Took money out of our checking account after we discontinued health ins. Told us we have to wait a month to get our money back when it shouldn't have been done in the first place. still waiting for the check since Jan. 2. thanks **** and ***** *******
Product_Or_Service: health insurance
need it now
To Whom It May Concern:
We are in receipt of your February 6, 2014, correspondence regarding a complaint affiliated with Case # XXXXXXXX.
CONEXIS Benefits Administrators, LP ("CONEXIS") performs ministerial tasks for FirstEnergy Service Company ("FirstEnergy") to assist it with satisfying certain administrative obligations imposed upon it by FirstEnergy's establishment of one or more health plans for certain individuals ("Participants") for which premiums are collected by means other than payroll deductions ("Direct Bill"). Our contracted duties include, among other things, distribution of required notifications on behalf of the plan administrator, addressing Direct Bill Participant inquiries, and premium billing and collection.
In this capacity as a contracted agent of FirstEnergy, CONEXIS' contractual duties are strictly ministerial in nature. FirstEnergy retains the sole responsibility and liability for establishment and operation of the group health plan(s), construing and interpreting the provisions of the group health plan(s), and deciding all questions of fact arising under the group health plan(s).
In addition, in this in this capacity as a contracted agent of the employer, CONEXIS does not serve as the "Plan Administrator" or "named Fiduciary" as defined by ERISA, whether or not ERISA is applicable. It remains the sole responsibility of FirstEnergy to ensure compliance with all applicable laws and regulations. CONEXIS' provision of services under the terms and conditions of its contract does not relieve FirstEnergy of this obligation or resulting liability related to non-compliance. As such, CONEXIS' provision of services is generally performed in accordance with the terms established by the employer, its instructions to CONEXIS, and/or standard operating procedures.
The following is a detailed narrative concerning the Direct Bill coverage of the complainant:
1. As of December 1, 2013, the complainant was - based on information provided to CONEXIS by FirstEnergy - enrolled in Direct Bill coverage for himself and his spouse. CONEXIS assumed billing administration for the complainant's Direct Bill coverage effective September 1, 2010; the complainant had paid premiums for this coverage through December 31, 2013 via Automated Clearing House ("ACH") transactions from his banking account.
2. On December 27, 2013, CONEXIS received the complainant's premium payment of $247.56 via ACH and applied it to his account. This payment satisfied the total premium indicated as required by the plan for the January 2014 coverage period.
3. On January 2, 2014, CONEXIS received notification from FirstEnergy that the complainant "waived coverage for 2014." FirstEnergy instructed CONEXIS to "waive his coverage effective 1/1/2014 and issue him a refund for January."
4. On January 3, 2014, CONEXIS processed FirstEnergy's request to cancel the complainant's coverage as of December 31, 2013. This resulted in an unapplied credit of $247.56 on the complainant's account.
5. On January 17, 2014, CONEXIS issued a refund check to the complainant (check number XXXXXXXX for $247.56).
6. Also on January 17, 2014, the complainant's spouse spoke with a CONEXIS Participant Services Representative ("PSR") via telephone to inquire as to the status of the aforementioned refund. CONEXIS call documentation reflects that the complainant's spouse was advised that the refund check had been expedited and was released on January 17, 2014.
7. On January 27, 2014, the complainant's spouse spoke with a CONEXIS PSR via telephone and indicated that she had not yet received the refund check. The According to CONEXIS call documentation, the complainant's spouse was informed the check was mailed to the last best address on file with CONEXIS: **** ******** **** ***** ************ **** XXXXX.
8. Also on January 27, 2014, the CONEXIS account manager for First Energy received a request from FirstEnergy via Web site (www.conexis.com) to update the complainant's address:
Please update address..
*** D ******** ******
**** ******* ** XXXXX
9. Also on January 27, 2014, the CONEXIS account manager for FirstEnergy updated the complainant's mailing address as instructed by FirstEnergy.
10. On January 28, 2014, the complainant's spouse spoke with a CONEXIS PSR via telephone and advised that the address as provided by FirstEnergy (see Line Item 8, above) was incorrect and should be indicated as "932 D Savannas Point."
11. Also on January 28, 2014, the CONEXIS account manager for FirstEnergy advised the CONEXIS Participant Services Representative that - for auditing purposes - all requests for address changes must be initiated in writing.
12. On January 30, 2014, a CONEXIS PSR contacted the complainant's spouse via telephone and requested that she or the complainant send a written request (e.g., via e-mail to ****************@conexis.org) to update their address to ***** D ******** ********
13. Also on January 30, 2014, the CONEXIS account manager for FirstEnergy received notification from FirstEnergy that the complainant's address was incorrect and should be corrected:
*** D ******** *****
**** ******* ** XXXXX
14. Also on January 30, 2014, the CONEXIS account manager for FirstEnergy amended the complainant's address as instructed by FirstEnergy.
15. Also on January 30, 2014, the CONEXIS account manager for FirstEnergy issued a research request to the CONEXIS Finance department concerning the status of the complainant's refund check. The Finance department confirmed that - as of that date - the refund check had not been cashed.
16. On February 3, 2014, CONEXIS Finance voided the previously issued refund check and mailed a replacement check (check number XXXXXXXX for $247.56) to the complainant's updated address.
17. On February 7, 2014, CONEXIS Finance received notification from Comerica Bank that the complainant's previous ACH payment (applied to his account on December 27, 2013) had been rejected due to a revocation of ACH authorization. The previously applied credit of $247.56 was debited from the complainant's account. This, coupled with the refund check mailed on February 3, 2014, resulted in the complainant's account reflecting a paid-through date of November 30, 2013.
18. On February 12, 2014, CONEXIS Finance voided the reissued refund check (see Line Item 16, above) to restore the complainant's correct paid-through date of December 31, 2013.
19. Also on February 12, 2014, a CONEXIS Support Services representative attempted to contact the complainant via telephone to advise him of the sequence of events delineated above and to offer any additional assistance he or his spouse may require. According to CONEXIS call documentation, neither the complainant nor the complainant's spouse was available. The CONEXIS Support Services representative left a voicemail message requesting a call back.
We regret any inconvenience or frustration the complainant or his spouse experienced during this time.
As of today, the complainant's account correctly shows a paid-through date of December 31, 2013 and that any funds received for periods of coverage after this date should be restored to his banking account. As such, we believe the issues that form this complaint have been resolved to the best of our ability within the scope of our contract with FirstEnergy.
CONEXIS Benefits Administrators, LP
Final Consumer Response
(The consumer indicated he/she DID NOT accept the response from the business.)
would not take address over the phone and have not lived at that address since 2008. they did have the correct address because we sent a voided check for them to take out automatic from checking account for payment.
Final Business Response
The address on file and in our system was provided by FirstEnergy on regular data files. As previously stated, any changes to the address - for security and data integrity purposes - were needed in writing from the client or the complainant (again, CONEXIS informed the complainant's spouse on January 30 that address change requests must be submitted in writing and provided her with all of the contact information to facilitate the change; we received an amended address from FirstEnergy in writing on January 30 and processed the change on the same day). We cannot process address changes based solely on an address listed on a voided check.
We again reiterate that the cancellation of coverage was processed as soon as practicable following notification from FirstEnergy. The refund check was issued to the address on file provided by FirstEnergy. Address updates were processed as soon as practicable following receipt of the information. We sincerely apologize for any inconvenience the complainant experienced; we believe these issues were addressed to the best of our ability and within the scope of our contract with FirstEnergy.