ComplaintsforFirst Risk Advisors, Inc.

• Initial Complaint

  09/20/2022

  Complaint Type:

  Product Issues

  Status:

  Unanswered

  More info

  9/6/22 I requested to waive my health insurance and offered to refund First Risk Advisors for the 2 months of coverage. My offer was accepted on 9/7, and then subsequently rejected on 9/8. On 9/8 I requested to continue the conversation, as there was a limited amount of time left to waive the insurance. 7 days later on Tuesday, 9/13 FRA responded that I could cancel my insurance. I just had a 5-business day window to do so from that day on Tuesday until Monday 9/19, today. I complied with their request and confirmed that my waiver and check of $560.12 and was delivered that Thursday 9/15. First Risk would not allow me to waive my insurance online, even though they had originally requested I waive it online in the first email. First Risk then again changed the agreement with me that they will not cancel my insurance until they cash my check, which has now been over 5 business days since it was received. They told me it would be cashed in 1-2 business days. Then once they received my check they changed again and said they would cancel my insurance only if my waiver was filled out correctly; however, they refused to address any of my questions or concerns about the waiver and timeline. I requested many times during this 5-day window if my information was sufficient. It is now past the arbitrary date for which I can waive insurance. The original agreement from 9/13 exchange is, "We will not remove coverage until this check is received in our office." My insurance should have been waived the moment the check was received - nothing is mentioned about cashing it. They conveniently changed the agreement on 9/15 after receiving the check, "We will confirm all contents are acceptable once your check has cleared. Please allow 1-2 business days for this." First Risk Advisors will not cancel the insurance if I use it before they confirm cancellation. Medi-Cal will only be a secondary provider during this time, so I have been without insurance coverage indefinitely.

• Initial Complaint

  09/02/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Unanswered

  More info

  My daughter, authorized me, to send take care of her student health insurance information while she is on a year leave as I knew about HIPAA rules. She went to ***** ***** University and she has had a health insurance for a year, from August 2021 to August 2022. She asked that her health insurance to continue for 3 months until open enrollment for new insurance elsewhere. She was told by First Student to fill out a continuance enrollment form and send a check to First Risk Advisors. We sent the cashier check of $770.45 along with the form that she filled out before she left on leave through certified mail of USPS on June 16, 2022 so we could make sure the check got there safely since it was "cash". I have a picture of the check I sent. A month later, we had not heard anything, so we called First Student and they said to contact the broker(First RIsk) through the school's website. So we contacted by phone but it was only a voicemail and we emailed and left a message to contact us. We never heard back after few days. Then I tried again myself in August to see if I could catch anyone on the phone through relay service (I am hearing impaired/deaf) but all I got was a voicemail. So I sent an email. Two weeks later, I checked my daughter's email (as she asked me to check for her) and she had received an email about her health insurance ended. There was no mention receiving the mailed check we sent. I was confused. I called the bank and found that the check was not cashed. I tried to call the FIrst Risk again asking about the check but all I got was a voicemail. If they would have the courtesy to answering the question or responding to the answer whether if they ever received a check or not. or why they could not continue her health insurance if they received the check. If they cannot return the check, at least please they send me a letter for the bank to return the cashier check to us because it was a "cash" check.

• Initial Complaint

  11/15/2021

  Complaint Type:

  Customer Service Issues

  Status:

  Resolved

  More info

  Good morning and thank you for your help. I would like to request an appeal for a waiver from First Risk Advisors and they will not contact me. All I want is a telephone call. In September 2021 I was charged for health insurance for my son in college. I did not submit the waiver in time which is my fault, but they do prorate so I am requesting a refund for the remainder of the academic year. I have called 3 times and left messages and now their mailbox is full. I have submitted 3 requests through their online portal to no avail. I would just like to speak to someone.

  Business response

  12/07/2021

  Dear BBB,
  
  We apologize for any delay in responding to requests from the parents of this ************* ******* student. Unfortunately, due to HIPAA privacy laws we are not allowed to respond to anyone other than the insured without a signed Authorization from the insured and securing these sometimes take time to get and verify receipt.
  
  ************* ******* offers a Student Health Insurance Plan that has an open enrollment/waiver period that extended to September 15, 2021 (see flyer attached). Students must either enroll in the coverage or provide proof of their own equivalent coverage to “waive out” of the school plan. Any student that does not act during this open enrollment/waiver period is automatically enrolled in the plan. Once enrolled, refunds are only allowed for ineligibility or enrollment in the armed forces. These policies are filed and approved in the Commonwealth of Pennsylvania, so we do not have the ability to waive any pf the policy provisions. Pro-rating is only allowed for students coming on the plan due to a “Qualifying Life Event”. Please see attached Certificate of Insurance” which outlines these policy provisions.
  
  Students receive extensive communications to their school email address as this is the College’s official means of communications with its students. This student was aware of the requirements of the plan since they did submit a waiver for the 2020-2021 Academic Year and by the parents’ own admission, they missed the deadline for the 2021-2022 Academic year. In addition, we were not contacted about this issue for the first time until November 4, 2021, over a month and a half after the enrollment/waiver deadline. Unfortunately, at this time, due to the facts stated above, we are unable to make any changes to the decisions already made. We confirmed this in writing to the parents on December 6, 2021.
  
  Should you or the parents have any additional questions, please feel free to reach out to David W. Opperman, President.

  Best Regards,

  Susan O*******

  Customer response

  12/22/2021

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
  
  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

  10/06/2021

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  This company is supposed to provide health insurance for collage student who do not have insurance .A waiver notification is supposed to be sent out for you to sign if you have your own, which most of us do. But they are sending the waiver in the students email ,not the parents who have the insurance , and of course you have a deadline to complete. The email ended up in my daughters spam folder , only for her to notice it , of course after the date, now they want to bill us an additional $2300,and add it on to her tuition. We already pay 11k $ a year for medical insurance .And we are not the only ones who this has happened to .I sent an email to the company basically stating how wrong this is, and tried to follow it up with a phone call ,but I was not allowed to speak on her behalf since my daughter didnt sign a consent form. Even before the school year started , we were required to send proof of health insurance, which we did. I really believe this is bogus.Any help would be great

  Business response

  12/14/2021

  Hello BB,
  University of ******** offers a Student Health Insurance Plan that has an open enrollment/waiver period that was extended to September 27, 2021 (please see flyer attached).  Students are required to either enroll in the coverage or provide proof of their own equivalent coverage to waive out of the school plan. 
  
  A student that does not take action during this open enrollment/waiver period is automatically enrolled in the plan once enrolled,refunds are only allowed for ineligibility or enrollment in the armed forces.
  
  These policies are filed and approved in the Commonwealth of Pennsylvania, so we do not have the ability to waive any person from the policy provisions.  Please see attached Certificate of Insurance which outlines these policy provisions.
  
  Students receive extensive communication to their school email address as this is the Colleges official means of communications with its students.  There were 10 emails sent to this students school email address out of the 10 sent all were opened and two were opened twice for a total of 14 times opened. I have attached a copy of the email wording.  Below are the dates of when the email went out and when it was opened. 
  
               7/21/21 Our records indicate you opened this on 7/24/21
               7/30/21 -Our records indicate you opened this on 8/17/21
               8/4/21 -Our records indicate you opened this on 8/17/21
               8/16/21 -Our records indicate you opened this on 8/17/21, 9/9/21, and 9/13/21
               8/27/21 Our records indicate you opened this on 8/27/21, 9/9/21 and 9/13/21
               9/3/21 -Our records indicate you opened this on 9/3/21
               9/7/21 -Our records indicate you opened this on 9/7/21
               9/8/21 -Our records indicate you opened this on 9/8/21
               9/10/21 Our records indicate you opened this on 9/10/21
               9/15/21 Our records indicate you opened this on 9/15/21
  
  We also sent a post card to the students home address with a mailing date of July 26, 2021, and I have attached the wording.
  This is the timeline on the email conversations with the student, and both the students parents.  Please note that at 18 years of age federal law (FERPA and HIPAA)considers them an adult and precludes us from communicating with anyone else on their behalf, including the parents without a signed authorization. 
  
  
  Below is CS Timeline:
               Daughter emailed in on 10/5/21 After Deadline.  Deadline was original 9/11/21 and then was extended to 9/27/21
               Father emailed ****** 10/5/21
               Account Manager Requested Customer Service Email Dad HIPPA Info and Student PRA Along with Denial Wording

                Customer Service Emailed both Father and Student 10/6/21
               Mother Email 10/6/21
               We responded with HIPAA Info again to mother 10/6/21
               Account Manager Received another email From School Regarding this student letting us know her mother was reaching out. 
               Account Manager Resent Email Customer Service Sent her with Denial and PRA 10/6/21
               Account Manager sent email to student on 10/6/21 with instructions on how to open secure email
               We received PRA in on 10/7/21
               Father Wrote in on 10/10/21 We confirmed PRA form was received and we sent a copy of the Denial Email to Father on 10/11/21
               Father wrote in on 10/23/21 Asking when ID Card will be sent to her and some benefit information
               We Responded 10/25/21 Letting them know student has coverage and directions on how to download ID Card.   We also provided *** Benefit/Claim CS number so he can ask his benefit questions.
  
  Should you or the parents have an additional question, please feel free to reach out to David *. O**********, President.
  
  Best Regards,
  
  Susan O***********

  Customer response

  12/22/2021

  [To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
  
   Complaint: ********
  
  I am rejecting this response because:
  I still stand by my complaint , the company can state all the notifications that they made to my daughter all they want . She is still only 18 years old , and I am sure that all 18 year old KIDS , do not know about health insurance , .You can state that she opened up the emails , but if she doesnt know what the **** she is looking at , it really doesnt matter, hence again why the emails were not sent to the parents email , since the parents pay for the insurance , but then again , maybe your18 year olds pay for their own . The next thing is , why is the waiver a necessity if the University requires a copy of health insurance coverage at the beginning of the school year ? If that has been provided , then apparently we do not need another insurance . We can go on and on , back and forth , but as long as the insurance company has their out clause of once the deadline has passed , no refunds are to be made ..There's the trump card . So it is what it is , right now , its a shame that i pay almost 11,ooo$ a year for health insurance , and i had to put out another 3000$ for this bogus insurance .And since there is double insurance , one will always cancel out the other , so this company will never have to pay a bill . How fortunate . How many other poor unfortunate fools end up paying for their kids just like we did ,  
  
  Regards,
  
  *******************************
  

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