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:03/06/2024

  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.

  03-04-2024 ***** Adoit health group didnt order plan Was on hold for 3hrs Saw that this company is a scam called bbb.org

  Business Response

  Date: 03/07/2024

  Ms. ************************************* is in receipt of your complaint to the Better Business Bureau alleging that you were charged $84.95 on March 04, 2023 for a plan you did not order.  Please know that our Company takes the allegations very seriously.  To be precise, you were charged $84.95 on March 01, 2023, as you have been every month since December of 2021 when you first purchased your accidental death and dismemberment and accident medical expense policy through our company.  At the time of your purchase, you signed an Enrollment Agreement that was sent to the exact same e-mail address from which you have lodged the present complaint.  Further, the internet protocol address from which your signature originated (xx.***.***.16) corresponds to your geographic location in ******.  Conversely, the agent-of-record is located in ******* and could not have possibly signed that document on your behalf from that geolocation, nor could anyone else have done so.  
  
  Our records also indicate that a copy of your receipt for your initial payment was e-mailed on December 04, 2021, to the exact same e-mail address designated on your BBB complaint.  Our records show that you opened that same date at 4:14 p.m.  Thereafter, you have received over 44 different e-mails from our Company of which you have opened at least 34. Copies of both the initial payment receipt from 2021 and one of the numerous payment reminders is enclosed herewith for reference.  (Note the system recordation of when these e-mails were opened and read, which appears at the top of each document.)
  
  Our communication records also reflect that you contacted **************** at 8:26 a.m., on March 05, 2025, demanding to cancel and receive a refund.  I have confirmed this morning that your account has, in fact, been cancelled at your request.
  
  We are unable to honor your request for a refund.  While we offer our customers a thirty-day period to cancel and receive a refund, you are over 27 months past this cancellation window.  Further, your claim that you did not purchase the product are wholly unsupported by the facts.  Nevertheless, rest assured that going forward, your account has been cancelled and no further charges will be incurred.  A copy of the cancellation notice that has been e-mailed to you this morning is also attached for your records.
  
  Sincerely,
  
  *************************
  General Counsel & Chief Compliance Officer
  

• Initial Complaint

  Date:03/06/2024

  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.

  On 2/15/24 I purchased Adroit Health Insurance for 377 dollars, and was told if I was not satisfied with the insurance. I have 30 days to cancel and I would receive a full refund. I canceled it the following day and now its been almost a month and I have not received my money yet!! Wish I would have done my research first, since it seems like this business is a scam!! Called several times and they keep telling me that it is in process, which I dont think so!!! What to do?

  Business Response

  Date: 03/09/2024

  ******************,
  
  Adroit Health Group, LLC, regrets that you were not satisfied with the *** Health plan you recently purchased.  Our records show a call with your agent of record on February 28, 2024, wherein a cancellation request was made.  The cancellation was processed at that time and a refund was issued to your credit card of record on March 04, 2024.  This refund occurred prior to the submission of your complaint to the Better Business Bureau.  A copy of the refund receipt, which was previously e-mailed to you at the same e-mail address from which you submitted your BBB complaint, is enclosed with this response.  Unfortunately, it appears that you never opened and read this refund receipt, which likely explains why you felt it was necessary to submit this complaint despite the refund having already been issued.  With regards to your assertion that you called several times and were advised that the refund is in process, Adroit has no record of any other calls from you to Member Services;  however, it is possible that you may have spoken to your agent-of-record, who we remind you, is not an employee of Adroit Health Group, LLC, and works for an entirely separate business.  Nevertheless, we apologize that this process has taken longer than you anticipated.
  
  Additionally, please be advised that depending on your particular financial institution, it may take up to five (5) business days before the refund shows up on your bank statement, which is outside our control.  If you have not seen the refund by Tuesday, March 12, please feel free to contact Adroits ************************** and they will be happy to follow up.
  
  Sincerely,
  *************************
  General Counsel & Chief Compliance Officer
  

• Initial Complaint

  Date:02/29/2024

  Type:Billing 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 emailed and called customer service to cancel my coverage because I have medical coverage under my employee. When I called customer service I was on hold for and being transfer several times. When I finally did talk to someone *****. Kept delaying the canceling process. He called a third party without my consent to get RX price which I didn't want. I told him to cancel and he called again after telling me that he was going to talk to his higher **** After almost an hour on the phone ***** didn't cancel my coverage. He was told me that could not cancel until he did a price check on my RX. Again, I didn't ask or gave consent to call ******************. After minutes of going back and forward. I had to go back to work and ***** didn't not send me the necessary paperwork to cancel my medical coverage.

  Business Response

  Date: 03/01/2024

  ****************,
  
  Thank you for making Adroit Health Group aware of the problems you encountered when attempting to cancel your account.  We agree that customers should not be experiencing these sorts of difficulties when trying to terminate their account, and we are doing everything possible to address your concerns. 
  
  When you indicate that you called customer service, it appears that you may have been speaking with the customer service representative for your sales agent.  Please be advised that Adroit Health Group does not engage in direct-to-consumer sales;  rather, we are a general agency that makes products available to third-party independent contractors who utilize our enrollment platform.  Adroits *************************** has no record of any call from you seeking to cancel your account or making any inquiry whatsoever.  However, there is a notation from the agent-of-records customer service representative on February 29, 2024, which is when we believe you made this inquiry.  Again, we were not involved in the subject call.  
  
  However, the conduct you described is not acceptable and we are addressing the problem with the sales agency.  In the meantime, I have directed our ****************** this date to process the cancellation of the account at your request and insure that you do not incur any charges for March-2024 and beyond.  A copy of the cancellation confirmation is enclosed with this response.  With regards to your request for an additional refund, it appears that the first request to cancel was made to the sales agency on February 29, 2024, and despite the difficulties, you were not charged for March-2024.  Of course, you would not be entitled to a refund for any prior months.

  We apologize for how this matter was handled by the agent-of-record.  If you encounter any further problems, you are free to contact my office directly at *******************************************.

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

  
  

• Initial Complaint

  Date:02/28/2024

  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 received a call from a company representative in October of 2023 for health coverage which I was gong to be in need of beginning of November. I was Informed they had special plans for small business owners and I was in the process of opening one. In that conversation I was told unlike other insurances there is no waiting period to use the insurance and I didn't have to change my doctors. I later found out I had my other insurance till the end of November. So I the changed the start date to December first. I used the insurance for a rash that had been badly inflamed and bright red. Now after using the insurance on December 14th for my rash they are telling me there is a thirty day waiting period. Originally they paid the claim then sent my Dermatologist a letter saying they made a mistake and want their money back. I would like them to pay the claim like they promised in the beginning. I think it is wrong to deceive customers.

  Business Response

  Date: 03/02/2024

  Dear ************,
  
  Thank you for making Adroit Health Group aware of your dissatisfaction with the sale of your *** Health limited medical plan.  Unfortunately, the complaints you raisenamely, that you were not advised that the plan had a waiting periodare better addressed to the sales agent with whom you dealt.  Adroit Health Group does not engage in direct-to-consumer sales;  rather, we are a general agency that makes certain insurance and non-insurance products available for sale by third-party independent contractors selling to the public.  However, our agreements with these sales contractors require that they provide accurate information to prospective customers concerning product offerings, exclusions and limitations, and associated costs.  To the extent you believe this was not the case with your account, we sincerely apologize.  However, we respectfully disagree with your assertion that you were not advised at the time of sale that there was a thirty-day waiting period.  Your attention is called to the Enrollment Agreement, which you signed on October 17, 2023, and to which you had access continually thereafter through our electronic member portal.  In particular, please note the following, express disclosures:
  
  1.         I further acknowledge and understand that some PLANS MAY HAVE WAITING PERIODS for benefits related to pre-existing conditions AND A THIRTY (30) DAY WAITING PERIOD FOR SICKNESS CLAIMS.  (******************* Enrollment Agreement, 10/17/23, p. 2, emphasis added)
  
  2.         Before your application can be processed you are required to read, and acknowledge your understanding of 7 facts regarding your Partnership and any company benefit plan that you may select:    6. THE *** PLANS HAVE A 30-DAY WAITING PERIOD BEFORE COVERAGE IS PROVIDED. (******************* Enrollment Agreement, 10/17/23, p. 3, emphasis added)
  
  3.         By placing your signature below, you acknowledge that you have read and reviewed each of the statements listed above. You further acknowledge that you have no questions regarding any of the limitations and exclusions of your *** BENEFIT plan. (******************* Enrollment Agreement, 10/17/23, p. 3)
  
  4.         I agree that I have a full and complete understanding of the products for which I am applying.  (******************* Enrollment Agreement, 10/17/23, p. 7)
  
  5.         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, 10/17/23, p. 8)
  
  Based on the above and foregoing, we believe you were, in fact, advised of the existence of a 30-day waiting period.  We also note that you logged into our electronic member portal on four (4) previous occasions (specifically, 11/15/23, 11/16/23, 2/27/25, and 3/1/24) evidencing that you had both the knowledge and capability of accessing both the Enrollment Agreement containing these waiting period disclosures, as well as the plan documents that also expressly reference same.  Consequently, no refund or claims payment is warranted under the circumstances.
  
  Adroit deeply regrets that you did not find the *** Health limited medical plan to sufficiently meet your needs.  However, we note that the account was cancelled at your request on February 28, 2024.  A copy of the cancellation notice that you were previously provided is enclosed with this response for reference.  
  
  Sincerely,
  
  *************************
  General Counsel & Chief Compliance Officer

  Customer Answer

  Date: 03/02/2024

  I am rejecting this response because:   You should be aware of what your AGENTS THAT REPRESENT YOUR COMPANY ARE TELLING POTENTIAL CLIENTS!! And don't hide behind them.  You should also be aware of your reputation which is bad And try to improve your service and I also found a lot of complaints about your practice of deceiving your clients.

  Business Response

  Date: 03/04/2024

  We respectfully disagree with the assertion that our Company has deceived any clients.  The consumer was repeatedly made aware in writing of the existence of the 30-day waiting period.  Again, on page 2 of her enrollment agreement, the disclosure specifically states that plans have a thirty (30) day waiting period for sickness claims.  Likewise, on page 3 of her enrollment agreement, it expressly states:  the TVP plans have a 30-day waiting period before coverage is provided.  This information was made available to the consumer for review continually following the sale, including during the first 30 days in which she could have cancelled for any reason and received a refund, but chose not to pursue.  She demonstrated your ability on multiple occasions to access our member portal containing this information.  Adroit is very sorry that the consumer found this product to not meet her needs, but she was fully apprised of the exact issue about which she is now complaining. We have not charged her for the March payment that would have otherwise been due because she failed to cancel at least five days prior to the renewal datewhich is also spelled out in her contract.  This was done solely as a courtesy to the consumer.  
  
  Sincerely,
  *************************
  General Counsel & ***********************

  Customer Answer

  Date: 03/04/2024

  I am rejecting this response because:   It is my understanding that verbal agreements are also binding and again I was told what is great about this insurance is there is no waiting period.

• Initial Complaint

  Date:02/20/2024

  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 received a call from a so called agent claiming I could save a lot of money on health coverage. Unfortunately, I didn't know they were a scam company and I bought into they're nonsense. I realized they were bogus when I tried to use their portal with the member number they provided and it didn't work. Do not purchase anything from this scam company!

  Business Response

  Date: 02/21/2024

  **************,
  
  We are in receipt of your complaint concerning access problems to the Adroit member portal.  Our system records all attempts to access accounts on the member portal. Unfortunately, our records reflect no attempt to access your account at any point between February 15, 2024 (the date of your accounts creation) and present.  We are unsure whether you may have inadvertently transposed or mistyped digits in your account number or have some other telecommunications issue.  Regardless, we have cancelled your account based on your request and have also issued a refund of your charges.  Copies of the cancellation confirmation notice and refund receipt are appended to this response for reference.  We hope this sufficiently addresses your problems.
  
  Best regards,
  *************************
  General Counsel & Chief Compliance Officer

• Initial Complaint

  Date:02/12/2024

  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.

  I was told this was a health insurance provider but this was misleading. I was also informed that they provide dental coverage. Which they do not. Due to the false information that I was provided with I missed dental appointments at a critical time. I also was forced to pay for additional dental coverage.Beyond the misleading information I was unable to contact the company. I tried to call the company several times as well as send emails but was unable to contact anybody at the company to cancel the service. I am now without health insurance and have been forced to spend money I do not have. As well as still trying to contact anybody at the company to actually cancel.Above all else I never once actually used the "services" they provided. I am seeking a total refund as I was without coverage so in the event I had needed any medical care I would have not been insured.

  Business Response

  Date: 02/16/2024

  ****************,
  
  Thank you for making Adroit Health Group (Adroit) aware of your dissatisfaction with the Joppa Health Share (******* Basic) plan and other products you purchased through our Company.  Please be advised that Adroit is a general insurance agency that does not engage in direct-to-consumer sales.  Rather, we operate an enrollment and **************** that makes certain insurance and non-insurance products available for sale by third-party independent contractors, such as the agent who sold you your policy.  While we are not privy to the discussions that you may have had with your agent, we must point out that you were presented and signed an Enrollment Agreement on June 29, 2023, detailing the products you were purchasing and which clearly and repeatedly discloses that the health care sharing plan in which you were enrolling was not a comprehensive insurance plan.  Specifically, your attention is called to the following disclosures:
  
  1.         Joppa Health Share is not an insurance company, and its product should never be considered insurance. If an individual joins this organization instead of purchasing health insurance, they will be considered uninsured.  (Enrollment Agreement, 6/29/23, p. 3, with not and uninsured underlined in the original for emphasis)
  
  2.         Joppa Health Share is not insurance. Joppa Health Share is a Healthcare **************** as outlined in the Patient ************************** Act.  (Enrollment Agreement, 6/29/23, p. 3)
  
  3.         Neither Joppa Health Share nor Members of Joppa Health Share (a.) guarantees payment of a Members medical bill, or (b.) assumes liability for the payment of a Members medical bill. (Enrollment Agreement, 6/29/23, p. 3)
  
  4.         This program is NOT insurance.  (Enrollment Agreement, 6/29/23, p. 3, emphasis original)
  
  5.         ******* Health Share is NOT INSURANCE.  (Enrollment Agreement, 6/29/23, p. 4, emphasis original)
  
  6.         Joppa Health Share is a not-for-profit health care sharing ministry program, and not a contract for payments or insurance.  (Enrollment Agreement, 6/29/23, p. 4)
  
  7.         I understand that I may only receive a refund if I am within my first thirty (30) days of membership following my original membership start date. I understand no refunds are permitted after the first 30 days of membership. There are no retroactive cancellations or refunds. (Enrollment Agreement, 6/29/23, p. 5, with no underlined in the original for emphasis)
  
  8.         I acknowledge to have read and agree to the terms and conditions set forth above regarding my membership in the Joppa Health **************** (Enrollment Agreement, 6/29/23, p. 5)
  
  9.         understand that this is not insurance; rather this is a health care sharing ministry made up of a community of like-minded people, like myself, who have voluntarily made a commitment to contribute financially to share the financial burdens of eligible medical costs with other members of the community as needs arise. (Enrollment Agreement, 6/29/23, p. 6)
  
  10.       By esigning below and submitting my esignature, I am hereby acknowledging my understanding of the above stated member disclosures, and understand that it is my responsibility to review the Member Guidelines as it pertains to my elected sharing level.  (Enrollment Agreement, 6/29/23, p. 6)
  
  11.       This plan is not insurance. (Enrollment Agreement, 6/29/23, p. 7)
  
  12.       I agree that I have a full and complete understanding of the products for which I am applying.  (Enrollment Agreement, 6/29/23, p. 18)
  
  13.       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, 6/29/23, p. 19)
  
  Additionally, with regards to your complaint concerning misrepresentation of dental benefits, the Enrollment Agreement you were presented and signed clearly referenced only the availability of dental discounts and does not reflect the purchase of dental insurance coverage.  Likewise, we should point out that you enrolled on June 29, 2023, at which point you had a thirty-day period to freely review your products and the plan materials associated with each.  During this time, you had the opportunity to ask any questions, which our records indicate you did not.  Likewise, you also had the opportunity during this period to cancel the account if you were not satisfied for any reason and receive a full refund.  Again, you chose not to do this.  
  
  We have also reviewed your account records and the first communication we received from you was on February 12, ****, at 12:56 p.m., at which time you indicated you wanted to cancel.  We transferred you to your agent-of-record for completion of the cancellation, and in the meantime placed an immediate billing hold on your account to ensure no further charges were incurred.  Our records further show that the account cancellation was processed that same date, less than two hours later, at 2:46 p.m.  A copy of the cancellation confirmation notice that was previously e-mailed to you is enclosed with this response for reference.  We have no record of any other calls or e-mails being placed to Adroit, although it is possible that you may have been attempting to contact the sales agency and/or the agent-of-record whose contact information you were also provided at the time of sale, and for which we have no records.  If that was indeed the case, we apologize for the inconvenience you experienced, although we do not control the responsiveness or accessibility of these third-party companies.  Moreover, we just conducted an internal audit of Adroits *************************** and found that the average call wait time was approximately two (2) minutes.
  
  Therefore, because you were provided ample disclosures concerning your account and the products in which you were enrolled, and you are far outside the thirty-day free look period, you are not *********** any further refunds.  We further note that your call to cancel your account was not placed until three days before the next billing date (February 15), and per the terms of your contract, that cancellation would ordinarily not be effective until the following month because of the requirement of a five-day advance notice of termination; but in light of your dissatisfaction, we were able to cancel the account without your incurring these additional charges.
  
  We also note that you have previously initiated a chargeback on your most recent payment, which precludes us at this time from even offering a courtesy refund of this payment pending a decision by your financial institution.  Nevertheless, in the event that your chargeback is not successful, please contact my office at *******************************************, and we will be happy to refund your January payment as a courtesy.     
  
  We regret that we could not have done more to satisfactorily meet your health care needs.  
  
  Sincerely,
  
  *************************
  General Counsel & Chief Compliance Officer    
  

  Customer Answer

  Date: 02/16/2024

  I have reviewed the business response and accept this resolution. 

• Initial Complaint

  Date:02/09/2024

  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 December 2nd 2023, I contacted a healthcare market service to purchase medical insurance, i spoke with a person named ******, she provided me with all the details and I purchased the plan, they charged my credit card 377.69.On January 3 **** two transactions were changed to my credit card and a third charge on January 15 for a total of 252.69.I tried using the insurance at my ************** but the Dr ****** could not confirm the insurance information because the numbers that are provided by this company no one answers them , they just connect and put you on hold for hours!This medical plan that they gave me was a limited insurance plan, nothing to what I asked for! I have repeatedly asked for a refund and they refuse, even after talking to someone they says yes theyre going to refund the money back to my card! I believe this is a scam.

  Business Response

  Date: 02/15/2024

  **************,
  
  Thank you for making Adroit Health Group (Adroit) aware of your dissatisfaction with your Impact Health limited medical plan underwritten by *************************** Life Insurance
  Company.  As you may be aware, Adroit is the general agency and enrollment platform, but we are not the insurance carrier.  Addressing your specific complaints:
  
  With regards to the multiple charges, you were billed December 02, 2023, the total amount of $377.69, which covered your first month of service.  You purchased multiple products, with one of those having an effective date of December 03 and the others having an effective date of December 15.  As a result of the multiple effective dates, your recurring monthly charges would be charged to your credit card on the corresponding monthly datesagain, on the 3rd of each month for your Impact Health product and on the 15th of each month for the other products.  In total, the aggregate charge for all products would equal $232.75 and would be broken up among those two billing dates each month.  The difference between the $377.69 you paid in December-2023 versus the $232.75 that you were to pay on a go-forward basis is due to the one-time enrollment fee that was charged to you in the first month.  All of this was detailed in your enrollment agreement and explained to you at the time of sale.  We note that you accessed the electronic member portal where this information is housed on multiple occasions, including December 05, 2023, December 23, 2023, January 2, ****, and January 16, ****. 
  
  With regards to your attempt to utilize your Impact Health limited medical plan at your physicians office, we show no record of any inbound calls being received by our *************************** from your provider.  It is possible that they attempted to contact Impact Health as their contact information is featured prominently on your membership identification card along with the notation, Claims Status and Questions.  Nevertheless, following receipt of your complaint, our ********************* conducted an internal audit of the responsiveness of Adroits *************************** and found that the elapsed time to speak to a representative was less than two (2) minutes.
  
  Additionally, we should point out that your Impact Health limited medical plan is a fixed indemnity plan.  Your attention is called to page 6 of your plan Certificate, which was made available to you as of the date of your initial purchase and continually thereafter through Adroits electronic member portal.  For reference, a copy of this document is being enclosed with this response.  You will note that, relative to physicians office visit benefits, the Impact Health limited medical plan pays you a flat amount for each day that you received the requisite physician office services--$50 per day for a maximum of three (3) days per coverage year.  Because of the fixed indemnity benefit design, no reimbursement is paid directly to the provider (in this case, your physician) by the plan;  rather, all payments are made directly to the member.  
  
  With regards to your allegation that the limited medical plan was not what you requested, you were clearly made aware that you were purchasing an Impact Health Plan and that this plan was, in fact, a limited medical plan as opposed to comprehensive health insurance.  Your attention is called to the following express provisions of your Enrollment Agreement dated December 02, 2023:
  
  1. Impact Health Limited Medical plan is made available through the National Congress 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, 12/02/23, p. 2) 
  
  2. The Impact Health Limited Medical Plan includes access to the MultiPlan PPO Network.  (Enrollment Agreement, 12/02/23, p. 3) 
  
  3. 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, 12/02/23, p. 3) 
  
  4. 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, 12/02/23, p. 3, emphasis original) 
  
  5. You understand that the insurance coverage included with this membership is an accident and sickness hospital indemnity plan.  (Enrollment Agreement, 12/02/23, p. 3)
  
  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, 12/02/23, 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, 12/02/23, p. 4)
  
  8. 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, 12/02/23, p. 5)
  
  9. I have read and agree to the Insurance Disclosures. (Enrollment Agreement, 12/02/23, p. 14)
  
  10. I agree that I have a full and complete understanding of the products for which I am applying.  (Enrollment Agreement, 12/02/23, p. 13)
  
  11. 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, 12/02/23, p. 13)
  
  Lastly, please be advised that you are not *********** a refund under these circumstances.  Our policy is to extend refunds to customers who cancel within the first thirty (30) days of the commencement of the account.  However, your cancellation request was first made on January 16, ****, which was beyond this thirty day free look period for refunds.  Additionally, as you will note from your Enrollment Agreement, cancellation requests must be received at least five (5) days prior to the billing date to avoid incurring charges for the following month, whereas your cancellation request occurred after the most recent billing date.  
  
  Adroit sincerely regrets that you were not satisfied with your Impact Health limited medical plan.  However, we can confirm that your account was cancelled on January 19, ****.  A copy of the cancellation confirmation that was previously e-mailed to you is included with this response.  You should incur no further charges.  Should you need anything further, please do not hesitate to contact me at *******************************************.
  
  Best regards,
  *************************
  General Counsel & Chief Compliance Officer

• Initial Complaint

  Date:02/06/2024

  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.

  I bought Individ Health Insurance from Adroit Health Group called TVP Health, sponsored by The Vitamin Patch. The description is ABA Membership, ABA Protect Premier, TVP Health. This Insurance was started September 9, 2023 @ 1st charge of $344.95. I had a Mammogram scheduled in ************ was informed that they didn't recognize this insurance, so I called the insurance ************ Primary ***************** together, to ascertain if BJC Health services/Primary Care doc was in network & was assured they are. This was same day in November because I had a December appt. I now have a $219.00 health clinic bill dated 12/29/2023 insurance declined. I spoke to a Tory, *********, & all sent me to another agency. I finally spoke to agent ***** to file a cancellation, she transferred me to another office & was told to leave my ******** would get a return call. I NEVER did.

  Business Response

  Date: 02/14/2024

  ******************,
  
  Thank you for making Adroit Health Group aware of the problems you have encountered with your *** Health Plan.  Please be aware that our Company is the general insurance agency only, and we are not the insurance carrierwhich is *** Health.  As such, we have no role in the review, processing, and payment of claims.  In fact, because of HIPAA privacy laws, we are not privy to any records concerning your health care services or payments for those services.  Because we have no access to the Explanation of Benefits that you should have received following submission of your claim(s), we are unfortunately not in a position to provide any further explanation of what may have transpired.  There could be any number of reasons that the claim was not paid, ranging from whether the provider was a participant in the ********** Network (which is a requirement under the *** Health plan) to whether services were received in a hospital (which is an express exclusion under the *** Health plan).  We note that your BBB complaint references BJC Health, which our review suggests is a hospital health system, and to the extent that your mammogram was performed in a hospital facility, it may well have triggered this policy exclusion.  However, this again is only speculation as we do not have any information about the services you received or the claims that were filed, nor do we have any information concerning the claims determination by *** Health.
  
  Having said that, we have confirmed that your *** Health plan does indeed cover 2d mammography for women ages 50 and over, at a frequency of once every two (2) plan years, provided again, that the services are not received at a hospital.  
  
  In the event you dispute the appropriateness of *** Healths claim determination, please be reminded that you do have certain appeal rights as detailed in the *** Health Consolidated Summary Plan Description.  A copy of these materials is available to you at any time through Adroits electronic member portal.  You are reminded that your appeal rights are subject to certain time limitations, so you are urged to act timely to make sure your appeal is submitted timely.  
  
  With regards to the multiple people with whom you had to speak regarding this matter, if you were inquiring about claims, it would have been necessary to route you to *** Health, because again, our Company does not have access to your claims information.  When you called on February 05, ****, to cancel the account, we transferred you to your agent-of-record to complete the cancellation, although the account was immediately placed on a billing hold to prevent future charges.  Our records  indicate that the agent was not available at the time of the call transfer and should have called you back;, although it appears that in the interim, you e-mailed the agent and the cancellation was processed based on that e-mail communication. Your account was cancelled on February 08, ****, at which time a cancellation confirmation was e-mailed to you.  For reference, a copy of your cancellation notice is enclosed with this response.  
  
  In light of these cancellation complications, and as a courtesy to you, we have this date issued a refund of your February payment in the amount of $329.95, which should help defray the cost of the services that were not reimbursed by *** Health.  Depending on your financial institution, it may take up to five (5) business days before this refund is reflected on your bank statement.  However, if you have not received this by next week, please contact my office at the e-mail address below and I will be happy to follow up for you.  
  
  Thank you for being a valued member of Adroit Health Group.  If you need anything further, please do not hesitate to contact my office at *******************************************.
  
  Best regards,
  
  *************************
  General Counsel & Chief Compliance Officer  

  Customer Answer

  Date: 02/14/2024

  The response given is a bunch of hoopla. TVP Health assured me that BJC Health & my doctor was in net-work.

  So, ****, claims ***** told me in no uncertain terms that BJCHealth & my Primary Doctor was NOT in network, so I have to pay the full Dr. ***** I asked to talk to Troys Supervisor,***, he said that a PO Box address for my Primary Dr. was not registered & thats why my claim was declined!??

  It seems as if no one is working together, no one knows what the right hand is doing.

  Customer Answer

  Date: 02/15/2024

  I have reviewed the business response and accept this resolution. 

• Initial Complaint

  Date:01/26/2024

  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.

  The company called offering health care insurance plans at a cheap rate. They advertised that the plan was a First Health PPO plan by *****. This was a LIE. They told us this was a major medical plan that covered everything with 80/20 coinsurance and an OOP maximum of $8000. None of this was true. They would give us any documents about the plan until we provided personal information and agreed to sign up for the plan. At that point we signed the documents and provided payment details over the phone. When I was finally sent the plan information it was not at all what they said it was. The plan information clearly states that this is NOT A MAJOR MEDICAL PLAN! It is only supplemental insurance. This company lied straight to my face. When I was reading the document I noticed it was mentioning supplemental insurance so I asked to clarify with my rep ***** that this is NOT a supplemental insurance plan to which she said it was not and this was an ADDITIONAL benefit to the insurance plan that we had. This was all a lie! I want my money back. I have attached proof that the cards state clearly this is not a major medical plan.

  Business Response

  Date: 01/26/2024

  ****************,
  
  Thank you for making us aware of your dissatisfaction with the health plan that was allegedly purchased through our company.  At the outset, we believe your complaint is misleading as we do not have any account under your name as purported, nor do we have an account under your email address or telephone number as provided to the BBB.  It appears that you may be a dependent on an account that bears the same address, but we can identify nothing that provides us with legal authorization to disclose that persons financial information to you or the Better Business Bureau.  Therefore, our response will necessarily be limited to providing general information, which we hope for privacy reasons you will understand. 
  
  As you may know, Adroit Health Group, LLC, does not engage in any direct-to-consumer sales;  rather, we make products available for sale on our enrollment platform by licensed third-party sales agents.  However, none of these agents are employed by our Company.  Nevertheless, we require that all agents selling on our platform provide truthful information to all prospective customers concerning plan offerings, limitations and exclusions, and associated costs.  To the extent you believe this was not the case with regards to the sale about which you are complaining, we are truly sorry.
  
  While we were not privy to the conversations that the customer may have had with the sales agent, we must explain that Adroit has implemented an important control to ensure that there are no misunderstandings of the sort you allude to in your complaint. Specifically, in order for a sale to be completed through our Company, all customers are required to review and sign an Enrollment Agreement.  These Enrollment Agreements contain significant disclosures concerning material aspects of the plans.  With regards to the *** plans, such as the one in your complaint, all Enrollment Agreements contain the following disclosures:
  
  1.  The *** plan is not a Major Medical or Comprehensive Coverage. The *** plan covers
  the preventive health services required by the **** **** (a) without any cost-sharing requirements.  (Enrollment Agreement, p. 3)
  
  (We note that this important disclosure is actually underlined for emphasis so that it is readily apparent to the customer at the time they are reviewing the Enrollment Agreement.)
  

  2.  This Plan does not cover benefits unless listed in the Schedule of Benefits, so please review that list carefully. (Enrollment Agreement, p. 4)
  
  (We note that this important disclosure is actually underlined for emphasis so that it is readily apparent to the customer at the time they are reviewing the Enrollment Agreement.)
  
  3.  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 Agreement, p. 4)
  
  (We note that this important disclosure is actually underlined for emphasis so that it is readily apparent to the customer at the time they are reviewing the Enrollment Agreement.)
  
  4.  The *** plan includes a supplemental benefit for hospitalization confinement payable at $1,000 a day for up to 10 days.  (Enrollment Agreement, p. 4)
  
  5.  You understand that the *** benefit plans are not major medical insurance and should not be viewed as a substitute for major medical coverage.  (Enrollment Agreement, p. 6)
  
  6.  The *** plans do not comply with the *************** Act (ACA), otherwise known as Obamacare." (Enrollment Agreement, p. 6)
  
  7.  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, p. 6, emphasis original)
  
  (We note that this important disclosure is actually capitalized for emphasis so that it is readily apparent to the customer at the time they are reviewing the Enrollment Agreement.)
  
  Hence, we respectfully disagree that the first time the customer knew they were purchasing a supplemental insurance plan that was not major medical insurance was when they received documents after the sale.  This is simply inaccurate.  All such disclosures are appropriately made prior to consummation of the sale and the charges being incurred.
  
  However, we believe that a source of the misunderstanding may be that the Wellness First Dental & ************** program does have an Aetna network component, although it should not have been conveyed or understood that the plan itself is an Aetna plan.  Nevertheless, a review of the Enrollment Agreement will find that there is no representation concerning Aetna therein.  However, out of an abundance of caution, we are going to follow up with the agent involved with this sale and make sure that this is not a knowledge deficit on their part.
  
  Regardless, it appears that the account associated with the household from which you are now complaining was cancelled as of 12:51 p.m. today.  The account holder should receive an email confirmation to their designated e-mail address on the next business day.  In the meantime, consistent with our refund policy, I have directed our ****************** to process a refund of all charges to the credit card on file.  Depending on the account holders particular financial institution, it can take up to five (5) business days before a refund appears on the account holders statement.  In the event the account holder has not received the refund by the following week, they may contact my office directly at *******************************************, and I will be happy to follow up.
  
  Sincerely,
  
  *************************
  General Counsel & Chief Compliance Officer

  Customer Answer

  Date: 01/26/2024

  I have reviewed the business response and accept this resolution. I accept this only because there is a promise to refund my money. However, this response immediately is incredibly disrespectful to spell my name last name incorrectly when it was clearly spelled for you in the complaint. To say that you cannot discuss the plan with me when my card was used in the purchase furthermore is ludicrous. Third, to insinuate that I am simply illiterate or as if this was a miscommunication is blatant misrepresentation of what occurred and to facts I clearly stated in my initial complaint. ***** was the second rep I spoke to selling your plan. Both representatives misrepresented the insurance plan. There are hundreds of complaints against your company of other people who have experienced the exact same thing I did. To say that they are a third party does not relieve you of responsibility to ensure that the representatives who represent your company are misleading and lying to consumers about the product they are selling. For hundreds of people to have this experience and for me personally to be lied to by TWO different representatives proves that this is not an isolated incident and is actually common company practice. When we were sent the documents to sign I asked the representative once again "Is this a medical plan, because this document is talking about supplemental benefits." The representative stated that this was an ADDITIONAL benefit on top of the *** plan. That was a LIE. We spoke to ******* once again today to request cancellation and once again ******* tried to convince us that this was a real *** Medical Plan and NOT a supplemental insurance. We finally got her to cancel the plan. I don't appreciate the insinuation of this response that I am lying about the experience I had or that I am simply an illiterate person who did not read the contract because as you would know I DID. This response was extremely condescending, rude, blatantly ignorant of facts, and I can only hope to educate others on how not to fall for scams like this. 

• Initial Complaint

  Date:01/24/2024

  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 submitted a search for health insurance online, entered my name, email address and phone number and requested information for a family health insurance plan. I get a call from someone from this company claiming to be a health insurance enrollment specialist for Cigna. He asks me all the information about myself, my wife and my kids ages then gives me 2 different price options for Cigna health care coverage, I chose the one which didnt require me to have a referral from a primary doctor (because that was one of the options he listed). He then goes through all of the questions that Ive been asked before in order to sign up for health insurance, my birth date, my wifes birthdate, each of our kids birthdates, etc, asks me if Id like to add vision and dental, I say yes, I ask for prices of adding those, he takes a minute so he can supposedly check our rates, then comes back with a price. It all sounds good to me so I tell him Yes sign me up for this Cigna health insurance and the dental and vision for our whole family. He takes my credit card info, tells me the insurance cards will be in the mail in about 10 days, says he will email me a receipt and to look for the email from ********************** I check my email, and sure enough theres a receipt from that email address so I thought it was legitimate. About 10 days later I get correspondence from a company called Adroit Health Group with 2 sets of cards that say THIS IS NOT INSURANCE in bold letters at the bottom. I didnt sign up for anything with Adroit Health Group so Im not sure why I even get those cards, but I know its not Cigna like I was told I was signing up for. I signed up in November but never received anything from Cigna, so I called their customer service line to see where my membership benefits info is, they tell me Im not a member and whoever is charging me is NOT THEM! Adroit Health Group POSED AS CIGNA, sold me a fake insurance policy, and is fraudulently charging me. SCAM!!!

  Business Response

  Date: 02/02/2024

  Dear *******************
  
  Thank you for making Adroit Health Group, LLC, (Adroit) aware of your dissatisfaction with your TVP Health Plan purchased from your agent-of-record.  You may already be aware that Adroit does not engage in any direct-to-consumer sales.  Rather, Adroit is a general agency that makes certain insurance and non-insurance products available for sale by third party sales agents through our enrollment platform.  However, we require that all agents selling on our platform provide accurate information to prospective customers concerning products, exclusions/limitations, and costs.  Further, in order to avoid miscommunication, we also require that customers are provided an Enrollment Agreement at the time of sale that details all of the products that you purchased.  We note that the Enrollment Agreement that you signed on November 14, 2023, references Adroit Health Group over seventeen (17) times and TVP twenty-seven (27) times, including a large, bolded heading reading TVP Health in a font over twice the size of the remainder of the contract.  By contrast, there is not a single reference to Cigna.  Likewise, we have spoken with your agent-of-record and he expressly denies ever having misrepresented that you were purchasing a Cigna plan.  
  We also call to your attention the following, material disclosures in your Enrollment Agreement:
  
  1.  The TVP plan is not a Major Medical or Comprehensive Coverage.  (Auguste Enrollment Agreement, 11/14/2023, p. 4, with original underlined for emphasis)
  
  2.  This Plan does not cover benefits unless listed in the Schedule of Benefits, so please review that list carefully.  (Auguste Enrollment Agreement, 11/14/2023, p. 4, with original underlined for emphasis)
  
  3.  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. (Auguste Enrollment Agreement, 11/14/2023, p. 4, with original underlined for emphasis)
  
  4.  THIS IS A SUPPLEMENT TO HEALTH INSURANCE AND IS NOT A SUBSTITUTE FOR MAJOR MEDICAL COVERAGE.  .(Auguste Enrollment Agreement, 11/14/2023, p. 6, with original capitalized for emphasis)
  
  5.  By placing your signature below, you acknowledge that you have read and reviewed each of the statements listed above. (Auguste Enrollment Agreement, 11/14/2023, p. 7)
  
  6.  I agree that I have a full and complete understanding of the products for which I am applying. I certify that I am the applicant listed above (Auguste Enrollment Agreement, 11/14/2023, p. 13)
  
  7.  By electronically acknowledging this authorization, I acknowledge that I have read and agree to the terms and conditions set forth in this agreement. (Auguste Enrollment Agreement, 11/14/2023, p. 13)
  
  All cards and documents you received from Adroit are wholly consistent with the policies purchased under your Enrollment Agreement.  Moreover, you were afforded a full thirty (30) days to review your purchases during which time you were allowed to cancel and receive a full refund.  Unfortunately, you chose not to avail yourself of this right, with your first complaint coming January 26, ****, which was significantly past your review period.  
  
  For each of the reasons noted above, we respectfully disagree with your allegations and assert that you were treated fairly and in conformity with the contracted into which you freely entered.  However, it is apparent that your understanding of the products you purchased is not consistent with the terms of your agreement.  Therefore, we believe the right thing to do under the present circumstances is to voluntarily refund your money despite being beyond your cancellation period.  For this reason, this date I have directed Adroits ****************** to issue you a refund of your first payment in the amount of $644.95.  While we would also refund your second payment, you have previously initiated a chargeback dispute with your bank, making us unable to process any refund pending their adjudication of your claim.  In the likely event that your financial institution rejects your chargeback dispute, we will still gladly refund your payment.  In such an occurrence, kindly notify our ********************* of the upheld charge and will commence a refund nonetheless.  They may be reached at ****************************.  
  
  This refund should not be interpreted, construed, or otherwise deemed to be an admission of any fault or liability on the part of Adroit Health Group, LLC, and its affiliates; rather, this constitutes a settlement, transaction, and compromise of a dispute claim.  Additionally, please be aware that, depending on your particular financial institution, it can take up to five (5) business days before a refund is reflected on your account statement.  In the event you have not seen this refund by the following week, please follow up with our ********************* at the e-mail account noted above.
  
  Again, we regret that you did not find your TVP Health Plan to sufficiently meet your needs.
  
  Best regards,
  
  *************************
  General Counsel & Chief Compliance Officer