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: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 signed up for a health insurance policy through this company. They cancelled the policy without my knowledge after one month and continued to bill me for ancillary products attached to the core policy. I am now outside the open enrollment period and cant sign up for another plan. There I have been charged for the ancillary policies for 3 months now...I have tried calling them numerous times to stop the charges but they refuse to stop and refue to refund my money for the ancillary services that are useless with the the core insurance policy. This may very well be a scam/fraud situation. I will be contacting a lawyer.

  Business Response

  Date: 04/28/2023

  ****************,
  
  Thank you for making our company aware of the problems you have experienced with your account.  As you are aware, on January 27, 2023, the carrier for the Association through which your group Limited Medical policy was written directing us that all such policies in ******** were required to be cancelled immediately as the carrier was no longer writing business in your state.  The cancellation determination was outside our control and we were obligated to comply.  You are correct that you had a number of other products purchased through our company in addition to the cancelled Limited Medical plan, including an Accident Medical Expense and Accidental Death and Dismemberment policynone of which was affected by the cancellation of the other policy, which again was outside our control.
  
  Our records indicate that you did speak to someone in our *************************** on February 27, 2023, wherein the continuation of all charges was specifically discussed, including the reason for the cancellation of the Limited Medical plan.  The account notes specifically indicate that you, want[ed] to make sure what [you] were charged for.  There was no indication at that time that you wanted to cancel the remainder of your plan.  However, we note that you were transferred to your sales agent for further assistance.  Your sales agent was ********************* with ********** Direct, LLC.  
  
  Because your cancellation was not in the first thirty (30) days of the contract period, nor was it in writing, we are under no legal obligation to issue you a refund.  However, being mindful of the significant change occasioned by the carriers cancellation of one of the major portions of your account so early-on, we believe the appropriate course of action is to extend a voluntary refund to you for the remainder of your account.  
  
  Therefore, this date I have directed our ****************** to issue a full refund of all charges incurred on your account.  This refund will be processed to your credit card on Monday, May 01, 2023.  Please be advised that, depending on your particular financial institution, it may take up to five (5) business days before the refund is reflected in your credit card account.  If you have not seen this refund within a week, please feel free to contact my office directly at ******************************************* and I will be happy to follow up.
  
  Sincerely,
  
  *************************
  General Counsel & Chief Compliance Officer 

• Initial Complaint

  Date:04/13/2023

  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.

  Company promised access to care and services that were not honored. I was enrolled in open enrollment in *******. I was told there would be a 30 day waiting. Period after my first payment before I could use my insurance. I paid this in February and was told I could not begin services until March. The interpretation I had was my insurance is not available to meet until March. Come to find out that it was actually retroactively created to start on ******* 1 of 2023. Again, remember I didnt even make a payment for insurance until February. So I was not even going to be able to use ******* time because it had gone by. Next, when, trying to use my insurance, things like co-pays for flu vaccinations, werent eligible to be reimbursed! I filed one claim in March thinking that I was able to have this claim approved because it was after the 30 day waiting. Period which happened in February. The claim was denied. It was denied because I didnt have coverage. But I thought I did because it was delayed. All in all adroit uses questionable sales tactics, is unclear to the customers what they are paying for, Their literature is opaque and difficult to understand. They are s******* consumers purposely.

  Customer Answer

  Date: 04/13/2023

  At issue is also their larger building practice. During open enrollment I registered with them. Late January I paid for the enrollment fee plus a sign on. I was told I must wait 30 days before I can use my health care which meant since it was almost February I could not use my for any services until March 1. The discussion then implied is that I was paying for insurance For the month of March. When I submitted my claims for services executed in March they were denied. I was told then when I called, that I did not pay for services in March. I also didnt pay for services in February. The money I spent was for services in JANUARY  Dash services I could not get obviously, because I would have to go BACK IN TIME this is my main issue they miss lead me with the understanding that I had a moratorium of services that I would have to wait for before they commenced, when, in actuality, I paid for a month that already had gone by .  Their sales staff was not clear, and they purposely, manipulated the conversation, steering me towards a product without being wholly transparent about how and when services would commence. Additionally, all information mailed to me, did not arrive to me until the end of February Dash I had no cards or anything, so again I assumed that my service period was starting March 1, that the money that I had paid that I could not use for 30 days was February so therefore the money that I had SPENT would be useable in March. And, accordingly, when I figured out what was going on in March, I stopped paying them.

  
  

  Also, I was signed up for life insurance that I did not ask for.

  
  

  All paper information that was sent said things like this is not insurance it did not come with the name adroit, for that matter, it didnt come with Strava. This company is playing a shell game with its customers by hiding who it really is, playing games in the health insurance market.

  
  

  I lost my job during Covid and have been unable to work. Im buying health insurance on a private market, so I can SURVIVE. This company is s******* people over who have no insurance by not being transparent about their services, start dates, costs, or accessibility , they should have their licensure to do so revoked.  

  Business Response

  Date: 04/14/2023

  
  ******************,
  
  Thank you for making our Company aware of your dissatisfaction with your Adroit/Strata account.  As you are aware, our Company does not engage in any direct to consumer sales, and we employ no sales representatives.  Rather, we are a general agency and enrollment platform that makes certain insurance and non-insurance products available for sale to the public by third-party independent contractors through our platform.  The sales agency with whom you dealt was ***************************** with Prime Healthcare Partners Insurance Agency, LLC, out of ***************, *******.  These third-party sales representatives typically (although not always) sell for numerous general agencies, including Adroit.  Thus, when you allege that our Company uses questionable sales tactics, we must respectfully disagree.  Regardless, our agreements with these independent contractors require that they provide accurate information to all customers regarding product offerings, purchased coverages, limitations and exclusions, and associated costs.  To the extent this was not your experience, we sincerely apologize.
  
  Nevertheless, because of the potential for miscommunication and to ensure our members have a thorough understanding of the products they are purchasing, we require that that the consumer is provided an enrollment agreement that details all of the products being purchased and contains important disclosures concerning coverages, limitations, and costs.  This enrollment agreement must be reviewed and signed prior to the account becoming active and prior to incurring any charges.  In light of your complaint, we have gone back and reviewed your signed enrollment agreement, which is still available to you through our electronic member portal.  We urge you to review this document also.  Therein, you will note:
  
  First, there is no reference to any 30-day waiting period.  However, there are limitations concerning pre-existing conditions and certain coverage requirements (namely, that you incur costs associated with covered accidents or covered sickness that are not otherwise expressly excluded under your plan documents, as you will note in the following point).  
  
  Second, the insurance product you purchased was a Group Accident and ***************** Indemnity Insurance Plan, and it does not appear to cover vaccinations.  The non-coverage is related to vaccinations not being a covered service, because again, as noted under your plan, this coverage provides benefits due to accidence and covered sickness.  Presumably a vaccination, by definition, is prophylactic in nature and not designed to treat an existing accident or illness.  As such, it would appear that this would not satisfy the coverage criteria of your plan.  We note, however, that Adroit is not the insurance carrier, and therefore, we would defer to the plan determinations of your actual insurance carrier.  However, if you believe their determination is in error, we note that you have certain appeal rights that you should pursue, but which are time-sensitive.  Hence, if you intend to appeal the carriers decision, please follow up with them directly as soon as possible.
  
  Third, the policy clearly and repeatedly states that the start date of your coverage was February 01, 2023. 
  
  Further, with regards to your claim that your paperwork lacked any reference to our business names of Adroit/Strata, again we must respectfully disagree.  Those names appears no less than twenty-one (21) times in your enrollment agreement, and also separately appears in the fulfillment materials containing your identification cards.  Within your enrollment agreement, which again you were provided prior to consummation of sale, the disclosure of our company name appears, as follows:
  
  Page 1one (1) time
  Page 2four (4) times
  Page 4one (1) time
  Page 6one (1) time
  Page 7one (1) time
  Page 8ten (10) times
  Page 13three (3) times
  
  Lastly, we respectfully disagree with your allegation that you were signed up for life insurance that you had not requested.  First and foremost, our Company does not offer any life insurance products through our platform.  Further, we have searched through your entire enrollment agreement and plan documents associated with the various products you purchased, and can find neither any reference to nor any charge for life insurance.  On some occasions, we are aware that the third-party sales agents *** sign up customers with other agencies for additional plans that we do not offer, so we cannot foreclose the possibility that this *** have occurred with regards to the sale by Prime Healthcare Partners.  However, we emphasize that any such life insurance product was not sold through Adroits platform.  Another alternative that we suggest *** explain your contention is that the Group Accident and ***************** Indemnity Insurance Plan that you purchased is provided by ****************** Security Life Insurance Company (******), whose name does appear in some of the product materials you were provided as required under state regulations.  However, we must point out that despite Life Insurance being part of AFSLICs name, it does not mean that all products that they offer are, in fact, life insurance.  If that is a source of confusion, we hope this explanation clarifies the name and coverage. 
  
  Nevertheless, while Adroit was not involved in the sales process, it is clear that there was a great deal of confusion associated with your account.  We note that the account has already been cancelled.  However, this date, I have approved a full refund of the charges you paid on the account.  Therefore, a refund in the amount of $394.90 will be processed to your credit card on Monday, April 17, 2023.  I am advised that, depending on your financial institution, it *** take up to five (5) business days before the refund is reflected on your statement.  If by end of week you have not received the refund, please feel free to contact me at *******************************************, and I will gladly follow up.  Please accept my apologies for the frustrations you have experienced.
  
  Best regards,
  
  *************************
  General Counsel & Chief Compliance Officer
  

  Customer Answer

  Date: 04/17/2023

  I have reviewed the business response and accept this resolution. 
  

  I am not a lawyer. I am a consumer. No comment after reading their counsels response to my complaint, is that you know full well what Im talking about. Youre a third-party agents are incentivized to sell insurance packages. Especially during the closing days of open enrollment, sales tactics are ruthless. Then, on the consumer side, its still aI am not a lawyer. I am a consumer. No comment after reading their counsels response to my complaint, is that you know full well what Im talking about. Your a third-party agents are incentivized to sell insurance packages. Especially during the closing days of open enrollment, sales tactics are ruthless. Then, on the consumer side, its still a pandemic.

  We are navigating a messed up health system that prioritizes profit making over clarity. To whit, Notwithstanding all of the comments from counsel defending themselves, it must still be pointed out that your materials and sales techniques are EASILY misread by consumers BECAUSE of the way they are written and designed. Counsel was able to point out all the times where it said where my program began. However, thats not what I heard. And if a consumer cannot understand whats going on mistakes will happen. And theres a simple simple solution: make your materials EASY TO READ.

  US MobileCounsel was able to point out all the times where it said where my program began. However, thats not what I heard. And if a consumer cannot understand whats going on mistakes will happen. And theres a simple simple solution: make your materials EASY TO READ.

  Consider, for example, what credit card companies were forced to do eventually because they were doing the same s***** practices - opaque legal jargon, 4 point font, asterisks and exceptions. Pages and pages of protections for the SELLER of the service that obscured the details and is made as such as a FEATURE to trip up, ensnare and cause more fees and less costs (usage) of the service. I believe their counsel here responded to my question of my start date by pointing out my service start date could be found in 14 places across nine different pages of a document they sent me. YET, no where was it printed in PLAIN LANGUAGE that was obvious.  And again thats on purpose. Its not a mistake. Its written that way, and again thats on purpose. Its not a mistake and its written that way.

  If you truly want to put your money where your mouth is then look at the materials that you send your consumers. Give them to a colleague or friends, and have them read them and see if they can understand what they say. They cant. Instead: why not this:

  Customer name
  Customer ********************** start date
  Current effective available policy COVERAGE period through to 

  etc  

  Now Im not a lawyer. And I dont have a time to nitpick through counsels response myself (im not getting paid to write those kind of emails, you are). So congratulations on your thorough response, you get to keep your job as their lawyer. that doesnt address however that these issues must be happening repeatedly.

  I appreciate that you would rather the problem of the confusion of the entire process. I do hope know that you will actually read what I put a bug here and consider implementing some of it into a practice that would aid your consumers. And if Adroit/strata would like feedback on how I would think a form could look better, hire me. Im serious. Dont just apologize - do some thing about the problem. 

  Thank you for your response and I accept the compensation refund.

  regards

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

• Initial Complaint

  Date:04/12/2023

  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.

  Strata health insurance charged me $155.00 for coverage on March 2023..a written contract was sent to me via text..phone number is not legit.

  Business Response

  Date: 04/12/2023

  Good evening, ****************,

  Thank you for making Strata Health Group ("Strata") aware of the problems you experienced with your account.  We have researched your claim that the number to which the enrollment agreement was sent was invalid.  However, the link that was sent in the text message containing your agreement was accessed and signed by a device bearing an internet protocol address ("IP address") corresponding to your residence in ********.  Therefore, we have no reason to conclude that the enrollment agreement was invalid.  However, because you cancelled your policy in the first thirty (30) days, pursuant to our company policy, you are entitled to receive a refund of the charges you incurred for this account.  Accordingly, I have this date directed our ****************** to process a refund ($154.95)  to the credit card on file for your account.  Please be aware that, depending on your financial institution, it can take up to five (5) business days before this refund is reflected on your bank statement.  In the event you have not seen the refund by this time next week, please feel free to contact me directly at ******************************** and I will be happy to follow up for you.

  Best regards,

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

  General Counsel & Chief Compliance Officer

  Strata Health Group

• Initial Complaint

  Date:03/29/2023

  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.

  I purchased a policy from this company March 21st 2023 from a third party sales agent. I didn't fully understand the policy was 'limited-benefit' plan. Once I realized that I knew this policy wasn't what I wanted and tried to cancel this policy the next day, March 22nd 2023. I called adroit health group's member service number. I told them I want to cancel my policy. The person on the phone then would transfer me to another person to help me with this process. Then, the person I was transferred to would try and talk me into keeping my policy. After saying no a few times, they finally caved and said okay. they would then ask for my information and say they have to transfer me again. However, this time I would not get to talk to another person, instead I would get disconnected. This process would repeat four more times on the day. I would get disconnected and have to start the **************** again. (I will like to add they gave me a number to call in case of a disconnection, but the phone would just ring until I get the message that this number's mail box was full and hang up) I wasted hours and hours trying to get someone on the phone to cancel a policy. Finally, on the fourth or fifth attempt, when I was transferred to the second person of this chain I told them what I have been through and that I wanted to just cancel this policy. He did his sales pitch (Which is fine) I refused and said no I want to cancel. He was going to transfer me again but I said no, I don't want to be put on hold. I asked to stay on the phone with him while he processed my cancelation. The person agreed. At the end of the phone call he said I would receive a email within the next 24 - 48 hours (a email I need to receive in order to finalize the termination of this policy) Im at the end of my 48 hour period and still no email. I don't trust the company to follow through. I want my policy canceled and I want my premium refunded since I should be in the ten day grace *******

  Business Response

  Date: 04/05/2023

  Good afternoon, **************,
  
  At the outset, please allow me to apologize for the challenges you have experienced in getting your account cancelled.  We generally try to involve the sales agent who was responsible for setting up your account because he/she is the agent-of-record.  Sometimes, when we do that, there are areas where the ball can get dropped, which is what appears may have happened here.  Regardless, it should have been handled quicker, and for that I am very sorry.
  
  I went ahead and confirmed with our ****************** that your account has been cancelled.  Our records reflect that a cancellation confirmation was e-mailed to you on March 27, 2023, at 7:56 a.m.  I also asked them to process a full refund of all of your charges in the amount of $474.85 has been initiated, which will process to the credit card that you provided at the time of sale. I am enclosing a copy of the receipt evidencing your refund this date.  Please be advised that depending on your financial institution, it may take up to 5 days before this refund is reflected on your bank account.  If you have not seen it by this time next week, please contact me directly at *******************************************, and Ill be happy to follow up.
  
  Please let me know if theres anything further I can do for you.
  
  Best regards,
  *******
  

  Customer Answer

  Date: 04/06/2023

  I have reviewed the business response and accept this resolution. 

• Initial Complaint

  Date:03/13/2023

  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.

  Around January 3rd this year I was very frustrated due to receiving an email from the state o* ******** *********** noticing me that my last year policy when up for this year 2023, in an 80%, I felt so anxious and frustrated so 2 days later the Jan 5 i grab my device and typing ****** *** for market place insurance number. 1800 # appears on the screen and a very nice female voice said yes to all my desperate questions- so very exited I ask the agent ? Can you help me looking for an affordable plan with my the same insurance company I had last year? She happily said absolutely she ask me few questions and go ahead and explane to me that she found the same plan for a ridicules better price, she sounds very positive so I do not hesitate to say yes! She said you just need to make a payment of $562 and and I'll add dental and vision coverage all in one package...
  I said yes and procede to share my credit & debit card info, my bank immediately send me a text asking if I authorize the payment and the agent told me to clic yes so I did authorize,
  Next I ask her when my policy will be effective ? she answers this month of January 15, so I felt a relief expecting my new insurance cards on the mail,
  
  Coincidentally Jan 15, I woke up sick serious with a UTI infection that makes me go to the immediate care nearby, front desk tell me no worries go this website as soon as you get your insurance,
  As soon as I felt better I did call the real state market place and ask for the status of my application,
  they told me there was no such application and alert me of fraud, also told me they never collect payments from applicants, I rechecked my mail and found nothing from insurance at all, I called my bank inquiring info of who collected the $562 on Jan 5, bank show me that was Strata health group, and provided me a contact number to request my money back, immediate contact to cancel and request my money back and my bank in******* a dispute for fraud as well,
  Strata health refuse to reimburse anything to the bank or myself,
  Hope you can help

  Business Response

  Date: 03/15/2023

  Dear Ms. ****** :
  
  
  
  Thank you for sharing your dissatisfaction with the health products you purchased from ******* ****** ********** *** ("*******"). Please be advised Strata Health Group ("Strata") is a general insurance agency that makes certain insurance and non-insurance products available to third-party agents for sale to associations and the public through our enrollment platform. However, Strata does 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. The third-party contractor who was responsible for the sale of your account was **** *** **** ******* ****** ********** **** *** ** *********** *******. Please note that neither Ms. *** nor ******* are owned or operated by Strata. Nevertheless, our contracts with these third-party agents, such as Ms. *** and ******* Health Solutions, obligate them to provide accurate and complete information to prospective customers concerning product offerings, their limitation and exclusions, and the associated costs. If this was not your experience, we sincerely apologize.
  
  
  
  Because of the potential for misunderstanding and miscommunication, we attempt to ensure our customers fully appreciate what they are purchasing in two important, additional respects. First , we provide an electronic enrollment agreement containing important disclosures pertaining to the products as well as their coverages, limitation and costs that must be reviewed and acknowledged prior to consummation of sale. At the time of enrollment, you were required to review this agreement and the disclosures and affirm your understanding of the agreement. Secondly, we provide our customers a thirty-day period within which they can review their purchases, and if dissatisfied for any reason, the customer is permitted to cancel the account and receive a full refund.
  
  
  
  Our records reflect that you signed the electronic enrollment agreement (which specifically states directly acknowledge that I have read and agree to the terms and conditions set forth in this agreement about your signature," and "I have a full and complete understanding of the products for which I am applying." on January 5, 2023, at 12:08:36 PM. At the time of your enrollment, you contracted coverages for limited hospital indemnity, accidental death and dismemberment, and a medical bill repricing negotiator, as well as certain other non-insurance benefits.
  
  
  
  As clearly noted in your enrollment agreement--in bolded, capitalized print: "******** ******** ********* ********* ** * ******* ******* ***** ********* ******* Your enrollment agreement also further declares, "the policy is not intended to be a substitute for medical coverage and certain states may require the insured to have medical insurance to enroll for the coverage." Other notable disclosures made concerning the limited nature of the products you knowingly purchased include the following:
  
  
  
  - "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." (emphasis original)
  
  
  
  - And a second time: "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." (emphasis original)
  
  
  
  - "This is not basic health insurance or major medical coverage and is not designated as a substitute for basic health insurance or major medical coverage. This is a Group Accident Only coverage that provides for limitations to the coverage."
  
  
  
  Hence, even if there was a misunderstanding with Ms. *** and ******* Health Solutions, LLC, that caused you to believe you were procuring more comprehensive care than you actually did, the disclosures in the enrollment agreement that you were provided prior to completing the sale, and the same disclosures that you attested to having read, understood, and agree clearly and repeatedly called this to your attention and made you aware of what you were purchasing.
  
  
  
  Nonetheless, as indicated above, we do provide customers an opportunity to review and cancel their account within the first thirty (30) days and receive a full refund of charges. Ordinarily, we would gladly extend this refund right to you under these circumstances. However, our records indicate that you initiated a chargeback through your credit card company for the charges that you had paid to Strata. Therefore, the matter has been taken out of our hands and we are unable to issue you a refund until such time as your financial institution makes a determination on your dispute. In the event you are unsuccessful with your chargeback dispute, please contact my office and we will arrange for you to receive a refund of your charges. Please be advised that, depending on your financial institution, it may take several months before they can adjudicate your dispute. For this reason, we always advise members to contact our Customer Service Department with any problems they may have, rather than filing a dispute with the bank or credit card company, as we can often resolve problems faster than through these alternate channels.
  
  
  
  Regardless, assuming your dispute is unsuccessful, we will still honor our commitment to issue you a refund due to your earlier cancellation.
  
  
  
  Strata regrets that you did not find your hospital indemnity, accidental death and dismemberment, and other non-insurance plans to your liking. If you have any further questions, please feel free to contact my office at *************@benefitadmins.com.
  
  Best regards,
  
  
  
  ******* *****
  
  General Counsel & Chief Compliance Officer

• Initial Complaint

  Date:11/30/2022

  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.

  Complaint is between 2 companies & affiliates as follows: Strata Health Group********************* XXXXX, *********************** XXXXX-*****, MN XXXXX-XXXX, ************* XXX-XXX-XXXX, Health XXXXXXXXXX, & ****************.
  Under ******: I received a call from ***** ****** who sold this "health insurance policy" as was stated in the phone call on 12-15-2021 w/an effective date of 01-01-22 under *********************** A 14 pg contract was sent via a timed email to be electronically signed. The first time; I took too long to sign & the email was resent. Timed amount is 1 minute 30 seconds. There's no way to have read the contract in its totality in that time & the pressure from ********** to sign "to keep the pricing" was big. I needed health insurance. My payments were as follows: 12-20-21 $677.79, 02-02-22 $552.79, 03-02-22 $552.79, 04-04-22 $552.79, 05-03-22 $552.79, 06-03-22 $552.79 totalling $3,441.74. I went to the Doctor, had various tests performed; my bills incurred have not been paid. I am currently in collections. I first went direct to ****** to discuss cancellation of this "policy" & a refund. There was no cooperation received. I was hung up on & transferred to a "manager" which had me on hold for 45 minutes with no pickup. After receiving no resolution with ******; I went to my bank to file a dispute for the above charges; including additional charges placed by Strata, & **************** for a contract previous. We were denied by the bank on the dispute; because we signed a contract. While I did; I have not received any of the services, it was not as described in the sales call & was misrepresented. My bank advised I had to go back to ****** direct. I did & was told that I no longer qualify for a refund because I disputed it with my bank. ****** states this is in their contract; however I cannot find this.
  The charges taken out by Strata, ****************** total $6,778.04. For all this money, I could have gotten real insurance.

  Business Response

  Date: 03/14/2023

  Business Response /* (1000, 5, 2022/12/14) */
  Mr. ********,
  
  Thank you for making ****** Health Group ("******") aware of your experience with our agency. Please be advised that ****** is a general insurance agency only. We are not the actual insurance carrier, and therefore, we are not in a position to adjudicate claims or process payments. The appropriate entity for you to raise concerns regarding coverage decisions and payments is ***** ************ and/or its third party administrator, *******************************, which may be reached at Post Office Box XXXXX, ******** ****** XXXXX-XXXX, telephone: ************* They can provide better information concerning the status of your sharing requests and any reason(s) for delays or denials of reimbursement. In addition, please be further advised that ****** does not directly employee any sales agents; rather, all sales and marketing are conducted by third-party independent contractors who are not owned by, operated by, or otherwise affiliated with ******* For your account, our records reflect that the sales agency was *******************************. Our agreements with these third-party contractors (who generally, although not always, conduct sales for a number of agencies including ******* require that they provide accurate and complete information to prospective customers concerning product coverages, limitations and exclusions, and associated costs. To the extent this was not your experience with *******************************, we sincerely apologize. For this reason, and to avoid any misunderstandings, our practice is to provide ample disclosures of the products that are being purchased in advance of the sale through the enrollment agreement that you reviewed and signed on December 15, 2021. Therein, you were provided ample disclosures about the coverages (and limitations and exclusions attendant thereto) available under the ******* ************ sharing plan you purchased. We should also note that this agreement, which you expressly acknowledged receiving and understanding contained not less than four (4) separate disclosures indicating that you were not purchasing comprehensive insurance.
  
  With respect to certain of your complaints, we offer the following responses:
  
  1. Regarding the alleged timing out ofThere is no "time-out" feature on the signature and execution components of our electronic documents. The only timing feature in any of our processes is an expiration for accessing the document's details, but this occurs 48 hours after the time sent to access the document. Because your contract was completed on the same day, this expiration feature would not have been triggered.
  
  2. Regarding the alleged pressure to complete the applicationAs reflected in your enrollment agreement, all ****** customers are afforded thirty (30) days to review their purchases, and if dissatisfied for any reason, to cancel and receive a full refund. You did not avail yourself of this right.
  
  3. Regarding not being able to access your account informationA copy of your signed enrollment agreement is available for review/download in its entirety in the ****** member portal. Using this portal, all members may read, review, dissect, etc., all details concerning their account. Additionally, the member portal contains important member documents, such as the ***** *********** Member Guidelines applicable to your account, as well as member identification cards. These are always listed in the member documents section of the member portal.
  
  4. Regarding ******************************** is NOT a company that ****** sells or represents. We do not have any relationship with them. Therefore, we are not in a position to comment or explain any charges that you may have received from them or for their plans. Further, you indicate that you have an address for ****** corresponding to ****** ********** However, this is not a place of business or address that is tied in any way to our company. It is surmised that perhaps you purchased additional insurance or non-insurance plans through ****** ********** ********* **** or another agency that are not part of the ****** platform. If so, we would respectfully direct your inquiries and complaints concerning **************** to those other entities, who again, are not associated with our company.
  
  5. Regarding allegations that claims are not being paidAs previously indicated, all matters involving the adjudication and payment of claims are controlled exclusively by ***** ************ and ****** has no authority or even ability to review claims. However, upon receiving your complaint, the undersigned reached out to ***** in an effort to expedite a favorable resolution of the problems for you. We have been advised by ***** that there is no record of any needs requests being submitted by you or any health care providers on your behalf. They also have no knowledge of anything having to do with **************** either. While ***** will pay your providers directly for needs that are shareable pursuant to their member guidelines and your policy terms, if a particular provider does not accept ****** you are still entitled to submit the needs request directly to ***** and, subject to the guidelines and terms of contract, they will reimburse you for those approved medical expenses. You may submit sharing needs requests to Joppa at the following address:
  
  *********** ********* *********
  PO Box XXXXXX
  Houston, TX XXXXX-XXXX
  Payor ID: *****
  
  On behalf of ******* we regret that your experience with our company has not been positive. We sincerely hope that the above and foregoing information is helpful as you work to have your outstanding claims addressed.
  
  Best regards,
  
  ******* *****
  General Counsel.& Chief Compliance Officer
  ****** Health Group, LLC

• Initial Complaint

  Date:11/01/2022

  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 need help getting refunded. Last month I was told on 9/9/22 my policy would be ending, but it didn't and I was charged another month. Chante never cancelled the policy, and never followed up as promised and never escalated my case to get a refund.
  
  I had a policy since January paying $387 and this company did not cover breast pumps with the 70% repricing or my emergency room care. These were the two things I told Kevin needed to be covered when signing up for this policy and I was fraudulently sold a policy that did not do either. I was told this was PPO insurance and then when I submitted to billing I find out it is actually a "limited benefits plan" - the company claims they cannot help you because you have 30 days to get a refund but you can't even go to a doctor and get a bill and find out these issues within 30 days.
  
  They are underinsuring clients, charging them the same they would pay for a high deductible plan with a legitimate company like Blue Cross Blue Shield and labeling their services as PPOs even though the plan does not act as a PPO when you submit something to billing. They claimed my emergency room bill was not coded as an emergency room visit even though it says "emergency room" directly on the bill I received in the mail.
  
  It is almost illegal to not cover breast pumps under the Affordable Care Act and yet this company didn't. They are not a grandfathered company (the legal exception) but they waste hours of your time giving you contradictory information and the providers they have listed as "in network" on their website are not and when you contact them or no longer even exist when you search for them on Google.
  
  They refuse to connect me with someone in the legal department to get the $387 I paid for 10 months totaling $3,870 refunded. This company has lied to me multiple times and not honored what they were supposed to cover ie breast pumps and emergency room care (I have recorded the calls but those files are not able to upload)

  Business Response

  Date: 02/23/2023

  Business Response /* (1000, 7, 2022/11/16) */
  Ms. *******,
  
  Thank you for sharing the problems you have experienced with the products you purchased through Adroit Health Group ("Adroit"). With respect to your complaints about coverage d****minations particularly regarding emergency room claims and breast pump coverage, Adroit is obligated to defer to the insurance carrier's coverage decisions. Please be advised that Adroit is a general insurance agency only, and we are not the carrier. As such, Adroit has no responsibility for or involvement with the adjudication of claims or coverage d****minations.
  
  With regards to your allegations about fraudulent sales, we certainly take these claims very seriously. Be advised that Adroit does not directly employ any sales agents; rather, all sales are conducted by third party independent contractors who typically (although not always) sell products for a number of insurance agencies including Adroit. Our records indicate that the sales agent who worked with you on the sale was Horizon Health Solutions, which is not owned or operated by Adroit. However, our contracts with all agents who sell products for Adroit requires that they provide accurate and complete information concerning all product offerings, limitations, and costs. To the extent that this was not your experience, we sincerely apologize.
  
  However, there are several steps we take to ensure that consumers are fully apprised of what they are purchasing. First and foremost, before any account can become active and any amounts charged by Adroit, customers must receive, review, and execute an enrollment agreement. This enrollment agreement contains ample disclosures about the products that are being purchased. You purchased a Limited Medical and Accidental Death and a Dismemberment, Accident Expense, and Critical Illness productwhich, as the names indicate, are both limited in their scope of coverage. As such, your reliance on the Affordable Care Act is misplaced. Your enrollment agreement for these products was received, reviewed, and executed on December 9, 2021, at 6:16 p.m. This document contains numerous disclosures that are inconsistent with your present contentions, including:
  
  (1) "I acknowledge that IDEALCARE IS A LIMITED BENEFIT HEALTH PLAN. Benefits are not intended to cover all medical expenses." (Enrollment Application, p. 3, emphasis original)
  
  (2) "I understand this is not a qualifying health coverage ("Minimum Essential Coverage") and will not satisfy the Health Coverage Requirements of the Affordable Care Act." (Enrollment Application, p. 3)
  
  (3) "You understand that the coverage applied for provides limited benefits and is not a major medical or comprehensive medical benefit plan and is not a substitute for such coverage. The Policy is limited and is not designed to cover all medical expenses." (Enrollment Application, p. 4)
  
  (4) "You understand that there are additional exclusions and limitations contained in the policy and you will have 30 days to review the terms and if you are not completely satisfied you can return it for a full refund." (Enrollment Application, p. 4)
  
  (5) "THIS COVERAGE DOES NOT MEET THE MINIMUM STANDARDS REQUIRED BY THE FEDERAL HEALTH CARE REFORM LAW." (Enrollment Application, p. 4, emphasis original)
  
  (6) "THIS POLICY PAYS BENEFITS FOR SPECIFIC LOSSES FROM ACCIDENT ONLY. IT DOES NOT PAY BENEFITS FOR LOSS CAUSED BY SICKNESS OR DISEASE." (Enrollment Application, p. 7, emphasis original)
  
  (7) "THIS IS CRITICAL ILLNESS INDEMNITY INSURANCE COVERAGE. THE POLICY PROVIDES LIMITED BENEFITS. THIS IS NOT A SUBSTITUTE FOR MAJOR MEDICAL COVERAGE." (Enrollment Application, p. 7, emphasis original)
  
  (8) "THIS IS NOT MEDICARE SUPPLEMENT COVERAGE. IT DOES NOT FULLY SUPPLEMENT YOUR FEDERAL MEDICARE HEALTH INSURANCE." (Enrollment Application, p. 7, emphasis original)
  
  (9) "This is not basic health insurance or major medical coverage and is not designated as a substitute for basic health insurance or major medical coverage. This is a Blanket Accident and Group Critical Illness insurance that provides for limitations to the coverage." (Enrollment Application, p. 7)
  
  (10) "I acknowledge that I have read and agree to the terms and conditions set forth in this agreement." (Enrollment Application, p. 11)
  
  
  The second **** we have in place to help protect our customers is affording them a 30-day period to carefully review all aspects of the products that have been purchased, and if dissatisfied for any reason, allowing them to cancel and receive a full refund. In the present matter, you were afforded the full 30-day review period and you did not elect to cancel. Further, our communications records indicate that you were advised at early as February-2022 that there was no maternity-related coverage on your account, yet you maintained the coverage without cancellation until October-2022. In sum, our review of your account evidences that you were fully apprised of the limited nature of the products you were purchasing and you were afforded a fair period to review and cancel, and as such this matter has been handled fairly.
  
  Nevertheless, because of the problems you appear to have had with respect to your cancellation process, I have asked our Billing Department to issue a refund of your last month's payment in the amount of $387.90. This is not to be construed or deemed an admission of any fault or liability on the part of Adroit Health Group, LLC, and its affiliates, and is solely a transaction and compromise of a disputed claim and gesture of good faith. I am advised that it may take up to five (5) business days before this may be reflected on your credit card statement. However, if you have not received the refund in the next week, please feel free to contact the undersigned at jeffrey.j****@benefitadmins.com.
  
  Adroit sincerely regrets that you were unhappy with this transaction.
  
  Best regards,
  Jeffrey J****
  General Counsel & Chief Compliance Officer
  
  
  Consumer Response /* (3000, 9, 2022/11/21) */
  (The consumer indicated he/she DID NOT accept the response from the business.)
  There is no way to understand if what was sold to you incorrectly by the sales team is inaccurate or not until you try and use your service and submit to billing. They label this plan as a PPO which you pay more for but when you search for providers in network the search results are closed businesses on Google that this company are still listing as multiple in network options. I have emails I would like to forward to your site to help remedy this issue. The process of discovering these fraudulently advertised in network providers can take more than 30 days to discover. I have multiple recorded phone calls with inaccurate information that are too big to upload here, please let me know where I could send hour long phone conversations. When you explicitly tell the agent helping you sign up for coverage you only have two purposes for needing coverage and the plan they sell you covers neither it does not matter how many legal loopholes they cover themselves with, they are lying to customers and taking advantage of people that do not understand the billing distinctions between different plans. This company because they have been so dishonest to deal with. Only after reaching out to the BBB did they finally refund one month to me. (When they claimed there was no email, department or way to receive a refund) They also claimed there were no notes on file that I had requested my service be cancelled a month prior to when it was (hence the 1 month refund) now when I get the BBB involved suddenly they have information to remedy one of their many errors in billing and providing coverage that matches the claims of their coverage. Please let me know how I can forward emails and submit my voice recordings.
  
  
  Business Response /* (4000, 11, 2022/11/29) */
  Please be advised that the products you purchased were all fixed indemnity plans that paid specific amounts to the Member (you) in the event of a covered event (i.e., accident, critical illness, or accidental death and dismemberment). While with certain of these products, there is a PPO structure in place, the use of an in-network provider is NOT required to obtain the fixed indemnity benefit; but rather, the PPO structure relates solely to the availability of discounts on the charges you might incur that are offset by the fixed payments you receive from your coverage(s). In other words, using a PPO network provider would not affect your eligibility to receive the fixed payments under your policy(s).
  
  Any alleged misrepresentations were not made by our company as the sales agent with who you dealt is a third-party independent contractor. As previously explained, in order to ensure that customers do not have any misunderstanding about these plans, we provide extensive disclosures of product coverages, limitations and exclusions, and costs in the enrollment agreement. Again, we reiterate that there were at least ten (10) clear disclosures of the limited nature of the products you were purchasing that were provided PRIOR to your enrollment in these plans, and you were, in fact, afforded thirty (30) days to review those plans to ensure they satisfactorily met your needs. Thereafter, you clearly became aware of the non-coverage of many of the expenses about which you now complain based on your inquiries of our Customer Service Department, yet you knowingly continued with the plans for many months thereafter when you could have cancelled. While we are under no obligation to refund any amounts under the circumstances, we did extend a refund of one month's charges in light of your history as a valued customer. We are sorry that this gesture is still not acceptable, but must stress again that you were fully informed of what you were purchasing and given the full opportunity to review and cancel the account.

• Initial Complaint

  Date:10/31/2022

  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.

  Paid 309.85 for Aetna medical (and other) health insurance. Billed cc as "Adroit Health Group" (website say, "In California, dba as Adroit Insurance Solutions, LLC, License #XXXXXXX")
  Neither my insurance card nor digital access arrived as promised.
  My portal also does not have this information after signing in.
  My agent's phone number has been disconnected.
  Calls to Adroit that are answered have no information then transfer me to another number.
  - Calls to or transfer to that number keep me on hold for 30 min then disconnect.
  - VM's to other Adroit numbers are not returned

  Business Response

  Date: 02/06/2023

  Business Response /* (1000, 5, 2022/11/14) */
  Mr. ********,
  
  Thank you for making Adroit Health Group, LLC ("Adroit") aware of your unsatisfactory experience. Please be advised that Adroit is a general insurance agency, and we do not engage in any product sales. Rather, all sales are conducted by third-party independent contractors who generally (although not always) sell product for a number of agencies, including Adroit. Our records indicate that the sales agent responsible for your account was Ryan O****** with Top Healthcare Options Insurance Agency, Inc., which is neither owned nor operated by Adroit. Mr. O******'s agency may be reached at either 866-439-6595 or via e-mail at [email protected]
  
  With respect to your specific complaints, you have stated that you were unable to timely obtain a copy of your membership identification card, and your efforts to contact both Adroit and your agent were futile, as you sat on hold for long periods of time, were transferred, and voicemails were not returned. I have reviewed all communication records related to your account. First and foremost, you were e-mailed information concerning your temporary identification card three (3) minutes after you signed the enrollment agreement on October 20, 2022. In this welcome e-mailwhich our records indicate you never openedthe following information concerning your membership identification cards was provided: "... digital ID cards are available in the member portal from the 'view and print' button next to the product name." A copy of this e-mail, which was sent to the same e-mail address that you entered in this BBB complaint, is provided again herewith for your review. Our records also reflect that you accessed this member portal multiple times on October 31, 2022, and November 01, 2022.
  
  With respect to your concerns regarding not being provided ready responses to your inquiry, Adroit's communication records indicate that the first contact we received from you concerning the account was on October 31, 2022. It does appear that the Customer Service representative attempted to put you in contact with your agent of record. If they were unable to respond to you in a timely and satisfactory manner, we sincerely apologize. However, it should be noted that Top Healthcare Options Insurance Agency, Inc., is located in Deerfield Beach, Florida, which had been dealing with certain communication disruptions related to Hurricane Ian.
  
  Additionally, your complaint also references that you believed you were purchasing Aetna insurance, which is not what you were ultimately provided. Our agreements with sales producers such as Mr. O******, require that they provide prospective customers with truthful and complete information concerning products, limitations, and costs. If this was not your experience, we are likewise concerned and, as indicated below, will endeavor to make you whole. However, for this reason, the enrollment agreement you were presented and signed contains numerous express disclosures that the products you are purchasing are not insurance. These disclosures included the following:
  
  (1) "Joppa Health Share is not insurance. Joppa Health Share is a Healthcare Sharing Ministry as outlined in the Patient Protection Affordable Care 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 Member's medical bill, or (b.) assumes liability for the payment of a Member's medical bill."
  
  (2) "This program is NOT insurance." (emphasis original).
  
  (3) "Bethany HealthShare is NOT INSURANCE." (emphasis original).
  
  (4) "Joppa Health Share is a not-for-profit health care sharing ministry program, and not a contract for payments or insurance."
  
  (5) "I understand that this is not insurance; rather this is a health care sharing ministry ..."
  
  
  Notwithstanding these disclosures, if you believe that the product was misrepresented by Mr. O****** and you wish to cancel the account, please contact my office and I will be happy to facilitate the cancellation, at which time, we will provide a full refund of the charges you paid. Should you wish to pursue this remedy, please send an e-mail to jeffrey.j****@benefitadmins.com. Please note that your account remains active and the next payment will be due on or about December 01, 2022, so if you desire to cancel, please contact us at least several days prior to the next billing date.
  
  Adroit sincerely regrets that your experience with our Company was not more positive. Please accept my apologies and feel free to contact me if you experience any further problems.
  
  Sincerely,
  
  Jeffrey J****
  General Counsel & Chief Compliance Officer

• Initial Complaint

  Date:10/28/2022

  Type:Customer Service Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

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

  Answered:

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

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Jan 10th, 2022, I went to the emergency room with Covid symptoms, they gave me a Covid test and sent me home with a prescription. The next day , Jan 11, I was back in the emergency room with severe covid like symptoms. The doctor advised me I had Covid based on the test they took yesterday. Gave me anotehr prescription and a bottle of oxygen and sent me home. That night, my temp was 104 and my oxygen levels were 69%. I went to a different emergency room and they admitted me, and within 12 hrs, I was in a coma and on a ventilator fighting for my life. I was in a coma and on a ventilator for 21 days in ICU. I came out of the coma and remained in the hospital until Feb 9th my discharge date. I signed up for insurance on OCt 21st, 2021 with an effective date of 11/1/2021. Strata health denied my two emergency rooms bills that are at $14,500, and they are not responding to the hospital where I was admitted and placed in a coma and on a ventilator. Looks like a lawsuit will be happening if Strata Health, now Adroit Health, does not follow through with paying for my medical expenses.

  Business Response

  Date: 02/06/2023

  Business Response /* (1000, 5, 2022/11/14) */
  Dear Mr. *****,
  
  Thank you for making us aware of your problems with getting your medical expenses paid by Joppa Health Share. As you may know, our company is a general insurance agency, who sells a variety of health insurance products, including Critical Illness, Accidental Death & Dismemberment, Short-Term Medical, and health sharing. The particular product you purchased is a Healthcare Sharing Ministry plan through Joppa Health Share, which is separate business that is not owned or operated by our company. Unfortunately, because we are not the health sharing plan, we have no authority or involvement with needs sharing decisions, adjudication of claims, or reimbursement of sharing requests. Therefore, the correct party to whom you need to address your inquiries and concernsand the party that would be in a position to both adjudicate the sharing request and provide you information on the status of sameis Joppa's needs processing provider, which is a company called Cornerstone. We are sorry that you are experiencing difficulties getting your reimbursement questions addressed, and to try and assist, we have separately reached out to Joppa and asked that they follow up directly on your behalf. In the meantime. you may also reach Cornerstone at the following telephone number: 1-888-479-0378.
  
  Kindest regards,
  
  Jeffrey J****
  General Counsel & Chief Compliance Officer

• Initial Complaint

  Date:10/11/2022

  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 have been trying to get their bait and switch corrected. I paid in monthly premiums only to find out they are under review with all Texas Departments. I've contacted every entity owned by this conglomerate, get hung up on and seriously have doubts of any of the companies legitimacy.
  

  Business Response

  Date: 12/28/2022

  Business Response /* (1000, 5, 2022/10/17) */
  Ms. ***,
  
  Thank you for raising concerns regarding your account. Unfortunately, your allegations contain few specific facts to which we can respond. However, please be advised that we are a single corporate entity that is a general insurance agency only and we are neither the third-party independent contractor who sold you the policies, nor are we the insurance carrier responsible for paying claims on those policies. You purchased a Critical Illness plan through Liberty Insurance Underwriters Inc., as well as a HealthShield hospital indemnity plan and a general wellness and preventative health plan through Davies Insurance Limited and a dental plan through United Concordia. In each case, Liberty Underwriters, Davies Insurance Limited, and United Concordia are solely responsible for all claims d****minations and payments. Should your complaints concern claims payments by these carriers, it is respectfully suggested that you reach out directly to them or about them.
  
  Further, despite your assertion that you have contacted every entity owned by this conglomerateof which there is only oneand have been hung up on, our account records reflect that you have had only five (5) phone calls with our Customer Service Representatives since 2021, namely:
  
  (1) on March 29, 2021, at 9:00 a.m., at which time you requested copies of your member identification cards that were subsequently e-mail to you;
  
  (2) on April 30, 2021, at 2:24 p.m., wherein you requested information concerning coverage for a CT scan, at which point you were transferred to BlackHawk Claims Administrators, which is the third-party claims administrator for your HealthShield Plan (and is neither owned, operated, or otherwise affiliated with our company);
  
  (3) on May 05, 2021, at 9:53 a.m., wherein you inquired about plan coverage for a CT scan at which point you were read a disclaimer that diagnostic tests were not covered by your plan;
  
  (4) on June 21, 2021, at 12:05 p.m., wherein you requested to cancel your account, at which point you were transferred to your Agent of Record, Ralph Castillo, with Top Healthcare Options Insurance Agency, Inc. (who also is neither owned, operated, or otherwise affiliated with our company) to complete the cancellation.
  
  (5) on June 29, 2021, at 3:15 p.m., wherein you complained that we were unable to reach anyone at BlackHawk Claims Services with respect to the payment of certain claim(s), at which time we were able to transfer you directly to BlackHawk as they were solely responsible for claims d****minations and payments.
  
  These represent the totality of calls our company has had with you since the inception of your policy, and we show no further communications with you since June 29, 2021.
  
  Additionally, in none of the foregoing communications is there any record of any calls being disconnected prematurely either by you or our representatives. Once again, if your issue is communication problems concerning the status of claims payments, including the denial of claims, (which appears to possibly be the case given the subject matter of your last call in June of 2021) these would need to be addressed to the respective carriers. Moreover, your Agent of Record is employed with Top Healthcare Options Insurance Agency, Inc., which maintains its own separate customer service department, so you may have had issues if you spoke directly with them, which we would not have any further information concerning.
  
  Likewise, with respect to your assertions that our company is "under review with all Texas departments," we have no information indicating that there are any open investigations of our company by any governmental agency in or for the State of Texas. However, we are aware that HealthShield has been under scrutiny in multiple jurisdictions, although again, they are not affiliated with our company.
  
  Should you have specific issues that you would like my office to investigate, kindly provide this information and we will be happy to review.
  
  Sincerely,
  
  Jeffrey J****
  General Counsel & Chief Compliance Officer
  jeffrey.j****@benefitadmins.com