Health insurance advise; have member id, not in system???

Question

My company changed group insurance from one company to another with an effective date of 2-1-08. As of today, I still have not recieved a card or anything. Yesterday, the broker sent me over a page printed on insurance company letterhead with my member number and group number. When I try to use this info to login to to the website to print a temporary card, they have no record of me. When I call (I called 5 different customer service numbers) they have no record of me or my social security number. The broker is saying that there is nothing he can do because it has all been sent to them. The HR person at work can't do anything more than the broker and I can't get anyone at the insurance company to help because according to them, I don't exist. I am 28 weeks pregnant and have not had a doctors appointment in almost a month because I don't have any valid insurance card or even valid info for them. What to do at this point? I was up half the night worrying about it.

Answer 1

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Answer 2

write them a letter threatening legal steps you will take. tell them if they do not find your information, and can't find anyone who can, you will take them to court. insurance companies will do anything and i mean anything to avoid court in this kind of case. if something was to happen to you or your baby due to their unprofessional tactics, they could be sued for A LOT. and i mean obscene amounts. and they know this, so to get the ball rolling, tell them your next step will be to get a lawyer. they will find your records or make another record so fast their head will spin. they know the court will rule in your favor so they will avoid court definetely. insurance companies have to protect every dollar they have in case they need to insure somebody in an unfortunate incident. so they will avoid a situation at all costs if it will cost them money. i am studying to be an insurance agent as we speak and i know this for a fact. you take this step, you will get whatever you want from them good luck and kick their butt.

Answer 3

I agree with New Jersey, the broker/agent should be helping with this.  They have company reps that they should be able to contact and have you manually entered in system.  

I would call the broker every hour until I got some where.  

That is what the broker is getting paid for.

Answer 4

Your OB/GYN should take the group number and member number and file a claim.  If it is denied, ask them to file again.  That will give the insurance company time to locate your records and get you into the system.  Continue to check on the situation with your carrier to make sure they are working on it.  Ask the broker to follow up with them as well.

I once had a situation with one of my clients that sounds almost exactly like this one.  One of the members was assigned a number from the group census page but when they were doing the data entry, two of the applications were turned at the same time.  That left us with a number but no record in the system.  As the broker, I had to resend that members application indicating the member number assigned.  It was straightened out in short order when I put pressure on them.

Answer 5

The broker CAN do something.  He/she can intercede with the insurance company to expedite getting you "into their system."  That's the kind of customer service problems that brokers are supposed to help with.  Lean on that broker and get youyr employer to do the same.