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:08/31/2023

  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.

  Me mudaba *************** ** para *********** y nos quedamos sin cobertura ***** y por telfono encontr esta agencia aparentemente de cobertura ***** y despus Medi cuenta que a mi esposa en su trabajo le iban a dar cobertura ***** para los dos y decid darle de baja ala cobertura antes del mes en curso agosto y pedirle que me devuelvan el dinero que le haba dado atra vez de la tarjeta de crdito ******, estuve casi todo un da intentando que me dieran de baja del seguro y como no entiendo muy bien el ingls colgu sin tener una respuesta completa de que dieron de baja al seguro y que me devolveran todo mi dinero.

  Business Response

  Date: 09/01/2023

  Dear Mr. *************************,
  
  We  are very sorry that you are dissatisfied with the limited medical plan you purchased through our company.  I can confirm that your request on August 30, 2023, we cancelled the account on August 31, 2023.  Per our agreement, because you cancelled during the first thirty days of the account, you are *********** a refund of all charges.  These charges were refunded on September 01, 2023.  Please be advised that, depending on your financial institution, it may take up to five (5) business days before the refund is reflected on your bank statement.  I am attaching copies of the cancellation notice and refund receipt for your records.  
  
  If you have any further problems, please do not hesitate to contact me directly at *******************************************.  
  
  Best regards,
  
  *************************
  General Counsel & Chief Compliance Officer

• Initial Complaint

  Date:08/30/2023

  Type:Billing 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.

  Purchased a hospital ins. policy for my young grand dtg. who works at a restaurant in ***********, **. They sent ** cards. Purchased it in June 2023.I sent her the ** cards because she was having health issues. She called several dr's, but none took the ins. She managed to get better & continued working. In July she got sick again and found out she was pregnant. Again, called Drs for OB/Gyn on their provider list, She went to a free clinic to get U.S. to prove she was pregnant, kept trying to find a dr. August rolls around & I get on phone to some of these preferred providers (in the meantime, she signs up for ******** to see if she can get on it) No luck finding providers for this insurance in ******************************* It was just useless. She told me to cancel the ins. since I had already paid $586.50 & no service. She felt she would get the ******** Ins. I called the customer service line **************, spoke to a guy, said his name was ******** (?) I told him I wanted to cancel the ins. and explained to him why, He would barely let me talk, because he was too busy telling me he could help me and that he could not cancel the policy, nor refund my money, which is being taken out of my checking account, automatically every month. I was on the phone with him almost 30 mins demanding that he cancel the insurance and refund my money, but he just kept on and on insisting that he could help me. This was on Friday, he asked me to wait till Mon. he was going to get a dr. & an appointment for my granddaughter and he would call me Monday with that info. I was crying my heart out by then & begging him to cancel this ins because it is no good and my granddaughter has not received any use of it. Today is Monday and he did not call or get that appointment for my granddaughter. I want this policy cancelled and $586.50 returned to my account. Just so you have info, the member ** number is ********* for ***********************, They also go by Health Depot, Multi ***** ******* Health

  Business Response

  Date: 09/06/2023

  Dear ************************,
  
  Thank you for making our Company aware of your granddaughters dissatisfaction with the limited medical plan.  Because of federal health care privacy laws, we are unable to provide specific information concerning your granddaughters protected health information (which unfortunately includes information concerning the financial aspects of that care).  However, I can provide some general information concerning limited medical plans that *** be helpful in understanding the nature of the problems that you *** have experienced.  Please be advised that the particular type of policy about which you are inquiring is a fixed indemnity plan.  This means that the plan pays a set amount upon the occurrence of a specific eventnamely, a hospital confinement or a physicians office visit.  Most plans will pay a set amount per event up to a maximum number of such events per year.  However, the plan pays the benefit directly to the Member and not the provider of services;  therefore, when the provider says that they did not accept this particular insurance, the underlying reason would be that the plans are not designed to pay the provider, but rather to issue the fixed indemnity payment to the Member.  The usage of a network provider does not affect the Members entitlement to the benefit.  However, by using a network provider, the Member receives a discount in his/her charges, which then allows the fixed indemnity payment to be stretched farther.
  
  Additionally, you reference that your granddaughter was seeking a provider for pregnancy-related services.  As noted in the plan certificate and the enrollment agreement that are presented to the Member at the time of sale and  available continually thereafter through our electronic member portal, for this particular limited medical plan, pregnancy would be considered a pre-existing condition for which coverage does not apply.  As clearly stipulated in the Description of Coverage section of the policy and on page 4 of the enrollment agreement, This insurance does not apply to normal pregnancy.
  
  Nevertheless, we are concerned about your interactions with *****************  When you called in, you were transferred to the sales agency per our normal process.  The agency, who is an independent contractor that is neither owned nor operated by Strata.  Further, ******** is a customer service employee of the sales agency, and is not a Strata staff member.  However, we are advised that ******** is a new employee of the agency, and it appears that he did not handle your call appropriately.  We have requested that the agency provide additional compliance training to Giovanni.  
  
  Unfortunately, your request to cancel the account was beyond the thirty-day cancellation window in which you are normally *********** receive a refund.  However, because of the problems that you encountered with the cancellation, I have directed our ****************** to process a discretionary refund.  The account was cancelled on August 31, 2023, and refunds (totaling $586.50) were processed on September 01, 2023.  Receipts evidencing these refunds have been e-mailed to your granddaughter.  Depending on your financial institution, it *** take up to five (5) business days before the refunds are reflected on your credit card statement.  In the event you have not seen the refund hit your account during that period, please feel free to contact me directly at *******************************************, and I will be happy to follow up.  I apologize for the problems you encountered in trying to cancel your account with the sales agency.  I hope these remedial steps are deemed sufficient to address your concerns.
  
  Best regards,
  
  *************************
  General Counsel & Chief Compliance Officer  

  Customer Answer

  Date: 09/07/2023

  I have reviewed the business response and accept this resolution. I appreciate your assistance with this issue. When purchasing this insurance plan, it was not explained to me about it being an indemnity plan. But anyway, we could not find a provider for this insurance plan, either a primary care Dr. ******** an OB/Gyn Dr. ** matter who we called, they had never heard of it and my granddaughter did not have cash to pay for office visits or lab tests, or Ultrasound  tests, which apparently this is how this plan works, then you file for reimbursements. They said they could not reimburse the money but they made an exception and did reimburse me which I really appreciate, due to my financial situation. Thanks from the bottom of my heart !!            

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

• Initial Complaint

  Date:08/25/2023

  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.

  After a year of being sick and having to go on Cobra due to not being employees related to medical I called a number which represented themselves as being part of the public marketplace and told me that there was no good public marketplace insurance available for me. They sold me a plan and told me it would say not insirance solely because to be considered insurance they had to cover mental health but it was just wording. I was also told I could call my personal agent ****** at ********************* and when I ****** to discuss the issues that I found out in attenpting to use this insurance I was told I was not allowed to ask for extensions any longer. I was put on hold and told I would be connected to the escalation department twice now for over 20 minutes with ***** ever returning to the line. I am a nurse who unfortunately became ill and this is unthinkable to take advantage of a person at a time of weakness. I still have not been able to speak to a person to cancel. Now I will also have to pay the $1000 to continue COBRA. There should be a law against misrepresenting eapecially in insurance matters and no loophole around that law. Thank God I needed dental work and found out before it was to late to continue my COBRA. Sadly reading the prior reaponses it looks like they will continue to get away with this.

  Customer Answer

  Date: 08/25/2023

  After 2 days of holding they are finally supposed to cancel and fully refund my account.  Hopefully that happens.  So deplorable to take advantage of people when they are ill.

  Business Response

  Date: 09/06/2023

  Dear ********************,
  
  Thank you for making our Company aware of the problems you experienced with regards to the purchase and subsequent cancellation of your NCE ************ Medical Plan.  Please accept my sincere apology for the problems you encountered in this transaction.
  
  It appears that the number you contacted when attempting to discuss your concerns was that of the sales agency.  Please be advised that Strata Health does not engage in direct-to-consumer sales and does not employ any sales agents;  rather, we are a general agency that provides certain insurance and non-insurance products to third-party sales contractors through our enrollment platform.  To reiterate, the sales agency with whom you dealt is a separate and distinct legal entity that is neither owned nor operated by our Company. Nevertheless, the conduct you have described is not acceptable and is not consistent with the compliance standards of our organization.  Further, even assuming that there was an innocent explanation for the miscommunications made regarding the plan, you should have been afforded the opportunity to cancel the account without unnecessary push-back, which does not appear to the be the case in this matter.  

  Your allegations are concerning and we have contacted the sales agency to demand that they conduct an investigation.  They have indicated that their *************************** has recently been beset by staffing turnover and new employees, which may have led to some of the problems you experienced.  In light of your complaint, we are requiring that their staff complete additional compliance training. We have also notified them that further cancellation issues and customer service problems will result in ********************** restricting them from further customer service functions and requiring that all such matters be handled by our ***************************. 

  In the meantime, you are *********** cancel the account and receive a refund of all charges.  Our records indicate that the account was cancelled at your request on August 28, 2023, at 7:35 a.m., and a full refund in the amount of $636.85, was processed that same date at 8:33 a.m.  For your reference, I am enclosing copies of the cancellation notification and refund receipt.  Depending on your particular financial institution, it can take up to five (5) business days for a refund to be reflected on your credit card statement;  however, if you have not seen that refund hit your account, please contact me directly at  *******************************************, and I will be happy to follow up.  Again, I apologize for the problems that you have experienced, and we will work closely with the sales agency to improve their customer interactions going forward.
  
  Sincerely,
  
  *************************
  General Counsel & Chief Compliance Officer

• Initial Complaint

  Date:08/18/2023

  Type:Sales and Advertising 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.

  This company represents itself as being a provider of health care coverage and prescription coverage. What is done for prescription coverage is provide discount coupons, which I can get myself. I'm paying more than $200 a month for coverage I don't need and is not useful for the cost.

  Business Response

  Date: 08/18/2023

  Dear Ms. *********************** you for making our Company aware of your dissatisfaction with the coverages you purchased through our Company.  Our records indicate that you purchased a Hospital Indemnity Plan, an Accidental Death and Dismemberment Plan, and a non-insurance discount plan that included a prescription discount card. We regret that you found these products to be less than satisfactory.  However, we respectfully disagree that any of these products, specifically including but not limited to prescription discounts, were misrepresented to you and that you were being provided full health coverage and prescription coverage.   
  
  Your attention is called to the enrollment agreement that you were presented contemporaneous with your sale on December 09, 2022.  This enrollment agreement contains clear disclosures concerning product coverages, exclusions and limitations, and associated costs.  In fact, you expressly acknowledged receiving, understanding, and agreeing to all of the terms of sale, which specifically included the following:
  I understand that the OneCare program 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 person's individual obligation to secure the requirement of minimum essential coverage under the *************** Act (ACA). (Enrollment Agreement, p. 3, emphasis added)
  
  1.  DISCOUNT RX IS NOT AN INSURANCE PLAN, BUT A DISCOUNT PRESCRIPTION PROGRAM. Simply present your Discount Rx card at any of our ****** participating pharmacies with a valid prescription to save up to 80% on your prescription medications.  (Enrollment Agreement, p. 4, emphasis added)
  
  2.  Discount Rx Discounts of up to 80%.  Completely FREE to use.  Accepted at over ****** pharmacies nation-wide. Discounts on over ****** medications. (Enrollment Agreement, p. 4, emphasis original)
  
  3.  THIS IS NOT AN AFFORDABLE CARE ACT PLAN. THIS IS NOT QUALIFYING HEALTH COVERAGE ("MINIMUM ESSENTIAL COVERAGE") THAT SATISFIES THE HEALTH COVERAGE REQUIREMENT OF THE AFFORDABLE CARE ACT. IF YOU DON'T HAVE MINIMUM ESSENTIAL COVERAGE, YOU MAY OWE AN ADDITIONAL PAYMENT WITH YOUR TAXES.  (Enrollment Agreement, p. 4, emphasis original)
  
  4.  Prescription Discounts THIS IS NOT AN INSURANCE PRODUCT.  (Enrollment Agreement, p. 6, emphasis added.
  
  5.  I agree that I have a full and complete understanding of the products for which I am applying.  (Enrollment Agreement, p. 8)
  
  6.  I acknowledge that I have read and agree to the terms and conditions set forth in this agreement.  (Enrollment Agreement, p. 9) 
  
  Hence, you were clearly made aware in numerous places and often with great emphasis that the products you were purchasing were not comprehensive health insurance coverage and any prescription benefits were solely in the form of discounts and not prescription insurance coverage.  

  Furthermore, per our Company policy, you were entitled to a period of thirty (30) days to review your purchases and if dissatisfied for any reason, you could cancel without obligation and receive a full refund of all charges.  You did not choose to cancel during this free look period, and as a result, while you have now cancelled the account, you are not eligible for a refund.  However, we note that you contacted the sales agency (which is a separate and distinct company) on August 18, 2023, requesting a refund of your most recent months payment.  While we are not obligated to issue a refund, in recognition of your long history as a good customer and as a gesture of good faith, I have this date requested our ****************** to issue a discretionary refund of your August payment in the total amount of $218.17.  This refund will be processed to your credit card on file, and depending on your particular financial institution, may take up to five (5) business days to be reflected on your account.  Please be advised that this refund shall not be construed or deemed as an admission of fault of liability on the part of Adroit Health Group, LLC, and its affiliates;  rather, it solely constitutes a settlement, transaction, and compromise of a disputed claim.
  
  Our Company sincerely regrets that you were dissatisfied with the products you purchased through our Company. 
  
  Best regards,
  
  *************************
  General Counsel & Chief Compliance Officer

  
  

  Customer Answer

  Date: 08/18/2023

  I have reviewed the business response and accept this resolution. 

• Initial Complaint

  Date:08/16/2023

  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.

  On the 15th of August, I was approached by a health care agent, who attempted to provide me with health insurance specifically for students. After listing off multiple insurances, we did not give me a quote till I gave my card details. After mentioning multiple times, to not make any transaction until I authorise it, he took the card details and gave me a quote. Immediately after that, there was a debit in my account of $409. When I tried calling back, another representative tried to sell insurance again, rather than refund my money, and I didn't get any insurance from them as well. I would like for my money to be refunded as soon as possible.

  Business Response

  Date: 08/18/2023

  Mr. *********************** you for making our Company aware of the problems you encountered in your sale and your effort to cancel your account.  At the outset, please understand that we do not engage in any direct-to-consumer sales;  rather, we are solely a general agency and enrollment platform, a  and all sales are conducted by third party independent contractors who generally (although not always) make sales for any number of agencies including our Company.  However, our expectation is that *************** will provide truthful information to prospective customers concerning plan coverages, exclusions and limitations, and associated costs. We also expect that *************** honor customers requests to cancel accounts.  In this case, it appears that this was not your experience, which is particularly troubling.  We apologize for what appears to have transpired.
  
  The occurrences that you have relayed are not reflective of our Companys normal practices and are wholly inconsistent with our policies and the contractual requirements we impose on the *************** utilizing our platform.  For this reason, we have commenced a compliance investigation of your complaint and the handling of your account by the third party sales producer.  In the event we substantiate the allegations, we will take immediate disciplinary action.  
  
  In the meantime, you are definitely entitled to a refund of your charges, which I approved on August 17, 2023.  A copy of the receipt evidencing this refund is enclosed with this response.  Depending on your financial institution, it may take up to five (5) business days before the refund is reflected on your bank statement.  In the event you have not seen the refund by the end of the week, please contact me directly at *******************************************, and I will be happy to follow up on your behalf.
  
  Please accept my sincerest apologies for the manner in which you were treated.  We appreciate your understanding and affording us an opportunity to make things right.
  
  Best regards,
  
  *************************
  General Counsel & Chief Compliance Officer

• Initial Complaint

  Date:08/14/2023

  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 was told that I was buying health insurance for cataract surgery, I was told it would be fully covered instead they sent me coupons

  Business Response

  Date: 08/18/2023

  Dear **************************,
  

  Thank you for making our Company aware of your dissatisfaction with the health benefits products purchased through our Company.  You have alleged that you were led to believe you were buying health insurance for cataract surgery and subsequently discovered that it was not covered resulting in you only receiving discount coupons.  
  

  We note that on August 10, 2023, you purchased an NCE ************ Medical Plan and certain ancillary products through our Company.  Please be aware that our Company does not engage in any direct-to-consumer sales;  rather, all sales on our platform are conducted by third-party independent contractors who generally (although not always) sell products for a number of general agencies, including Strata.  However, to avoid miscommunications and misunderstandings with our customers, our standard practice is to provide an enrollment agreement at the time of sale that contains many important disclosures concerning the coverages, limitations and exclusions, and associated costs.  
  

  As you will find in your enrollment agreement, cataract surgery was not a covered benefit of your limited medical plan. Rather, your NCE ************ Medical Plan covered only accident and sickness hospital on a fixed indemnity basis, meaning that you would receive a set indemnity payment of $100 per day (for a maximum of 30 days per year) in the event you were confined to the hospital or up to $50 per day (for a maximum of 3 days per year) in the event you received care from a primary care physician or specialist.   Further, your attention is called to the following disclosures in your enrollment agreement:
  

  (1)  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.  (Enrollment Agreement, p. 3)
  
  (2)  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, p. 3)
  
  (3)  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, p. 4)
  
  Please note that per the NCE ************ Medical Plan Guidelines, which were made available at the time of sale through our electronic member portal, a pre-existing condition is not covered under your plan.  As expressly stated in your plan, 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.  
  
  You have cited the plans failure to cover your cataract surgery as the basis for your complaint.  Given the medical certainty that a cataract is not a sudden-onset medical condition, and rather develops over a protracted period of time, it would certainly constitute a pre-existing condition where you are seeking coverage of the surgery for its removal in the very first week of your coverage.  The failure of your plan to pay any benefits for cataract surgery in the first seven days of coverage is not a result of any misrepresentation on the part of the sales agent, but rather, your attempt to procure coverage for a pre-existing condition.
  
  Nevertheless, we have noted that you were entitled to review your purchase for a period of thirty (30) days and cancel without obligation if you were not satisfied for any reason.  Your cancellation on August 17, 2023, was well within that 30-day window, and as a result, you were entitled to a full refund of your charges.  Your refund was processed on August 17, 2023.  A copy of the receipt evidencing this refund along with the cancellation notification e-mail and refund notification e-mail are enclosed with this response for your reference.  Please be aware that, depending on your particular financial institution, it can take up to five (5) business days before a refund may be reflected in your bank account.  In the event you do not see this refund within the next week, please feel free to contact me directly at *******************************************, and I will be happy to follow up on your behalf.
  
  Best regards,
  
  *************************
  General Counsel & Chief Compliance Officer

  
  

• Initial Complaint

  Date:08/04/2023

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Yesterday July 26th 2023 we were desperately searching for insurance for my mom since she no longer qualified for ********* I filled out a form on a .ORG website, which I believed meant it was a safe government form. A number called about the form said they were going to help us find insurance. Finally they said they had the perfect one it was very confusing and sounded like a discount plan. I asked several times if it was in fact ACTUAL insurance they said it was. My insurance broker finally got back to me to inform me it was not insurance. It was a scam, they scammed me into purchasing a bunch of discount programs that would act sort of like insurance but was NOT insurance. They charged me $581 for this fraud. She signed me up with market place insurance for $2. I called them to cancel since it was a scam!!!! And they said they would be happy to cancel but not issue the refund. WHEN I PAID IT SAID I HAD A 30 day FREE trial and if we decided to cancel we would get a refund. Insurance was for my mom *******

  Business Response

  Date: 08/04/2023

  ****************,
  
  Thank you for making Strata Health Group (Strata) aware of your dissatisfaction with your account.  Please be advised that Strata is a general agency that does not engage in direct-to-consumer sales;  rather, all sales through our platform are conducted by licensed, third-party independent contractors who typically (although not always) sell for a number of agencies.  In the present matter, you purchased an NCE ************ Medical Plan from your third-party sales producer.  Your broker is misinformed, as this plan is not a discount plan, although it is a fixed indemnity plan that provides fixed indemnity benefits for hospital, emergency room, and physician office visits subject to meeting the plan terms and conditions.  We do note that, in addition to your NCE ************ Medical Plan, your account did feature additional discount products. 
  
  Nevertheless, you enrolled with these plans through your third-party agent on July 26, 2023.  The following day (July 27, 2023), you demanded to cancel the account and be issued a refund and the agent spoke with you that same date at 12:20 p.m. Consistent with our company policy and the terms of your contract, the cancellation was issued that same date (July 27, 2023) at 2:17 p.m., and the refund was issued to your credit card of record that same date (July 27, 2023) at 2:12 p.m. CDT.  Copies of the e-mail notifications of the cancellation and refund are both enclosed with this response as well as the receipt evidencing the refund to your credit card.  Depending on your financial institution, it may take up to five (5) business days before the refund appears on your statement.  If you have not received the refund, please advise the undersigned via e-mail at ******************************************* and I will gladly follow up on your behalf.
  
  We sincerely regret that you found the NCE ************ Medical Plan to be unsatisfactory;  however, your account was timely cancelled and your charges refunded per your request.
  
  Best regards,
  
  *************************
  General Counsel & Chief Compliance Officer  
  

• Initial Complaint

  Date:08/01/2023

  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.

  The transaction happened November 2, 2020 over the phone which I never do. **** ( Benefits Manager) and Brain ( representative). I was paying $468.89 a month for my husband and I. My husband had to go to a specialist for his Followup appointment on his health and I advised **** and ***** that we are planning to expand our family. Confirmation # TH6000.He kept insisting that I was in the right place. Every time I called to speak to him to ask more questions he was never available, step away from his desk or not there. Which I think he was and his co workers were lying for him. I did become pregnant and the doctor ****** said I possibly wasnt covered two days before I had my daughter and I called the company to verify. The company said yes I was. I didnt write down the young lady name I spoke to that day.Now after and a couple of months prior I had my daughter I spoke with ****************. I told him everything and he said oh I see and everything would be taken care of. ******* was taken care of.******************** says in another conversation oh you werent covered under the pregnancy part. You have to be with the company for 10 months to be covered which makes no sense at all.Now Im not with that horrible company at all. Ive been trying to call the health advocate though because I have a ***** bill and have left several messages for months and nothing. The doctors ****** even said they are the worst. They never answered and kept giving them the run around.A one point when I did call to make a complaint I was given a number to a supervisor for the *** who told me her mailbox is filled with complaints from this company.

  Business Response

  Date: 08/03/2023

  ************:
  
  Thank you for making Strata Health Group aware of your dissatisfaction with the coverages you purchased through our Company.  Please be advised that Strata does not engage in any direct-to-consumer sales;  rather, sales are conducted by third-party independent contractors who generally perform marketing and sales for not only Adroit but other general agencies. However, our agreement with all such independent contractors requires they provide prospective customers with truthful and complete disclosures about product offerings, coverage limitations and exclusions, and product costs. We regret that you do not believe this was your experience in this particular instance.
  
  In order to address potential misunderstandings about these important matters, Strata provides extensive disclosures about all key aspects of the plans being purchased in the enrollment agreement that is provided to the customer at the time of sale. The customer is required to attest to receiving, reading, and understanding these matters, which in this case you did on November 02, 2020. Thereafter, we also afford all customers with a thirty-day "look-back" period during which they have the opportunity to carefully review the products they purchased to confirm these are satisfactory, and in the event, they are not found to be suitable for any reason, the consumer is *********** cancel the sale and receive a full refund during the thirty-day period. Despite having this information in hand and an ample opportunity to review and confirm your satisfaction with the terms and their consistency with what you claim the third-party sales representative advised you, you did not avail yourself of these rights.
  
  In the enrollment agreement which you verified you had read and understood there are numerous disclosures detailing that you were not purchasing comprehensive health insurance coverage, to wit:
  

  -  Joppa Health Share is not insurance.  (Enrollment Agreement, p. 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, p. 3)
  
  -  This program is NOT insurance.  (Enrollment Agreement, p. 3)
  
  -  ******* HealthShare is NOT INSURANCE. For a full list of services eligible for sharing, limitations and restrictions, further documentation will be made available to members in the Member Guidelines accessible via their member portal following enrollment.  (Enrollment Agreement, p. 4)
  
  -  I understand that this is not insurance.  (Enrollment Agreement, p. 6)
  
  -  I understand that IT IS MY RESPONSIBILITY TO REVIEW THE MEMBER GUIDELINES BEFORE RECEIVING MEDICAL CARE.  (Enrollment Agreement, p. 6, emphasis added)
  
  -  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, p. 6)
  
  -  I agree that I have a full and complete understanding of the products for which I am applying.  (Enrollment Agreement, p. 14)
  
  -  I acknowledge that I have read and agree to the terms and conditions set forth in this agreement.  (Enrollment Agreement, p. 15)
  
  It appears that the expenses you incurred with respect to your pregnancy and childbirth were not covered by your ******* Choice plan.  We should emphasize that Strata is neither the carrier nor the healthcare sharing ministry, and therefore, we have no involvement with or authority for the determination and payment of claims and needs sharing requests under your plan.  However, it is clear that these maternity-related expenses were likely excluded under the ******* Choice plans pre-existing condition exclusions as detailed in both the enrollment agreement you reviewed and signed on November 02, 2020, and the plan materials to which you had access continually thereafter and which you expressly acknowledged your responsibility for reviewing prior to receiving any services.  Your attention is called to the following provisions from your enrollment agreement:
  
  -  I understand that this program has pre-existing condition limitations and/or waiting periods before medical bills relating to a pre-existing condition and/or waiting periods may be considered for sharing.  (Enrollment Agreement, p. 6)
  
  -  I understand that it is my responsibility to review the Member Guidelines before receiving medical care.  (Enrollment Agreement, p. 6)
  
  Further, as you should have noted in the ******* Choice Guidelines made available to you as of the date of your initial enrollment and about which you acknowledged your responsibility to review prior to receiving medical services, it clearly states on page 9 under the large, red headline, Waiting Periods: 
  
  -  There is a 10-month maternity waiting period from each members effective date for maternity in-hospital and outpatient services.  (******* Choice Guideline, p. 9)
  
  Moreover, our account communication records detail that after purchasing your plans in November of 2020, you contacted the sales agency (and not our Company) on March 23, 2021, to inquire about benefit coverage which included pediatric care.  Again, the following year, you contacted the sales agency (again, not our Company) on March 17, 2022, to lodge a complaint against the agents with whom you initially spoke regarding the same misrepresentations you now claim are the fault of our Company.  However, on March 28,  2022, there is documentation in the communication records from the sales that you had admitted in their call with you that you understood the ******* Plan would not cover your pregnancy as the plan requires a ten-month waiting period for the member to avail themselves of maternity coverage. Additionally, the same customer service communication notes reflect that you informed the staff you had state maternity/childbirth coverage which your doctor would not accept, and the specialist scheduled to perform your husbands surgery denied State Coverage as well. 
  
  Adroit sincerely regrets that the products you purchased were found to not sufficiently meet your needs. However, based on the totality of information reviewed, we believe you have been treated fairly and in accordance with the terms of your contract and applicable law.  Strata remains committed to working with you to identify the best options available for your needs.
  
  Best regards,
  
  *************************
  General Counsel & Chief Compliance Officer

  Customer Answer

  Date: 08/03/2023

  I am rejecting this response because:   The representative **** that I spoke with  who was the leading person on this sent me a list showing me that I was indeed covered for maternity. Thats why I signed when **** sent that to my email address. I made it very clear to him over the recording that we are planning to have another child. I asked him multiple times is this health insurance he said yes. When I was looking for health insurance how would you have gotten my number to call me and ask me we see you are looking for health insurance. Than ask me questions over the phone relating my health to get a health insurance quote?? 
  

  That means this company is misleading and lying to customers on a continued basis. 
  

  I asked **** more than once and when I called to reach and spoke to another gentleman in that department because I couldnt get him. He also advised yes its health insurance. So for you to lie and say its not health insurance your company needs close down..thats absurd.
  
  Even when I was calling Joppa same thing. I was directed to someone from the **** She even said they are misleading clients because her mailbox was full of complaints. How did I get that number? From calling your company when I need to make a complaint and thats the number your customer representatives kept giving me.

  Now Ive been calling for health advocate for several months through your company. How did I get that number through your representatives. If youre not in health insurance you have a health advocate number to give. Ive called for several months and no phone call has ever been returned. 
  

  Even my doctors office said you are the WORST COMPANY they had to work with. This company doesnt pay, redirect calls and giving wrong numbers, they couldnt never get in contact with anyone. If it wasnt health insurance they would never had accepted that insurance they would have said this I not health insurance.

  I dont want anyone else to be taken advantage of and than lied on. I just want my money back even if its half.

   

  Business Response

  Date: 09/05/2023

  ************,
  
  Thank you for your response.  Unfortunately, we disagree with your contentions and reiterate the same arguments previously provided.  In advance of your purchase, you were provided a dozen disclosures concerning the limited coverages available under your health care sharing ministry plan, which you acknowledged receiving, understanding and agreeing.  We dispute your characterization that the third-party sales producer, who again is not an employee of our organization, misled you.  In fact, it appears that maternity coverage is available under your plan just as the agent indicated, provided however, those maternity expenses are incurred after the ten-months that constitute your pre-existing condition period.  Again, you were clearly made aware of this common limitation.   
  
  Likewise, we reiterate that you indicated to the sales producer on March 28,  2022, that you understood the ******* Plan you purchased would not cover your pregnancy expenses as the plan requires a ten-month waiting period which you did not meet. Additionally, the same customer service communication notes also indicate that you admitted you had state maternity/childbirth coverage that your physician was not accepting, and the specialist scheduled to perform your husbands surgery also refused to accept your State Coverage.
  
  In sum, you were provided fulsome disclosures concerning the product you purchased and its limitations, and you had ample opportunity during the first thirty days of your plan to review the coverages and cancel if you were dissatisfied, which you elected not to do.  You have been treated fairly in this matter.  Again, Strata Health Group regrets that you did not find this product to your liking, but we assert that the evidence in this matter establishes you were treated fairly by our company consistent with our legal and contractual obligations. 
  
  Sincerely,
  
  ****************************
  General Counsel & Chief Compliance Officer

  Customer Answer

  Date: 09/05/2023

  I am rejecting this response because:   
  This company is the worst just like my doctors office said to me recently again when I spoke with them.

  1st you are completely wrong about my husband. When I was still working I had atena. My husband surgery was covered. When covid hit and I didnt have my coverage anymore my husband had a Followup appt. When it was time for his checkup to see whats going I had a state coverage on the website it said it took the coverage and I spoke with the assistant there who said they same thing. When we got there thats when they said the young lady wasnt correct and they didnt accept that insurance anymore.

  Thats one reason I got the insurance. Which I thought was a good through you and its not.

  2nd All the disclosures you keep talking about when I called to speak with rep who supposedly helped me ( which he didnt ****) I could never get him. I had questions and when asked I heard laughing at times, lying saying he wasnt there but he was, given a wrong number literally they gave me a number to an IRS supervisor who said her mailbox was full of complaintsHe does represent your company! At the end of the day he still picks up a phone or speaks to clients everyday to sell your products. He represent you!! I was calling to have someone explain to me about things and still no one mentioned that to me at all.
  

  I didnt hear anything about 10 months..that was never mentioned on the first callI would never have signed. If I called saying I want coverage because my husband and I are going to expand our family that should be the first thing said. 
  

  Also, when I spoke to another representative he said he didnt sign me up for the correct one and he ( ****) have been signing up a lot of people with the wrong coverages and supposedly is in troubledoubt it.

  3rd When I spoke to the other representative after I had my daughter thats when he tried to sell me the correct coverage through his partner he works with. I was sold the wrong coverage!!
  

  4th My doctors office even said that your company is very suspicious. They could never contact anyone and when they finally did it was a rep name ***** in October. When asked how is everything going to be process so they can get in contact with me to tell me whats going onGrace never gave her information on that just said its a questionnaire that has to be answered. My doctors office they never experienced before because other insurances doesnt do that. My doctors even said they would have let me know a long time to discontinue with you if they could have processed the claimed earlier to see if you were actual covering anything prior to the beginning visits. Every time I call my doctors office all they keep saying its the worst company ever. Never sign up with them again.

  5th You making pass judgements saying about my character which is false to cover up your horrible company because you dont want to take the blame on your end about what happened. 
  

  This shows proof that some companies shouldnt be present and this company is definitely one of them.
  

  Again, just want half or all my money back.

• Initial Complaint

  Date:07/28/2023

  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.

  For one year, beginning June 15, 2022, I paid $280 per month for my adult sons health care. We never found a doctor that accepted this companys benefits, however, they refused to let me cancel until July 2023 after collecting $3,000.

  Business Response

  Date: 08/02/2023

  ****************,
  
  On behalf of Strata, we apologize that you have not found the provider network associated with your adult sons ******* Essential plan to be useful.  This plan utilizes the **** network, which is one of the nations largest network of participating providers.  While you indicate that you were unable to find a participating physician in the course of a year, I was able to identify 158 family physicians and 114 internal medicine doctors within a 20-mile radius of your sons residence.  It is recommended that you consult with the ****s online search tool, which may be accessed at 
  **********************************************************, in the event you still encounter difficulty with securing services at one of these 272 providers, you still have the ability to submit the charges you incurred directly to the ******* Plan and be reimbursed personally.  For your convenience, I am attaching the needs sharing reimbursement form that needs to be completed and submitted to the plans third party administrator for claims payment, Cornerstone Resources.  If you have any questions about this process, your son is welcome to call Stratas **************** number.
  
  With regards to your claim that you were refused to cancel until July 2023, we respectfully disagree. Our communication records for your account reflect a call from you, and not your son, on September 06, 2022, at 1:00 p.m., at which time you were advised that due to federal healthcare privacy laws, we were not permitted to discuss your adult sons account with you, and he would need to contact our **************** Department to follow up.   Your adult son did not thereafter contact us to cancel.  Then on June 20, 2023, at 12:28 p.m., you e-mailed Stratas **************** Department seeking to cancel your adult sons account, at which time you were again advised that we could not discuss his account with you due to Federal privacy rules.  Your adult son subsequently e-mailed a cancellation request on June 28, 2023, at 9:34 a.m., and his cancellation was processed within 48 hours.  Any refusal to cancel the account was attributable solely to you not being an authorized party to access your adult sons account informationa reasonable restriction imposed by law of which you were expressly made aware on multiple occasions;  however, upon your adult son making the cancellation request, it was promptly honored.  No additional charges were incurred from the time of your sons cancellation request to the completion of the cancellation process.   Consistent with the terms of your sons contract, there is no entitlement to a refund of charges after the first thirty (30) days of the account, which right expired over one (1) year ago.
  
  Sincerely,
  
  *************************
  General Counsel & Chief Compliance Officer
  

• Initial Complaint

  Date:07/24/2023

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I researched multiple health care providers to ensure that my doctors would be covered and there would be a max out of pocket. I was told that I would be ensured with a PPO in 1st Health and that 5 of my doctors were all covered in network. I had to pay a $125 sign up fee and coverage was to begin July 1, 2023. I called today to confirm that my doctors were covered in network prior to scheduling a dr visit. They confirmed today that my doctors were NOT covered in network. I asked to cancel the coverage and receive a full refund for the signup fee and first month premium. After an hour on the phone they agreed to cancel, but not immediately (policy ends 7/31) and no refund. Luckily I paid via Amex so I have filed a dispute with Amex to not pay. The forms I received in the mail - none of the brands on the cards matched what the brands were when I spoke to the sales rep. ** health cards says ******* Elite Member ID *********, ABA Association Membership (same ID), and GlicRx. I had never heard of these brands as I was told FirstHealth was the provider. I want to file a complaint for misselling, misrepresenting the brand and that it is not actual insurance coverage and they do not have an obligation to pay the bills, and for lying to me about my doctors being in network prior to me signing up. I want a full refund of the $125 and the first month's premium. And I want them to be banned from misselling in the future. I had filled in the nygov health marketplace forms, and started receiving dozens of calls from insurance reps. **** should be illegal for non-valid insurance companies to call and represent themselves as selling actual health insurance. Thank you.

  Business Response

  Date: 08/02/2023

  Ms. *************** behalf of Strata, we are very sorry that you were dissatisfied with your account and believe you were not provided accurate information.  Please be advised that Strata is a general insurance agency and enrollment platform that does not engage in any direct-to-consumer sales;  rather, all sales on our platform are conducted by third-party independent contractors who generally (although not always) conduct sales for any number of agencies.  However, these agents and agencies are separate and distinct legal entities that are neither owned nor operated by Strata.  Nevertheless, we require the sales agents selling through our platform to provide accurate information to prospective customers concerning product coverages, exclusions and limitations, and associated costs.  
  
  You were correctly advised by your third-party sales agent that the particular plan you selected, ******* Elite, features a *** network through First Health.  Further, under your plan, you were entitled to seven (7) visits per member year for any combination of primary care, specialist, or urgent care, for which you had a Member Responsibility share of $45 (for PCP) or $75 (for specialist/urgent care), and whereafter eligible expenses would be shared up to $250 per visit.  However, your eligibility for coverage was not dependent on the usage of a First Health provider, although use of a First Health network provider would result in lower costs incurred and therefore the sharing made by the ******* Elite plan would obviously go farther.  First Health was indeed the *** network provider for the ******* Elite Plan.  Your attention is called to the attached copy of your membership identification card, which expressly notes the First Health Network next to the ******* Elite logo at the top of the card (which has been circled in red for reference).
  
  We respectfully disagree with your assertion that you were not advised you were purchasing actual insurance.  Your attention is called to the Enrollment Agreement that you received, read, and agreed to on June 19, 2023, wherein the following specific disclosures were made to you:
  
  -  Joppa Health Share is not an insurance company, and its product should never be considered insurance.  (Enrollment Agreement, p. 3)
  
  -  If an individual joins this organization instead of purchasing health insurance, they will be considered uninsured. (Enrollment Agreement, p. 3)
  
  -  Joppa Health Share is not insurance.  Joppa Health Share is a Healthcare **************** as outlined in the Patient ************************** Act. (Enrollment Agreement, p. 3)
  
  -  Membership in Joppa Health Share LLC, a Health Care **************** providing access to the sharing of medical bills within the community. This program is NOT insurance. (Enrollment Agreement, p. 3)
  
  Further, with regards to your assertion that you never heard of ******* Elite, the **** and GlicRx the *** these simply do not comport with the evidence in this matter.  In particular, you were advised of all of these entities and their various roles in the enrollment agreement that you reviewed and signed on June 19, 2023, wherein you attested to your understanding of same.  Over six (6) pages of disclosures were provided to you concerning ******* Elite, three (3) pages of disclosures were provided to you concerning the **** and one (1) page of disclosures were provided to you concerning the **************** plan that is offered through the GlicRx card you received.  Further, additional, detailed information concerning all of these components was made available to you as of the moment of sale through our electronic member portal.  In fact, you expressly attested to your understanding of these matters
  
  You agree to be fully responsible for reviewing your membership and/or plan materials carefully to ensure your full understanding of all provisions, conditions, limitations and exclusions.  (Enrollment Agreement, p. 1)
  
  - I agree that I have a full and complete understanding of the products for which I am applying. (Enrollment Agreement, p. 19)
  
  - I acknowledge that I have read and agree to the terms and conditions set forth in this agreement.  (Enrollment Agreement, p. 19)
  
  Again, Strata regrets that you were dissatisfied with your choice of plans, but we are committed to resolving the matter to your satisfaction.  Because you were within the first thirty (30) days of your plan, you are entitled to cancel and receive a full refund.  However, by filing a dispute with Amex, you have taken the matter out of our hands temporarily while the credit card company reviews your claims.  In the likely event that Amex denies your dispute, the funds will be released back to Strata.  At that time, please contact my office at *******,****************************, and I will be able to direct our ****************** to process a refund.
  
  Sincerely,
  
  *************************
  General Counsel & Chief Compliance Officer