Complaints

This profile includes complaints for Strata Health Group's headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

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  Strata Health Group

  700 Central Expy S Ste 360 Allen, TX 75013-1002

• 

  Adroit Health Group /Impact Health limited medical

  PO Box 576 Arnold, MD 21012

• 

  Strata Health Group

  PO Box 310 McKinney, TX 75070-8136

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:06/25/2025

  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.

  The place where I worked was going to be closed at the end of May. So I contacted a person through HR at my work at the end of April. This insurance was to be effective June 1 for a 30 day trial.I paid for it in April over the phone. When I tried to use the insurance it didn't cover anything. So I canceled it yesterday. It was only the 23rd of June. So I was within my 30 days. I paid about 415 dollars for the month. But the person on the other end of the phone said that her supervisor declined my refund. I said why it hasn't been 30 days? She said that her supervisor said I called in April 21 and that was the date they were going by. Not the effective date June 1 2025 which was was right on the card. I know businesses go by the effective date. I've never heard of a business doing what this insurance business did to me .

  Business Response

  Date: 06/25/2025

  Dear Mr. ********************** you for making Adroit Health Group (Adroit) aware of your dissatisfaction with the denial of a requested refund for your *************** 365 limited medical plan.  Our records indicate that you enrolled on April 21, 2025, with an effective date of coverage of June 01, 2025.  Thereafter, you sought to cancel the account on June 23, 2025, through a request made to the sales agency, which is not affiliated with Adroit.  
  
  As stipulated on page 4 of your Enrollment Application agreement, you were provided a period of 30 days from receipt of your enrollment confirmation e-mail to review your membership, during which time you could cancel and receive a full refund.  Your enrollment confirmation e-mail was sent to you on April 21, 2025, at 9:44 a.m.  A copy of the April 21, 2025, confirmation e-mail is enclosed with this response for your reference.  Therefore, your window to cancel the account and be eligible for a refund ran until May 21, 2025.  However, you did not attempt to cancel the account until June 23, 2025, which was unfortunately outside the refund window.
  
  However, understanding that you may have misinterpreted the cancellation window to run from the effective date of your plan (and for which your cancellation would have been timely), as well as the dissatisfaction you expressed with the plans coverages, Adroit has determined that the appropriate course of action is to issue a discretionary refund of your charges despite the accounts cancellation occurring outside the regular refund window.  Accordingly, this date I have requested Adroits ****************** to process a refund in the amount of $414.85, which will be credited to your credit card of record.  As I indicated in my e-mail to you earlier this afternoon, depending on your financial institution, it can take up to 3-5 business days before a refund is reflected on your bank statement, which is outside our company's control.  In the event you have not seen the refund hit your account by the middle of next week, you are encouraged to contact my office directly at *********************************************, and we will be happy to follow up for you. 
  
  Thank you for being a valued customer of ********************,
  
  Best regards,

  ******* Jeter 
  General Counsel & Chief Compliance Officer
  Adroit Health Group, LLC

  Business Response

  Date: 06/26/2025

  Attached is the receipt evidencing the refund issued to this consumer as of this date (06/26/2025).  A copy of the receipt has also been sent to the consumer for his records.

• Initial Complaint

  Date:06/12/2025

  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 am writing to formally express my deep frustration and disappointment regarding the handling of my coverage and claims through what was presented to me as a Christian Health Ministries cost-sharing plan, purchased through United Enrollment.For over a year, I had no claims. When I did file claims, the majority were denied without clear justification. The few claims that were acknowledged as payable have now been in limbo for more than a year, pending payment from the "carrier" to the "claims department"a delay that is completely unacceptable.Throughout this ordeal, I have made countless calls. Androit, who debits my account, insists I contact United Enrollment. ***************** directs me to the claims department. The claims department, in turn, offers no answers and claims they have no authority to escalate my concerns. All three entities describe themselves as third-party administrators and disavow any responsibility for resolving the issue or even clearly identifying who is ultimately in charge of my funds and claims.After over a year of chasing answers, I finally discovered that Strata Health Group is the actual party withdrawing funds from my account. This was never made clear to me at the time of enrollment.This entire experience has been convoluted, evasive, andfranklyfeels intentionally deceptive. I entered into this agreement in good faith, expecting transparency and accountability. Instead, I have encountered a complete lack of clarity, communication, and follow-through. At this point, this appears to be a deliberate runaround at ****** a coordinated scam at worst.I demand release of payment to the claims department, so that our claims can be paid.

  Business Response

  Date: 06/20/2025

  Dear Ms. Crow,
  
  Thank you for making Adroit Health Group (“Adroit”) aware of the problems you have had with getting your needs sharing requests processed by your health care sharing ministry plan, Joppa Health Share. 
  
  First and foremost, we respectfully disagree with your assertion, “After over a year of chasing answers, I finally discovered that Strata Health Group is the actual party withdrawing funds from my account. This was never made clear to me at the time of enrollment.”  At the time of your initial enrollment in July-2023, you reviewed and executed an Enrollment Application that contained important disclosures concerning your transaction.  Your attention is called to the following disclosures from that July-2023 Enrollment Application:  
  
  1.  “You expressly authorize Adroit Health Group, through its TPA Multiply Benefits, to automatically debit your bank account or credit card on the monthly agreed upon due date. You also acknowledge and agree that your monthly payment(s) will be automatically charged or drafted every month from the credit card, debit card or bank account you provided to us.” (Crow Enrollment Application, 07/03/2023, p. 2).
  
  2.  “You authorize Adroit Health Group to store your payment credentials to be used for future transactions on the monthly agreed upon due date.”  (Crow Enrollment Application, 07/03/2023, p. 2).
  
  3.  “You understand that this authorization will remain in effect until you cancel it in writing, and you agree to notify Adroit Health Group in writing of any changes in your account information or termination of this authorization at least 5 business days prior to the next payment due date.”  (Crow Enrollment Application, 07/03/2023, p. 2).
  
  4.  “Your monthly credit card statement will reflect the following: A1 Healthcare 800-269-3563 or your monthly bank statement will reflect the following: Health 8002693563.”  (Crow Enrollment Application, 07/03/2023, p. 2).
  
  5.  “You agree that Adroit Health Group is authorized to contact you via phone, text or email regarding payments due. For questions about your billing, please contact the Member Services department at 800-269-3563.” (Crow Enrollment Application, 07/03/2023, p. 2).
  
  6.  “Member hereby acknowledges and agrees that he/she has provided Adroit Health Group, LLC, and/or Strata Health Agency, LLC, and their affiliates (collectively, the "Company") with his/her cellular telephone number.” (Crow Enrollment Application, 07/03/2023, p. 15).
  
  Additionally, simultaneous with your enrollment, you were e-mailed a receipt showing your initial charges that included all of our Company’s information, as well as our name (in multiple references) and logo, toll-free telephone number, and customer service e-mail address and you were specifically advise that our Company was the entity charging your credit card and how this would be reflected on your credit card statement.  Our records indicate that you opened and read this e-mail the following day on July 4, 2023, at 12:36 p.m.  On the same day of your enrollment, you were also sent a Welcome E-mail that notified you of how to access Adroit’s Electronic Member Portal which contained all of your account information.  Of note in this e-mail, which our records show you opened and read on July 3, 2023, at 5:35 p.m., were the following express disclosure: 
  
  “You are receiving this email because you have at least one enrolled product administered by Adroit Health Group. Adroit Health Group LLC, a Licensed Texas Agency, License #2100853, dba Adroit Insurance Solutions, LLC in California, License #0129105, provides billing and benefit administration for all membership packages and products through its TPA, Multiply Benefits. You will see either ‘Benefits 800-269-3563’ or ‘Health 8002693563’ on your billing statement each month. If you have a billing question or need to update your billing information, please contact Adroit Health Group at (800) 269-3563 or email [email protected].”   This was followed by a lengthy disclosure of who our Company is and what our Company does.
  
  Furthermore, each month you received four (4) separate payment reminder emails that all had Adroit’s logo and also referenced our trade name, “Strata.”  These were sent to you in advance of your payment being withdrawn from your bank account as you authorized in your enrollment agreement.  This occurred at least 72 times during the course of your account and did not include numerous other e-mails concerning declined payments that also contained our Company’s information.
  
  Lastly, on June 12, 2024, you received via e-mail our Company’s Annual Consumer Notice that described our Company and our role in the transaction.  Our records indicate you opened and read this e-mail on June 12, 2024, at 1:09 p.m.  A copy of the Annual Consumer Notice that you received is appended to this response for your reference. Therein, you were expressly advised, “In some states, we operate under different trade names, such as Adroit Insurance Solutions, LLC, and Strata Health Agency or Strata Health Group. Our parent company is A1 Health Group, LLC.”  The Annual Consumer Notice also included lengthy descriptions about the roles and responsibilities of our Company as well as those of your licensed insurance agent and your carrier/health care sharing ministry.  
  
  In sum, we apologize that these 75 separate notifications were insufficient to call your attention to the fact that our Company was responsible for withdrawing funds from your account. 
  
  With regard to your complaint about the challenges obtaining information about your pending claims, we definitely understand your frustration.  Our records reflect that since July of 2023, you have made six (6) calls to Adroit’s Customer Service Department, including one call related to changing your method of payment in January-2024.  You are correct, however, that several of these calls had to be transferred to Joppa Health because the inquiries sought information about pending needs sharing requests (i.e., claims).  We wholeheartedly agree that waiting for a year to find out the status of your bills is unacceptable.   
  
  Please be aware that Adroit is not a health care sharing ministry provider (akin to a “carrier” as you have referenced in your complaint) nor are we the sales agent from whom you purchased this health care sharing ministry plan.  Rather, Adroit functions solely as an independent marketing organization that providers third party administrative services related to enrollment and billing.  In this capacity, we make certain insurance and non-insurance (including health care sharing ministry plans such as Joppa Health Share) available for sale by third-party independent contractors (such as United Enrollment) through our enrollment and billing platform.  The funds that Adroit collects from you are then remitted to the various carriers and vendors whose products you purchased, and Adroit is not responsible for payment of the benefits payable under the various plan;  rather, the individual carriers and vendors (or in this case, your health care sharing ministry) receive those dollars and are responsible for paying benefits.  
  
  Because many customers purchase a number of products through our platform, we also provide a centralized customer service number from which we can help direct your inquiries, whether this is in relation to questions about a particular product or claims related to another product, etc.  However, as you alluded in your complaint, we are unfortunately not privy to all information about your various accounts.   Notably, Adroit has no involvement with, responsibility for, or authority over the claims review, claims processing, and claims payment functions for any product.  None of the health care sharing ministries or health insurance carriers whose products are sold through our platform share this information with us.  For this reason, when you call Adroit’s customer service department, we make sure you are transferred to the appropriate party at the health care sharing ministry to assist with your request.  We sincerely regret the challenges you have encountered getting information and getting your needs sharing requests paid, but we have no more access to this information than you do.
  
  Nevertheless, following receipt of your BBB complaint, we contacted the leadership at Joppa Health Share to make them aware of the serious problems you have encountered.  Joppa Health Share relies on a company called Cornerstone Resources, which is not affiliated in any way with Adroit, to serve as its third-party administrator for needs processing.  In other words, they are the entity that reviews and pays needs sharing requests for Joppa.  According to the executives we spoke with at Joppa, they have experienced performance problems with Cornerstone and are in the process of transitioning these services to a new company.  However, Joppa has issued instructions to have all of your claims processed and paid by Monday, June 26.  Joppa also relayed that Cornerstone approved 18 separate bills to be paid, with the remainder being deemed ineligible for sharing by Joppa.  I believe Cornerstone will make these payments via a check made payable to you.  If you have not received the reimbursement within the next week, I would recommend you contact Cornerstone directly at Cornerstone Preferred Resources, P.O. Box 680468, Houston, TX 77268-0468, (844) 884-7526.  Alternatively, you are also certainly free to contact Adroit’s Compliance Department at any time ([email protected]) and we will be happy to follow up on your behalf.
  
  Please accept our deepest apologies for the problems you have encountered with Joppa Health Share.  We hope our efforts have assisted in getting these problems rectified.
  
  Best regards,
  
  Jeffrey Jeter
  General Counsel & Chief Compliance Officer
  
  

• Initial Complaint

  Date:05/01/2025

  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.

  Was mislead into believing I was signing up for health insurance. They were not and never sent me any information.

  Business Response

  Date: 05/06/2025

  Dear Mr. ****************** you for making Adroit Health Group (Adroit or the Company) aware of your dissatisfaction with the Good Health minimum essential coverage plan you purchased through our platform on February 10, 2025.  We appreciate the opportunity to review your concerns.
  
  In your complaint, you allege that you were misled  into believing you were signing up for health insurance.  Please be advised that Adroit does not engage in any direct-to-consumer sales.  Rather, our Company functions solely as an independent marketing organization that makes certain insurance and non-insurance products available for sale to the public by third-party sales agents using our Companys enrollment and billing platforms.  All sales on our platform are conducted by licensed, third-party independent contractors. None of these sales producers are employees of Adroit Health Group, nor are the agencies for which they work owned by, operated by, or otherwise affiliated with our Company.  Therefore, we can definitively attest that our Company made no verbal representations to you at the time of sale concerning the products you purchased and the benefits they offered, as all such discussions were had between yourself and the licensed, third-party sales producer. 
  
  However, in order to avoid confusion and ensure that consumers are fully apprised of what they are purchasing, Adroit does require that all sales on our platform be consummated through the presentation, review, and execution of a written Enrollment Application agreement.  Your Enrollment Application agreement was presented to you and signed on February 10, 2025, at 3:07 p.m.  This Enrollment Application agreement is important because it contains disclosures concerning product benefits and coverages, limitations and exclusions, and associated costs.  With regard to your claim that the products were misrepresented as insurance, we call your attention to the following express disclosures from your signed Enrollment Application agreement:
  
  1.  This group health plan is limited to covering preventive and wellness services as required by the Patient Protection and *************** Act as well as other benefits noted in the Summary Plan Description, which describes the benefits covered by the Plan and how these benefits are covered, including information on copays, deductibles, and limitations.  (**** Enrollment Application Agreement, 02/10/2025, p. 3, original version with bolded text and highlighted emphasis)
  
  2.  The Good Health benefit plans have a limited schedule of benefits and will only pay for those items specifically listed in the schedule of benefits.  (**** Enrollment Application Agreement, 02/10/2025, p. 3)
  
  3.   The Good Health benefit plans are not major medical insurance and should not be viewed as a substitute for major medical coverage. (**** Enrollment Application Agreement, 02/10/2025, p. 3, with the term not underlined for emphasis in the original)
  
  4.   The Good Health benefit plans do not comply with the *************** Act (ACA), otherwise known as "Obamacare." (**** Enrollment Application Agreement, 02/10/2025, p. 3, with the term not underlined for emphasis in the original)
  
  5.  THIS IS A SUPPLEMENT TO HEALTH INSURANCE AND IS NOT A SUBSTITUTE FOR MAJOR MEDICAL COVERAGE. LACK OF MAJOR MEDICAL COVERAGE (OR OTHER MINIMUM ESSENTIAL COVERAGE) MAY RESULT IN AN ADDITIONAL PAYMENT WITH YOUR TAXES). (**** Enrollment Application Agreement, 02/10/2025, p. 3, capitalized emphasis original with all text bolded in the original for additional emphasis)
  
  6.  The Good Health benefit plans do not replace ***** Medical, Cobra, ******************* or Medical Disability. (**** Enrollment Application Agreement, 02/10/2025, p. 3, with all text bolded in the original for emphasis)
  
  7.  The GHDP plan is not a ***** Medical or Comprehensive Coverage. (**** Enrollment Application Agreement, 02/10/2025, p. 10, with all text bolded and underlined in the original for emphasis)
  
  8.  The GHDP plan covers the preventive health services required by the **** 2713 (a) without any cost-sharing requirements. All covered In-******* preventive services will be 100% covered by the Plan. Out of ******* services will not be covered unless otherwise specified, and the Plan Member will owe 100% of the cost of these services. (**** Enrollment Application Agreement, 02/10/2025, p. 10, with all text underlined in the original for emphasis)
  
  9.  This Plan does not cover benefits unless listed in the Schedule of Benefits, so please review that list carefully. This group health plan is limited to covering preventive and wellness services as required by the Patient Protection and *************** Act as well as other benefits noted in the Schedule of Benefits, which describes the benefits covered by the Plan and how these benefits are covered, including information on copays, deductibles, and limitations. (**** Enrollment Application Agreement, 02/10/2025, p. 10, with all text underlined in the original for emphasis)
  
  10.  The GHDP plan includes a supplemental benefit for hospitalization confinement payable at $1,000 a day for up to 10 days.(**** Enrollment Application Agreement, 02/10/2025, p. 10, with all text underlined in the original for emphasis)
  
  11.  BENEFIT ACCEPTANCE - I agree that the membership plan I enrolled in does not replace ***** Medical, Cobra, ********, ********* or Medical Disability. (**** Enrollment Application Agreement, 02/10/2025, p. 11)
  
  12.  You understand that the **** benefit plans are not major medical insurance and should not be viewed as a substitute for major medical coverage. (**** Enrollment Application Agreement, 02/10/2025, p. 12)
  
  13.  The GHDP plans do not comply with the *************** Act (ACA), otherwise known as Obamacare." (**** Enrollment Application Agreement, 02/10/2025, p. 12)
  
  14.  The **** Plans have a limited schedule of benefits and will only pay for those items specifically listed in the schedule of benefits. (**** Enrollment Application Agreement, 02/10/2025, p. 12)
  
  15.  THIS IS A SUPPLEMENT TO HEALTH INSURANCE AND IS NOT A SUBSTITUTE FOR MAJOR MEDICAL COVERAGE. LACK OF MAJOR MEDICAL COVERAGE (OR OTHER MINIMUM ESSENTIAL COVERAGE) MAY RESULT IN AN ADDITIONAL PAYMENT WITH YOUR TAXES. (**** Enrollment Application Agreement, 02/10/2025, p. 12, capitalized emphasis in original)
  
  16.  I agree that I have a full and complete understanding of the products for which I am applying. (**** Enrollment Application Agreement, 02/10/2025, p. 22)
  
  17. By electronically acknowledging this authorization, I acknowledge that I have read and agree to the terms and conditions set forth in this agreement. (**** Enrollment Application Agreement, 02/10/2025, p. 23)
  
  Additionally, your Enrollment Application agreement contained a six (6) page chart detailing all aspects of the coverages available under your Minimum Essential Coverage plan.  In sum, there were some two-dozen disclosures made to you concerning the extent of the products you were purchasing.  All of this was made available to you prior to sale, and you were required to review this document and electronically sign it in order to purchase the products.  This same document was made available to you in the Adroit Electronic Member Portal to which you had access continually following your enrollment.  
  
  Moreover, even if there was a misunderstanding concerning the products you were purchasing, you were afforded a full thirty-day period to review the agreement during which time you could have cancelled for any reason and received a full refund.  These rights are clearly spelled out in your Enrollment Application agreement:  Beginning on the effective date of your plan, you have a 30-day right to review for cancellation as long as there are no claims utilized, including usage of prescription program. In that case, the plan may be eligible for a refund, and all medical claims will be denied retroactive to the effective date. After 30 days, any payments made will not be eligible for a refund. (**** Enrollment Application Agreement, 02/10/2025, p. 10.)
  
  Lastly, your allegation that our Company never sent [you] any information is wholly without merit.  Our records show a total of 17 separate messages were e-mailed to you concerning your account, which consisted of a payment receipt, welcome e-mail, a portal notification e-mail, multiple product summary e-mails, multiple upcoming payment reminders, and a cancellation notice.  Additionally, we sent you multiple e-mail communications on April 01, 2025, and again on April 30, 2025, detailing how to access all of your account information, including product information and documents, in the Adroit Electronic Member Portal.  Representative samples of these various communications are enclosed with this response for your reference.  We further note that out of the 17 e-mail communications that were sent to you, our records reflect that you bothered to open and read only two (2) of these messagesspecifically, the original payment receipt and the final cancellation notice.  Meanwhile, you ignored all other substantive information that was sent to you in good faith concerning your account and the products you purchased.  
  
  In sum, our Company made no verbal representations to you concerning these products, and in point of fact, we provided you with ample disclosures concerning exactly what you were and were not purchasing, with many of these disclosures emphasized with capitalized text, bolded text, and underlined text in order to call your attention to their content and applicability.  Furthermore, consistent with the terms of your contract and our Company policy, you were afforded a full thirty days to review and reconsider the purchase, which you failed to exercise.  We regret that you found the Good Health MEC product to not sufficiently meet your familys needs, but the overwhelming evidence in this matter shows that you were treated fairly and in full compliance with the terms of your contract and applicable law.
  
  Sincerely,
  
  ******* *****
  General Counsel & Chief Compliance Officer
  Adroit Health Group, LLC
  

  Customer Answer

  Date: 05/06/2025

  I am rejecting this response because:   The man on the phone stated it was health insurance. number 2 they never sent any information in the mail about this and by the looks of their record they do this often.

  Business Response

  Date: 05/07/2025

  Thank you for your follow-up to our initial complaint response.  As previously indicated, the sales producer with whom you spoke is not an employee of our Company.  Therefore, we were not privy to any discussions that he had with you nor what information may have been communicated verbally at that time. Many times, the sales producer will review a variety of plans with a customer which represent different kinds of offerings, including some that are insurance products and some that are not insurance products.  In the course of the discussion, a customer may gravitate towards a particular product and away from others for reasons such as cost considerations, pre-existing condition requirements, and preferred benefit offerings.  It is unclear the reason(s) that you and the sales producer landed on the Good Health product.

  As noted in the multiple pages of disclosures provided to you, the Good Health plan does provide a modest array of minimum essential coverage benefits, including physician office visits (both primary care and specialist) as well as an extensive  series of wellness and preventative health services.  However, consistent with the repeated, bolded and capitalized disclosures in your Enrollment Agreement application, the plan is NOT a substitute for major medical insurance and should be regarded as a supplement to such plans.  This fact was repeatedly called to your attention in the written Enrollment Application agreement that you were provided at the time of sale, and which you certified as having received, read, and understood.

  Lastly, while we apologize that the method of delivery of this information to you via electronic mail versus regular post was not your preferred mode of receiving such information, we believe that electronic delivery is faster and more cost-effective with those savings helping keep your costs lower as well.  The use of e-mail in this context is a common practice throughout all commercial transactions as of this date and ensures that you receive all information in a timely manner and without risk that articles are lost in transit or delivered to the wrong address. While it is certainly disappointing that you elected to ignore 15 of the 17 electronic communications that you were sent, the fact remains that all of this information was provided to you in a timely manner despite your failure to open and read the many communications.  

• Initial Complaint

  Date:03/30/2025

  Type:Product 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.

  My husband attempted to buy health insurance for me on March 17 for $422.90. When we discovered it was not truly insurance that he purchased, I called on March 19 for a cancellation of policy and a refund of our money. After speaking to 3 representatives, they refunded $306, but said that the remaining balance that was owed to us was an enrollment fee. My understanding is that there is a 30 day window in which to review insurance policies. They told me we could email them, which I did on 3/20 at **************************************************************************************. However, when I had not heard from them, I attempted to reach out to them the following week at the same address. The email bounced back to me with this explanation: "Recipient address rejected: Access denied." I would like the remaining $116.90 credited to us.

  Business Response

  Date: 04/01/2025

  Ms. ******************** you for making Adroit Health Group aware of your dissatisfaction with the Good Health that you purchased through our company.  We are also dismayed to learn of the problems you encountered in trying to cancel the account.  In this response, we hope to address both issues that you have raised.
  
  First, with regards to the Good Health product you purchased.  We respectfully disagree that the Good Health product is not insurance.  Rather, this particular plan is a Minimum Essential Coverage plan.  While this type of plan is certainly not comprehensive insurance coverage nor major medical insurance, it still covers the full array of benefits required of a minimum essential coverage plan.  On page two of your signed Enrollment Agreement, it specifically states in bolded and highlighted text:  This group health plan is limited to covering preventive and wellness services as required by the Patient Protection and *************** Act as well as other benefits noted in the Summary Plan Description, which describes the benefits covered by the Plan and how these benefits are covered, including information on copays, deductibles, and limitations.  Immediately following this emphasized disclosure, the following important terms are listed:
  
  -  The Good Health benefit plans have a limited schedule of benefits and will only
  pay for those items specifically listed in the schedule of benefits.
  
  -  The Good Health benefit plans are not major medical insurance and should not be
  viewed as a substitute for major medical coverage.
  
  -  The Good Health benefit plans do not comply with the *************** Act (ACA),
  otherwise known as "Obamacare."
  
  We regret that you found these benefits to not satisfactorily address you and your familys needs.  Nevertheless, you were well within your rights to change your mind and cancel the account.  You are also correct that our Company policy is to afford customers a full thirty (30) day period to review the product and cancel for any reason if dissatisfied.  It does appear that you attempted to exercise this right in a timely fashion.  Your request should have immediately been honored.  We are sorry that this was not the case.
  
  As you have stated in your complaint, it appears you contacted the sales agency, and not Adroit Health Group directly, in attempting to cancel the account.  The @************************************ e-mail address you cited is connected only with the sales agency and not our company, and it appears that your telephone inquiries also went to the sales agency.  Regardless, you should have been refunded the full amount at that time by the sales agency.  
  
  We have contacted the sales agency and demanded that they investigate the customer service problem and take steps to address the problems going forward.  In the meantime, I asked Adroits ************************** to confirm that a full cancellation of your account and all products has, in fact, occurred.  I have also directed our ****************** to process a full refund of all charges.  I am pleased to report that all of these open items have now been addressed.  Copies of the cancellation confirmation notice and the refund receipts for all your charges are appended to this response for your records.
  
  If you encounter any further problems, please feel free to contact Adroits ********************* at any time.  You may reach us at *********************************************.  Again, please accept our sincere apologies for the manner in which this was handled.
  
  Best regards,
  ******* *****
  General Counsel & Chief Compliance Officer
  Adroit Health Group, LLC
  

  Customer Answer

  Date: 04/02/2025

  I have reviewed the business response and accept this resolution. I understand what was said in your letter that what my husband purchased was indeed insurance. However, he was led to believe it was major medical, which, as you explained, it was not. The full amount has been refunded, and we appreciate the quick and prompt action you took. We are thankful you will be looking into this with your sales' team since they represent your business. It would be great if this doesn't happen to others.

  I would like to thank the BBB for representing us in this matter. I know this isn't always the case, but our complaint was resolved quickly once they got involved.

• Initial Complaint

  Date:03/20/2025

  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.

  ADROIT HEALTH GROUP said they were enrolling me in an AETNA health care insurance program. But this company just charge me $261.95 for nothing. It is a scam. I tried calling them to ask them to refund me my money and they just hanged up. I file a claim with ********************* my bank and they cannot give me my money back because they also agree that it was a scam and they do not cover scams. I have attached the letter that ***** fargo sent me.

  Business Response

  Date: 03/27/2025

  Ms. *********,

  Thank you for making Adroit Health Group aware of the problems you encountered with the sale and attempted cancellation of your plan.  Our records show that you were enrolled in a **************** Medical Plan, which is underwritten by ****************** Security Life Insurance Company and not *****.  It appears that the miscommunication may have arisen out of the fact that certain products do utilize an ***** provider network, but this is different than their being an Aetna plan--which they are not.  I apologize if this was communicated in a misleading manner.  Moreover, the manner in which your cancellation attempt was handled is not acceptable and you should have never been hung up on by anyone.  Please know that the telephone number you contacted was not an Adroit *************************** number, and it appears to be a telephone number associated with the sales agency who sold you the products in question.  These agencies and their agents are not employees of Adroit Health Group, and instead are solely third party contractors.  I appreciate your speaking with me yesterday and providing me additional information about what transpires.  We are conducting an internal review and will take appropriate disciplinary actions.  In the meantime, I have directed Adroit's ****************** to process a cancellation of your account and issue you a full refund of all charges.  I am attaching to this response a copy of the receipt evidencing this refund.  Depending on your financial institution, it may take up to five (5) business days before the refund is reflected on your bank statement.  If you have not seen the refund hit your account by early next week, please feel free to contact me again at ******************************** and I will gladly follow up for you.  Please accept my sincerest apologies for the problems you experienced.

  Best regards,

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

  General Counsel & Chief Compliance Officer

  Adroit Health Group, LLC

  Customer Answer

  Date: 03/27/2025

  I have reviewed the business response and accept this resolution. However, they are very misleading. Even though I appreciate they refund me the money I still believe they are a scam because they do not enroll you in any health insurance plan. 

• Initial Complaint

  Date:03/04/2025

  Type:Sales and Advertising 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 got insurance through this company. Not my medication, not one Doctor's visit for myself or my husband has ever been paid, not even $10 every time I call them. They said my provider was in the network, but however, I'm stuck with paying high medical bills. Pay full calls for all my medication and also pay them every month.Two hundred and seventy dollars

  Business Response

  Date: 03/12/2025

  We have been unable to locate any account corresponding to this consumer under either the name, address, telephone number, or e-mail address provided with the complaint.  We believe this consumer could be listed under a different name or as a dependent under another person's account.  We have sent multiple messages to the complainant at the e-mail address listed on the BBB complaint ************************* asking for her to provide the account number about which she is complaining.  Copies of all e-mail messages sent to this complainant are enclosed for reference.  To date, we have received no response.  If these messages are being directed to the complainant's junk e-mail account and she is able to view this response, she is certainly free to contact me directly at ********************************  

  In the event this consumer provides additional details about the account, we will respond directly to her concerns in a timely manner. We apologize for the inconvenience.

  Best regards,

  ******* *****, General Counsel & Chief Compliance Officer

• Initial Complaint

  Date:03/01/2025

  Type:Sales and Advertising 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.

  Insurance scam - false advertising with coverage and in network providers

  Business Response

  Date: 03/04/2025

  Thank you for making our company aware of Ms. **** dissatisfaction with the *** Health product that was purchased through our enrollment and billing platforms.  Our records show that Ms. ** purchased a standard minimum essential coverage plan issued by *** Health on July 01, 2024, with an effective date of August 01, 2024.  However, it appears that she cancelled the plan on September 09, 2024.  
  
  Please be advised that our Company does not engage in any direct-to-consumer sales. Rather, our Company functions solely as an independent marketing organization that makes certain insurance and non-insurance products available for sale by third-party independent contractors through our Companys enrollment and billing platforms.  In this transaction, Ms. ** worked with a sales producer who is not an employee of our Company and whose agency is not owned or operated or otherwise affiliated with our Company.  They are totally separate and distinct entities who do contract with our Company to access our platforms.  Our agreements with these sales producers require that they provide accurate information concerning product coverages, exclusions and limitations, and associated costs.  To the extent Ms. ** believes that the coverage and network components of her *** Health Plan was misrepresented to you, we sincerely apologize. 
  
  Because we were not privy to the discussions that she may have had with her third-party sales producer on July 01, 2024, we are unable to comment on the accuracy of his statements. However, in order to ensure that customers transacting business on our platforms fully understand the terms and conditions of their sale, we require that all transactions be consummated through the presentation, review, and execution of a written Enrollment Agreement.  In this particular case, Ms. ** received your Enrollment Agreement on July 01, 2024, and signed it that same date at 2:13 p.m.  Your attention is called to the following express disclosures contained in this signed Enrollment Agreement:
  
  1.  The *** plan IS NOT A MAJOR MEDICAL OR COMPREHENSIVE COVERAGE. The *** plan covers the preventive health services required by the **** 2713 (a) without any cost-sharing requirements. (** Enrollment Agreement, 07/01/2024, p. 3, original underlined for emphasis, capitalized emphasis added)
  
  2.  All covered IN-NETWORK PREVENTIVE SERVICES WILL BE 100% COVERED by the Plan. (** Enrollment Agreement, 07/01/2024, p. 3, original underlined for emphasis, capitalized emphasis added)
  
  3.  OUT OF NETWORK SERVICES WILL NOT BE COVERED unless otherwise specified, and the Plan Member will owe 100% of the cost of these services. (** Enrollment Agreement, 07/01/2024, p. 3, original underlined for emphasis, capitalized emphasis added)
  
  4.  NONE OF THE PREVENTIVE HEALTH SERVICES ARE COVERED IF THEY ARE PROVIDED AT A HOSPITAL. (** Enrollment Agreement, 07/01/2024, p. 3, original underlined for emphasis, capitalized emphasis added)
  
  5. THIS PLAN DOES NOT COVER BENEFITS UNLESS LISTED IN THE SCHEDULE OF BENEFITS, SO PLEASE REVIEW THAT LIST CAREFULLY. (** Enrollment Agreement, 07/01/2024, p. 3, original underlined for emphasis, capitalized emphasis added)
  
  6.  THIS GROUP HEALTH PLAN IS LIMITED TO COVERING PREVENTIVE AND WELLNESS SERVICES AS REQUIRED BY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AS WELL AS OTHER BENEFITS NOTED IN THE SCHEDULE OF BENEFITS, WHICH DESCRIBES THE BENEFITS COVERED BY THE PLAN AND HOW THESE BENEFITS ARE COVERED, INCLUDING INFORMATION ON COPAYS, DEDUCTIBLES, AND LIMITATIONS. ***/VP LP sponsors this group health plan.  (** Enrollment Agreement, 07/01/2024, pp. 3-4, original underlined for emphasis, capitalized emphasis added)
  
  7.  The *** plan includes a supplemental benefit for hospitalization confinement payable at $1,000 a day for up to 5 days. Neonatal ************** (NICU) is not covered. This supplemental hospitalization confinement benefit component contains a pre-existing condition limitation for an illness, injury, or condition, for which medical advice, diagnosis, care, or treatment was recommended to, or received by, a covered person or that manifested symptoms which would cause an ordinarily prudent person to seek diagnosis or treatment within 12 months immediately preceding the effective date the covered person became insured under the Plan. This exclusion will apply for the first 12-months the Plan is in force. (** Enrollment Agreement, 07/01/2024, p. 4)
  
  8. Your Plan allows you to enjoy significant savings through the First Health Network, which can significantly reduce your out-of-pocket expenses. OUT OF NETWORK SERVICES ARE NOT COVERED. (** Enrollment Agreement, 07/01/2024, p. 4, emphasis added)
  
  9. You understand that the *** benefit plans are NOT MAJOR MEDICAL INSURANCE AND SHOULD NOT BE VIEWED AS A SUBSTITUTE FOR MAJOR MEDICAL COVERAGE. The *** plans DO NOT COMPLY WITH THE AFFORDABLE CARE ACT (ACA), otherwise known as Obamacare. (** Enrollment Agreement, 07/01/2024, p. 6, emphasis added)
  
  10.  THE *** PLANS HAVE A LIMITED SCHEDULE OF BENEFITS AND WILL ONLY PAY FOR THOSE ITEMS SPECIFICALLY LISTED IN THE SCHEDULE OF BENEFITS. (** Enrollment Agreement, 07/01/2024, p. 6, emphasis added)
  
  11. The *** Plans have a 30-DAY WAITING PERIOD for sickness before coverage is provided. (** Enrollment Agreement, 07/01/2024, p. 6, emphasis added)
  
  12. THIS IS A SUPPLEMENT TO HEALTH INSURANCE AND IS NOT A SUBSTITUTE FOR MAJOR MEDICAL COVERAGE. LACK OF MAJOR MEDICAL COVERAGE (OR OTHER MINIMUM ESSENTIAL COVERAGE) MAY RESULT IN AN ADDITIONAL PAYMENT WITH YOUR TAXES. (** Enrollment Agreement, 07/01/2024, p. 6, emphasis original)
  
  13. [x| By electronically acknowledging this authorization, I acknowledge that I have read, agree, and consent to the terms and conditions set forth in this agreement ,.. (** Enrollment Agreement, 07/01/2024, p. 7)
  
  14. I agree that I have a full and complete understanding of the products for which I am applying.  (** Enrollment Agreement, 07/01/2024, p. 15)
  
  15. By electronically acknowledging this authorization, I acknowledge that I have read and agree to the terms and conditions set forth in this agreement. (** Enrollment Agreement, 07/01/2024, p. 15)
  
  Immediately upon execution of your Enrollment Agreement you were provided a Welcome E-mail that advised how you could use our electronic Member Portal to access your plan documents, including your *** Health Schedule of Benefits.  In particular, this e-mail noted, You have 24/7 access to important product information and program documents via the Member Portal. Your login instructions are listed below. Please register to use the Member Portal as soon as possible using the link provided. NOTE: Most product documents and important information is only provided electronically from within the member portal.  A copy of the Welcome E-mail and Portal Notification is appended to this response for reference.  We note that our system records indicate that you did, in fact, open and read this e-mail on July 01, 2024, at 2:16:23 p.m.  Our system has also recorded that you accessed your Member Portal on multiple occasions thereby indicating you had both the knowledge of and access to the portal where you could have and should have reviewed the *** Health Schedule of Benefits which you were admonished to do in the Enrollment Agreement.
  
  In sum, Ms. ** received ample written disclosures concerning the limited nature of the *** Health Plan you purchased. She was also advised to review the Schedule of Benefits for a detailed description of the coverages.  All of these disclosures were accurate and reflected the full scope of her plan. While it is unclear what if anything the third-party sales producer may have told her about specific health care providers, we note that a providers participation in any network is dynamic and subject to change from time to time.  Ms. ** also had accurate information about the First Health Network and how to verify the status of a provider, which was made available to her with your fulfillment materials (including your member identification card) through the Electronic Member Portal.  We should note that the fulfillment materials separately include a number of the same disclosures excerpted above.  A copy of these fulfillment materials is also enclosed with our response.
  
  Furthermore, as noted on page 4 of your Enrollment Agreement, Ms. ** was entitled to a full thirty (30) day period to review the plan and plan materials, and if she was dissatisfied for any reason, she could cancel during that time period and receive a full refund.  Her cancellation on. September 09, 2024, occurred outside this thirty-day window, and for this reason, she is unfortunately not eligible for a refund.  
  
  Our Company regrets that Ms. ** did not find the *** Health Plan to satisfactorily meet her insurance needs. However, based on the above and foregoing, we believe she was fully informed of the coverages and network requirements associated with this plan and there is no evidence that she was subjected to a scam as has been alleged. Additionally, Ms. ** had a thirty-day period to review the plan and cancel to receive a refund, but you failed to exercise this right in a timely manner.  As a result, it is our belief that that Ms. ** was treated fairly and in full compliance with applicable law.

  Thank you for affording us an opportunity to review and respond to this complaint.

  Sincerely,
  ******* *****
  General Counsel & Chief Compliance Officer 

  
  

  Customer Answer

  Date: 03/04/2025

  I am rejecting this response because: i believe third party sales platform receives commissions fees from promoting your health plan which was advertised inaccurately during the process by them

  Business Response

  Date: 03/10/2025

  Thank you for these additional comments.  We must reiterate that accurate information concerning all purchased products, inclusive of coverages, limitations and exclusions, and costs was indeed provided to Ms. ** at the time of sale in her Enrollment Agreement. This was the sole point of contact that our Company had with the consumer concerning the details of your purchase.  A detailed summation of those various disclosuresfifteen in totalhas been previously provided in response to this complaint.
  
  Further, information concerning our Company and its role has previously been provided to Ms. ** at the time of sale.  Reference is made to the Welcome E-mail sent to the consumer on the date of enrollment that spells out our role in providing benefit and enrollment administration and billing services, as well as that of the sales agent responsible for the sale (who you are reminded is not an employee or affiliate of our Company) and the carrier or provider who is responsible for the payment of claims and benefits  (again, who you are reminded is not an affiliate of our Company).  
  
  In short, Ms. ** was, in fact, provided accurate information concerning the products at the time of sale by our Company and she was afforded a full thirty-day period to consider her purchase and cancel in order to receive a refund.    

  Customer Answer

  Date: 03/10/2025

  I am rejecting this response

• Initial Complaint

  Date:02/24/2025

  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 paid Strata Health Group $339.90 on February 6, 2024 for a medical benefits plan to include my specific medicines. I can't find a pharmacy to accept insurance and all the numbers for customer service are not working. I would like a refund.

  Business Response

  Date: 02/26/2025

  Mr. ********************* you for making our company aware of your dissatisfaction with your recent purchase.  We regret that you have been unable to locate a pharmacy that will accept the prescription discount benefit. 
  
  Our records show that you purchased this plan from your agent of record at Legacy Health Insurance Advisors, on February 05, 2024.  As detailed on page 5 of your Enrollment Agreement, you are eligible to cancel your account during the first thirty (30) days and receive a refund of charges.  Based on your request in your BBB complaint, we processed the cancellation of your account as of February 25, 2025. A copy of the cancellation notice is appended to this response for your records.  Additionally, we processed a refund of all charges in the total amount of $339.90 on February 25, 2025.  A copy of the receipt evidencing this refund is also enclosed with this response.  Depending on your financial institution, it may take up to five (5) business days before the refund is posted onto your bank or credit card statement.  If you have not seen the refund hit your account by this time next week, please feel free to contact our ********************* at *********************************************, and we will be happy to follow up for you.
  
  Best regards,
  ******* *****
  General Counsel & Chief Compliance Officer

• Initial Complaint

  Date:12/19/2024

  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.

  I was sold health insurance with false information regarding coverage. I was rushed through the whole process. I was totally unaware that in these documents it stated I could not dispute the transaction. I filed a dispute with my bank but they were provided documentation on why. This transaction took half of my monthly social security amount. I was taken advantage of and would like my money returned to me.

  Business Response

  Date: 12/20/2024

  Dear Ms. ********************** you for making our company aware of your refund issues.  We appreciate the opportunity to review and address your concerns.  Our records indicate that you purchased a limited medical plan and a dental and vision savings plan through Adroit Health Group (Adroit) on October 02, 2024, and your policy was cancelled on November 08, 2024. It is unclear what false information you believe you were provided concerning the products you were buying.  However, we should point out that the sales producer with whom you dealt is not an employee of our company.  Rather, Adroit is an independent marketing organization that makes certain insurance and non-insurance products available for sale by licensed, third-party sales producers through our billing and enrollment.  The sales producers are independent contractors who generally (although not always) makes sales for a number of agencies, including Adroit.  Because we were not privy to the discussions that you had with your sales producer, we are not in a position to address the accuracy of the representations that may have been made.  However,  Adroit requires that all sales on our platform be consummated through the presentation, review, and execution of a written Enrollment Agreement.  This Enrollment Agreement contains important disclosures of all material terms of the sale, specifically including but not limited to details concerning product coverages, exclusions and limitations, and associated costs.  You received and signed your Enrollment Agreement on October 02. 2024, at 6:43 p.m., from a computer IP address corresponding to your physical location.  The provisions of the written Enrollment Agreement that you reviewed and signed accurately describe all terms of the account, including but not limited to the product coverages and/or other benefits.
  
  Based on the fact that your complaint only references dissatisfaction with the cost of your products, we should point out that accurate disclosures of each products cost was provided to you in multiple places in your Enrollment Agreement.  Specifically, the accurate cost disclosures appear on pages 1, 5, 7, 10, and 11.  Further, a summary of all product costs appears at the end of your agreement immediately above where you physically signed the contract.  
  
  With regard to your claims about being told you cannot dispute the transaction, we should clarify that you agreed in your Enrollment Agreement that you would not commence a chargeback dispute with your financial institution.  Your attention is called to the following provision from your signed Enrollment Agreement:  

  You certify that you are an authorized user of this credit card, debit card, or bank account. You agree that you will not dispute the scheduled payments with your credit card company or bank provided the transactions correspond to the terms indicated in this authorization. You agree that if any such charge is dishonored, whether with or without cause and whether intentionally or inadvertently, Adroit Health Group, the carrier, the association, the service provider, the bank or credit card company shall be under no liability whatsoever, even though it may result in forfeiture of your plan or membership.  (******** Enrollment Agreement, 10/04/2024, p. 2)
  
  As you attested upon your signature of the Enrollment Agreement, you acknowledge that I have read and agree to the terms and conditions set forth in this agreement.   Therefore, per the terms of your contract, by commencing the chargeback dispute that ***** our company, you have forfeited any right to a refund and our Company has no further liability towards you.
  
  Our hope is that when customers have an issue, they will be able to amicably resolve the problems with our *************** Department.  Unfortunately, when a chargeback dispute is commenced with ones bank or credit card company, as occurred in this instance, it completely takes the transaction out of our control and makes it impossible to make any adjustments to the charges while the financial institution reviews the dispute.  This unnecessarily delays any resolution of the problem. In such an occurrence, even if we were inclined to issue you a refund, there is simply nothing for us to refund as the charge has essentially been placed on hold by the financial institution while they review your claim.  This is precisely what has transpired here.
  
  After reviewing your account, although it appears you are outside our 30-day refund window, Adroit is willing to provide you a refund of your charges as soon as we are able.  However, again, we are unable to issue a refund at this time due to your chargeback dispute taking the transaction out of our control.  Therefore, in the likely event that your financial institution determines that the charges were appropriate and it upholds the transaction and releases the hold on the charge, we will be happy to issue you a refund at that time.  This commitment to issue a refund should not be construed, interpreted, or deemed to be an admission of any fault or liability on the part of Adroit Health Group, LLC, or its affiliates, and instead is a gesture of good will to a valued customer and serves solely as a transaction and compromise of a disputed claim.  
  
  Further, this date I have been advised by Adroits Billing Department  that the dispute has not been adjudicated and remains pending.  I have asked them to continue monitoring the chargeback and if/when your dispute is denied, they have been asked to issue you a refund.  If your chargeback dispute is approved, then obviously there will be no need to issue a refund as your financial institution will automatically credit you with the refund.  Once you become aware that the chargeback dispute was denied, you may wish to contact Adroits ********************* to confirm the status of the refund we have promised you in this response. They may be reached at *******************************************.  Please note that in my experience, your bank will notify you of their decision sometimes weeks before they notify our Company, so there may be some lag before we are able to confirm the decision.  If you have any other problems, our ********************* staff will be able to assist.
  
  Adroit deeply regrets that you did not find that your limited medical plan sufficiently met your needs.  I hope that this response and the remediation offered herein satisfactorily addresses your concerns. 
  
  Best regards,
  
  ******* *****
  General Counsel & Chief Compliance Officer

• Initial Complaint

  Date:10/11/2024

  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.

  I enrolled in a multi plan PPO in January 2024, where they were supposed to be in network and pay a discount for Services. I was provided with the insurance information cards for the plan and it there is a claims number clearly stated on the back where my doctors billing department could submit claims. Apparently nothing has been done since March claims have been unpaid no explanation given cant get through to the customer service number tried multiple times, obviously a scam but they accept my $370 per month and the initial $400 for an enrollment fee to be in a nationwide PPO network. I basically I paid $370 for nothing. I didnt even get medication coverage that I was supposed to get discounts .I ended up going with good RX because they gave a better discount when I first asked about this back in February. They said oh theyre just not familiar with this, but I asure you theres no problem with it its very easy to use ! , Well apparently my doctors offices which there are several are all coming now with statements are with hundreds and thousands of dollars old for services back in March and April that Im just finding about it now !!! Had I known this I wouldve canceled immediately I need Help. I cant get through to anyone but they do collect my money every month please help me .!

  Business Response

  Date: 10/15/2024

  Dear Ms. ********************* you for making Adroit Health Group (Adroit or the Company) aware of your dissatisfaction with your Impact Health limited medical plan.  As you know, a limited medical plan is not comprehensive health coverage and is only intended to provide members, and their covered dependents, with basic insurance benefits that are capped at specific amounts for specific services.  Per the terms of your policy, you are to be paid a fixed indemnity benefit in the event of a covered accident or sickness.  The fixed indemnity benefits include the following:  (1) hospital confinement benefit--$100/day for up to thirty days per coverage year; (2) physician office visit (primary and specialist) benefit--$50/day for up to three days per coverage year;  (3) emergency room benefit--$50/day for up to one day per coverage year.  However, as you have been made aware, your plan also included a 12-mpnth pre-existing condition limitation whereby claims related to conditions for which you have received care in the preceding twelve (12) months would be excluded from coverage. 
  
  At the time of your enrollment for the Impact Health limited medical plan, you were presented a written Enrollment Agreement by your sales agent.  This Enrollment Agreement was reviewed and executed by you on December 7, 2023, at 11:11 a.m.  The purpose of the Enrollment Agreement is to memorialize what you are agreeing to purchase and to make sure that you receive full and complete disclosures of all material terms of your plan.  To that end, your attention is called to the following disclosures from your Enrollment Agreement:
  
  1.   Impact Health Limited Medical plan is made available through the ***************** of Employers and offers affordable benefits designed for individuals and families who need basic, routine wellness coverage or expanded coverage to help address day-to-day health care expenses.  (******* Enrollment Agreement, 12/7/2023, p. 2)

  
  2.  A Limited Benefit Medical plan is NOT A COMPREHENSIVE MAJOR MEDICAL PLAN, NOR IS IT INTENDED TO REPLACE A MAJOR MEDICAL PLAN. The plan is intended to provide members, and their covered dependents, with basic insurance coverage that is capped at specific amounts for specific services. (******* Enrollment Agreement, 12/7/2023, p. 3, emphasis added)
  
  3.  THIS IS A SUPPLEMENT TO HEALTH INSURANCE AND IS NOT A SUBSTITUTE FOR MAJOR MEDICAL COVERAGE. LACK OF MAJOR MEDICAL COVERAGE (OR OTHER MINIMUM ESSENTIAL COVERAGE) MAY RESULT IN AN ADDITIONAL PAYMENT WITH YOUR TAXES. (******* Enrollment Agreement, 12/7/2023, p. 3, emphasis original)
  
  4.  You understand that you have a free trial period of 30 days. During this trial period or free look, you can cancel this membership and receive a full refund excluding the onetime enrollment fee, as long as you have not used any benefits. (******* Enrollment Agreement, 12/7/2023, p. 4)
  
  5.  You understand that the insurance coverage included with this membership is an accident and sickness hospital indemnity plan. (******* Enrollment Agreement, 12/7/2023, p. 4)
  
  6.  You confirm that the details of the accident and sickness hospital indemnity plan have been explained to you by your agent, including the limitations and exclusions. (******* Enrollment Agreement, 12/7/2023, p. 4)
  
  7.  This policy provides limited benefits on a fixed indemnity basis. It does not constitute comprehensive health insurance coverage (often referred to as major medical coverage) and does not satisfy a persons individual obligation to secure the requirement of minimum essential coverage under the *************** Act (ACA). (******* Enrollment Agreement, 12/7/2023, p. 4)
  
  8.  You understand the plan shall pay the benefit amounts listed in the Schedule of Benefits that will be included in the membership materials sent to you upon enrollment. (******* Enrollment Agreement, 12/7/2023, p. 4)
  
  9.  You understand that if you have a pre-existing condition, the accident and sickness hospital indemnity benefits may not be immediately available for claims associated with this condition. (******* Enrollment Agreement, 12/7/2023, p. 4)
  
  10.  You understand specifically, if you have had care rendered or prescribed to you by a physician within the 12 months leading up to your effective date, you will have a waiting period for 12 months before any claims related to your condition will be covered. (******* Enrollment Agreement, 12/7/2023, p. 4)
  
  11.  You understand that the BENEFITS INCLUDED WITH THE ACCIDENT AND SICKNESS HOSPITAL INDEMNITY PLAN ARE NOT DEPENDENT ON THE USE OF THE MULTIPLAN PPO NETWORK. (******* Enrollment Agreement, 12/7/2023, p. 5, emphasis added)
  
  12.  You understand that if there are any discrepancies between what the agent told you about the plan and what the actual policy states, that the policy terms will apply. (******* Enrollment Agreement, 12/7/2023, p. 5)
  
  13.  Pre-existing Condition Limitation - There is NO COVERAGE FOR A PRE-EXISTING CONDITION FOR A CONTINUOUS PERIOD OF 12 MONTHS FOLLOWING THE EFFECTIVE DATE OF A COVERED PERSONS COVERAGE under the Policy. (******* Enrollment Agreement, 12/7/2023, p. 6, emphasis added)
  
  14.  I agree that I have a full and complete understanding of the products for which I am applying. (******* Enrollment Agreement, 12/7/2023, p. 13)
  
  15.  By electronically acknowledging this authorization, I acknowledge that I have read and agree to the terms and conditions set forth in this agreement. (******* Enrollment Agreement, 12/7/2023, p. 13)
  
  As reflected in the contractual excerpts referenced above, your policy was not comprehensive health insurance, and instead provided only limited benefits in the form of fixed indemnity payments that are payable directly to you and not paid to your providers.    This was clearly disclosed to you in writing at the time of sale, and you were afforded a full thirty-day period to review the account and all coverages during which you were free to cancel for any reason and receive a refund of your charges.  
  
  To clarify, the use of an in-network provider does NOT affect your eligibility for benefits under your Impact Health limited medical plan. However, utilizing an in-network provider, while not required, is advisable because it reduces the out-of-pocket costs you incur against which those fixed indemnity payments can be applied.  Therefore, you would receive the same $50 benefit for a physicians office visit regardless of the physician you utilizedwhether in-network or out-of-network.  For example, the use of an in-network provider might result in you being charged $75 for that visit versus $125 for an out-of-network provider, for which you would have received the same $50 payment from your plan.
  
  Therefore, assuming that the services you received were for covered accident or covered sickness, and assuming again that those services were not for a pre-existing condition, your policy would pay you $50 per day for physician services (either primary care or specialist or a combination thereof) for a maximum of three days.  
  
  Unfortunately, our Company is not the insurance carrier nor are we the carriers third-party claims administrator.  This means that Adroit has no involvement with, nor any authority over, the claims reviews, claims processing, and claims payment.  Hence, we have no visibility into the basis for any claims determinations that may or may not have been made, nor do we have any ability to resolve your claims-related issues all of which reside solely with your carrier and its third-party claims administratorneither of whom are Adroit. 
  
  We acknowledge that you have contacted Adroits ************************** with several claims inquiries, at which time you were directed to the ***************** at the carrier.  As you have been previously advised, all questions regarding claims status and payments should be directed to International Benefits Administrators, who is the third-party claims administrator for the Impact Health Plan.  Their contact information is as follows:  International Benefits Administrators, Attn: ************* Post Office Box 576, ******* ********, *****, telephone:  ************.  If you believe that your claims are not being properly addressed, we urge you to follow up directly with International Benefits Administrators at the number provided above.
  
  With regards to your complaint concerning medication coverage, we note that your Impact Health limited medical plan does not provide prescription coverage, although you do enjoy certain prescription discounts through your membership as noted on your membership identification cards and plan materials.  A copy of your membership identification card reflecting these discounts is enclosed with this response for your ongoing reference.
  
  Adroit regrets that you have been unable to receive a sufficient response to date from Impact Health and its third-party administrator, International Benefits Administrators, and we apologize for the challenges you have encountered.  We have attempted to relay your problems to the *** in hopes that they follow up with you directly.  Further, we note that, as a courtesy, you have been refunded your most recent four (4) months of payments in the amount of $307.70 each.  Receipts evidencing these four refunds are appended to this response for your reference.
  
  Best regards,
  
  ******* *****
  General Counsel & Chief Compliance Officer