Reviews

Review Details

• Review fromVikki W

  Date: 10/30/2023

  1 star
  As a healthcare representative with 20 years of experience working with insurance, this company has been the most frustrating to work with. Their automated systems (both voicemail and online) don't work. When you finally get a human they cannot answer any details on the plan and refer you to the "public" information. No code level details, no details AT ALL. The person I spoke to had NO CLUE how insurance claims worked, asked if I submitted the procedure as a basic or major service on the claim. I almost cried I was laughing so hard when she had no clue that procedure codes were used on claims. Tried to excuse the ignorance by saying they were the plan administrators not the insurance company. How can they administer if they have no clue how insurance works? Have no hope for the claim actually being paid.

• Review fromCharles W.

  Date: 12/18/2022

  1 star

  Charles W.

  Date: 12/18/2022

  I feel like my story needs to be told as a warning for anyone else who might want to get insurance through this company or any business that is looking towards them for insurance. In April this year I got into a significant accident that required surgery. My employer had switched over to HealthEZ the previous year, however HealthEZ did not move my policy over; they told my HR that I would have to wait until the renewal period (in August; my clavicle was literally shattered inside of my body), despite the move supposedly being automatic. My HR was able to get HealthEZ to provide the coverage that they should have been providing. When I went for surgery, everything seemed to be going alright, until a few months later I received a subrogation letter in the mail; HealthEZ wanted to dispute their paying for the surgery, because I'd been in a car accident. The deductible on their plan is high, as are the copays; I paid everything in full. Just today, I received a bill in the mail for the anaesthesiologist ($1300), which HealthEZ apparently did not cover, or did not feel the need to cover after my employer switched away from their health plan this year, despite the services being provided more than 6 months ago. I'm in a good financial situation and have plenty of resources, so this is a headache more than anything, but I could not imagine having to deal with a health insurance company like this without what I have.I know that there are probably employers out there who see something like this as a potentially beneficial cost saving option; please be aware that this is a company that is only interested in that cost saving, regardless of how that *** affect your employees.

  HealthEZ

  Date: 01/13/2023

  Unfortunately, we often see confusion with the ins and outs of self-funded health benefit plans as most people are more familiar with traditional health insurance. With a self-funded plan, the employer determines the structure of the benefit plan elements like eligibility, coverage, deductibles and copays. HealthEZ is an administrator of self-funded plans, not an insurance company with a profit incentive to deny claims, eligibility or coverage.Relating to the concerns shared in this review, and without getting into personal health information, heres what likely explains the reviewers experience:Plan eligibility:The employer determines eligibility and enrollment in their benefit plan. If an employee isnt listed as eligible in our database, we cant process claims for that individual. The request to add an individual to the plan must be handled at the employer level.Subrogation:Subrogation is very common in the case of medical costs related to an auto accident. Its simply an effort to ensure the correct entity covers the related medical costs. In most cases, the auto insurance company would be the responsible party.Claims and deductibles:If an employee has not met their deductible in a plan year, they will be responsible for any care costs until theyve reached that limit. That most likely explains the $1,300 bill, not our unwillingness to cover it. We will process all eligible claims on behalf of the employer.We regret the confusion and frustration the reviewer experienced and hope he has fully recovered from the accident.