Complaints

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

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  AmeriFlex

  Frisco, TX 75034-1992

  
• 

  AmeriFlex Cobra Processing Department

  PO Box 2077 Omaha, NE 68103

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:04/08/2025

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

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

  Answered:

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

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I paid AmeriFlex to continue my COBRA coverage; however, my medical insurance has not been reinstated. Due to their internal processes, a reinstatement letter was never sent to my health insurance company. After contacting them, they explained that the issue would take over a week to resolve. So I paid my monthly insurance premium to basically not have insurance or receive any services from their company for part of this month.

  Business Response

  Date: 04/10/2025

  Dear *******,

  The cause of this issue is that inactive plans were inadvertently added to your profile instead of the current active ones. The reinstatement notices, which were originally scheduled to be sent after your initial payment was made, were held while we worked to correct the plan information on file. We regret that this led to a delay in the reinstatement of your coverage. To resolve this issue, we have taken the following steps:
  Profile Correction: We have updated your profile with the correct, active plan information.
  
  Urgent Reinstatement: We have sent an urgent reinstatement on 04/09/2025, with the correct election information.
  
  Carrier Processing Time: The carrier typically processes urgent requests within 3-5 business days, although they may take up to 7-10 business days.
  
  We are committed to resolving this matter as quickly as possible and ensuring that you receive the proper coverage. If you have any further questions or need additional assistance, please do not hesitate to reach out to our customer support team.

  Customer Answer

  Date: 04/14/2025

  I am rejecting this response because: at this point I have been given various dates for when my reinstatement was sent to my insurance company. My spouse still does not have coverage. According to the **************** at ******* Blue on 04/14/2025, no reinstatement notice has been received. Each time Ive reached out to AmeriFlex about this I get a different date as to which the notice was sent to the insurance company. I am also told I will be updated via email and that also never happens. 

  Business Response

  Date: 04/17/2025

  Thank you again for your continued communication and for giving us the opportunity to respond further. We understand your frustration and sincerely apologize for the confusion and inconvenience caused by the delay and inconsistencies you've experienced.
  
  To clarify, a delay in your COBRA reinstatement occurred due to outdated plan information being assigned to your profile at the time it was created. This unfortunately affected the timing and accuracy of the initial reinstatement notices.
  
  Once the issue was identified, we took immediate steps to correct your profile and submitted an urgent reinstatement notice to the insurance carrier on 04/09/2025. Regular notices were then sent again by our system with the updated information on 04/11/2025. Our system reflects that the coverage has been updated accordingly and that both individuals are enrolled under the correct plan.
  
  We understand there has been confusion surrounding the dates provided in past communications. This was not our intention and we sincerely apologize for any mixed messages. As noted during your conversation with our supervisor on 04/14/2025, we have confirmed that multiple reinstatements were sent, and coverage will be backdated appropriately once the insurance carrier completes their processing.
  
  While we do not have control over the exact processing timeline on the carrier's side, urgent reinstatements are generally handled within 35 business days, though it can take up to 710 business days per the timelines they have given us. 
  
  We apologize again for the disruption and appreciate your patience as the carrier finalizes the reinstatement. We remain committed to supporting you through this process and will continue monitoring the situation closely to ensure your coverage is fully restored.

  Customer Answer

  Date: 05/12/2025

  Hello,

  I just called my **************** provider for the month of COBRA and was informed that documentation was never received to reinstate my husband on this COBRA policy. So AmeriFlex still hasnt contacted them to update this health plan. After speaking with an agent from AmeriFlex on the phone today May 12, 2025 they informed me that coverage was only in place for dental and vision. I did not pay for either of those health plans. I only paid for regular health coverage through Florida Blue, which was not reinstated as of May 12, 2025. 

  Business Response

  Date: 05/21/2025

  Thank you for reaching out and for bringing your concerns to our attention. 

  After reviewing your account, Id like to clarify a few key points:
  You elected only medical coverage through ******* Blue under COBRA. While dental and vision plans were available to you, they were not selected, and no payments were made toward those plans. You were never enrolled in either dental or vision coverage. We believe there may have been a miscommunication during the most recent call. Please note that the only plan you were ever enrolled in was the medical.
  We also show that we received a request from you to terminate your medical coverage effective April 30, 2025. Based on that request, your medical plan was removed from your account. This may have been what led to the miscommunication since the plan is no longer listed.
  
  On May 12, 2025, following your phone call, we resent the necessary notices to the employer's office, who will be completing the reinstatement of coverage with ************ as an urgent reinstatement, to have the coverage made active.

  
  

  Customer Answer

  Date: 05/21/2025

  I am rejecting this response because: your company has accidentally miscommunicated information each and every time that I have called in. I have been trying to get medical coverage activated for my spouse since March 30, 2025. Its now May and it still had not be activated.
  

  The last representative informed me that I never elected medical coverage for my spouse. That representative explained that I had only elected dental and vision for my spouse. I am fully aware that I did not elect to have either dental or vision coverage. The call weeks before led me to believe that coverage for my spouse was sent over weeks prior. That manager made it clear that I was wrong for doubting that it was sent over even after ********************** vehemently denied it.

  At another point I was informed by one of your representatives that my spouses DOB was incorrectly entered into the system. They explained that now it was fixed and coverage should be in place soon. 
  

  Its been almost 2 months of back and forth. I want the complaint on record, so everyone can see how AmeriFlex does business. Your company collected my payment for medical in March and it took a phone call to the HR department of my previous employer to fix this issue. Your company didnt even get things set straight. 

  Your lack of action and attention is almost comical, yet you insist that Im wrong. Its my fault that my spouse didnt get coverage within the month we have elected COBRA. 
  

  I am also aware that I canceled my coverage at the end of April 2025. Was I supposed to keep paying you for a service that you never completed? 

  This entire experience has been a nightmare. Youre dealing with healthcare. One of the fundamental human needs, and your company acts as if I am complaining about a trivial issue like a lost Amazon package. 
  

• Initial Complaint

  Date:02/24/2025

  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.

  My husband changed jobs and I had to stay on cobra through Ameriflex for my insurance because I am medically retired. I paid all of the fees up until December 2023 when I needed to cancel service because I went on my husbands new insurance. I started getting bills around mid March of ************************************* December and end of November. I started calling Ameriflex and the doctors offices and **** of Illinois to figure out why I was being billed. The insurance company paid the bills and then requested the money back stating that I didn't have coverage after November 24th 2023. I made an extreme amount of phone calls to the insurance company, ********* and the doctors offices begging them to hold on until I get it fixed. We went back and forth with Ameriflex when they said yes I paid until December 31 2024. I made MULTIPLE attempts to get Ameriflex to send the information to BCBS ******** for the rest of 2024. I have been sent to collections and can no longer see these doctors or offices until I pay the bills. **************** called me last week and said the payments to my doctors were denied because Ameriflex took too long to get the information to them. I have made multiple attempts to call Ameriflex to either have them pay the bills or at least send me my money back for the 5 weeks I had no coverage. I have been able to pay some of the lower bills out of my own money but I had mammogram and ultrasounds I can't afford to pay. I need someone to help me. Please let me know what I can do or someone that can help, I am at my wits end.

  Business Response

  Date: 02/27/2025

  Dear Member, 
  
  We are sorry to hear about the inconvenience this has caused you.  
  
  Please be informed that Ameriflex has communicated with the carrier numerous times to have your eligibility dates corrected in their systems. Please review the dates below that Ameriflex communicated with the carrier for the updates. 
  
  On 12/16/22 the Status (Coverage Level) Change Notices were sent requesting that the coverage level be changed to Spouse Only effective 11/1/22, for both the dental and medical plans. Termination Notices were also sent on 12/16/22 requesting that the ** be termed from the dental and medical coverage, effective 10/31/2022.
  
  On 1/12/24, we sent a Plan Add (Dependent Only) Notice requesting to add the dental plan for the Spouse effective 1/1/2024. A Termination Notice for the dental plan was also sent on 1/12/24, requesting that this plan be termed effective 12/31/2023.
  
  On 1/17/24, we sent a Plan Add (Dependent Only) Notice requesting that the medical plan be added effective 1/1/2024 for the Spouse Only.
  
  Termination Notices were sent on 2/6/24 requesting that the ***** dental and medical plans be terminated effective 12/31/2023. 
  
  Ultimately, the carrier advised that the notices were not sent timely; however, all notices were submitted to the carrier timely for processing. The carrier advised that all enrollment and cancel requests must be submitted within 90 days of the effective date of coverage. Per our records, all notices were sent to the carrier timely and within 90 days of the effective date of the changes. 
  
  Ameriflex sent detailed information to the carrier as noted with pdf copies of the original notices and original emails that were sent to the carrier's eligibility team for processing. Ameriflex is committed to assisting our participants and will be connecting with the carrier again to attempt to have this rectified. Please feel free to contact us via email at ************************************ or by phone at ************ Monday-Friday from 8:00 AM- 9:00 PM EST or Saturday from 10:00 AM- 2:00 PM EST.

  Sincerely,

  Natassia

  
  

  Customer Answer

  Date: 02/27/2025

  I am rejecting this response because:   

  All of 2024 was going back and forth with Ameriflex, saying they will send the information, and BCBS of Illinois, saying they did not receive the information. Every month I checked in (because the doctors offices and facilities were calling me almost every other week wanting me to pay the bills) with both companies and them telling me to give it time. Well, time is now the issue because the insurance company is stating they didn't get the updated cancelation date in time. I tried  just about everything I could do to resolve this and it got me nowhere. My husband and myself worked on this mess that Ameriflex created ALL YEAR! I paid all of my fees on time every month until the cancelation date of 12-31-24. It makes no sense that neither of these companies will take responsibility for what has happened. I should not be liable for ANY of these charges and one or the other should pay for it. I am in the process of making a complaint to the Insurance Commision and anyone else that will listen to me. 

  I don't have the money to pay these charges unless I take out a loan. Now that my excellent credit score is ruined, not sure that can happen. The insurance policy I had paid all charges after the deductible was met and in December of 2024, I had multiple procedures. 

  This has gone too far to tell me that Ameriflex did what they were supposed to do because they didn't. I am angry because it just went too far. Please fix this as I requested many times last year. 

   

  Customer Answer

  Date: 03/01/2025

  I apologize, the year was 2023 that the issue occurred. 

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

  Business Response

  Date: 03/03/2025

  Dear Member,

  We have reached out again to the insurance carrier with a detailed request, showing all of the evidence of when our original termination date request was, as well as multiple emails that were sent to the carrier within the original 90-day timeframe, requesting multiple times that they set the last day of coverage to 12/31/2023. We are now awaiting the response from the insurance carrier. 

  Sincerely, 

  Ameriflex COBRA Department

  Customer Answer

  Date: 03/03/2025

  I am rejecting this response because:   

  I don't understand why I have to wait until you get a response from **** of ********. This is what I dealt with all year last year with no resolution at all. I would like to know how November 24, 2023 got put as that date of cancelation date? I sent my payment at the end of October for the November payment and at the end of November for the December payment. How did this happen? 

  This has caused so much stress and anxiety for me and my family. It never should have happened. It makes no sense. 

  Please let me know how the wrong date got sent to ************************ in the first place. 

  Customer Answer

  Date: 03/04/2025

  Attached is the reply from BCBS of Illinois on February 10, 2025.

  Customer Answer

  Date: 03/12/2025

  Hello. 

  Where are we at with this case? I haven't heard back from anyone lately. Did you receive my photos of the message sent to me from BCBS of Illinois?

  What happens next?

  Thanks, ****** ******

  Business Response

  Date: 04/03/2025

  Hello,
  
  At the present time, the insurance carrier continues to insist that the 11/24/2023 termination date is valid, and they continue to insist that Ameriflex did not submit timely notification that the coverage should have been terminated effective 12/31/2023. Your insurance carrier states that a "timely" notification is one that would have occurred within 90 days of the 11/24/2023 termination date.
  
  As of 4/2/2025, we at Ameriflex sent an additional correspondence to your insurance carrier via secure email, requesting further review of the matter, due to two key reasons:
  
  1) Ameriflex never requested a 11/24/2023 termination date with your insurance carrier. Your insurance carrier took the action of terminating your coverage as of that date despite Ameriflex never making such a request.
  
  2) Ameriflex sent multiple correspondences to your insurance carrier on 2/6/2024, on 2/9/2024, on 2/15/2024, and on 2/20/2024. All of these correspondences to your insurance carrier specified that coverage should be terminated on 1/1/2024 (covered through the end of day 12/31/2023). Each of these correspondences were sent to your insurance carrier within 90 days of 11/24/2023. Despite this, your insurance carrier never took the action of updating your coverage termination date to 1/1/2024.
  
  We are awaiting a reply from your insurance carrier at this time. Depending on the level of review that this is sent for with the carrier, it is possible that their response may take a prolonged amount of time, but we would anticipate their reply likely within the next 7-14 business days. Once we receive an update from the carrier, we will be sure to let you know of the status.
  
  Sincerely,
  Ameriflex ********************

  Customer Answer

  Date: 04/03/2025

  I am rejecting this response because:   

  When I contacted Ameriflex back in March of 2024, I was told that they (Ameriflex) sent over the incorrect cancellation date and that they would fix it. You all took the full blame each time i contacted you. Why would **** say they were waiting on you to send over the correct date? Every person I talked to at Ameriflex admitted that you sent over the wrong date, all of the phone calls, listen to them. I would like to have all of the correspondence that occurred during this mess between Ameriflex, BCBS of Illinois and me and my husband sent to me. 

  You can send it through the BBB, I have already requested it through your portal. 

  Business Response

  Date: 04/07/2025

  Hello, 

  Upon review of the calls between yourself and Ameriflex agents, we can confirm that Ameriflex never stated that we requested a 11/24/2023 termination date. 

  Please be advised that all notices and correspondence are being sent to you via secure email.

   

  Sincerely, 

  Ameriflex Participant Services

  Customer Answer

  Date: 04/07/2025

  I am rejecting this response because:   

  Why is it stated that Ameriflex was constantly sending BCBS the corrected cancelation date? It had to originate from yall as the cobra carrier.  **** kept saying they were waiting on the corrected date. One of the persons i spoke with at Ameriflex said, just tell them the corrected date, really?  BCBS didn't deal with the cobra part at all. We were told by **** that they were sent the incorrect cancelation date and as soon as we got involved **** said they were waiting on the corrected date from Ameriflex. For a year. Ameriflex kept saying they sent it. How is it that one or more of yall created this issue. I am the one that is paying for it?

  I have the transcripts from those conversations. Amerflex told us that they had sent the email with the correct date so many times, it was sent to the wrong email address. 

  I don't understand why you can't give me my money back for the time it was canceled to when it was supposed to cancel. From Novemeber 24 to December 31. I paid $799 per month so that would be one month and a week. I am not asking for anything that is not owed to me. Yall said I didn't have insurance so send me my payment back so I can pay the bills that didn't get paid. Plain and simple.

  Business Response

  Date: 04/16/2025

  Hello, 

  The carrier has responded and requested additional information, which was provided today.

  We will follow up with you directly once a resolution is provided by the carrier. 

   

  Thank you, 

  Ameriflex Participant Services

  Customer Answer

  Date: 04/21/2025

  Please keep me informed on any progress. I am trying to make payment arrangements with the hospital because I have to have surgery but can't until this bill is paid. 

  Thank you, ****** ******

  Customer Answer

  Date: 04/22/2025

  I am rejecting this response because:   

  Please keep me informed on any progress. I am trying to make payment arrangements with the hospital because I have to have surgery but can't until this bill is paid. 

  Thank you, ****** ******

  Business Response

  Date: 04/22/2025

  Hello, 

  
  Please be informed that as of 4/21/2025 the carrier has provided confirmation that the coverage dates have now been corrected in their systems, to reflect a correct termination date of 1/1/2024. The carrier confirmed that you were moved to your own policy effective from 11/01/2022 until 12/31/2023, with the first day of no coverage listed as 1/1/2024. 

  
  We sent a secure email to you yesterday including the carrier's response and advising you to contact the carrier directly to ensure that your claims are processed correctly on their end. 

  
  Again, we sincerely apologize for any inconvenience received due to this matter. 

  
  Sincerely, 
  Ameriflex Participant Services

  Customer Answer

  Date: 04/22/2025

  I am rejecting this response because: 

  I am not exactly rejecting the response but its not completely finished. 

  I am not receiving any emails from Ameriflex. My email address is: ****************************** 

  Please send all of the info that I requested and also the email that you sent yesterday.  Any correspondence between myself, my husband (***** ******), Ameriflex and BCBS of Illinois.

  I don't want to close this without the information sent to the correct email address. 

  Thank you, ****** ******

  Business Response

  Date: 05/01/2025

  Hello, 

  Please be informed that all follow-up emails were sent to ******************* as that is the email address on file for the member's account in our system. Due to HIPAA, we sent all follow-up emails to only the email address that is on file in our system. 

  Thank you, 

  Ameriflex Participant Services

  Customer Answer

  Date: 05/01/2025

  I am rejecting this response because:   

  I did receive the emails through my husbands email address. 

  I need to know what I do now?

  Is BCBS going to pay the bills that are all in collections? What is the next step? Are you doing everything possible to solve this or are we going to sit around and nothing be done? If **** does not pay the bills due, I want my money back from the payment for the time that I "didn't have coverage". 

  That is perfectly the right thing to do. I have a ton of people that agree. 

  I will be talking to the insurance commission next if this doesn't get solved. 

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

  Business Response

  Date: 05/02/2025

  Hello, 

  We have sent a follow up request to **** asking if they can reprocess the denied claims as they have now corrected the eligibility dates in their system. Please feel free to contact the carrier directly on your end as well to confirm the reprocessing of the denied claims. 

  Once we have received a response back from the carrier, we will follow up with you. 

  Thank you, 

  Ameriflex Participant Services

• Initial Complaint

  Date:02/18/2025

  Type:Service or Repair Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

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

  Answered:

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

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I paid to get my cobra dental insurance Reinstated and they say it has been reinstated and when I call united healthcare to confirm they tell me it hasnt been reinstated between both Ameriflex and united healthcare they just keep saying its the others fault and its hasnt been reinstated

  Customer Answer

  Date: 02/19/2025

  Can u please close this case it has been resolved thank you

• Initial Complaint

  Date:10/17/2024

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

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

  Answered:

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

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I applied for Cobra dental insurance after leaving my previous employer. Americas sent me the paper work. I filled it out and paid premiums up until 07/31/2024. At which time I have given up on getting coverage. My issue is for the last 10 months I have been fighting with Ameriflex to get my coverage reinstated even though they have had no problem cashing my checks but have yet to notify Principal dental that my coverage should be reinstated. Last I heard from ******** my previous employer needed to contact Principal which they did back in July. But I still have no coverage from January through July. I tried calling Ameriflex and get no where. My ******************* now refuses to pay because they say I have primary insurance that needs to pay first. This is a disaster and needs to be resolved

  Business Response

  Date: 10/17/2024

  Dear member,

  While we understand your frustration, your previously employer opted to handle all reinstatements directly and has not provided us with an email address or fax number for your dental carrier so that we may reach out to the carrier directly.
  
  We have however, reached out to your previous employer repeatedly requesting they work with your dental carrier to reinstate coverage for the months in which you paid, January 2024 through July 2024.
  
  We sent reinstatement requests and/or reached out to them on the following dates:
  
  2/26/2024. 5/22/2024, 6/6/2024, 6/25/2024, 7/23/2024, 7/29/2024, 7/31/2024, 10/11/2024
  
  Additionally, all payments made toward your dental premiums have been remitted to your previous employer, who in turn, will forward your premium payments to the dental carrier. As we have remitted them to your previous employer, we do not have them to refund.
  
  We feel we have done everything within our power to reinstate coverage and sincerely apologize for any inconvenience you have incurred.

  Sincerely,

  Ameriflex COBRA Department

• Initial Complaint

  Date:07/24/2024

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

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

  Answered:

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

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I was working at The ****************** (Cosmic Realty LLC) managed by Hersha Hospitality. One of the benefits the company offered was pre-tax money deduction for transportation. This pre-tax money service was provided by Ameriflex.Ameriflex would receive the pre-tax money from my paycheck and allot this into an Ameriflex Debit Card that could only be used for transportation.After I left the company, I realized that I had an outstanding balance of $175.00 on the Debit Card.From April 16 to July 01, 2024 I attempted to use the card on 3 different times and the card declined the transaction. It was then when I noticed that the transactions were being denied because I had left the company.I reported this twice via their online system and they did respond in a satisfactory manner (they asked to contact the previous employer (cases #******* & #*******). Last week, I called Ameriflex in hopes that someone would be able to reinstate the Debit Card so that I may apply the funds to my Metro Card. I even suggested to apply the tax of it if needed.Instead, the agent denied the claim stating that per the **** this account was on a "you use it or you loose it" basis. The agent emphatically directed me to contact my previous employer to resolve the issue; however, the $175.00 are still available in the Ameriflex Debit Card (see attackments)These moneys were deducted from my hard earned money and I should be entitled to use it as intended. The expectation is that they reimburse the moneys. They easiest way is to reactivate the Ameriflex card is ending in 7962 until I have used the funds.

  Business Response

  Date: 07/26/2024

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

  
  We at Ameriflex would like to assist you in recouping any funds possible within the regulations of your plan.

  Please note that per federal regulations, reimbursement may only be provided for dates of service that took place while the plan participant was actively employed by their employer.

  TRANSIT ACCOUNT OVERVIEW

  A transit account can be used to pay for transit expenses to go from home to work, and back home

  Transit funds and Parking funds are not interchangeable

  Funds are available as deducted from your payroll

  Other important things to know

  No manual claims are permitted per IRS rules

  Mass transit passes may only be paid at the point of sales with your MyAmeriflex Debit Mastercard

  You can only use funds while you are an active employee, and your employer cannot ***** an extension for you to use funds after termination

  Expenses cannot be reimbursed after you terminate from your job and funds remaining in the account will be forfeited.

   Any unused commuter benefits funds will be returned to the company. Per IRS regulations, your employer can't refund your unused commuter benefits funds back to you.

• Initial Complaint

  Date:07/08/2024

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

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

  Answered:

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

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  On January 4th I termed my employment with Hall County Housing. On January 16th I received a letter from Ameriflex giving me information on how to Cobra my Dental and ***************** On February 1, 2024 I filled out the paper work to Cobra my Dental and ***************** On February 10th 2024 I received a letter from Ameriflex stating they received my information and sent me invoices. I sent the first payment on February 16th. I received a letter on March 1, 2024 for stating I hadnt paid enough and on March 3rd 2024 I sent in my second payment. Again on March 10, 2024 I received another letter stating I still have not paid the required amount. On March 11, 2024 I sent in payments for March and April 2024. All payment had been cashed. On March 29th I went to the dentist and the dentist told me my coverage had termed as of 01/04/2024. I called Ameriflex who in turn told me my coverage had termed because they did not receive my payment by 03/15/2024. I asked the representative to then send my money back to me which she said we cant do that. You will need to appeal the decision. On 04/03/2024I received a letter from Ameriflex stating your coverage has been reinstated. I went back to dentist on 04/15/2024 and again was told your insurance termed on 1/4/24. I sent a letter to Ameriflex. Again I received a letter stating my insurance was reinstated. I paid May and Junes premiums. On 06/15/24 I went back to dentist and again was told my insurance was **** on 01/4/2024. I again wrote and emailed Ameriflex and now they are not responding

  Business Response

  Date: 07/12/2024

  Dear Participant,

  I apologize for the frustration you have experienced thus far with your dental coverage. I reviewed your account and the employer has configured their account with us, such that all reinstatement requests are not sent to the insurance carrier, but rather, the requests are sent to the employer themselves, with the understanding that the employer will be completing the reinstatement with the insurance carrier. Thus far we have sent two notices to the employer requesting that your dental coverage becomes active. I have created a ticket today to escalate this matter so we may reach out to the employer directly from our end to request the reinstatement of your dental insurance coverage.  So far we have tried to stay in communication with you by answering your calls as well as emailing you follow-up details on May 22nd, 2024, May 29th, 2024, June 6th, 2024 and June 25th, 2024. Once again, I apologize for the frustration and I will personally make sure to send you an additional email today providing you with your new ticket number. You are one of our top priorities and I apologize that previous interactions did not provide you with a detailed explanation on the next steps we can take to work together to get this resolved. As soon as we get a response from the Client Relationship Team who converses with the employer, we'll provide you with any response that we receive on this matter.

  Customer Answer

  Date: 07/15/2024

  I am rejecting this response because: This issue has been going on for over 6 months.  There is absolutely no reason I still dont have dental coverage.  Over a $1000.00 in dental expenses.  That should have been covered by insurance.  And the only response I have got from Ameriflex is we have activated your insurance you are now covered.  Just to be told by my dentist I have no insurance.  I first contacted Ameriflex in March about the issue.  Why 4 months later am I still having the same issue.  I dont care whos problem it is.  My premiums have gone to Ameriflex.  They need to make this right.

  Business Response

  Date: 08/02/2024

  Dear Member,

  We apologize for the inconvenience you have incurred and are working with your previously employer to have coverage reinstated. They have not provided us with any contact information for your dental insurance carrier's eligibility department, but have rather asked that all reinstatements are processed by them.

  Once coverage has been reinstated, you will be able to file claims with the carrier to be reimbursed for all eligible out of pocket expenses.

  We will continue to work to resolve the matter and will follow up once it has been resolved.

  Sincerely,

  Ameriflex COBRA Department

  Customer Answer

  Date: 08/04/2024

  I am rejecting this response because:   This has been going on since January.  Why in August are we just finding out that my previous employer needs to handle things.  What is Ameriflexs liability in this?  Considering the Cobra letter I received came from Ameriflex.  The premiums have been sent to Ameriflex.  The last response I received stated I needed to contact Hall County Housing myself to get them to reinstate me. How is that my responsibility?  Apparently Ameriflex was hired by ******************* to handle there cobra policys.   Right know I am out thousands of dollars in unreimbursed medical expenses plus hundreds in premiums that I have paid for dental insurance for the last eight months.  How much longer do I have to wait to get my coverage reinstated.  And now there telling me that my former employer has to authorize whether or not I even have cobra coverage eight months after my coverage should have started.  This is absolutely ridiculous.  I have never witnessed a more messed up unorganized situation.  

• Initial Complaint

  Date:06/11/2024

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

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

  Answered:

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

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Ameriflex is my employer's new FSA provider. I submitted my claim for reimbursement of $240 for services rendered by ************** during 2023 (3 office visits). Prior to the 3/31/24 deadline for 2023 claims, my claim and records were twice submitted - initially on 2/13/24 and again on 2/27/24 with the additional supporting records requested by Ameriflex. When my claim was denied the second time on 2/27/24, I called ***************** The representative I spoke with confirmed that I had submitted all required records, put me on hold a few times to speak with a supervisor, and eventually told me the claim would be resubmitted as they could find no reason for the denial. Several weeks passed but I heard nothing further from Ameriflex. I called **************** again in April and spoke with a male representative who was very apologetic about the issue still being unresolved. He also reviewed my account and confirmed that my claim and all of the records were in order but they seemingly had never been resubmitted. He assured me that the claim would be processed immediately and I should hear back from Ameriflex within the next 5-6 business days. Again, I heard nothing further from Ameriflex. I did not get the names of the representatives I spoke with, but both confirmed that the calls would become part of my account file. I called **************** again today at about 4 p.m. (PST) to see who I should file a complaint with. When he told me to submit it to **************************************** and confirmed that all other inquiries are also sent to this email address - I decided to skip what I believe would be another useless attempt to have Ameriflex process my claim and issue my reimbursement check. Ironically, they approved my claim for the medicinal tea that ********** prescribed, yet denied my claim for his office visits. I note that the subject $240 they are holding was deducted from my pay and is for services provided over one year ago. Thank you for your assistance. *********************

  Business Response

  Date: 06/13/2024

  Dear Participant,

  We apologize for the inconvenience this has caused you. The claim was denied correctly as we need proper documentation. 

  The claim was submitted before the deadline and this still has time for an appeal. We will email you separately to provide the details.

• Initial Complaint

  Date:03/20/2024

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

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

  Answered:

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

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I am a PCA. I pay out of pay check deducted for HSA FSA THE **** I HAVE...They no longer in business but my card has almost $200 on it ..I called them and 2 months now said they mailing me the money nothing and nit answering their phones HR said more people waiting too please contact them let's see Thank u

  Business Response

  Date: 03/25/2024

  Dear Participant, 

  We apologize for any inconvenience you may have incurred. Please note that effective December 23, 2023, Ameriflex is no longer be processing any claims or card transactions for your employer, as your employer has transitioned from Ameriflex to a new administrator. For any further information about claims or card transactions, please contact ******************* directly at **************. We no longer have access to your funds and will need to work with ******************* directly.
  

   

  Sincerely,
  

  Ameriflex

• Initial Complaint

  Date:02/20/2024

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

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

  Answered:

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

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I hope this email finds you well. My name is ************************* and my Member ID Number is *******. I am writing to urgently request assistance with my COBRA benefits enrollment.Recently, I retrieved all of my mail from my previous residence and promptly contacted your office to sign up for my COBRA benefits. However, I was informed that I had missed the enrollment deadline. I was advised to submit an appeals letter outlining my circumstances, which I promptly did on two separate occasions, once in January and again in February.The reason for my delayed enrollment stems from challenges I faced after losing my job and relocating. Unfortunately, I encountered issues with the postal service's mail forwarding system, which resulted in a significant delay in receiving important correspondence. It was not until the end of 2023 that the postal service finally resolved the issue and forwarded all of my old mail to my current address.Given these circumstances, I kindly request your assistance in facilitating my enrollment in COBRA benefits. I understand the importance of maintaining healthcare coverage and assure you that I am committed to fulfilling all necessary requirements promptly.Your prompt attention to this matter would be greatly appreciated. Please do not hesitate to contact me at ************ or ******************* if any further information is required.Thank you for your understanding and assistance.

  Business Response

  Date: 02/23/2024

  Dear Member,

  We apologize for any inconvenience you may have incurred.

  We regret that we are unable to enroll you due to Ameriflex no longer being the COBRA administrator for ************* Sources, LLC. Please kindly contact your new benefits administrator or your previous employer for further assistance. 

  Best regards,

  Ameriflex

• Initial Complaint

  Date:01/30/2024

  Type:Product Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

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

  Answered:

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

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  This company administers my employer's Flexible Spending Account program. I have been trying to get my money from claims last year since the deadline to file. I get different excuses every call (about 6 calls to date) and have been declined when I have asked to have my call escalated to a supervisor. They're 'not available.' I sent in the paperwork they requested after the first denial. Then I was given a different 'reason' to deny **** had the funds in my account available but since they're poor service, if they don't reimburse me, I lose the money I contributed. I have since retired from my employer, but have confirmed that I am *********** the reimbursement since I filed before the deadline after my employment terminated. I have seen the other complaints against them and seek your help. Regards, *************************

  Business Response

  Date: 02/02/2024

  Hello Participant, I apologize about your frustration regarding this account. We were able to email you on 08/28/2023 and 12/04/2023 urgently requesting that you update the needed documentation that is needed to approve the service you were seeking reimbursement from before your deadline; however, we did not receive the updated document at all. I apologize that you were unable to submit the needed form to assist in your claim approval; however, as I advised when I spoke with you on the phone 1/30/2023, you have been reimbursed by what you contributed to the account. As I stated on the phone, you were able to receive even more of a distribution from the account than the amount you contributed. Your employer was able to offer you 3 months to file claims and Ameriflex was able to provide an additional 6 months to appeal a claim as well. You asked me to forward you the emails from August 2023 and December 2023 so you could be sure they were sent, and I forwarded them as soon as we disconnected from the phone line on 01/30/2024. Because the date listed on the Letter of Medical Necessity (LMN) you provided was after the date that the service took place, the claim was not able to be approved; therefore, you weren't able to provide the documentation the claims department needed to approve your claim. Since the claim denials occurred on 6/30/2023, there was a 180-day period during which appeals for the claims could have been filed. However, since the 180-day appeal period has now ended, there is no longer an available option to appeal these claims. 

  Customer Answer

  Date: 02/05/2024

  I have reviewed the Ameriflex response and accept this resolution. It is unfortunate that I was given so many assurances of reimbursement by at least 3 call center associates over the course of five months. It took several calls to finally get someone to give me the actual requirement. With this in mind, I accept the response and trust that the employees will be counseled per the recent phone conversation. I also hope that the availability of more knowledgeable associates increases. Being told my call could not be escalated was also frustrating. I accept my responsibility in the situation. Thank you BBB for your assistance.