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Business Profile

Employee Benefit Plans

Allegiance Benefit Plan Management, Inc.

This business is NOT BBB Accredited.

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Complaints

This profile includes complaints for Allegiance Benefit Plan Management, Inc.'s headquarters and its corporate-owned locations. To view all corporate locations, see

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    Customer Complaints Summary

    • 9 total complaints in the last 3 years.
    • 2 complaints closed in the last 12 months.

    If you've experienced an issue

    Submit a Complaint

    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.

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    Complaint type

    • Initial Complaint

      Date:01/06/2025

      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.
      I have been trying to get medical care for a urinary issue i have been having for 7 months now. When I first got the referral for pelvic therapy l from my gynecologist back in July, Allegiance told me that this provider (SWFL Pelvic Health) was out of network. So I asked them whom else I could see. They gave me the name of Fysical Therapy. I called them four times over the course of two weeks. I left messages each time I called since no one ever answers the phone. They never returned my calls. Needless to say I needed the pelvic therapy urgently, so I had no other option than to go to SWFL Pelvic. I filled out the single case agreement. They denied it twice. I am now appealing it since it is not my fault Fysical doesn't answer their phone, and it is impossible to communicate with them. I had been in contact with ******* ******** who is the liason for my employer and Allegiance. She stated that they wont approve my appeal. That is totally unethical on Allegiances' end. I literally have no other choice than to go to the out of network provider. I have also applied for reimbursement on all the money i've spent so far to treat my condition. I haven't heard back. Women's health is important after childbirth, and they are totally neglecting women by not caring about their pelvic health.

      Business Response

      Date: 01/13/2025

      Allegiance Benefits Plan Management, Inc.  (Allegiance) provides third-party administrative (TPA) services to self-funded employer health plans (Plans).  Customer is a member of one of the Plans to which Allegiance provides TPA services.  As a TPA, Allegiance has no discretionary authority and must strictly follow the terms, conditions, limitations, and exclusions set out in the applicable plan document as established by the particular employer. Allegiance has made numerous attempts to assist the customer with contacting in-network facilities for those services that are the subject of this inquiry. Unfortunately, Allegiance is unable to control the responsiveness of providers or facilities and must follow the language in the governing plan document as written.  At this time, customer may further dispute the determination by filing an appeal with the plan administrator of their employers Plan for additional consideration.

      Customer Answer

      Date: 01/14/2025

       
      Complaint: 22774369

      I am rejecting this response because: Your company has not assisted me at all. That is very far from the truth.   You have the power to approve my single case appeal, but you choose not to.  Everytime I call, someone tells me a different story.  They suggested a place called "Freedom".  I called and they don't even have the pelvic floor therapist I need.  I called Fysical Therapy in ****** on these dates and times and emailed them as well.  Still no response. THERE ARE NO OTHER THERAPISTS FOR PELVIC FLOOR THERAPY ON YOUR IN NETWORK LIST! Here is a breakdown of all the times i've attempted to call Fysical, your other failed suggestion. Please also see all my attachments of screenshots of emails. 

      ************-Fysical

      Dec. 13th, 2024 2:30:called and left message
      Dec, 17th 2:47. 2024 pm: called and left message
      dec 27th 3:15, 2024 called and  left message
      dec. 30th 4:02, 2024 called and left message
      Jan 6th, 8 02 am, 2024: emailed on their website to request appt., no response as of 1/14/2025



      Sincerely,

      **** *****

    • Initial Complaint

      Date:10/30/2024

      Type:Service or Repair Issues
      Status:
      ResolvedMore 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.
      Date of service was 10/09/2023 in the amount of $631.98, which was paid by me upon receiving the vaccines. The claim that was filed was for coverage of the two vaccines, Prevnar 20 and Arexvy. I am reaching out to the BBB to see if you can assist me is getting a resolution to this claim being paid as all I get from Allegiance is they deny the claim. I was instructed by Allegiance prior to going to get the vaccines and was told by an employee that I could go to any *** pharmacy, so that is what I did. Now they are telling me that I should have gone to a minute clinic or my PCP. I have filed two appeals and both have been denied stating I was out of network. I am preparing to file a third appeal but would greatly appreciate any help you could provide with this problem. Claim number ********ACYR in the amount of $631.98 for RSV and Pneumonia vaccines.o Vaccination date 10/9/2023 o I was informed on the last appeal the *** needed to be a walk in clinic and not a *** Pharmacy ? I have always received vaccinations at **************. I filed the claim as instructed by Allegiance and received a check for one of the administered vaccines. Following up with Allegiance as to the status of reimbursement of the other vaccine, I was told that the payment that I had received was issued in error and that I would need to return that amount and that a new claim process for both vaccines would need to be done. Upon follow up of the new claim, I was told the claim was missing the Tax ID and NPI numbers from the *** pharmacy the administered the vaccines. I provided Allegiance with the requested *** tax ID *********, NPI number **********. Upon follow-up I was told the claim was denied. I hope you can appreciate how very frustrating and disappointing this process is. To add to this, at of the time this took place, I was under COBRA insurance in the amount of $747.00 a month out of pocket. Thank you in advance. Sincerely, *** ****

      Business Response

      Date: 11/20/2024

      The complainant was a member of a self-funded health plan to which the respondent provides third party administrative (TPA) services.  As a TPA, the respondent must process claims in compliance with the Plan Document as established by the Plan Administrator.  The claims in question were processed in accordance with the terms of the Plan Document.  In addition, the complainant filed an appeal, and the denial was upheld by the Plan Administrator.   

      Customer Answer

      Date: 11/26/2024

       
      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.

      Sincerely,

      *** ****
    • Initial Complaint

      Date:05/14/2024

      Type:Order 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.
      I would like Allegiance to do their jobs in a timely manner and pay claims. I have a claim from 10/4/2023 they have not paid and said they were waiting on an explanation of services. I got copies and sent everything to them on 4/10/24 and it is still in review. In addition, I paid for two months of COBRA for Nov and Dec of 2023. Allegiance cashed my $2400 check right away but denied all claims for two months saying they had not processed my cobra benefits paperwork. It is intentional and they seem to float the money for as long as possible.The system is broken and puts a huge burden on members.

      Business Response

      Date: 05/21/2024

      The claim in question was received on 10/18/23 for services including one code that required medical necessity review.  Medical records were requested for the specific code from the referring provider on 10/25/23.  No responsive medical records were received, so the code was denied on 12/7/23.  Eventually, the required medical records were received on 4/10/24.  Review of the records for medical necessity was performed, and the code was approved as being medically necessary on 5/16/24.  The claim has been reprocessed based upon that determination, and payment will be issued to the provider. 

      Please note that our company is not the COBRA administrator and would not have received the two months of payments that the consumer references.  It is our understanding that the consumer's former employer contracts with an entity unrelated to our company to administer COBRA payments.  Regardless, the approval or denial of the claim was independent of the receipt of the payment from the consumer, and approval was delayed due to non-receipt of the required medical records.  

    • Initial Complaint

      Date:02/08/2024

      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.
      On 8/28/23 and 10/3/23 I ordered replacement breast pump supplies through 1 natural way (milkzoom replacement supplies). I got a bill in the mail in december for these two dates stating allegience did not pay the claims. I called allegience early december and was told that the claims were being reprocessed. The end of december I checked back and saw that allegience had processed the claims. I received another bill in the mail January 2024 for the two claims that 1 natural way never received payment for. I reached out to 1 Natural way to determine and they state that they never received the money. I then called allegience and spoke to **** who stated that she can see that Allegience paid evacore a third party company who then will pay the claims to the provider. **** provided me with the transaction number of ********* and stated the amount of $177.18 was paid to evacore to pay the 1 natural way company. **** then provided me the number to evacore to have them determine what happened to the funds. I spoke with ****** at Evacore who stated that they don't handle any kind of payments and so she would advise I call Allegience back. I let her know that 1 natural way is threatening legal action since the claims were never paid. She stated she doesn't know anything about transactions and would reach out to allegience and give a call back. Not one of these companies are taking responsiblity and it is causing stress and hardship on myself. This needs to be taken care of as it has been ongoing for almost 6 months now and I should not be held responsible because these companies can't figure out how to do their jobs appropriately.

      Business Response

      Date: 02/22/2024

      We received confirmation from the network that payments were issued to the rendering provider via electronic fund transfer as follows:

      1.  Claim with a date of service of 10/03/23 was paid on 02/09/24; and

      2.  Claim with a date of service of 08/28/23 was paid on 02/12/24.

      It is our understanding that the payment details were relayed to the provider.  A representative from our company will be reaching out to the customer to provide an update.  Please let us know if there are additional questions.

      Thank you.

    • Initial Complaint

      Date:10/30/2023

      Type:Customer Service 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.
      -Date: All the year of 2023 -Description: refusal to pay out / investigate claims in a timely manner resulting in delay of healthcare and worsening of personal health. -As of 10/30/2023, claims spanning back to 1/24/2023 are still not being paid by this plan. -They have stopped responding to me, they refuse to return my voicemails and cannot give me any information when I call and speak to any customer service individual. Manager named **** has never returned any calls after her initial call to me. I was to hear back within two weeks. This was *** 2023.-I would rather die than go back to the doctor under this health insurance plan. I am a NURSE.

      Business Response

      Date: 11/10/2023

      Allegiance Benefit Plan Management (Allegiance) provides claims administration to the self-funded employee health benefit plan (plan) sponsored by the consumer's employer (employer).  Claims that have been filed correctly by healthcare providers have been processed.  If the claim is not filed correctly by a provider, claims may be denied with an explanation of the error and directing the provider to re-file. 

      Allegiance does not provide customer service to members of the employer's plan as the employer has contracted with another independent third-party entity to provide customer service to its plan members.  As such, Allegiance has not interacted or communicated with the consumer regarding their claims and has no no record of being contacted by the consumer.  The third-party entity with which the employer contracted to provide customer service has confirmed that they have interacted and communicated with the consumer.  We are unable to provide further information regarding the communications.

      Customer Answer

      Date: 11/10/2023

       
      Complaint: 20800833

      I am rejecting this response because:

      Sincerely,

      *************************
    • Initial Complaint

      Date:04/10/2023

      Type:Product 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.
      I used my reimbursement debit card for my ****** dental appt dated 1/11/23. Allegiance shortly thereafter began demanding an "explanation of benefits. I have since sent all requested documents on multiple occasions, with my only response being You have not sent the required substantiation (e.g. itemized statement or explanation of benefits from insurance) for this expense, therefore we must deny this claim as invalid.If you find or obtain valid substantiation for this expense, please send to us immediately with this letter and we will reconsider qualification of the claim. If your I have no other information left to send them as I have previously sent before. What they are currently doing is nothing short of harrassment. The billing even by there correspondence is noted as :503827230113D0002201 Medical FSA 1/11/2023 ****** DENTAL 046 $55.40 $55.40, which I would think would at least be a hint that the expense is applicable.Being that I have no other recourse I am appealing to you to request that you intervene on my behalf to settle this matter!!I only wish I actually had a choice whether or not to use these people because they totally **** ass!!!But since I am required to thru my company I can only appeal to you for help!!! Thank you for your consideration!!!

      Business Response

      Date: 04/13/2023

      IRS rules require substantiation of Flexible Spending Account (FSA) transactions (even those made using a debit card) to avoid adverse tax consequences to the person submitting the claim.  The documentation provided must contain sufficient information to verify the expense is eligible for payment, including service dates, service description and charges for the service received.  The information previously provided did not include all of the necessary data.  Allegiance will be reaching out to assist with the filing of this claim.

      Customer Answer

      Date: 04/17/2023

       
      Complaint: 19908032

      I am rejecting this response because: For whatever reason allegiance chooses not to accept the information that ****** gives me. They keep whining that they need an explanation of benefits where this is a plan which documents the treatment which I was given.  There is no difference between this and a explanation of benefits. The charge itself should do this, but again they wont accept. My main point is that they only charge the give me this hassle for is whenever I see the dentist. For no other medical purpose do they do this to me.

      Sincerely,

      *********************
    • Initial Complaint

      Date:03/09/2023

      Type:Product 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.
      I signed up for Allegiance to manage my COBRA plan, to fill in the gap between when my new employer healthcare plan would start. I sent in my check and paperwork in late February. They sent my info to the healthcare provider on Feb 28. I called my healthcare provider in early March and my plan was not re-activated. I called Allegiance and they told me it would take 3 -5 days to activate. I waited. I called 5 days later and the plan was still not activated. I called on 3/9 and after calling twice was informed that my plan was activated and that the agent didn't know what happened. If I had not called several times I would not have had my healthcare activated. My check was cashed on 2/27/23. During the gap where I did not have insurance I held back on two doctor visits. I would like a partial refund of my $552 COBRA payment to compensate for the 8 days I did not have health insurance.

      Business Response

      Date: 03/29/2023

      Allegiance notified the carrier, ******, of the payment within 24 hours of receiving the check from the COBRA participant.  During a phone call with participant, an Allegiance representative informed participant that his coverage, once reinstated, would be retroactive to 3/1/23.  The coverage was reinstated by ****** on 3/9/23, retroactively to 3/1/23.  Therefore, there was no period during which the participant was eligible when he did not have coverage.  Allegiance is unable to control the time that it takes for the carrier to process on their end.  While it normally takes 3-5 business days for coverage to be reinstated, there may be times when this is not the case.  Allegiance appreciates the information and is using this opportunity to train staff to provide more clarity about the timing for carrier processing.

      Customer Answer

      Date: 03/29/2023

       
      Complaint: 19563286

      I am rejecting this response because: I avoided getting care until the insurance was activated. Your agents did not inform me that the care was retroactive until 3/9. That left no care for 3/1 - 3/8. When I asked what was taking so long with ****** an agent said that they "did not know what was going on."

      Sincerely,

      ***************************

      Business Response

      Date: 04/12/2023

      As required by law, the effective date of coverage of 3/1/23 was shown on the COBRA Specific Rights Notice sent to the qualified beneficiary and was also noted on the Enrollment Confirmation Notice.  Allegiance appreciates the feedback and is training staff to provide more clarity about the timing for carrier processing.

      Customer Answer

      Date: 04/19/2023

       
      Complaint: 19563286

      I am rejecting this response because: I understand what Allegiance is saying but the fact of the matter is: (1) Agents told me, on the phone, that my coverage hadn't started and they were investigating why and (2) I held off on medical care as a result. If Allegiance had trained it's employees properly this would not have happened. It is a matter of not delivering on the service agreed upon, and training your employees. I understand that I am not likely to get any of that money back, but I would like this to be a matter of public record so others know what sort of predatory company they are dealing with. Perhaps you should use my money to train your employees and run your business well. 



      Sincerely,

      ***************************

    • Initial Complaint

      Date:12/14/2022

      Type:Order 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.
      Apparently, more regulatory oversight is needed over this company Allegiance Benefit Plan Management ****Allegiance wrote a ****************** they dated 12/5/2022 stating on each of its pages that in 2023 my premium cost to Allegiance will be $779 per month in each/every month of this soon-to-begin year 2023. I received those documents in mid-December 2022. Included in there it states the 1st payment of 2023 is due 1/1/2023, $779. I want continue automatic withdrawal of that $779 per month from my bank.Allegiances website had me locked me out from seeing anything. Then 12/13/2022 I re-registered again from scratch on an Allegiance website & I wrestled my way in. Now within Allegiance's website I was shocked to discover Allegiance intends to instead take $809 per month beginning soon 1/1/2023 & each month, instead of the $779 Allegiance recently wrote all over their paper documents Allegiance recently sent me.Therefore I called Allegiance 12/13/2022, I asked why within Allegiances website alludes to $809 instead of $779. Allegiances phone answerer said it looks like will be $809 beginning soon on 1/1/2023. I asked repeatedly: Why didnt Allegiance ever tell me Allegiance plans to automatically take very-soon (1/1/2023) $30 higher per month than Allegiance recently wrote all over paper documents Allegiance gave me recently this month? Allegiance has always had my only phone *********** home address, yet Allegiance never informed me this. Their phone answerer had no explanation.Theres no excuse for Allegiances never informed me Allegiance intends to take $30 more per month than Allegiance recently wrote throughout each page of documents to me this month December 2022. Allegiance had figured I wouldnt discover the $30 theft per month until too late.That attempt by Allegiance to steal, shows the public needs any government entities to perform more regulatory oversight over this company Allegiance Benefit Plan Management ****

      Business Response

      Date: 12/21/2022

      Allegiance is a third party administrator.  We provide retirement billing services for ************************ retirement premiums. Allegiance does not set the premium amount, nor do we retain the funds. All premiums collected are sent to ************************.  
      Our records show that we sent you an open enrollment letter on 10/28/22 that included the correct, updated 2023 premium rate. Unfortunately, remittance coupons (the paperwork you received showing your payments due) were sent out before the new 2023 rates were updated in the billing record; therefore you received incorrect rate coupons subsequent to receiving the correct rate information from the 10/28 open enrollment letter that was sent to you. Correct remittance coupons are being sent to you.
      Our records also show that you called on December 13th and spoke to one of our representatives about the discrepancy and they who advised you that the coupons were sent in error and the new rate listed in the 10/28/22 open information letter was correct.  The rate that you can view online is also correct.  
      We do apologize for the incorrect remittance coupons being sent in error.  We were glad that you called and we were able to clarify the situation.  Thank you.

      Customer Answer

      Date: 12/22/2022

       
      Complaint: 18570924

      I am rejecting this response because:

      12/22/2022 Thurs afternoon on BBB website I replied this to that statement from Alllegiance:
      I am hereby requesting BBB to post my original complaint in full on at BBBs website regarding Allegiance company. That is because Allegiance wrote misleading statements in their Allegiance response to the complaint:

      1) Allegiances response blamed a different entity: ************************.  That is although ************************ did not send the misleading papers Allegiance dated December 5th 2022 & Allegiance mailed to me.  Allegiance wrote that, not any other entity. Allegiances response blaming other excuses such as this blaming a different entity, is the same thing Allegiance did when I called Allegiance on the phone to tell Allegiance about Allegiances price switch upward without having informed me, that phone call I made to Allegiance was to try to avoid my needing to report Allegiances price-switch-upward-without-informing-me to the BBB.

      2) Allegiances response to BBB was long (I appreciate that length) but made no mention of the fact Allegiance on December 5th ****************************************************************************** 2023 will be $779 per month.  Allegiance in their response to BBB after I had pointed that out to Allegiance & then in writing to BBB, Allegiance never mentioned December 5th 2022.  As stated in the original complaint, December 5th is close to January 1st when the first payment of 2023 is due to Allegiance.  That closeness in dates from December 5th Allegiance when prepared & mailed out all those papers stating the price will be $779 per month, that being recent right-before payments of that will be due, gives or at-least alludes to, that price of $779 being the correct amount.

      3) Allegiance now states Allegiance wrote/dated an enrollment letter 10/28/22 stating some other premium rate than $779.  I have not received such, & I have not received anything indicating any other premium cost per month for year 2023 other than the many papers I received in mid-December (recently) from Allegiance stating $779 per month.

      BBB please post the original complaint from me.

      Thank you.

       



      Sincerely,

      ***********************

      Business Response

      Date: 01/18/2023

      In response to your second complaint, Allegiance is not blaming any other entity for the issue that you have brought up.  Here again are the facts:

       

      On October 28, 2022, an open enrollment packet was sent to you at your address on file. This letter contained information about the January changes that included the correct January premium that had increased by $30. This rate is set by ************************, not by Allegiance. Allegiance is a third party administrator who provides retirement billing services to ************************.  Allegiance does not set premium, nor do we retain funds. The retiree premiums belong to ************************.

      You have stated that you did not receive this open enrollment packet. We did not receive it back from the postal service.  Any documents returned to us are noted in the file and we did not receive it back.  

      We acknowledge that you did receive a new set of payment coupons with the $779 rate as you noted.  This document was sent out by us in error prior to the new rates being loaded into our system

      You called Allegiance to ask why there was a discrepancy between the payment coupons you received and what you saw online noting that the premium was actually $30 more.  In listening to the recording of the call, our representative explained that the coupons were sent out in error and that you would be getting a new set of coupons with the correct amount.  

      The new letter with accompanying payment coupons was sent to you on December 20th.

      Again, Allegiance does not set premiums, the employer does. We are an administrator who provides payment coupons, collection of premiums and remittance to ************************ of those funds that we collect.

      The rates did change by $30 and effective January 1, 2023, in order to maintain your retiree coverage with ************************, you are required to pay the new amount.

      Thank you. 

      Customer Answer

      Date: 01/18/2023

      Complaint: 18570924

      Therefore looks like there is nothing I can really do about this, therefore I'll have to end my complaint here & I will pay that higher amount.  But I want all my writings of this on BBB to stand on BBB as a warning to other customers to beware of such Bait & Switches.

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