refunds are not permitted under any circumstances, nor be transferred between the Mass Transit and Parking accounts without the client agreeing to allow the latter option for all plan participants, which this client did not authorize. The desired settlement of “use these benefits for parking anywhere” has technically always been an option to ******* up until the client termination, as long as the parking expenses are related to their work commute.Thank you,David S****** Participant Services Benefit Resource, LLC

  Customer response

  04/05/2022

  Better Business Bureau: I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below. I was never notified by anyone that the account would lapse. How can they close the account without any notice. In addition, I tried to use my parking account at a location near my new job (3rd Ave. & 58th Street) as opposed to Broadway between 19 - 20th streets and it was declined as being outside my job location! Regards, ******* ******** 

• Initial Complaint

  03/10/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  BRI has applied my 2022 Gym/Wellness benefit to a 2021 Expense and after multiple calls being told it would take 48 hours to fix we are now on month 3 of this issue. No one resolves the issue, management will not call back.

  Business response

  03/14/2022

  Hello,This client’s Specialty Program for Gym/Wellness is an employer funded account, and the employer sets the parameters of the program which Benefit Resource administers for its employees. Per the plan’s design, the program year beings January 1st and ends on December 31st, however the eligible dates of service that an employee may claim against goes “…from December 11th of the prior year through December 9th of the current plan year.”. There is also a deadline of December 10th to submit claims each plan year, for the services rendered through the day prior.Mr ******* submitted a claim to Benefit Resource on 12/28/21 for a service rendered on 12/12/2021 which was approved and reimbursed out of his current plan year (eligible dates of service from 12/11/21 – 12/9/22). Mr ******* is requesting that this claim from 12/12/21 be paid from the prior plan year, however that is not permitted based on the plan design for both the date of service and the date of submission. The date of service is 3 days after the last eligible date of service for the 2021 plan year (12/12/21 vs 12/9/21), and the date of submission was 18 days after the deadline for the 2021 plan year (12/28/21 vs 12/10/21) – if the date of service was on or before 12/9/21 which is not the case here.Mr ******* was reimbursed for his claim, however it is not possible to allow the claim to be moved to show paid from the prior plan year. We have already reached out to his employer to discuss this request, to which they have confirmed the plan design must be followed, and the request was denied for making an exception. Mr ******* is encouraged to reach out to his employer should he have additional questions regarding this matter, as they are aware and able to confirm the above information.Thank you,David S****** Participant ServicesBenefit Resource, LLC

• Initial Complaint

  02/15/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Resolved

  More info

  I submitted 2 claims to BRI for reimbursement. They denied both claims stating "duplicate claim." I made multiple attempts to call, chat, email this company and have not been able to get through to them. I would like clarification as to why those claims were denied since I never submitted them before and there is no reason why they should be denied. I call them and do the call back and no one calls me back. Twice I did the call back and no one called me back. I emailed them and no one emailed me back. I did the chat several times and after waiting on hold for 45 min the chat says no one is available. One day I waited on hold 2 hours and the agent did not want to help me. All she did was resubmit the claims again. So I am trying to find the status of the claims becasue my account is not showing any updated information. I paid $1100 out of my pocket for medical expenses and would like for BRI for reimburse me. They are extremely unprofessional and I cannot get a hold of anyone.

  Business response

  02/18/2022

  Hello,After researching ******’s account here, there was previously a discrepancy between the claim that we received directly from her insurance carrier to our system in September 2021 where only a portion of the claim was deemed eligible with the carrier. When ****** submitted the claim herself in January 2022, our system flagged this as a duplicate claim, and no reimbursement was issued. I asked our Claims team to review what ****** submitted to us on her claim, and we were able to confirm that the portion previously denied by insurance was in fact eligible to reimburse. The other claim in question was related to a previous payment with her benefit card tied to the account here. We received a refund from the provider here on 2/6/22, cancelling out the original payment. This now allowed us to re-process the claim submission and generate a reimbursement in full for $303.42. The $804 claim was fully approved, and has exhausted her HRA balance here in the amount of $601.04. These checks have since been mailed out on 2/16 and 2/17, respectively, to ******’s address on file and the account has no funds left to reimburse, resulting in this matter being resolved. Thank you,Dave S****** Participant ServicesBenefit Resource, LLC

  Customer response

  02/22/2022

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me. However, the only reason the claims were approved was because I re-submitted them myself online. It is their poor customer service that I was filing a complaint about. They never looked at my ticket. They never called me back. They never emailed me back. I waited on hold over 2 hours. I did several online chats and were eventually disconnected. I even had an agent hang up on me. I had one agent say she was going to re-submit the claims and never did. I'm glad the checks were issued. They need to improve their customer service!
  
  Regards,
  
  ****** Mileski
  
  
  
  
  

• Initial Complaint

  02/10/2022

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  I cancelled my COBRA policy effective 12/31/21, but had already been charged for the month of January 2022. I contacted Customer Service and was assured that a refund would be processed. Last communication from them was on 1/22 and I have still not received my refund as of 2/10/22. Attempting to contact via email has been fruitless, as have all attempts via phone. After being on hold for 25 minutes, the phone just goes dead (after multiple attempts at sitting on hold.)

  Business response

  02/18/2022

  Hello,I spoke with ***** about the refund that had not been received, and he was able to confirm that the ACH payment did successfully post to his bank account this week, so this matter has been resolved.Thank you,Dave S******Participant ServicesBenefit Resource, LLC

  Customer response

  02/22/2022

  Better Business Bureau: I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.  Regards, ***** ****** 

• Initial Complaint

  01/21/2022

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  I opted to receive Cobra insurance coverage from a previous employer as I retired January 2021. I paid for cobra for 9 months, which was February 2021 through to October 2021. I became eligible for Medicare in October 2021, and sent a notice to cancel the cobra coverage effective September 30, 2021. Cancellation was accepted and a refund of $708.97 is due me for the month of October 2021. I was notified by Lillian M***** with BRI Cobra LLC, that I am not due a refund. I promptly responded with the amount I paid, the check numbers, the dates the checks were written and cashed by BRI., I finally get a response January 4, 2022, after many emails and several months wanting to know where my refund is and nobody responding, I had to get the Account Manager who is the broker from my previous employer involved, because no one at BRI was responding. So the correspondence from January 4, 2022, stated that they sent a check on January 3, 2022 and to give 10 business days, it has been that and then some, and I find out the check was sent to a PO Box I haven't had for 10 years. It has been nothing but problems and incompetence's from day 1.

  Business response

  02/14/2022

  Hello,Regarding the desired settlement, I received confirmation from our Accounting team that the most recent refund check was cashed on 1/28/2022, the day that it was scheduled to arrive to the member’s address. We had originally sent out the refund check on 1/6/22 after a request was submitted on 1/3/22 to Accounting here. The address on file is the member’s responsibility to keep up to date, which is noted on their Specific Rights Notice – “you should keep BRI Cobra, LLC informed of any address changes.”. The account manager here asked the member for banking information so that we could send the refund via ACH instead of through the mail, but she declined the option. This is when a new check was issued on 1/26/22 that was later cashed on 1/28/22.Thank you,David S****** Participant Services Benefit Resource LLC

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩