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

• 

  Strata Health Group

  PO Box 310 McKinney, TX 75070-8136

• 

  Adroit Health Group /Impact Health limited medical

  PO Box 576 Arnold, MD 21012

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:07/18/2023

  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 was trying to look for healthcare coverage and I was contacted by someone named ****. Unfortunately, to my demise that wasnt his real name and it was revealed until AFTER my supposedly documents I received to my email, that I seen that I was lied to & that everything was fraudulent even down to my bank statement. After i immediately hung up, I decided to do some searching and found out that my suspicions were right and I called back immediately asking for a refund. I was told that I could not get a refund because it was already pre-paid but that didnt make sense due to **** legit companies giving you a certain amount of time to cancel. They refused to give me my $250.75 back and instead tried to force me to stay with them after telling them I no longer wanted their service. My trust is totally gone and Im still without the proper health insurance. DO NOT FALL FOR THIS COMPANY! THEY ARE CROOKS. I just want my money back, as I did call my bank to to get a replacement card and filed a dispute.

  Business Response

  Date: 07/19/2023

  ******************,
  
  Thank you for making Strata Health Group aware of the problems you encountered when trying to cancel your account.  Our company policy is to permit any customer to cancel their account during the first thirty (30) days for any reason and receive a full refund.  Based on our review of your account, it appears that you were not extended this courtesy, which is not acceptable to Strata.  We regret the way in which this matter has been handled thus far, but we hope we can better address the problems to your satisfaction now.
  
  A review of your account cords indicates that when attempting to cancel the account, you spoke with a relatively new customer service representative of the sales agency.  Strata does not engage in direct-to-consumer sales and, therefore, we do not employ any sales agents;  rather, all sales are conducted by third party independent contractors who may sell for any number of general agencies.  In many cases, these sales agencies also maintain their own customer service departments, which includes the staff member with whom you dealt.  Nonetheless, all of the agencies and their staff are required by contract to abide by our standards and should be acting accordingly.  

  Following receipt of your complaint, Strata reviewed the matter with the sales agency. The *********************** Representative with whom you deal, who advised that you were not entitled to a refund, has been terminated as of this afternoon.
  
  Further, earlier today I approved a refund off all charges that you paid on your account.  A refund in the total amount of $250.75 has been processed back to your credit card.  I have been advised that, depending on your particular financial institution, it can take up to five (5) business days before the credit appears on your card.  If you have not received the refund by this time next week, please contact me directly at *******************************************, and I will gladly follow up for you.  
  
  Please accept my sincerest apologies for the manner in which you were treated.  Your request should have been handled better, and we will work closely with the sales agencies to improve going forward.  Should you need anything further, please do not hesitate to let me know.
  
  Best regards,
  
  *************************
  General Counsel & Chief Compliance Officer

• Initial Complaint

  Date:07/18/2023

  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.

  In November 2022, I contacted Adroit Healthcare for Healthcare coverage. My one request was to keep my GP Doctor- **************************** I was assured she was covered by the plan. (screenshot showing she is a covered Dr). ******* made for coverage for 2023. At the End of *** 2023, I wanted to make an appt with *******************-- her ****** said that they did not accept my insurance. Multiple calls were made to Healthcare customer service number, back to my Dr's ****** and then calls between the **************** agents and my Dr's ******--by this time, we are well into February. Me still trying to get an appt and get this figured out. Documents being sent and calls being made. Finally, there was a resolution-- while my Dr was covered, because she bills through BJC, BJC will not accept the insurance?!!! What ? 1) no mention was ever made by anyone at Adroit that this could be a possibility--and the cust service agents were unaware also. I also talked to Supv (****) who agreed that info was not made clear to me. 2) I did as instructed, called my Medical Provider BEFORE my appt to make sure I had coverage. 3) I didnt need an appt until ***/Feb. At that point, my 30 days to decline coverage was over 4) and now, open enrollment was closed to me for alternate providers - Luckily, I still had Cobra as an option (a higher price option than if I been able to utilize Open Enrollment ).. but had to pay for Cobra AND Adroit for 2 months -- as Adroit would not refund my money as I was outside the 30day window. I am requesting a refund of payments made for *** and Feb 2023 (receipts attached) and am pursuing action with the State.

  Business Response

  Date: 07/19/2023

  Dear ****************,
  
  Thank you for making Strata aware of the problems you have encountered with the coverage of certain physician office visits under your NCE ************ Medical Plan. Based on our review of the matter, it appears that the sales agent did provide accurate information that ******************** was covered under the plan. Had you inquired about coverage for BJC, the correct information could have been ascertained and provided to you.  Therefore, we do not believe that the agency misrepresented coverages to you, but it does appear that all parties had incomplete information.
  
  Nevertheless, we must point out that, per the terms of your NCE ************ Medical Plan, there is no in-network requirement in order for payments to be made.  This plan is a fixed indemnity plan that provides fixed benefits for physician office visits consisting of $50 per day per insured person, with a maximum of 5 days per year, which can be used in any combination of primary or ***********************.  While there is a MultiPlan PPO Network, this network serves only to reduce the amount of the office visit for which the $50 benefit would cover.  However, as noted on page 4 of your enrollment agreement, the benefits included with the Accident and Sickness
  Hospital Indemnity Plan are not dependent on the use of the MultiPlan PPO Network.  Therefore, you would have been eligible to receive your $50 plan benefit regardless of whether the office visit was billed directly by ******************** or BJC.    
  
  Notwithstanding the foregoing, in recognition of the problems you have experienced, Strata has this date issued a refund of all charges for January-2023 and February-2023.  This refund shall not be construed, interpreted, or otherwise deemed as an admission of any fault or liability on the part of Adroit Health Group, LLC, and its affiliates, but rather serves only as a settlement, transaction, and compromise of a disputed claim.  Please be aware that, depending on your financial institution, it may take up to five (5) business days before the refund is reflected on your card.  If you do not see the refund by the end of next week, please contact me directly at *******************************************, and I will be happy to follow up.
  
  Best regards,
  
  *************************
  General Counsel & Chief Compliance Officer  
  

  Customer Answer

  Date: 07/19/2023

  I have reviewed the business response and accept this resolution. Thank you for your time and consideration. 

• Initial Complaint

  Date:07/14/2023

  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.

  $97.95 deducted from my bank account monthly for 7 months without any communication from Strata. No ID card, No policy in writing or email. Today, I had to go to my bank to figure out who was getting this money. I called Strata to find out what this money was for only to find out it was for an accidental death and dismemberment policy. I selected this coverage as part of my insurance package through the Marketplace in November 2022. I cancelled this coverage in December, and then again in January due to my employer's insurance automatically carrying over into the 2023 year. I did not need my own policy. I cancelled in January 2023 because I continued to have coverage after cancelling in December 2022. Today, I found out that I had to cancel this policy directly through Strata and not the Marketplace, which is why the money continued to be deducted from my account. I asked why I had not received any information from Strata in writing about these policies, any ID cards, policy numbers, etc. **************** stated ********************** does not send any information out to consumers in writing. How would I have known how to cancel this policy without information about the policy? The portal is of no use to me because I received no information about the portal until I made the call today. I was not able to access the portal to communicate with anyone because I had no information about my alleged policy, policy number, member or ID number, etc. God forbid I, or my designee, needed these policies! How would I have accessed the benefit I was paying for? This is a total money grab and scam, in my experience.I would love my $685.65 back, but seriously doubt that will happen. No claims on these policies were ever made.Please evaluate Strata's intentionally difficult, if not impossible, systems to navigate that hold their consumers hostage financially. Bank records available at BBB request.

  Business Response

  Date: 07/19/2023

  Dear ****************,
  
  Thank you for making our Company aware of your dissatisfaction with your Strata account.  Our records indicate that on October 06, 2022, you purchased an Accident Expense and Accidental Death and Dismemberment policy with an effective date of November 15, 2022.  We have no record of any other policies being purchased through our Company, and further, we do not participate in the healthcare marketplace.  It is surmised that you may have purchased other product(s)  with your sales agent, who is a third-party independent contractor and not an employee of our company.  Assuming this is the case, this other account has no bearing on your Strata account, and we would we have no knowledge of any purported cancellation of this other account.  
  
  Further, we respectfully disagree with your other allegations, which have no underlying factual support. 
  
  With regards to your statement:  $97.95 deducted from my bank account monthly for 7 months without any communication from Strata.  This is patently false.  To the contrary, you received twenty (20) e-mails from our Company from October 06, 2022 through June 08, 2022, including two (2) emails each month reminding of you of your upcoming payments sent seven (7) days in advance of each payment.  In particular, you received payment reminder communications from our company on the following dates:
  (1)   12/08/22 at 1:41 p.m.
  (2)   12/08/22 at 1:41 p.m.
  (3)    01/08/23 at 12:03 p.m.
  (4)    01/08/23 at 12:03 p.m.
  (5)    02/08/23 at 12:19 p.m.
  (6)    02/08/23 at 12:19 p.m.
  (7)    03/08/23 at 12:12 p.m.
  (8)    03/08/23 at 12:12 p.m.
  (9)    04/08/23 at 11:50 a.m.
  (10)  04/08/23 at 11:50 a.m.
  (11)  05/08/23 at 12:16 p.m.
  (12)  05/08/23 at 12:16 p.m.
  (13)  06/08/23 at 12:11 p.m.
  (14)  06/08/23 at 12:11 p.m.
  
  Unfortunately, our records reflect that you chose not to open many of these e-mails.  However, we note that you did open seven (7) of these payment reminders.  You opened and read communications on the following dates/times:
  
  (1)  01/09/23 at 10:39:41 a.m.
  (2)  04/09/23 at 9:32:01 a.m.
  (3)  04/09/23 at 9:23:30 a.m.
  (4)  05/09/23 at 8:27:42 a.m.
  (5)  05/09/23 at 8:28:30 a.m.
  (6)  06/11/23 at 2:33:13 p.m.
  (7)  06/11/23 at 2:33:51 p.m.
  
  Copies of the e-mails with details concerning when you opened them are enclosed with this response for the BBBs reference.
  
  With regards to your statement: No ID card, No policy in writing or email.  On October 07, 2022, you received an e-mail notification concerning the availability of the electronic member portal, which houses all plan information and member identification cards.  A copy of the portal notification e-mail that was sent to you is enclosed herewith.  Had you taken the effort to open the e-mail, you would have read the following:  
  
  Heres some important information about accessing your product information and important documents from the member portal. Please save this email so you can refer to it later.  You have 24/7 access to important product information and program documents via the Member Portal. Your login instructions are listed below. Please register to use the Member Portal as soon as possible using the link provided. NOTE: Most product documents and important information is only provided electronically from within the member portal.  If any of your product(s) enrolled include ID cards, digital ID cards are available in the member portal from the 'view and print' button next to the product name. The Member Portal is also a convenient way to update your contact information, view your payment history, update and change your method of payment or view your product enrollment information.
  
  With regards to your statement:  Today, I found out that I had to cancel this policy directly through Strata and not the Marketplace, which is why the money continued to be deducted from my account.  However, in your enrollment agreement signed on October 06, 2022, you were advised and in fact agreed that cancellations of your account had to be submitted in writing to our Company.  Your attention is called to the following on page 1 of your enrollment agreement:  You understand that this [billing] authorization will remain in effect until you cancel it in writing, and you agree to notify Adroit Health Group in writing of any changes in your account information or termination of this authorization at least 5 business days prior to the next payment due date.  To suggest that you had no knowledge of these billing requirements is simply not accurate and not supported by the facts.
  
  With regards to your statement:  How would I have known how to cancel this policy without information about the policy? The portal is of no use to me because I received no information about the portal until I made the call today. I was not able to access the portal to communicate with anyone because I had no information about my alleged policy, policy number, member or ID number, etc. God forbid I, or my designee, needed these policies! How would I have accessed the benefit I was paying for?  You were notified about the portal on October 06, 2022, in the enrollment contract that you signed acknowledging your understanding and agreement.  You were notified again in the portal notification e-mail received on October 07, 2022.  And thereafter, in each of fourteen (14) monthly payment reminder e-mails you received (and again, with at least seven of those e-mails having been opened and read), you were specifically advised as follows:  Should you need to update your information, please login to your member portal by visiting ******************************************** and select Update Your Information or Your Payment Method. View your current information and update any payment or personal information.  Accordingly, you were repeatedly advised of how to access the portal and the information housed within the portal.  
  
  In sum, ****************, you were fully apprised of the extent of your purchases through our Company, both at the time of sale and on an ongoing basis thereafter.  You had access to information concerning monthly payments provided to you on an ongoing, monthly basis.  You further opened and read certain of these e-mails on multiple occasions.  Therefore, you were provided complete and accurate information and had constant access to all account information.  For this reason, your allegations are without merit.
  
  We regret that you were not satisfied with your Strata account.  Because you cancelled your account significantly beyond the thirty-day lookback window, we are unfortunately unable to extend a refund. Nevertheless, we hope that you have found alternate coverage that sufficiently addresses your health care needs.
  
  Sincerely,
  
  *************************
  General Counsel & Chief Compliance Officer
  

• Initial Complaint

  Date:06/28/2023

  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.

  We were contacted by an agent from strata health to notify us that my insurance had an upgrade to it at a cheaper price. I agreed to the upgrade to change my GMember Insurance (Health Depot) at $331.00 to the now offered Strata Health at $321.85. It was understood at that time that the Gmember would be cancelled and the Strata Health would then be charging us. We never got new info on the insurance and I have reached out to the agent with no answer or replies to messages. So for months now we have been being charged for both and we have no policy information or anyway to cancel or any feedback whatsoever from Strat Health. The policy has never been used, and no way that I know of to cancel. We need a refund back for all payments to them beginning 7-5-2022 to 06-20-2023 (12 Payments) $3,862.20.

  Business Response

  Date: 07/02/2023

  ******************,
  
  Thank you for making Strata Health Group aware of your dissatisfaction with the products purchased through our Company.  Please be advised that Strata does not engage in any direct-to-consumer sales;  rather, we are a general insurance agency that makes certain insurance and non-insurance products available for sale by third party sales representatives through our enrollment platform.  It appears that the sales representative with whom you dealt was independent agent ***************************** out of ***************, *******.  With regards to the pre-existing GMember Insurance (Health Depot) plan that you reference, Strata has no record of any such plan under our platform.  Hence, Strata would have no ability to cancel that plan nor any legal obligation to do so.  Your complaint concerning non-cancellation is better addressed by the insurance agency responsible for the sale of (and therefore the cancellation of) the GMember Insurance Health Depot product you were attempting to replace.
  
  With regards to your assertion that you received no information on the new plan that you purchased, Strata respectfully disagrees.  In the 11 months that your Strata account was active, you received 33 e-mail messages.  All of these e-mails included specific information about how to reach our *************************** via a toll-free telephone number.  Despite your representations that you made multiple calls to ******************, your agent, you failed to make a single call to Stratas ***************************. Likewise, your assertion that you never received any information on your policy is also without merit.  Among the 33 e-mails that you were sent includes a notification concerning Stratas electronic member portal, which houses all of your policy documents, including member identification cards, plan certificates, and your agreements.  Your portal notification e-mail was sent on July 1, 2022 at 11:22 a.m., which was the exact same time your payment was processed.  A copy of the portal notification e-mail that you were sent is being provided as an attachment to this response.  This e-mail, along with the other 32 e-mails you were sent were all sent to the exact same e-mail address that you used for this Better Business Bureau complaint.
  
  In addition, our account records reflect that you or your wife accessed the electronic member portal on July 19, 2022, at 11:29 a.m.  The internet protocol address from which you accessed the member portal corresponds to the area in which you reside.  
  
  As a result, it is clear that Strata repeatedly communicated with you.  Further, these communications clearly and consistently advised you how to reach us.  Moreover, you were specifically advised of the existence of the electronic member portal, its contents, and how to access it in order to obtain any information you might need.  And in point of fact, you and/or your wife clearly used this information to actually log into the electronic member portal.  
  
  Furthermore, your attention is called to the enrollment agreement you executed on July 01, 2022.  Therein, we disclose that you had thirty (30) days to review your purchases and if you were not satisfied for any reason, you were entitled to cancel and receive a full refund.  During that first 30 days, you and/or your wife clearly accessed the electronic member portal and had the full and unfettered opportunity to familiarize yourself with all aspects of your account.  During that same time, you also received no less than three (3) e-mailseach of which included a specific, detailed disclosure concerning how to contact Strata **************** to obtain assistance and any additional information you might need.  Despite having that full thirty-day look back period and despite having the plethora of account information available to you, you failed to cancel the account or take any action to timely resolve your purported problems.  
  
  As a result, we must reiterate the following governing provisions of your enrollment agreement.  This contract specifically provides that you authorized recurring monthly payments, which will remain in effect until you cancel it in writing at least 5 business days prior to the next premium due date.  You were reminded of the forthcoming payment each month prior to your credit card being charged, and yet you again failed to notify us of any intention to cancel the account.
  
  Nevertheless, we note that you were provided a voluntary refund of your most recent months charges in the amount of $321.85 on June 26, 2023, at 1:10 p.m., although our Company was under no obligation to do so.  Based on the above and foregoing, Strata contends that you have been treated fairly in this matter and respectfully decline to refund you additional amounts under these circumstances.  We regret that you were dissatisfied with your Strata account.
  
  Kindest regards,
  
  *************************
  General Counsel & Chief Compliance Officer
  
  
  

• Initial Complaint

  Date:06/26/2023

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

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

  Answered:

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

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I was given false information and was not told important things. I was just trying to buy an insurance policy on the open market. I was not told the policy I purchased forced me to join a limited partnership with responsibilities and tax consequences. That alone is unconscionable. Here is a quote from the brochure I was sent:"Limited partners are liable for taxes on partnership revenues even if they defer distribution. Nevertheless, the partnership maintains a tax distribution requirement so that limited partners receive distribution of revenue in an amount necessary to cover their allocable income. The ******************* will provide a K-1 form noting earnings that have been distributed."Next - the person who said her name was ***** assured me this was identical to my current UHC plan. The plan she sold me is not even major medical. She assured me that a medicine I need, that had no generic equivalent, was covered. The paperwork said it was not. She also assured me that hospital stays were covered - the paperwork for all hospital items says 'Not Covered - 100% paid by member'. I could go on.I was lied to repeatedly and given the run around when trying to cancel. Please don't waste your time - and ask a lot of questions when you do buy insurance. She said she was a licensed agent so 'Buyer Beware'.

  Customer Answer

  Date: 06/27/2023

   

  I received a phone call regarding this matter and attached are the documents provided to me by the insurance company.

  Business Response

  Date: 06/28/2023

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

  Thank you for sharing your dissatisfaction with the health products you purchased from Horizon Health Solutions, LLC (Horizon).   Please be advised that our Company is a general insurance agency and we do not directly employ any sales representatives.  All sales are conducted by third-party independent contractors who generally (although not always) sell for a number of insurance agencies, including Strata.  Horizon Health Solutions is not owned or operated by Strata.  In fact, the plan that you cite in your complaint is not sold through Strata.  It appears that in addition to the products that Horizon sold you through the Strata platform, they also sold you a MEC limited medical plan from another agency.  This is not a product we offer.  The products you purchased through our company, and those for which we are responsible, were (1) Key Protector (Accidental Medical Expenses and Accidental Death and Dismemberment) and (2) Advanced Dental.  Neither of these plans have limited partnership requirements of the sort you identify in your complaint. The limited partnership provisions you cite are typically associated with Minimum Essential Coverage (MEC) plans, which again, our Company does not offer.  Our understanding is that the limited partnership provisions are required in order to permit you to gain group insurance benefits under the plan.  Based on our discussions with Horizon, it appears the particular MEC plan you purchased was Optimed, which is not a product that our Company sells and this particular sale was through another agency.  
  
  We are very sorry that aspects of a plan we do not sell has soured you on utilizing our services.  Our understanding is that you have already been reimbursed by Horizon for the $1028.56 you were charged to obtain Optimed.  Nevertheless, based on this misunderstanding, it appears that you also instituted chargeback on our unrelated charges on June 20, 2023,  when you cancelled the Optimed policy.  Ordinarily, because you are in the first thirty days following purchase, you would have qualified for a full refund;  however, the chargeback removes our ability to process a refund until such time as your financial institution adjudicates the dispute.  If you find the credit card company does not rule in your favor, we are happy to refund your payment as you cancelled within the lookback period.  Please notify us in the event the chargeback is denied by contacting *****************************, and we will process a full refund at that time. 
  
  If you do not see the refund or if you encounter any further problems, please feel free to contact my office directly at *******************************************. 
  
  Best regards,
  
  *************************
  General Counsel & Chief Compliance Officer

  
  

  Customer Answer

  Date: 07/07/2023

  I am rejecting this response because:   I received a phone call regarding this matter and attached are the documents provided to me by the insurance company.

  Business Response

  Date: 08/02/2023

  ********************,
  
  Thank you for the additional information you provided.  In your rebuttal, you provided a series of nine (9) documents that you said were provided by the insurance company.  Again, with the singular exception of the Notice of Privacy Practices (attachment number 9), none of these documents were prepared by, provided by, issued by, or have any connection whatsoever with our Company.  As previously detailed, it appears that the insurance sales agent with whom you dealt from Horizon Health Solutions sold you products through two different companiesboth our Company and a separate company, OptiMed, which is not our Company.  All of the information you provided in your rebuttal concerns the *** Plan from OptiMed, which again, has no connection whatsoever to Strata.  Conversely, you did purchase a dental plan and an accidental death and dismemberment plan through our Companybut these are not the source of the issues and problems about which you complain.  It is respectfully suggested that your concerns are better addressed to OptiMed, whose BBB page may be accessed at ******************************************************************************************************************************************************************************** regret that we cannot provide a more satisfactory resolution to your concerns.
  
  Nevertheless, as I previously offered, Strata was willing to issue you a refund in the event your chargeback dispute with your credit card company was unsuccessful.  Following the submission of your dispute to your credit card company, you have indicated that the bank found in our favor;  however, to date, we have not received notice of the determination and the charge is still unavailable to use to process a refund.  Please continue to monitor your account and advise the undersigned at ******************************************* when that charge is restored so we can facilitate a refund as promised.  
  
  Sincerely,
  
  *************************
  General Counsel & Chief Compliance Officer

• Initial Complaint

  Date:06/07/2023

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

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

  Answered:

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

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I went in for my knee on March 3rd 2023. Adroit Health refuses to share the bill & making me jump through hoops that even Allina Health has no idea what they're talking about. I've attached my bills & have left this membership after a yr as they didn't cover anything & refuse to reimburse me. So frustrating! Allina health said they had ab hard time contacting them as well & I believe it as whenever I call, it's a ***** min deal & then when I do get someone, they don't help me.

  Business Response

  Date: 06/16/2023

  ****************,
  
  Thank you for making Adroit aware of the problems you are experiencing getting your claims reimbursed. As you are aware, Adroit is a general insurance agency and is not the carrier, or in your particular case, the health care sharing ministry.  The health care sharing ministry plan you have is the ******* Essential Plan through Joppa Health Share.  Unfortunately, we have no authority over nor involvement with the review and determination of needs sharing requests by ***** and their third-party administrator, Cornerstone Resourcesboth of which are separate and distinct companies that Adroit neither owns nor operates.
  
  Following receipt of your complaint, we did contact ***** on your behalf and forwarded the bill that you had provided with your complaint in order to get an update on the claim status.  In turn, Joppa consulted with Cornerstone (who again processes all bills for their plans).  Their records reflect other bills that have been processed and reimbursed for you in the past.  However, the particular Allina Health bills you submitted fin your complaint were not in the Cornerstone system, meaning they were never submitted by the provider. Per Cornerstone, Allina Health has previously advised with regards to other plan members they do not work with health share plans.  After receiving the bill that we forwarded for you, Cornerstone advised that they would still need the diagnosis codes, the *** number for the provider rendering the services, and their tax identification numbers in order to process this need sharing request.  Per the terms of your policy, if the provider (in this case Allina) does not submit the bill, it is the members responsibility to obtain the needed information and provide it to Cornerstone.
  
  You may submit the required information to Cornerstone at the following address:  *******************************, Post Office Box *****, *******, *****, **********, telephone: ************.   
  
  In addition, for your convenience, I am enclosing a Member Reimbursement Form that Joppa provides in the event a Provider refuses any Assignment of Benefits, which you use to request sharing of medical expenses be paid to the you, rather than to the provider.  It is strongly suggested that you enclose copies of the outstanding ********************* with the requested information noted above along with the attached Member Reimbursement Form.  You may also access this form in the future through Adroit's online member portal.
  
  I hope that this information is helpful in getting your problems with Joppa Health Share resolved.  Please accept my deepest apologies for the problems you have encountered.
  
  Best regards,
  
  *************************
  General Counsel & Chief Compliance Officer

  Customer Answer

  Date: 06/19/2023

  I am rejecting this response because:   

  We tried submitting & they want these codes that I have no idea what they're talking about & neither does ****** that they referred me to? See below that I copied from your response. They make us run around in circles & we can't get anywhere with them! Sooooooo frustrating that I pay these monthly fees for the past yr & I go to get my knee checked out & I/we need to jump through hoops the get any reimbursement. These codes, again, we don't have a clue what they're talking about so how can we fulfill their request! I shouldn't have to do anything! 

   However, the particular Allina Health bills you submitted fin your complaint were not in the Cornerstone system, meaning they were never submitted by the provider. Per Cornerstone, Allina Health has previously advised with regards to other plan members they do not work with health share plans.  After receiving the bill that we forwarded for you, Cornerstone advised that they would still need the diagnosis codes, the *** number for the provider rendering the services, and their tax identification numbers in order to process this need sharing request.  Per the terms of your policy, if the provider (in this case Allina) does not submit the bill, it is the members responsibility to obtain the needed information and provide it to Cornerstone.

  Business Response

  Date: 06/28/2023

  ****************,

  I understand your frustration with the reimbursement requirements that your health care sharing ministry plan is requiring in order to share your expenses.  As previously relayed, our Company is only the general insurance agency who facilitated the sale, and we are not an insurance carrier (or in your case, the health care sharing ministry) nor are we the third party administrator for the plan responsible for making needs sharing determinations and issuing payments.  We have no access to your medical records or medical bills, and even if we did, we have no authority to direct Joppa or Cornerstone to take any particular action.  What we can do, and what we have already done, is make an inquiry on your behalf to obtain further information about the problems with the needs sharing requests.  Based on those conversations, we advised you that your provider did not submit the bills in question to them, and that those bills lacked certain essential information necessary to review the claim for payment.  If the provider can submit this information, Joppa and Cornerstone have advised that the needs sharing request can be processed.  If the provider refuses to submit this information as it appears they have done in the past, your recourse is to submit the needs sharing request directly and any amounts to be repaid will be sent directly to you.  You may obtain the member reimbursement form at any time through Adroit's electronic member portal. However, again, if Joppa and Cornerstone are going to process that needs sharing request--whether submitted by your provider or by you directly--it will be necessary to provide them the billing information they request. The facility can help you obtain that information.  I apologize that I can do nothing further for you, but I have exhausted all that I have legal authority to do in the present matter.  

  Best regards,

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

  General Counsel & Chief Compliance Officer

  Customer Answer

  Date: 07/03/2023

  I am rejecting this response because:   

   

    I submitted the paid bills. Why would I need to provide anything else & furthermore, ************* & I have no idea what these codes are that they're 

  referring too. This business is a scam & should be shut down from taking clients money & not performing on their end. 

  How would you feel if you were in my shoes? !

• Initial Complaint

  Date:05/17/2023

  Type:Order 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 TRIED TO CANCEL THIS TRANSACTION IMMEDIATELY AFTER HANGING UP AND REALIZING I HAD MADE A ERROR IN JUDGEMENT .THEY SEND YOU IN CIRCLES TO ONE CSR AFTER ANOTHER AND YOU ARE JUST CAUGHT IN A VICIOUS CIRCLE OF REPEATING YOURSELF .THIS IS NO DIFFERENT THAN ANY OTHER SCAM THAN A SCAM

  Customer Answer

  Date: 05/17/2023

  I closed my debit card and filed a dispute on 5/12/23 .Today I did receive my money. And recieved a cancellation notice via email .This business has disguised themselves as Obamacare insurance.They are no better than fraudsters .Glad to be done with them 

  Business Response

  Date: 05/17/2023

  Good afternoon, ************************,

  Thank you for making our company aware of the problems you experienced in cancelling your account.  You are entirely correct that you are free to cancel the account for any reason in the first thirty (30) days and receive a full refund.  I have examined your account records and it does appear that there was some back-and-forth between you and our *************************** and the agent-of-record who facilitated your account on May 11, 2023, and it does appear that one call appeared to have dropped.  The records also reflect that another voicemail message was left for you on May 12, 2023. 

  Nevertheless, I am happy to confirm that your account has been cancelled and a full refund in the amount of $415.90 was processed to your credit card of record this morning, May 17, 2023, at 9:43 a.m.  A copy of the receipt evidencing this refund is being attached to our response for your records.  I am advised that, depending on your particular financial institution, it could take up to five (5) business days (or sooner) before the refund is reflected on your bank statement.  If you do not see this on your account by this time next week, please feel free to contact me directly at ******************************** and I'll be happy to follow up for you.  Additionally, if you encounter any further problems, do not hesitate to contact my office.  I apologize for the frustrations you have experienced.

  Best regards,

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

   

  Customer Answer

  Date: 05/17/2023

  I have reviewed the business response and accept this resolution. 

• Initial Complaint

  Date:05/09/2023

  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.

  This place is a scam they took my money after refusing to send me medical cards and I Tried to get my money back for 30 days or more still nothing I AM VERY ******...

  Business Response

  Date: 05/09/2023

  Our company is in receipt of the complaint submitted to the BBB by Ms. ******* Means* and regret that she is upset with the handling of her account.  However, for the reasons that follow, we respectfully disagree that she has been treated unfairly.  
  
  With regards to the alleged refusal to provide medical cards, please be advised that Ms. *********** enrolled through our company on December 02, 2022, with an effective date of coverage of December 15, 2022.  Immediately upon enrollment, she was provided access to our electronic member portal, which contains temporary member identification cards that could be downloaded for immediate use.  She was specifically notified by e-mail of the availability of the member portal on December 02, 2022, and our records reflect that she opened this e-mail that same date at 10:04:19 a.m.  We note that this was the very same date that she initially enrolled.  This portal notification e-mail specifically addresses the availability of identification cards, which provides, in pertinent part: If any of your product(s) enrolled include ID cards, digital ID cards are available in the member portal from the 'view and print' button next to the product name.  A copy of this notification e-mail is included with our response for your reference.  Further, our account records indicate that Ms. *********** logged into the member portal on December 29, 2022, from 3:08 3:14 p.m.  Furthermore, we are also providing to the BBB a copy of the temporary member identification cards that were, in fact, made available to this consumer on December 02, 2022, and remained continuously available to her via the electronic member portal.
  
  With regards to the claim that Ms. *********** was entitled to a refund, again, we believe that she did not qualify.  While our members are generally allowed to review their account for a period of 30 days and cancel and receive a refund if dissatisfied, the first cancellation and refund request from this consumer was not received until significantly past this 30-day window, and in fact, we spent months trying to obtain valid payment information from you with no success.  Our account records indicate that the first contact received from the consumer regarding a cancellation or refund was not until late April of 2023.  In addition, in accordance with our contract, her commencement of a chargeback dispute with her credit card company resulted in the forfeiture of any refund rights that she might otherwise have enjoyed had they, in fact, been exercised timely, which we again contend was not the case.  We further note that Ms. *********** previously raised her objections with her credit card company in the payment dispute, which was ultimately decided in our companys favor.
  
  We sincerely hope that the BBB finds that this response adequately addresses the complaints raised by this consumer.  While we regret that we could not service her account to her satisfaction, we believe the documentation establishes that Ms. *********** was treated fairly in this matter consistent with the terms of our contract.  Should you require any further information regarding this matter, please do not hesitate to contact my office.
  
  Best regards,
  *************************
  General Counsel & Chief Compliance Officer 
  
  
  (* - Please note that the name used in this complaint is ***** but the name under which the consumer procured her coverage was Means.)
  

• Initial Complaint

  Date:05/01/2023

  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.

  After making an inquiry about ACA Marketplace health insurance in *********** I received numerous calls. I spoke to one of the unsolicited callers. He identified himself as *************************** from Strata, a TPA.He provided 3 possible options for insurance. One had a significantly lower premium than the others. I agreed to that. After signing up and agreeing to premium and sign up fee I received an email with the benefits outline and other information. I then noted that I had not been previously informed that this is a health sharing program, non-profit and **************** It also does not cover hospitalization. I made repeated calls and either no one answers and only music plays. If I did get a human to answer they always say they must transfer the call but always terminate the call. I will change my policy to another insurer. However, on the member page of the Strata website there is no capacity to discontinue the credit card assigned for payments. There is no contact for cancelling a policy. The phone message about contacting the company gives a hard-to-understand email address. I have notified the person who emailed me the benefits information so that it is in writing. I also filed a dispute with the credit card company and placed a block on Strata for any further attempts at charges.

  Business Response

  Date: 05/05/2023

  ********************,
  
  Strata Health Group ("Strata") regrets that you are dissatisfied with the ********************** share plan you purchased through our company.  Please be advised that Strata does not engage in any direct-to-consumer sales and we do not employ any sales representatives; rather sales are conducted by third-party independent contractors through our platform.  The sales agency with whom you dealt was Top Healthcare Solutions, LLC, which is neither owned nor operated by Strata.  Our agreement with all of these independent contractors, including Top Healthcare Solutions, LLC, requires that they provide prospective customers with truthful and complete disclosures about product offerings, coverage limitations and exclusions, and product costs. To the extent this was not your experience, we sincerely apologize.
  
  In order to ensure our customers understand what they are purchasing and to avoid potential misunderstandings about these important matters, Strata provides extensive disclosures in our enrollment agreement provided to the customer prior to sale.  You received your enrollment agreement on April 10, 2023, which you attested receiving, reading, and understanding. With regards to your claim that you were unaware that you were purchasing a Christian ********************** sharing product, we respectfully point out the following disclosures that were made in your enrollment agreement:
  
   1.  Joppa Health Share is a healthcare sharing ministry, a subsidiary of the National Hispanic ******************************* or NHCLC, based on a biblical model. (p. 2)
  
  2.  The purpose of Joppa Health Share is to bring Christians together in sharing Gods blessings and to share each others burdens. The concept of sharing is not new. For centuries, Christians all over the world have shared their lives, resources, and blessings as first outlined in the book of Acts. All the believers were united in heart and mind. And they felt that what they owned was not their own, so they shared everything they had. The apostles testified powerfully to the resurrection of the *******************, and Gods great blessing was upon them all." Acts 4:3233 (p. 2)
  
  3.  Joppa Health Share is not insurance. Joppa Health Share is a Healthcare **************** as outlined in the Patient ************************** Act. Each Joppa Health Share member is always solely responsible for the payment of his or her own medical bills. 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. Furthermore, no Member shall be compelled to make sharing contributions. If sharing occurs, the shared medical bills are paid by the Member that incurred the bill solely from voluntary contributions of Joppa Health Share Members and not from funds of Joppa Health Share itself.  (p. 2)
  
  4.  ******* HealthShare is NOT INSURANCE.  (p. 2, emphasis original) 
  
  5.  Joppa Health Share is a not-for-profit ********************** care sharing ministry program, and not a contract for payments or insurance. (p. 3)
  
  6.  I understand that this is not insurance; rather this is a ********************** 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. (p. 3)
  
  7.  I understand that it is my responsibility to review the Member Guidelines before receiving medical care. (p. 4) 
  
  Further, with regards to your claim that you were under the mistaken belief that hospitalization was covered under your plan, we must again respectfully disagree.  The enrollment agreement clearly outlines the coverages included under your plan, including preventative care, 4 doctors visits for primary and specialty care combined, urgent care, and lab and wellness discounts.  There is no reference to hospitalization coverage.  Further, as noted on page 2 of your agreement, the full list of specific services eligible for sharing, as well as limitations and restrictions were available to members in the Member Guidelines accessible via their member portal following enrollment. As you will note in the Member Guidelines, hospital expenses are expressly excluded from your plan.
  
  However, our company policy is to extend a thirty- (30) day period for customers to review their purchases during which time they may cancel and receive a full refund.  Our records show that you exercised these rights by cancelling on April 25, 2023, and a full refund of all charges ($309.85) was processed to your credit card that same date.  
  
  Strata sincerely regrets that the products you purchased were found to not sufficiently meet your needs, but hope that this refund adequately addresses your concerns. We remain committed, however, to working with you to identify the best options available for your needs in the future.  Please feel free to contact our *************************** at ************** at any time if there is anything further our company can do for you.
  
  Best regards,
  *************************
  General Counsel & Chief Compliance Officer

  Customer Answer

  Date: 05/06/2023

  I do recall that I had a printed copy of the policy or an email of the policy and do not find it in my email records.   I believe that Strata needs to reinforce with its third party to tell the truth.  The representative clearly told me it is insurance.  I did not know that hospitalization was not included until I researched and read a general policy on the internet.  I accept ************; response but feel intervention with Strata marketing is needed.

  Customer Answer

  Date: 05/12/2023

  I have reviewed the business response and accept this resolution. I do recall that I had a printed copy of the policy or an email of the policy and do not find it in my email records.   I believe that Strata needs to reinforce with its third party to tell the truth.  The representative clearly told me it is insurance.  I did not know that hospitalization was not included until I researched and read a general policy on the internet.  I accept ************; response but feel intervention with Strata marketing is needed.

• Initial Complaint

  Date:04/28/2023

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

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

  Answered:

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

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I have had coverage from this health share since october of 2020. I pay a monthly bill of ******. On April 24,2022, I had a surgical procedure to remove a cyst from back of my head. I was under the impression this procedure would be covered by this agency and the hospital accepted the coverage. I have contacted this agency at least 10 times inquiring on the payment of this claim. At first they wanted information about preexisting conditions. Then they said they were waiting for the hospital to respond. I recently received a bill from the hospital that payment was due of 20000$ for this procedure. This agency never paid this claim. I contacted the hospital and they informed me they have never been able to establish contact with this agency. The agency now claims they will pay 2500$ and the check is pending.

  Business Response

  Date: 05/03/2023

  ********************,
  
  Thank you for making our company aware of the problems you are experiencing with getting your claims paid by Joppa Health Share.  We are very sorry that you are dealing with such extensive delays. Please be advised that our company is a general insurance agency that makes certain insurance and non-insurance products (including health sharing ministry plans such as the one you purchased) available for sale by third-party agents through our enrollment platform.  However, we are not an insurance carrier nor are we a health sharing ministry.  Consequently, we have no authority for, nor any involvement in, the claims review, adjudication, and payment processes of the carriers/health ******************.  As you are aware, there are certain coverage requirements as well as limitations and exclusions on what is covered under your plan and how much the plan pays for such services.  However, we would have to defer to Joppa Health Share and their third party administrator, ********************** for those determinations.
  
  Having said that, upon receipt of your complaint, we did reach out to Joppa to express our concern with the delays on processing your bills.  Their records show that a total of five (5) bills have been submitted.  Three of those needs submissions were denied or around February 08, 2023;  however, we do not have any visibility into the reasons for the denials.  One of the bills (for $1850) was paid ($1465.20) on or about February 22, 2023, with check number 12061. The remaining bill ($27,507.01) appears to have been processed on April 03, 2023, and $2500 appears to have been paid (check number 14787) on April 22, 2023.  Again, we are not involved in the processing of needs by ***** and do not have any visibility into the bill that was submitted.  Therefore, we can only speculate as to the reason the reimbursement was limited to $2500.  Your attention is called to the ******* Program Member Guidelines that are accessible to you through our electronic member portal.  You have noted that the $25,000 bill related to a surgical procedure you underwent.  Per your plan guidelines, it appears that the maximum amount that can be shared for surgical services is $2500 per day.  Nevertheless, our assumptions as to the basis for the claim adjustment may not be accurate and/or there may be other reasons for the claim determination that was made, so we must defer to Joppa and Cornerstone for a more comprehensive explanation.
  
  For additional information concerning the status of your sharing requests and the reasons for particular payments or denials, you should contact ********************* at Post  Office  Box  68015,  *******,  *****,  **********, telephone: ************.  We further note that you have certain appeal rights in the event you believes these payment determinations are in error; however, her appeal rights are time sensitive, so we encourage you to timely submit any appeal to Joppa in accordance with the plan guidelines. You may access information regarding your appeal rights through the ******* Member Guidelines that is available through the online member portal.
  
  Again, we apologize for the delays you have experienced getting your bills paid by *****. Unfortunately, we have no authority and involvement in the payment processes.  Hopefully, this information is helpful and our inquiries on your behalf may have jump-started the process.  Please let me know if there is anything further my office can do to assist you.  You may feel free to contact me directly at *******************************************.  
  
  Best regards,
  
  *************************
  General Counsel & Chief Compliance Officer 
  

  Customer Answer

  Date: 05/03/2023

  I am rejecting this response because:   This is not sufficient payment for the 27,000$ medical bills that I have. Also the hospital has no record of this supposed 2500$ payment.

  Business Response

  Date: 05/25/2023

  We have previously advised and reiterate that our company is only the general insurance agency and is not an insurance carrier nor are we a healthcare sharing ministry.  Therefore,, we have no authority over nor involvement in the processing and payment of needs sharing requests by Joppa Health Share.  In order to get information concerning the payment of these needs sharing requests, it is necessary for ******************** follow up directly with Joppa Health Share and/or their third party administrator ********************** who may be reached at Post  Office  Box  68015,  **********************************************************, telephone: ************.  Further, in the event ******************** requires copies of the payment(s) issued for these charges, these records are not maintained by our company and may instead be obtained directly from Joppa and ********************* using the foregoing contact information.  Likewise, if ******************** believes the needs sharing requests were no properly addressed by ********************** there are certain appeal rights provided under the health share plan, and we urge him to pursue these rights in a timely manner.