Complaints

The complaint text that is displayed might not represent all complaints filed with BBB. 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.

• Initial Complaint

  Date:02/03/2023

  Type:Order Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  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.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  On 2/1/23 my husband and I wanted to cancel our Health Insurance plan with First Health Network effective 2/8/23 as we switched to a better plan. On 2/1/23 we called ************ and spoke with a gentleman named Daryl and were told the cancellation will be effective ONLY at the end of the current month (February 28) - and that they cannot cancel it effective 2/8/23 as per our request. So we are paying for almost an entire month without getting anything in return. Can this be legal or allowed through current regulations within this industry? We definitely expected an appropriate refund in this case.

  Business Response

  Date: 02/07/2023

  2/7/2022

  In response to the above complaint, Enrollment First offers monthly products (plans).  The Member Services Representative was correct in his response. The next Effective Cancellation Date for the customer was 2/28/2022.  We do not allow mid-month cancellations for refund or prorated rates.  However, if the customer is able to show proof that they had obtained additional coverage, we can back date the account to reflect the Effective Cancellation Date to 1/31/2022.  Please let us know if you have any further questions regarding this matter. 

   

  Thank you,

  Marcia ******* (Assistant Director of Operations)

  Business Response

  Date: 02/09/2023

  We want to clarify that the dates included in Enrollment First's original response should reflect the 2023 year.  We can change the Cancel Effective date to 1/31/2023 if they can show proof of new insurance effective 2/1/2023.  Please let me know if you have any further questions regarding this dispute.   

  Thank you,

  Marcia ******* (Assistant Director of Operations)

   

• Initial Complaint

  Date:05/26/2022

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  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.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I found a doctor in network from the insurance website. then when i was at the doctors I called the insurance company to verify this doctor and this location was in network , they said yes. and i showed my insurance card to the doctor and she said it was a prescription card but its what the insurnace company emailed me but the doctor let me in anyway since they don't turn patients away but as i said i called to verify with enrollment first that this doctor and address were in network and they said yes so even though i only had a prescription card (not knowing it was a prescription card) i saw the doctor. well today, the insurance company emailed me my real insurance card and the doctor said they do not participate with that insurance plan. I called the insurance company, enrollment first, they said they will not pay it cause they are not responsible for the wrong information on the provider look up list (where i got the doctor info) cause the website belongs to a different company. They also said they are sorry they emailed me the wrong insurance card but it still doesn't make them responsible for the $1007.00 bill that the doctor is charging me cause I should have made sure i had coverage and they are sorry that the person on the phone told me that doctor is in network. I would like this insurance company to not be able to do this to another person. I would like them to pay the $1007.00 bill that the doctor is charging me, i would also like my payments refunded so i can find insurance that does mislead and lie and that takes responsibility.

  Business Response

  Date: 07/01/2022

  Business Response /* (1000, 7, 2022/06/10) */ According to our records, Ms. *********** enrolled in the SelectMed Max plan on April 19, 2022, through our consumer enrollment portal. The plan was effective 5/1/2022. This particular plan requires additional paperwork to be signed. We contacted Ms. *********** on 4/20, 4/22, 4/28 and finally on 5/3 to followup on the unsigned paperwork. After confirming the additional paperwork had been signed, we sent Ms. *********** an email with her ID cards on 5/6. The email, which I will be glad to share, includes two documents, both the SelectMed ID card and the prescription ID card. It also includes the phone number and email address to use to find an in-network provider and a comment which says "It is also important to confirm with the physician he/she is a member of the network prior to an appointment." Our call notes indicate that on 5/10/2022 Ms. *********** contacted our office and we confirmed that the plan was active and that the doctor was part of the network according to the website provided and maintained by the network. As noted in the original email which included both ID cards, only the provider can confirm whether they are in-network or not. The website is only valid if the provider communicates with the network that they have elected not to participate any further. HMA is the third party administrator which handles claims for this plan. According to their website, they have not received a claim submission from the provider's office. After reviewing all the details, I believe we did everything we could based on the information we had available. Ms. *********** should have provided the correct ID card to the provider and the provider should have confirmed coverage before making an appointment or seeing Ms. ***********. We are not a third party administrator, therefore we don't handle claims and do not have authority to pay the outstanding claim. If Ms. *********** would like to cancel her coverage, she can contact us a XXX-XXX-XXXX Monday thru Friday, 8 am - 7 pm. I would be willing to make an exception and cancel the plan back to the original effective date and return the money paid toward this coverage.