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:09/25/2024

  Type:Service or Repair 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.

  Due to a medical condition that necessitated extensive treatment, I unfortunately lost my job. I chose to continue my healthcare coverage through *****. However, I have encountered significant issues with the compliance and administration services provided by PayPro TPA, the third-party administrator contracted by my former employer. There have been instances of receiving inaccurate information, mishandling of my payments to them, and charges for a plan that I did not consent to. This situation has resulted in interruptions in my medical treatment and loss of my healthcare coverage.When I sought to resolve these issues directly with PayPro TPA, their response has been to attribute the difficulties to a technical glitch. This has happened on more than one occasion and for different types of issues. Unfortunately, their attempts to address my concerns have not resulted in a satisfactory resolution. It appears that, while they are billing my former employer for compliance with ***** regulations, they are failing to adequately uphold those obligations. This negligence has adversely affected my health and well-being, contrary to the intended purpose of their services.The frequency of these "glitches" raises serious concerns regarding their business practices. I am submitting this complaint in the hope of protecting others from experiencing similar challenges.Attached are the letters I received from PayPro which may require further explanation or context that I am happy to provide if needed.

  Customer Answer

  Date: 10/04/2024

   I am rejecting this response because:
  

  In the response received it was acknowledged on PayPro TPA's part that the *** plan options were not updated until August 30th, which did not give me the appropriate length of time as required to review and enroll before September 1st. I had not reviewed the enrollment options in the portal because they were not on my portal, which the employee I spoke with acknowledged and credited to a "glitch" in their system. How am I meant to review and enroll in an option that was not provided to me? The notices sent are delayed and not received until 5-7 days after they are reflected in PayPro's system because they are sent by physical mail. Due to this timing, I continued treatment the first week of September. All notices I had received did not suggest that Innovative (former employer) was changing their plan options from BS to ***. In fact, they reflected that my BS plan was continuing, and that the cost of that plan was increasing. If my BS plan was not continuing, why did I receive a notice that the cost of the premium for that plan increased? What dates was PayPro notified by Innovative that these changes were being made? Is it the responsibility of PayPro to cover the medical expenses I incurred the first week of September due to their negligence? Or did Innovative fail to provide PayPro adequate information to distribute appropriately?