ComplaintsforSASid, Inc.

• Initial Complaint

  03/21/2024

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  Stay away from this company. I purchased temporary health and accident insurance in Summer of 2023. When I went to cancel after I joined my wife's insurance plan, they sent me a form and information on how to cancel. I complied and filled it out only to find out 4 months later that I had only cancelled the Health Insurance plan and not the Accident insurance, even though I emailed them for directions on how to cancel. Because I asked "how do i cancel my insurance" and not "how do I cancel health and accident insurance" I paid 4 extra months on the accident insurance. When i brought this to their attention, they only offered to refund 1 of the 4 months of payments even though they classify both policies as "Insurance" and I asked "How do I cancel my insurance?". Shady business practice, I would never purchase from them again.

  Business response

  04/01/2024

  InsuranceTPA.com, or any health plan administrator cannot make assumptions as to how to administrate policies unless specific directions regarding the billing component of the plan is provided.  In this case, we followed the directions provided by the policyholder.   If the assumption was to cancel the accident plan as well, and an accident had occurred, then the policyholder would have been 100% for the cost of treatment due to the accident.

  InsuranceTPA.com followed the directions provided by the policyholder when the cancellation request was received.

   

  Thank you.

  InsuranceTPA.com

• Initial Complaint

  02/07/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Was told in discussions with ****** that I would be purchasing coverage for health dental vision and prescription for myself and my son. This is untrue the coverage is non existent cussing me bills and missed appointments for him.

  Business response

  02/14/2024

  InsuranceTPA.com does not administrate  these dental and vision policies.  They were purchased through an association that we are not a part of.  InsuranceTPA.com only administrates short term medical for this agent/association.

• Initial Complaint

  02/01/2024

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  I have no idea who or what this is

  Business response

  02/02/2024

   InsuranceTPA.com is the ************************** for the premium drafts for the vision plan through EyeMed that you self-enrolled in with an effective date of 02/01/23. Your annual payment was initiallyt drafted on 12/30/22 and the second annual payment was drafted on 01/30/24.  If you have any questions, please call **************.

• Initial Complaint

  01/02/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  I have never been able to reach a single person by phone or by email for 6-months. No one answers their support phone number and I have emailed their support email ([email protected]) for three months with no response.They have never paid for any medical coverage and always claim it was a pre-existing condition and send a form for a claims appeal for every EOB. Those go unanswered as well. Also, they subscribe members to a 3rd party company, AUIC (auic.org) which charges $16/mo. for being a 'member'. They charge you separately, but billing goes through InsuranceTPA and neither will cancel the plan I didn't agree to sign up for. I had to put stop payments on my bank account and report fraudulent/unapproved charges.I did a text back from AUIC, not a call or email, that said I had to contact InsuranceTPA to cancel the charges from them. I'm not sure if we actually had legitimate health coverage at all during the 6 months or not, but the complete lack of interaction or support is unacceptable.

  Business response

  01/29/2024

  This response was emailed to BBB on 01/12/24, but it appears to be an open complaint, which is untrue.

  Our response was sent to: *******************************************************' <******************************************************> via email on 01/12/24.

  This open complaint shd be closed. 

   

  Business response

  02/01/2024

   Thank you for allowing us to respond to this complaint.

  Due to HIPAA, we cannot share specific information related to your complaint on a public forum.

  Please note that, based on our findings, we have no emails or appeals received from ***************************** on file. 

  Your short term medical plan expired on 11/29/23.

  Your **** membership was canceled on 01/03/23 per your request via email received on 01/03/23.

  As a Company, we do not allow a policyholder to cancel online as we want to know and understand the reason for the cancelation so that we can assist the policyholder with solutions.

  In order to enroll into the short term medical plan, an **** membership is required.  The short term medical plan is a benefit of the **** membership.

  Your enrollment into these two plans was completed online through eHealthInsurance.  You self enrolled on 04/29/2023.

  Based on your phone number on file, we show that you called on 10/28/23 called and hung up after 40 seconds. There are no other calls on file from the phone number given at time of enrollment.

  Based on our findings, there is no fraudulent activity or misrepresentation on the part of InsuranceTPA.com.

   

   

  Customer response

  02/05/2024

  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and do not find that this resolution is satisfactory to me. However, I don't have the time or energy to invest in pursuing an apparent hopeless cause here. I hope you listen to the reviews of customers on businesses and promote that for others like me. I am the small guy that doesn't live in the world of legalities and business policy, I just know a bad company and when I, as a customer, am being treated poorly and taken advantage of. This was an avenue to try and find a resolution, but recognize that will not be found here. 
  
  Regards,
  
  *****************************
  

• Initial Complaint

  12/22/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  In may of this year 2023, I was looking for insurance since mine changed at my employer and I became a **** employee for a real estate company. I spoke with a rep and was told I had to give a credit card to get a quote for insurance. I went through the process but the insurance was too high. I went to the website and tried to find something affordable, which I was able to find, I thought with this company. Unfortunately, once I got it started with the company online I had no idea I was signing up for something that cost over 500 per month but wasn't even actual health insurance. I was excited to receive the info in the mail and went to my pharmacy to pick up much needed medication and was told what I had given for a health insurance card was not insurance at all and wouldn't be able to be used for that. I immediately called and said to cancel whatever they had on file for me and i would just do without insurance since I couldn't trust anything I had read or been told. I also had given my checking acct to draft money but they used the credit card from my husband (**************************) that did not authorize the charges to begin with. They continued to charge him without my knowledge and they refuse to give the money back now even though they clearly see I did not authorize this. 10 charges = ****** x 5 and ****** x 5 and ***** interest - *********** was ****** and ****** I want all money that was taken by this company refunded to my Husband who never authorized or signed anything giving permission to debit his credit card. If they do not want to give it back I will go to the Attorney General of ******* and ********* to advise them of the issues with the company.

  Business response

  12/27/2023

  H3132**36373134313132H has reviewed your complaint and our response is listed accordingly.

  Our records show that you enrolled into this policy online and therefore it was a self-enrollment.  *** fulfillment materials that you would have received specifically state that this is a not an H3333323335**363338**H plan and does not meet the *** requirements for H32393532353233**3834H H3333323335**363338**H.  This plan is a limited medical indemnity benefit type policy that provides benefits for illness and sickness.  This is identified in the Enrollment Form and the Certificate of H33**3332353236373636H in which the policyholder would have received the paper fulfillment in the mail.  *** Certificate of H33**3332353236373636H specifically states: THIS IS A CERTIFICATE OF INSURANCE FOR A LIMITED FIXED INDEMNITY POLICY.
  IT PAYS BENEFITS REGARDLESS OF ANY OTHER INSURANCE. THE POLICY IS NOT A MAJOR MEDICAL OR COMPREHENSIVE MEDICAL H32**3733333531343134HCARE POLICY. PLEASE READ THIS CERTIFICATE CAREFULLY.  In addition, the credit card on file was the card information that the policyholder would have entered in online when applying for coverage.  Our records do not indicate any change in payment method during the duration of this policy.  H3132**36373134313132H cannot access random payment information at any time.  It has be the payment method provided by the policyholder.  *** Certificate of H33**3332353236373636H has an Exclusion which can be found on page 18, exclusion #** that reads "Prescription Drugs unless specifically provided for under the Policy".  It is up to the policyholder to read and understand the conditions of their policy either prior to enrolling, or upon receipt of the fulfillment documents. ***re is a  right to review period noted in the documents that would have been received that reads * You have the right to cancel this plan within ** days of the effective date for a full refund of fees paid."  We were not notified to cancel this policy and therefore the premium drafts continued from the financial institution provided at time of application. 

  We were contacted on 12/14/23 and a refund was requested of the funds involved with the payment disputes with the bank for both the dental and H32393532353233**3834H plans.  H3132**36373134313132H arbitrated with the financial institution of the chargebacks initiated by the policyholder.  *** financial institution also confirmed that there was no misrepresentation or fraudulent activity and therefore allowed the drafts of the premium payments.

  Based on our findings, there has been no fraudulent or misrepresentation of the H32393532353233**3834H plan chosen or the administration of this policy and therefore a refund is not warranted.

  *** complaint received does not state any communication regarding the dental policy.

  Best regards,

  H3132**36373134313132H

  Customer response

  12/28/2023

  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, details of the offer I reviewed appear below.
  
  I *** not accept this explanation! I was shown one thing before enrolling and then what I enrolled into was totally different. I called and canceled the contract within a few days once I realized that this was NOT insurance. There is no way in the world I would ever pay over 500 per month for this c*** that isnt helping anyone but the insurance company.  Why would you have a way in the first place for someone to fill it out online when you have to be licensed in the **************** in order to sell medical insurance which is what I was led to believe! Also the only reason I put that card info online was to get the quote ONLY! I was not saying that you should continue to bill that card. Im not even an authorized user for that card and was only given permission to have used it for the purpose of getting a quote. Once I found out what it really was I cancelled it and said DO NOT EVER TAKE ANOTHER PAYMENT. I WILL ALSO BE FILLING AN ATTORNEY GENERAL COMPLAINT FOR THE **************** AND ********* IF YOU DONT DO WHAT IS RIGHT AND GIVE MY HUSBAND BACK HIS MONEY NOW. 
  
  Regards,
  
  ***************************

• Initial Complaint

  12/18/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I paid ***** to this company (TPA) to provide eye insurance for me. I do not have a policy issued in my name, I am unable to get into my account with them online anymore. My eye doctor is unable to find an account with them in my name. I, on several occasions, have spent hours on hold but my call is never answered. I will try to file a dispute via my credit card company. Something here is very wrong with this companyThank you .*****************************

  Business response

  12/27/2023

   InsuranceTPA.com has reviewed this complaint.

  The application for this policy was complete on 09/30/21.

  Fulfillment kit was mailed to the policyholder on 09/30/21.

  On 11/16/22 the policyholder called to change the payment method on file. Payment method changed and payment was posted.

  On 10/24/23 the policyholder called to cancel policy.  This policy was canceled and the last payment made, in the amount of $49.93, was refunded back to the policyholder.  No additional payments were taken.

  Based on our findings, the Disputed Amount: $49.93 in this complaint was actually refunded back to the insured and would be reflected within the financial institution on file. The refund was complete on 11/03/23.

  There are no additional refunds to be issued.

• Initial Complaint

  12/12/2023

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  I had lots of trouble canceling this policy. They don't answer the phone and their website doesn't work. After trying to call sporadically for several months when I could find the time, I had to receive a new debit card which had updated information that the company (tpa) didn't have. Once my updated card canceled out my old card tpa began calling and sending emails that they couldn't run the [payment and that my insurance would be canceled by a certain date. After investigating my bank account I found out I was still being charged by them and for an even higher amount.I once again began calling them again and trying to use the chat feature on their site. Today, 12/12/2023 I finally reached a Team Member name ********* who was very rude and extremely condescending who canceled my policy and refused to refund my unauthorized charges. I would like to be refunded for at least the past 5 months, this service is horrible and although I've been trying to cancel for over 11 months with no resolve, and a member for over 5 years I will be satisfied with a refund beginning August 2023.

  Business response

  12/13/2023

  InsuranceTPA.com apologizes for any inconvenience you may have experienced with MDLive. InsuranceTPA.com is the 3rd Party Administrator for this account.

  Each policyholder of MDLive was notified via email in July of this year that the premium/rate for this product was increasing in August.  You would have been notified in advance.  The rate increase is the first increase in 3 years of subscription.

  We have refunded your account for the last 4 months of premium drafts.  That timeline is when the rate increase incurred and also when the payment method was updated.  A refund in the amount of $38.00 will be reflected with your financial institution in the next 5-7 business days.

  InsuranceTPA.com

  Customer response

  12/13/2023

  [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

  11/20/2023

  Complaint Type:

  Product Issues

  Status:

  Unanswered

  More info

  I want to cancel my policy with this company. I cannot get a person to speak with me. This is the second year I have been unable to cancel. If I don't get it cancelled this time I am going to file a lawsuit. I emailed a cancellation notice to them on October 31, 2023 and never got a response.

• Initial Complaint

  11/15/2023

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  This company is extremely difficult to cancel. I sent an email notice on 10/27/2023 to cancel my flex term insurance as requested. They never processed it. On 11/14 I was still charged.

  Business response

  11/15/2023

  We apologize for any inconvenience in this matter.

  Refunds in the amount of $15.95 (AUIC Membership) and $88.52 (FlexTerm Health Plan) will be issued on 11/24/23.

  Once a premium draft has occurred, we have to wait 10 business days to refund the amount due to financial transaction(s) timing of events.

  Thank you.

• Initial Complaint

  10/05/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Better Business Bureau:My wife and I purchased health insurance through InsuranceTPA and a Everest/Flexterm policy. We have a completed application, a receipt from paid premium, a member ID card, a policy number, and a notice that our policy is active.However, throughout the last eleven months InsuranceTPA.com has not responded to any claims requests. Upon investigation and calling two times, they are unable to identify information regarding our policy. Which is the same indication that they have given three medical providers attempting to begin a claim for medical treatment. InsuranceTPA has failed to respond to claim request and is unable to identify the policy in a timely manner.Member ID ********* Policy effective date: 11/19/2022 Paid thru date: 11/18/2023 Premium paid: $3461.01 It is my firm believe that InsuranceTPA is likely a company which is trying to evade claims processes. Please investigate this matter further and protect consumers against this predatory behavior.Thank you.

  Business response

  10/18/2023

  Due to privacy concerns, neither Everest nor InsuranceTPA is able to provide specific details in response to Mr. ******** concerns to be posted for public view and nothing in this response shall constitute a waiver of any privileges, defenses, or rights in connection with this matter.   Please also note that the coverage that ****************** purchased is sitused in a state other than *********.
  
  We understand that the complainant states that although his Short Term Medical Insurance Certificate was issued, providers have allegedly submitted claims on behalf of ****************** and/or a member of his family that have not been addressed.  Based on the limited information provided, we are unable to locate any such claims submitted prior to the receipt of this inquiry.  We have made contact with ****************** in order to address his concerns accordingly. 
  
  Should you have any further questions or concerns, please feel free to contact us.
  

  Customer response

  10/18/2023

  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, details of the offer I reviewed appear below.
  

  This is no response at all.  InsuranceTPA simply claims they never received claims requests because they never were able to locate my policy.  Which they have since identified and have claimed they have corrected.  However, there are numerous logs by the service providers where they sent claims requests that were denied because InsuranceTPA said that no coverage existed.  So InsuranceTPA does have records.  Whether they want to find them or not, that's up to them.  Clearly they don't want to look back and locate claims that came with my name and policy number.  They want to simply avoid this issue in its entirety.

  InsuranceTPA shrouds itself behind a cloak created with "deny everything" mentality.  Even if they have records that indicate claims requests they won't search for them.  

  InsuranceTPA simply didn't provide the service they promised and were paid for.  We have already reached out to the Commissioner of Insurance for the State of ********* who is very interested in these sorts of fraudulent activities.  I suspect this will end up with severe penalties and I am willing to continue to fight for what I feel is right.  InsuranceTPA acted fraudulently in this situation and want me to believe it was a "glitch".  If they took my premium, they have to provide service.  I should not, as the consumer, be responsible to fix their glitches or call their attention to fixing their internal protocols.  If they accepted my premium they have a responsibility to respond to claims.  I am not, as the insurance holder, responsible for every part of their claims processing.  That is their job and what they are paid to manage.   

  To date they have offered no solution other than to send all my eleven month old claims over again.  Some were already paid because they timed out with the providers and I didn't want to have collections on my record.

  
  Regards,
  
  *************************

  Business response

  10/31/2023

  Everest ******************************** acknowledges receipt of an inquiry from the ********* Office of the Insurance Commissioner (OIC) and responded October 25, 2023.  Everest was also informed a consumer complaint was submitted to the ******************** of *********** Trade &******** ************ ****** of ******** Protection, but has not received any inquiry from the policyholder's state entity.  If received, it will be responded to as directed.

  Customer response

  10/31/2023

  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, details of the offer I reviewed appear below.
  
  Not a response.  But, the *** did refer me to the Virginia Insurance Commissioner and has forwarded the complaint to start a case in my state.  

  BBB should continue to pursue this, and other claims similar to it that have been reported.  Looking at the businesses track record on BBB it appears this is not an isolated incident.  I am surpised to see the BBB rating given to this company as it's clearly misleading insured to believe they have coverage then failing to provide it.

  
  Regards,
  
  *************************

*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. ↩