Wednesday, May 11, 2011

Prepare to face the wrath, Kaiser.

I am filing a complaint with the Hawaii Insurance Commissioner, and the Hawaii Attorney General, even though the latter complaint will be redirected to the Insurance Commissioner.  I just want to be able to say both next time I talk to Kaiser.  Shoot (I mean "shoots"), I took the time to write it... why not print it twice?

Here are my responses to the two detailed portions of the complaint form:

Provide a Summary of your complaint or inquiry. Include (1) all information you believe to be relevant to your claim and (2) the issues of concern. If you need more space please prepare and attach additional sheet(s).

On 2/7/2011, I enrolled in an insurance plan available to Hawaii Pacific University students, provided by Kaiser Permanente, for the period of 1/1/2011 - 8/30/2011.  The premium for the entire period ($4,064.82) was due upon enrollment.

Subsequently, my wife got a job that has an insurance option with better coverage at a lower rate, provided by HMSA.  On 4/1/2011, I called Kaiser to find out if I could cancel our plan and get a refund for the remaining premium.  They informed me that I could.  I have attempted to do this three times:

1) The woman I spoke to on 4/1 said that I could login at and submit a request to cancel, effective 3/31.  She said that my login credentials would be sufficient to confirm my identity and cancel my membership, and that the unused portion of my premium would be refunded.  I did as she directed on 4/2, and informed Kaiser that I wanted the refund send to my home address.  On 4/4 I got a response indicating that my request needed to be submitted in writing, with my signature.  On 4/5, I wrote back (electronically) to confirm that the 3/31 cancellation date would still be honored, even with the delay of using regular mail (our HMSA insurance started on 4/1, and I did not want to be paying two premiums at the same time).  On 4/6, I received a response to my second message, which stated, "Your request to terminate your coverage effective March 31st will be accepted."  I have included a copy of my 4/2 and 4/5 messages, and Kaiser's 4/4 and 4/6 responses.

2) I wrote a letter, my wife and I signed it, and I mailed it as directed.  I have included the letter.  I retroactively dated the letter 4/1/2011, but I actually wrote and mailed it around April 7th (not sure of the exact date).  In response, I received a notice in the mail indicating that my request was incomplete.  The letter said to "return all requested items, along with this form" to Kaiser, but the letter did not actually request any items.  I called Kaiser again, and was told that I needed to include proof of new insurance coverage.  Again, I confirmed that the 3/31 cancellation date would be honored, in spite of the ongoing delays.  Again, I was assured that the 3/31 date would be honored.

3) I contacted HMSA and acquired proof of our new insurance coverage.  I have included the letter I received from HMSA.  I sent this letter, along with the notice Kaiser had mailed to me, back to Kaiser.  I added a handwritten note, again informing Kaiser of the address to which they should send the refund of the unused premium.

Today, 5/11/2011, at about10:15 AM, I called Kaiser to check the status of the pending refund.  I talked to a customer service representative in Hawaii, who informed me (for the first time) that I could not cancel my HPU insurance plan.  She told me that I should have received a letter, dated 5/3/2011, informing me of this.  I was not at home when I made the phone call.  When I got home, the letter had arrived.  I have included the letter.

The Hawaii customer service representative also gave me a phone number for a Kaiser office in California.  The phone number is 866-575-3551.  I called this number at 11:22 AM today and spoke with Liliana.  Liliana informed me that my plan had in fact been cancelled, effective 3/31.  Then she put me on hold, and when she came back, she informed me that I could not cancel my plan.  I reminded her that she already told me it had been cancelled, and asked, "Are you saying my plan has been reactivated while I've been on the phone with you?"  She responded, "Yes, sir.  It should not have been cancelled.  I'm not sure how that happened."

State what you would consider to be a satisfactory resolution to your concerns:

I paid $4,064.82 for a coverage period of 242 days.  I used 90 of those days (1/1 - 3/31), leaving 152 days to be refunded:

4064.82 / 242 * 152 = 2553.11

Therefore, a satisfactory resolution would be a refund from Kaiser in the amount of $2,553.11


Jenn said...

That is SO frustrating! I hope they acquiesce to your demands.

Shannon said...

Wow, sounds like a mess. And it sounds like they don't know what they're talking about, or that they have conflicting policies. Anyway, I hope you get your money back!

Dennis said...

Insurance wars...I am so glad your Mom fights ours and has a winning record. Good luck! Persistance...they think they can wear you down and you will give up.

Taylor said...

git em Brett!