ComplaintsforEyeMed Vision Care, LLC

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Initial Complaint
07/13/2024
Complaint Type:
Product Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
EyeMed sent me a reimbursement check - but mispelled my name on the check and I couldn't deposit it. They made it out to ******* and my name is ******. EyeMed refuses to correct the mistake they themselves created - they are simply ignoring all my followup efforts the past 4 months. Please find: 1. Original mis-spelled check: See original EyeMed misspelled check and check stub: I took a color copy of check before sending it back to them. Had a feeling this team would screw up again and I'd need proof of what they sent me. This check is made out to a ******* ******. My name is ****** ******. (**** ****** is the EyeMed member mentioned on the documentation - he's my husband, but I'm also an approved member as his spouse.) 2. March 2024: Eyemed's "Whoops - sorry we messed up" letter: Here you will see that they freely admit to and apologize for their clerical mistake - printing the wrong name on my reimbursement check. They ask for their mispelled check back and state my request for a reissue check is approved. I mail the check back to the address they specify. Crickets. Never heard back. 3. July 2024's Weird "rejection" letter: After following up a 5th time via email on July 2 still searching for my corrected check, EyeMed sends me a letter informing me that I have "exhausted my appeal rights." and my "case is closed" There was no appeal! They already approved my claim in January. The issue is their team MISSPELLED my name on the March check they sent. It was THEIR clerical error I need them to fix. Their team cannot seem to comprehend this. They can verify that this "*******" check has never been cashed - it's likely still at the bottom of someone's inbox. I have invested at least 6, if not more hours trying to get their screwup fixed for a $42 reimbursement check. All they have to do is spell my name correctly on a reissued check! Geez.
Business response
07/25/2024

July 22, 2024

VIA EMAIL TO: ****************************

***** ********
BBB Serving Southern Ohio, Northern Kentucky, Southeast Indiana
1 E 4th, Suite 600
Cincinnati, OH 45202

Re: Complaint ID ********

Dear *** ********,

The above referenced complaint sent to EyeMed Vision Care, LLC, was forwarded to Fidelity Security Life
Insurance Company (“FSL”) for review and response. The complainant is a covered dependent of a
member issued coverage under a Limited Benefit Group Vision Insurance Policy/Certificate underwritten
by FSL with certain administrative services provided by EyeMed Vision Care, LLC. and claim services
provided by First American Administrators, Inc. (collectively herein “EyeMed”).

According to information from EyeMed it has initiated the process to reissue the check in the correct
name. Receipt of the issued payment can take up to 30 days.

FSL appreciates the complainant bringing this matter to its attention and EyeMed apologizes for the
clerical error. If you have additional questions or concerns, please feel free to contact our office.

Sincerely,

Fidelity Security Life Insurance Company
Customer response
07/26/2024
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, provided I actually RECEIVE the corrected check (which has not arrived yet as of 7.27). They've apologized and promised to reissue the check once already, yet never did. Hopefully, this will soon be resolved, as promised.

Regards,
****** ******
Initial Complaint
06/14/2024
Complaint Type:
Order Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I had paid for ***** benefits after using this company’s insurance through the company I previously worked for. When I made appointments to receive eye exams i was told i didn't have insurance. Knowing that this was incorrect and i could prove payments to ***** I continued to the appointments for myself and my beneficiaries. I took photos of the receipts and sent into Eye Med. These receipts were denied with the statement that I didn’t have insurance. After 2 phone calls it was determined that my last name was spelled incorrectly- one extra letter. All of the other information was correct and the same information from when i had benefits through my employer. When this name difference was discovered, i was told to appeal the denial from QA. The denial appeal was denied , i wrote once more asking for review of the denial. The request from me was to verify that all information was the same (address, ss#’s and ages) all match with the only difference being an additional letter in my last name. My review was denied once more. It is very difficult to get in touch with anyone as the system will not easily connect to a person.
Initial Complaint
05/09/2024
Complaint Type:
Billing Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
Claim ID: ************ Dear Sir/Madam I wish to dispute the subject claim. I have paid into your company for almost 5 years. It seems that I pay in more than I get out. But the above claim has been denied for no logical reason. I require a full and detailed explanation why this is the case. I have recently got new glasses. They aren’t the ‘plain glass, horn rimmed glasses’ you apparently only allow. But they are still glasses and I expect at least something back. I have been refunded a small amount, for each year that I have claimed, these glasses are no different to previous glasses. My wife had a similar claim, for much more expensive glasses, and got $57 back. A small pittance, but nevertheless something. I am not surprised to read so many negative reviews about your company online.
Business response
05/22/2024
May 22, 2024
VIA PORTAL

Attn: ***** ********
1 E. 4 , Suite 600
Cincinnati, OH 45202

RE: ID ********
***** *******

Dear *** ********:

This letter is in response to your inquiry concerning a complaint filed with your office by ***** *******
(“Member”) regarding the out-of-network (OON) claim. EyeMed Vision Care, LLC (“EyeMed”) is a network
administrator for vision care benefits and its wholly owned subsidiary, First American Administrators, Inc. is
a licensed third-party administrator handling vision care claims.

Upon reviewing the Member’s situation, we noted that the Member filed an OON claim online on
February 18, 2024, for materials with a date of service (DOS) of February 12, 2024. As a member of the
****** **** group, it appears you have two separate plans: one that covers exams only (****** VISION
PLAN EXAM *******) and another fully funded plan (****** **** *******).

The OON submission was initially made under the ****** VISION PLAN EXAM *******, which resulted
in the correct denial of the claim since this plan does not cover materials. The Member subsequently
submitted an appeal to our Quality Assurance (QA) team on April 18, 2024, with Reference ID
*********961. The appeal was denied as the claim was accurately processed under the plan it was
submitted under.

To resolve this issue, a ticket has been submitted to reprocess the Member’s claim under the correct plan
that covers OON materials, active on the DOS. The claim has been reprocessed as OON Claim ID
************* Please find attached a screenshot of the claim details for your reference. Please allow 14-28
days to receive the payment.

It is important to note for future submissions that Claims cannot accept receipts that do not include the
member's name, address, date of purchase, and other pertinent information necessary for verification. Such
receipts are not considered clean claim submissions.

We apologize for any inconvenience this may have caused and appreciate the Member’s patience as we
work to resolve this matter. If you have any further questions or need additional assistance, please do not
hesitate to contact us.

Very truly yours,

Amy E. S******
Manager – Compliance and Licensing

Customer response
05/23/2024
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
04/30/2024
Complaint Type:
Sales and Advertising Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I keep receiving junk mail from a First American Administrators addressed to my home. When I google FAA, Eye Med pops up. I'm not signed up for ANY paper mail, I'm signed up for email notifications about my account. I do not want to receive any more paper mail from your company. Email me a notification if I have a EOB or other information related to my account.
Business response
05/09/2024
May 8, 2024

VIA EMAIL TO: ****************************

***** ********
BBB Serving Southern Ohio, Northern Kentucky, Southeast Indiana
1 E 4th, Suite 600
Cincinnati, OH 45202

Re: Complaint ID ********

Dear *** ********,

The above referenced complaint sent to EyeMed Vision Care, LLC, was forwarded to Fidelity Security Life
Insurance Company (“FSL”) for review and response. The member was issued coverage under a Limited
Benefit Group Vision Insurance Policy/Certificate underwritten by FSL with certain administrative
services provided by EyeMed Vision Care, LLC. and claim services provided by First American
Administrators, Inc. (collectively herein “EyeMed”).

According to information from EyeMed, the member is registered for electronic communication and it
has confirmed that communications to the member should be sent via email only. Please note that
payment due to the member as the result of a fully processed claim is a paper check attached to an
explanation of benefits document which is mailed.

We trust this response satisfactorily addresses the issues presented by the member. If you have
additional questions or concerns, please feel free to contact our office.

Sincerely,

Fidelity Security Life Insurance Company
Initial Complaint
04/24/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I contacted Eyemed today to inform them I lost my glasses. They told me the soonest I could get replacement would be June 2024 and that I should call ****** to see what can be done. According to ****** they follow Eyemed policies and recommended I try finding an optician who will submit the claim, knowing it will be denied before an appeals process can be started. I am concerned about the time this will all take to get resolved even if i do find a doctor willong to submit the paperwork. In the meantime, I found an old pair of glasses with a much weaker prescription which makes it hard to see clearly or drive.
Business response
05/13/2024
May 13, 2024
VIA PORTAL

Attn: ***** ********
1 E. 4 , Suite 600
Cincinnati, OH 45202

RE: ID ********
***** **************

Dear *** ********:

This letter is in response to your inquiry concerning a complaint filed with your office by ***** **************
(“Member”) regarding her eyewear coverage. EyeMed Vision Care, LLC (“EyeMed”) is a network administrator for
vision care benefits and its wholly owned subsidiary, First American Administrators, Inc. is a licensed third-party
administrator handling vision care claims.

The Member’s eligibility for lenses and a frame is scheduled for 6/13/2024, as per the terms of her coverage. While
we understand her request for an earlier replacement due to the loss of their eyeglasses, we must adhere to the policy
guidelines to maintain fairness across all our members.

However, EyeMed has made an exception, and we are pleased to inform the Member that her material benefits
have been reinstated as of 5/8/2024, which should facilitate a smoother process for obtaining her eyewear.

Should the Member have any further questions or require assistance, EyeMed encourages her to reach out to us
directly.

Thank you.

Very truly yours,

Amy E. S******
Manager – Compliance and Licensing
Initial Complaint
04/23/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I submitted an online claim to EyeMed Vision Care on 1/2/24 for out of network purchase of prescription eyeglasses on 12/29/23. On 3/19/24, after inquiring by phone, I was informed the claim had not been received. I sent the claim again on 3/19/24 and I received an email saying the claim has been received that same day. As of today, 4/23/24, I still have not received any response to the filed claim. I’ve called customer service multiple times to inquire about the status. I’ve been disconnected FOUR times today. The customer service reps have been no help, and I’ve gotten absolutely nowhere with this inquiry. The claim is not in my online account information, even though I received an email saying my claim was received. I’m beyond frustrated. I sent the claim again today and received the same auto generated email saying the claim was received. I'm unable to locate any management email contacts to escalate the inquiry.
Business response
05/06/2024
May 6, 2024
VIA PORTAL

Attn: ***** ********
1 E. 4 , Suite 600
Cincinnati, OH 45202

RE: ID ********
******** *****

Dear *** ********:

This letter is in response to your inquiry concerning a complaint filed with your office by ******** *****
(“Member”). EyeMed Vision Care, LLC (“EyeMed”) is a network administrator for vision care benefits and its
wholly owned subsidiary, First American Administrators, Inc. is a licensed third-party administrator
handling vision care claims.

This is an ***** product and as such, we have forwarded this to ***** for awareness. ***** is working
to respond to the Member’s concern directly.

Should you have additional questions or need anything further, please don’t hesitate to contact me.

Very truly yours,

Amy E. S******
Manager – Compliance and Licensing
Initial Complaint
04/16/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I have being attempting to get my password reset since 3/22/2024. I have followed all the customer service recommendations without any success and was notified today I successfully logged in on 4/15/2024. Considering I haven't been able to reset my password to log in, I find this implausible. The website feature to reset a password is broken and was already noted in a different complain from 1/24/2024. Please fix this.
Business response
04/19/2024
Good afternoon,
We want to make sure we are locating the correct member. Can the member please confirm a full address on file, date of birth and group/member number? There was limited information contained in the complaint to fully identify the correct member.
Thank you.
Amy S******
Customer response
04/22/2024
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, reasons for rejection are included below.
The information they are requesting was provided on 4/2/2024 at 1:12 PM according to my e-mail timestamp. They did not respond to this e-mail until I reached out again.
I verified my birthday again on 4/16/2024 at 8:07 AM according to my e-mail timestamp and received a response that I successfully logged in on 4/15/2024.
On 4/16/2024 at 11:13 AM I replied that I wasn't sure how I would've logged in without acquiring a password to log in and that I still required assistance with resetting my password but have not received a response from EyeMed Customer Support.
Here is the requested information again:
***** ***
**********

The membership ID number I was given in a previous e-mail from EyeMed Customer Support is ************ on 3/25/2024 at 3:49 PM according to the e-mail timestamp.
Regards,

***** ***

Business response
05/02/2024
May 1, 2024

VIA EMAIL TO: ****************************

***** ********
BBB Serving Southern Ohio, Northern Kentucky, Southeast Indiana
1 E 4th, Suite 600
Cincinnati, OH 45202

Re: Complaint ID ********

Dear *** ********,

The above referenced complaint sent to EyeMed Vision Care, LLC, was forwarded to Fidelity Security Life
Insurance Company (“FSL”) for review and response. The member was issued coverage under a Limited
Benefit Group Vision Insurance Policy/Certificate underwritten by FSL with certain administrative
services provided by EyeMed Vision Care, LLC. (“EyeMed”).

According to information from EyeMed, there have been several email communications between it and
the member. On April 30, 2024, EyeMed reviewed the member account and sent an email to the
member stating it showed a registered account and that if the member was still having trouble, to
respond to the email.

FSL suggests, if the issue is yet unresolved, that the member contact EyeMed via response to its April 30,
2024, email or by phone a ###-###-####.

We trust this response satisfactorily addresses the issues presented by the member. If you have
additional questions or concerns, please feel free to contact our office.

Sincerely,

Fidelity Security Life Insurance Company
Customer response
05/08/2024
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, reasons for rejection are included below.
I am still unable to access my account. When I attempted to register an account and submitted a password the web page continuously loaded - this has been communicated to the customer support. The reset password feature does not work - the web page continuously loads after I've submitted a new password, and this has been communicated to the customer support. I have tried all the suggestions offered by customer support without any luck.

Regards,

***** ***
Initial Complaint
04/09/2024
Complaint Type:
Billing Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
Status of claims ************ and ************. After two months and substantial effort on my part, EyeMed has not provided any communication whatsoever on these claims.
Business response
04/10/2024
Good afternoon.
Please see the attached.
Thank you.
Amy S******
Customer response
04/16/2024
The business has responded.

I consider this matter closed.

Thank you for your assistance.
Initial Complaint
04/09/2024
Complaint Type:
Billing Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
I have ****** ******** they contract with EyeMed for my vision care; however, every time I go to ********* **** ******* *** ********** ********* ******** **** ****** ********* ***** * *********, ** ***** ###-###-#### for vision care they cannot locate me as a patient of EyeMed. Each time we spend hours on telephone with EyeMed ###-###-#### with no assistance from EyeMed. Their customer service says my file is active and the funds are available but ********* **** ******** *** ********** is showing me on their computer where it’s saying client not found. I need this situation resolved. It’s stressful, embarrassing and uncalled for. ********* **** ******** *** ********** are asking me to pay for service that should be covered by EyeMed and ****** is said if I pay when company in Network I cannot get reimbursed. After three painful hours ********* **** was able to pull up my information. This happens every time I visit ********* **** for eye care
Business response
04/17/2024

We are unable to locate the member with the information provided and will need the member’s date of birth, member ID number and group ID number.
Thank you.
Amy S******
Customer response
04/17/2024
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, reasons for rejection are included below. Date of birth **** ** ***** Identification number with ***** and EyeMed ************

Regards,

***** *******
Business response
05/14/2024
May 14, 2024
VIA PORTAL
Attn: ***** ********
1 E. 4th, Suite 600
Cincinnati, OH 45202
RE: ID ********
***** *******
Dear *** ********:
This letter is in response to your inquiry concerning a complaint filed with your office by *****
*******(“Member”) regarding her recent experience with our service at ******** **** ******** *** **********.
EyeMed Vision Care, LLC (“EyeMed”) is a network administrator for vision care benefits and its wholly owned
subsidiary, First American Administrators, Inc. is a licensed third-party administrator handling vision care claims.
Upon investigation into the matter, we have confirmed that the servicing location encountered an issue accessing
the Member’s routine vision care account during her visit, resulting in her payment of $112.83 out of pocket, whereas
the EOB indicated a owed amount of $25.
We want to assure the Member that we take matters like this very seriously and have taken immediate action to
rectify the situation. A claim (Case#*******) has been swiftly submitted to our managed care department for further
review and resolution.
We are pleased to inform the Member that a payment was recently issued to the provider on 04/17/2024. Once
this payment is applied to her account, a reimbursement check for the overpayment of $87.83 will be promptly issued
to the Member.
Thank you for bringing this matter to our attention, and please do not hesitate to contact us if there are any further
concerns or if the Member requires additional assistance.
Very truly yours,
Amy E. S******
Manager – Compliance and Licensing
Customer response
05/14/2024
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
03/26/2024
Complaint Type:
Billing Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I filed a claim for an out of network reimbursement on January 24, 2024. My claim never showed up in my portal despite receiving a confirmation email. This was odd so I emailed them. Never heard back. I emailed them again and still didn't hear back. After contacting them a third time, they said there was no claim. I asked them to check again and they found it. They said a reimbursement check was approved and mailed to me on January 24, 2024 and that it would arrive in 7-10 days. By the time they emailed me back, weeks had gone by and no check was ever received. They said the check amount was for $105 although my annual allowance for contact lenses is $130. After telling them I never received the check it took them 2.5 weeks to respond just to say that I should receive the check 7-10 days after Jan 24...at this point it's March. I again say, I haven't received it and again wait days to hear back asking if I want my check traced. YES. Almost a month has gone by and nothing. I am unable to reach a human when I call the number they tell me to call. This reeks of FRAUD to me. The amount of time I have spent trying to be reimbursed for $130 is criminal. This company should be ashamed of itself.
Business response
04/01/2024
April 1, 2024
VIA PORTAL

Attn: ** ***** ********
1 E. 4 , Suite 600
Cincinnati, OH 45202

RE: ID ********
***** ****

Dear *** ********:

This letter is in response to your inquiry concerning a complaint filed with your office by ***** ****
(“Member”). EyeMed Vision Care, LLC (“EyeMed”) is a network administrator for vision care benefits and its
wholly owned subsidiary, First American Administrators, Inc. is a licensed third-party administrator
handling vision care claims.

This is an ***** product and as such, we have forwarded this to ***** for awareness. ***** is working
to respond to the Member’s concern directly.

Should you have additional questions or need anything further, please don’t hesitate to contact me.

Very truly yours,

Amy E. S******
Manager – Compliance and Licensing
Customer response
04/08/2024
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, reasons for rejection are included below.
I have been told numerous times by numerous different EyeMed customer service agents that they sent a reimbursement check - I never received a check and they said multiple times they would track the check and get back to me. Despite following up via your chat and email, no one ever actually got back to me.
Your BBB response from April 1 said someone from ***** would reach out to me. That has not happened. And none of the several EyeMed customer service agents said this was an ***** issue. If it were, why would you have a place on your website to submit out of network claims? It doesn't make sense. I should be reimbursed for all of the time spent on dealing with this seemingly simple task.

Regards,

***** ****

Business response
04/15/2024
April 15, 2024
VIA PORTAL

Attn: ** ***** ********
1 E. 4 , Suite 600
Cincinnati, OH 45202

RE: ID ********
***** ****

Dear *** ********:

I am writing in response to your follow-up letter dated April 10, 2024, regarding a complaint filed by
***** **** ("Member") with your office. We appreciate the opportunity to address this matter.

As previously stated in our correspondence dated April 1, 2024, EyeMed Vision Care, LLC ("EyeMed")
promptly forwarded the complaint to ***** for resolution. The complaint was transmitted to ***** on
March 28, 2024. Subsequently, ***** reached out to EyeMed on April 8, 2024, seeking further clarification to
facilitate a swift and satisfactory resolution for the Member.

Please be assured that ***** is diligently working to address the concerns raised by the Member. We
understand the importance of timely and effective communication, and we are committed to ensuring that
the Member's needs are met promptly and professionally. ***** will be reaching out to the Member directly
to address their concerns and provide any necessary assistance.

Thank you for your attention to this matter.

Very truly yours,

Amy E. S******
Manager – Compliance and Licensing

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