The complaint has been investigated and
resolved to the customer's satisfaction
Resolved
Wage Works/ Cobra CoverageReimbursement for services not rendered

L

I unfortunately lost my job in September of 2008. I am regularly being treated for a previous job related back injury and high blood pressure. Therefore, the very minute I realized I would not be covered for health insurance; I elect Cobra coverage through Wageworks to cover me for a month while I sought out sources for more affordable coverage. Being a single female, and not having the amount of cash available to pay for my first month's premium, I took the money out of savings and elected coverage the first week of December which amounted to $603.04 (I was covered by my previous employee until November 27th, 2008), Wageworks received my check and election on December 15th. Their policy is that once payment is received and processed, your carrier (Empire Blue Cross) is notified. However, during the following weeks, I would go to doctor's appointments and pick up prescriptions to discover that I was not covered at all. Since services were already rendered, I paid out of pocket. This was very taxing on me as my check ups cost me $150 per visit (2) and prescriptions ran me over $100.00. Mind you, I am paying out of pocket from funds I received from an unemployment check! Finally, I called Wageworks after the New Year holiday and demanded to know what was going on. I was informed by the representative that they were behind in notifying my carrier due to the holiday and the amount of layoffs that were occurring. Therefore, I should call my carrier to verify that Wageworks had notified them and that perhaps it was an oversight on the part of my carrier. I couldn’t figure out why it was necessary for me to do the legwork, but I did so in earnest to make sure that I was being covered. When my carrier informed me that they had not been notified, I called Wageworks and cancelled my coverage with them. Additionally, I demanded a full refund for services that were "not" rendered. After an apology from the Customer Services Representative, I was handed over to another representative to file a complaint.

After two weeks of waiting to hear back from them, I called again. I was told that the complaint was listed, but I would not be able to receive a refund as it was not COBRA's policy to provide them. I was outdone! The representative allowed me to file another complaint, and after waiting for another four weeks, I received a check from them for the amount of $36.00. I immediately called them and implied about the check. They informed me that this was what was left me from the time I was not covered until the day I elected to cancel my coverage. This mere check was not going to appease me. I requested to speak to a supervisor. Once again, I was told that it was not the policy of COBRA to return a full refund. And, if I wanted to submit the bills for the "out of pocket" services that were rendered to me, I should notify my previous carrier, (mind you, not them). Needless to say, I was furious!!! I proceeded to ask the supervisor what does this "so - called" COBRA policy state regarding non - reimbursement. She just reiterated by saying, "It's their policy". I then asked for written documentation detailing this, but of course, she would not provide any.

My only recourse is to file a complaint with the board. I also intend to go to the media with this. I'm quite sure that I am not the only recently unemployed individual that is being duped by the scams and schemes of COBRA. It’s sad that you have of come out of pocket to pay for the excessive fees they charge. But, it’s a travesty that many of us do not have a choice, and that America is not doing something about the deviousness of the healthcare monopoly.

Responses

  • Ba
    babaliksayopanlukomo Oct 11, 2011

    I STRONGLY AGREE WITH ALL THE COMPLAINTS. I WAS NOT ABLE TO RECEIVE MY $400.00 IN FSA FOR 2010 DUE TO ERRORS IN ANSWERING SERVICE AND CALLING THEM TOOK OVER AN HOUR EACH. AND EVERYTIME I CALLED, I GET DIFFERENT ANSWERS, PREVENTING ME TO GET WHAT I NEEDED. I BELIEVE THERE ARE LOTS OF COMPLAINTS IN THIS COMPANY THAT THEY ARE AVOIDING CALLERS.

    1 Votes
  • Rg
    rgarza Feb 01, 2010

    I just started my health care coverage under COBRA and my previous employeer directed me to WageWorks. After two payments, the insurance carrier still has not recieved my information and I am forced to cancel doctor's appointments since the doctor's office cannot verify my coverage.

    1 Votes
  • Wh
    Whatnow300 Dec 31, 2009

    I was using Wage Works through our company as the holder of an FSA account, but with the same type of results you are having. We put the money in and will most likely not get it all back. I've called over nine times on one medical expense to try and find out why we can't get reimbursed, and every time it's a slightly different answer. Included with the bills were the Drs name, the clinic, the details of the procedure, the expense before and after insurance paid, the place of the procedure, the date, phone numbers they could call for more information. Our HR department touted this company, but I'll be surprised if that continues. Our claims have been all medical (trips to the Dr., dentist, medicine, etc.), and it's been incredibly difficult to get a consistent or complete reason why we can't get reimbursed. I would strongly recommend anyone think stronglyand research before using Wage Works.

    1 Votes
  • Us
    usr Sep 18, 2009

    I am also writing here to complain about somewhat similar problems with wageworks.

    I sent them a check that should cover about 4.5 months of cobra however when checking their website it became apparent that they miscomputed the monthly premium. I called to have them fix it twice but they still show partial errors.

    What is more annoying however is that my health insurance company was never informed of me paying COBRA even now 3.5 months later and health coverage has been routinely denied because of that during all these months. After reading the prior comment, it seems obvious that wageworks never notified my insurance company.

    When confronted about this, their customer service reps give variable answers going as far as blaming the insurance company, but thus far the problem is still not fixed.

    What a bunch of amateurs...

    1 Votes

Post your comment

    By clicking Submit you are agreeing to the Complaints Board’s Terms and Conditions

    IN THE NEWS

    Unhappy consumers gather online at Complaintsboard.com and have already logged thousands of complaints.
    If you see dozens of complaints about a certain company on ComplaintsBoard, walk away.
    One of the largest consumer sites online. Posting here your concerns means good exposure for your issues.
    A consumer site aimed at exposing unethical companies and business practices.
    ComplaintsBoard is a good source for product and company gripes from especially dissatisfied people.
    You'll definitely get some directions on how customer service can best solve your problem.
    Do a little research on the seller. Visit consumer complaint websites like ComplaintsBoard.