CIGNA

A final determination has been sent to the customer today, April 4,

Cigna sent me another release of information form last week, which I previously completed so I called them and I spoke with Tikia (sp) and she told me she would send me the requested information AGAIN because she said it looked like it hadn't been sent yet I then received the requested information about days later so I think this nightmare is over and I appreciate all of your help! Sincerely, [redacted] ***

Thank you for forwarding this complaint to CignaCigna has reviewed this complaint and resolution letter has been sent to the customer on 09/20/2015.Erica M***Executive Office Advocacy Team

Thank you for this informationWe will contact the customer directly Thank you, [redacted]

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received your complaint will be closed Administratively Resolved] Complaint: [redacted] I am rejecting this response because:I received a call stating they were going to correct the issue through Julysetting the rate to $through July and refunding me accordingly through thenwhich is not what was initially agreed toIn May I was still charged $which leads me to believe nothing happen Regards, [redacted]

A private written response was sent to the customer as of January 29th,

Thank you for forwarding this complaint to CignaCigna has reviewed this complaint and the customer was contacted on 10/25/2016.Erica M***Executive Office Advocacy Team

Thank you for forwarding this complaint to CignaCigna has reviewed this complaint and resolution letter has been mailed to the customer on 11/22/2016.Charlene V [redacted] Executive Office Advocacy Team

Thank you for bringing your concerns to the attention of the Executive Office at CignaTo Whom It May Concern, I want to let you know that I received the inquiry about [redacted] I am part of the Executive Office Advocacy TeamMy job is to look into the concerns Cigna customers, and their representatives, bring to the attention of our president and senior leadership team.We take patient confidentiality seriously Protecting our customers' personal health information is criticalSo much so, that the Health Insurance Portability and Accountability Act (HIPAA) requires that we protect an individual's private health information (PHI)Because your inquiry requires that I look into Ms [redacted] 's information, I need her to give me permission to share my findings with the Revdex.comMs [redacted] can grant this permission by signing an Authorization for Use and Disclosure formNext Steps I will reach out to Ms [redacted] to let her know that I received your inquiry, that the Revdex.com would like a response and that I need permission to communicate with youI will also send the Authorization for Use and Disclosure form so she can sign itI have attached a copy to this letter too so you have an idea of what it looks likePlease know that I must receive this signed form from Ms [redacted] in order to respond to youIf I do not receive a signed form, I will communicate only with herThank you again for sharing your concerns with the Executive Office at CignaSincerely, Nicole P [redacted] Executive Office Advocacy Team

Cigna has been in contact with the customer and a resolution has been reached for Revdex.com complaint # [redacted]

Hello, Thank you for this inquiry I have reached out to the customer to obtain further information, and will continue to do so until completion Thank you, Kelly

Hello,Thank you for this information.I will be in review of this issue and will contact the customer directly.Thank you,Nicole P [redacted]

Hello-Thank you for forwarding this customer's complaint to CignaCigna will review this customer's complaint and provider folldirecly with the customerThank youTanya H***CignaExecutive Office of Complaints

Hello- Thank you for forwarding this complaintCigna will review and folldirectly with the customer Thank you Tanya H [redacted] Cigna's Executive Office of Complaints

[A default letter is provided here which indicates your acceptance of the business's response If you wish, you may update it before sending it.] Better Business Bureau: I have reviewed the response made by the business in reference to complaint ID [redacted] , and find that this resolution is satisfactory to me as far as returning the $ However, the money you charge for the services covered should be illegal and what Cigna advertises is false Regards, [redacted]

We are writing to acknowledge and respond to your correspondence dated April 1, 2016, regarding Joey ***’s claim for Long Term Disability (LTD) benefitsMr [redacted] was covered under his employer provided, fully-insured LTD policy [redacted] , which was underwritten by Life Insurance Company of North America (***) and issued in Georgia.Mr [redacted] raised concerns regarding his most recent LTD claim experience and claim decisionPlease allow us this opportunity to address his concerns and explain our decisionWith respect to Mr [redacted] employer’s LTD policy [redacted] , in order for benefits to be payable, his medical records needed to support that his health conditions caused a functional impairment that would continuously meet the following definition of Disability/Disabled to be eligible for benefits:Definition of Disability/DisabledThe Employee is considered Disabled if, solely because of Injury or Sickness, he or she is:unable to perform the material duties of his or her Regular Occupation; andunable to earn 80% or more of his or her Indexed Earnings from working in his or her Regular OccupationAfter Disability Benefits have been payable for months, the Employee is considered Disabled if, solely due to Injury or Sickness, he or she is:1) unable to perform the material duties of any occupation for which he or she is, or may reasonably become, qualified based on education, training or experience; and2) unable to earn 60% or more of his or her Indexed Earnings.The Insurance Company will require proof of earnings and continued Disability.While his LTD benefits were approved for a time, continued LTD benefits were not payable to Mr [redacted] beyond October 29, 2014, because he no longer met the policy’s definition of DisabilityBenefits were subsequently paid through this date and then discontinuedAccording to our records, this determination was also reviewed and upheld through two separate administrative appealsWhile we understand Mr [redacted] disagrees with our determination and paid for coverage under policy [redacted] , further LTD benefits would only be payable if a continued functional impairment was supportedAt this time, it has been determined that Mr [redacted] did not meet this definition of Disability/Disabled beyond October 29, as required by his employer’s policyBased on our review, no further financial compensation is due to Mr [redacted] at this timeShould you have any questions or would like to discuss this matter further, please feel free to contact me directly at ###-###-####.Sincerely,Eric F [redacted] ,Compliance SpecialistCGI Consumer Advocacy

Hello, Thank you for notifying CIgna of this complaintWe will be following up with the customer directlyThank you, Nicole P [redacted]

Good morning, I sent a written response to the customer in regard to his concerns earlier todayThe response was sent out via email and regular mailThe claim for the customer was processed on 11-29-per the instructions on the electronic claimThis issue has been resolved

[A default letter is provided here which indicates your acceptance of the business's response If you wish, you may update it before sending it.] Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] and although I haven't verified the completeness/correctness of the audit results I am ok with closing the complaintThe business has tried to contact me a couple of times over the phone as well as sending the results, but I have been unavailable due to travel, so they made their best effort Regards, [redacted] ***

February 2, Dear Sir or Madam:We are writing in response to your correspondence dated January 25, 2016, referencing [redacted] claim for Long Term Disability (LTD) benefits [redacted] was covered under his employer's fully insured LTD group benefit policy [redacted] This policy was underwritten by [redacted] (***) and sitused in the state of Massachusetts[redacted] raised concerns regarding his most recent LTD claim experience and claim decisionPlease allow us this opportunity to address his concerns, explain our decision, and provide an updated status.With respect to [redacted] ***'s employer's LTD policy [redacted] , in order for benefits to be payable, as of November 27, 2015, his medical records needed to support that his health conditions caused a functional impairment that would continuously prohibit him from performing the material duties of any occupationThe policy's "Definition of Disability/Disabled” lays out these requirements and is defined on page of the enclosed policy.While his LTD benefits were approved for a time, continued LTD benefits were not payable to [redacted] beyond November 27, 2015, because he no longer met the policy’s definition of DisabilityThis determination was based on our ongoing medical review of the relatively stable findings received from his providersAfter a complete medical review of the available records on file, it was determined that [redacted] ***'s condition would not render him Disabled beyond the date referenced above, according to the terms of his LTD policyAs a result, no further benefits were payable and his claim was closedOn September 3, 2015, a letter was sent to [redacted] ***, which explained our decision, provided information that may be helpful to perfect his claim and further explained the appeal process.Subsequent to our decision, [redacted] requested an administrative appeal review of his LTD claimAs part of our process, his entire file was referred to an independent peer reviewer for evaluation.For your reference, we have enclosed a copy of LINA's recent correspondence to [redacted] ***, explaining that our prior decision on his claim was overturned on appealAfter reviewing updated medical