Rhythm Of The Markets

From: [redacted] , Director of Compliance, MagnaCare Your email regarding [redacted] was sent to Tisa C***, a manager in our Marketing and Consumer Education Department She passed it on to me as my department is responsible for researching and responding to such complaintsPlease note MagnaCare is a service provider, it is not itself a health plan and, accordingly, did not insure, underwrite, sponsor or assume financial responsibility for the health benefits received by the complainantRather, the complainant was covered under the ERISA self-insured health benefits plan sponsored by Pavers and Road Builders, [redacted] That being said, I have spoken with [redacted] who clarified that he is concerned only about a claim for services rendered to him on January **, by a physician with Columbia University DoctorsHe informed me that at the time of service, the claim for these services was sent by the provider to the wrong insurance company in error Because the claim was never paid it went to collection and in December he faxed this information to MagnaCare asking that we consider paying this claim The claim for $was processed in December and was denied because the time limit for claim submission had expired Additionally, Pavers and Road Builders ceased being a client of MagnaCare effective January ** [redacted] will have to direct his complaint to that organization at the address noted above

*** *** complaint is directed at the wrong entity. Any issue he may have is with the self-inured health plan that he is enrolled in which in this case is International Brotherhood of Trade Unions, *** *** *** *** *** Welfare Fund MagnaCare is not an insurance company.
MagnaCare provides administrative services to the union’s self-insured plan but does not handle enrollment, employee contributions or eligibility determinations. At no time and under no circumstance would MagnaCare have access to a union member’s bank account or ever handle any union member’s funds. Nor is MagnaCare in any way related to the broker the complainant mentions in his complaint. The issues *** *** raises should be addressed to his health plan

From:    [redacted], Director of Compliance, MagnaCare Your email regarding [redacted] was sent to Tisa C[redacted], a manager in our Marketing and Consumer Education Department.  She passed it on to me as my department is responsible for researching and responding to...

such complaints. Please note MagnaCare is a service provider, it is not itself a health plan and, accordingly, did not insure, underwrite, sponsor or assume financial responsibility for the health benefits received by the complainant. Rather, the complainant was covered under the ERISA self-insured health benefits plan sponsored by Pavers and Road Builders, [redacted]   That being said, I have spoken with [redacted] who clarified that he is concerned only about a claim for services rendered to him on January **, 2015 by a physician with Columbia University Doctors. He informed me that at the time of service, the claim for these services was sent by the provider to the wrong insurance company in error.  Because the claim was never paid it went to collection and in December 2016 he faxed this information to MagnaCare asking that we consider paying this claim.  The claim for $245 was processed in December 2016 and was denied because the time limit for claim submission had expired.  Additionally, Pavers and Road Builders ceased being a client of MagnaCare effective January ** 2016.  [redacted] will have to direct his complaint to that organization at the address noted above.