Eric C Afw

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| map-marker Austin, Texas

Where's My Full Refund?

3/5/2022 Hello Sendero Health Plans, Back on 12/15/2021, I finalized my Marketplace Insurance and choose your company. It promptly asked me to make a payment so coverage would start for 1/1/2022, on that day.

I made payment within two days in the amount of $316.16. In addition, payment for Feb. 2022 was sent prior to 2/1/2022, again in the amount of $316.16. Lastly payment again was sent in Feb 2022, again for $316.16 for March 1, 2022, in Feb 2022.

A total sum of 3 payments made = $948.48. I do not recall ever receiving notification, program information or ID Cards this year for 2022. However, since Christmas 2021, up through this week, I have been dealing with many stressors like loss of one of my two part time jobs, not having any Christmas and that *** I went thru on Christmas Day, into New Year of 2022, car breaking down - twice, death of friend and a family member due to COVID and finally, most recently, getting sick myself, not COVID, and trying just to survive. The program and ID cards had slipped my mind.

When I became sick in Feb 22, I was reaching out for a Dr. and medicine, only to discover that when I do contact your company for services, my one and only time, I am not active or a member in your system. The representative at the time I spoke with (name forgotten) explained I had a credit on your books. Sure, a credit of 2 payments sent and a third on the way for coming March 22.

I asked the representative to investigate this situation, however I still to this day, do not know, nor can your company tell me who screwed up my enrollment back on December 15, 2021? I still am awaiting that answer on what happened? In discovering not having medical insurance in Feb 2022, I decided to check into Dental Plan I had also enrolled upon at the same time thru the marketplace. In researching it, I was shocked to discover that I must wait a whole 12 months, while still making premium payments, to utilize the Dental Plan of Dentures and Implants.

Nowhere on the Dentist Program I choose stated 12 month waiting period, nor did I see that in their literature. So, I called the marketplace on both my dental and medical and what had happened with both. I was advised to start over with both and so I did. I re-visited the medical first and although I saw another option, I liked better, it didn’t offer everything, so I choose Sendero once again.

As for Dental, I choose a complete other company. Both selections were done prior to the marketplace's March 1, 2022, Deadline on February 23, 2022. After I redid both insurances, I contacted your company back that week and spoke with 2 representatives on two separate days. The one name that stuck out with me and was very helpful was a lady whose name I was understanding as Timber.

I discovered only later, her name is Taber (sp?) She gave me all the info I needed when I called the second time. I explained what happened with both your company and the dental and the marketplace and that I started over from scratch last week when I choose both. I also explained to Taber that I wanted not the credit on your books for 3 separate payments, but a Full 100% Refund of $316.16 x 3 = $948.48. Taber stated she would help me but that the new Premium for March 1, 2022, needed to be in ASAP.

See my two plans below here: ORIGINAL START #1 Health Medical Plan for Eric Allen Crabtree - MARKETPLACE SELECTION - 12/15/2021 Sendero Health Plans, Local Nonprofit Sendero IdealCare Silver 94% / $5 PCP / $5 Gen Rx + Free Wellness & Preventive Screening + Free Dedicated Healthcare Team + Free 24/7 Virtual MD Visits + No Pre-existing Condition Restrictions •Metal Level: SilverSilver •Plan type: HMOHMO •Plan ID: 71837TX0010001 Monthly premium $316.16 Including a $950.00 / Was $1,266.16 _____ RESTART #2 Health Medical Plan for Eric Allen Crabtree - MARKETPLACE SELECTION – 2/23/2022 Sendero Health Plans, Local Nonprofit Eric Allen Crabtree (Age 61) with an estimated effective date of 03/01/2022 2022 Texas application for Individual & Family Coverage Status: Submitted ID#: 412424**** Sendero IdealCare Silver 94% / $5 PCP / $5 Gen Rx + Free Wellness & Preventive Screening + Free Dedicated Healthcare Team + Free 24/7 Virtual MD Visits + No Pre-existing Condition Restrictions Monthly Premium = $327.95 Including a $983.00 Tax Credit ______ My First Question / Issue is this. #1. If these two Plans are the same, why on 12/15/2021 was it $316.00 Premium and on February 23, 2022, it jumped to $327.95 - a difference of $11.95??? When I had to Redo/Restart all over again because Sendero screwed me up on my active coverage back in Dec 2021 into Jan and Feb of 2022, I was told through the marketplace to redo and I did on 2/23/2022, and choose again, Sendero.

But this time, the Premium Monthly is now $327.95. Is it possible, that since Sendero screwed up my original membership I enrolled back on 12/15/2021, I can keep and maintain the Monthly Premium of $316.00 and not $327.95 for April 2022 going forward? Question / Issue #2 Who and why at Sendero Health Plans back on 12/15/2021 going forward thru Feb 2022, dropped the ball and did not follow-up or activate my membership? Especially after already receiving 2 full monthly premium payments for Jan 22 and Feb.

22, with a 3rd that was sent for March 1, 2022, in late Feb 22?? I mean the payments of $316 x 2 and then x 3, didn’t raise any red flags on who they were for and why wasn’t I sent ID Cards, Documents or activated in your systems?? Question / Issue #3 Taber stated I would be getting my Full Refund of $316 x 3 = $948.48 when I requested this last week as well as Thursday, when I spoke with her and when I called in again on 3/4/2022. As much as I tried to pick up the check instead of having it mailed, (tons of USPS Issues) I was convinced to do a direct deposit for my refund instead.

Those presented other issues, I will not go into those at this time, because now it is a moot point. Taber stated she would be submitting the information and my request and after long holds and getting all information and agreements, I was told that I should have the $948.48 in my bank account either today, March 4, 2022, or latest, Monday March 7, 2022. Why did this not happen for my Full Refund Amount? Question / Issue #4 On 3/4/22, I called back about the Direct Deposit we agreed upon the day prior yesterday and I explained I would rather have a check and pick it up instead.

That phone call was this morning at 9:48 am, 3/4/2022. Taber took down my concerns and request and we left it that she would do more investigation and she would call me back later with all updates. Well not hearing anything from her at around 3:30 pm and knowing your company’s call center closes at 5pm, I called back. Taber was on another call so I requested the representative to have her call me back when she finished that call and he stated he would get her the message.

No Call back as promised from Taber at all today. I called a final time, right prior to 5 pm, but could not get through, so no answer at all to my questions, concerns and request. I am very upset and frustrated. Why was I promised and nothing happened?

Question / Issue #5 When I spoke originally to Taber about my concerns of Direct Deposit, two of them right off the bat was me checking every 5 seconds if it had been deposited or not, which, is ridiculous. And secondly, the huge risk of when it is deposited, that money be pulled out from a loan issue source or ex-roomie who had my card access. After my total frustration of numerous attempts thru your phone center and representatives as well as here online, I just gave up. On Friday, 3/4/22, I just happened to check my bank account late in the afternoon on information on another issue, when I noticed a deposit today in the amount of $738.01.

Right away I went down to my bank and withdrew $500 immediately, only to discover that $200 was already deducted out prior to me even getting there and hitting an ATM. My fears came true and now, I am even more angry and upset over this whole situation. Question / Issue #6 Ok, Thank You Sendero for the $738.01, but that is a far cry from the total of $948.48 I was supposed to have received back. So where is my missing money of $210.47???

$948.48 - $738.01 = $210.47 Still Owed Me by Sendero Now? I know it is not for any coverage as the marketplace as well as your own company stated I was not covered with Insurance from 1/1/2022 through March 1, 2022. Thus the 3 payments made was for no insurance and I want my FULL REFUND PLEASE NOW. HOW CAN THIS HAPPEN??

Question / Issue #7 A check for my new Coverage starting March 1, 2022 – Dec 31, 2022 was mailed out from me sent out on 3/3/2022 via USPS Express 1-day Delivery to be received at your company guaranteed on 3/4/2022 – Check # 76927 in the Amount of $327.95 – USPS Tracking # EJ96863****US – Received after checking online: Delivered, PO Box March 4, 2022 at 8:32 pm DALLAS, TX 75260 I purposely spoke with Taber about this 4th check coming into Sendero Health Care overnighted when we spoke on March 2 & 3, 2022. I gave her the above information of amount, check number, how it was mailed, everything. This information was given when I was told about the March 2022 payment for my insurance restart not received. So please explain to me why I did not get my Full Refund of $948.48 this past Friday late afternoon?

And where is my remainder of this $948.48 totaling a difference of $210.47 due myself per my request?? Also, when and how will I receive this balance owed, ASAP? Because clearly my payment for the Restart and Enrollment of New Coverage has been paid and received for March 2022 as stated above and as explained to your representative Taber back early last week. Lastly, with no activation happened from Jan – March and now this who business of my refund, what am I now to expect from Sendero Health Plans when and if I start to use my medical insurance?

I have already gone thru a nightmare and a half already with your company. Should I be contacting the marketplace again to redo for a 3rd time for 2022, my new medical insurance and not choose Sendero but another or can you help elevated all my frustrations, and worries from what I have already experience? I look forward to lots of answers please, Today, Monday, 3/7/22.

Thanks! Eric Crabtree - 512-554-**** Texman512@***.com

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