Sendero Health Plans

Thank
-0.1pt;">you for the opportunity to address the concerns mentioned within this complaint. When Sendero Health Plans (Sendero) originally received this member’s 2017 reenrollment file from the Marketplace Exchange, on October 31, 2016, Mr. [redacted] was given a $402.00 advanced premium tax credit (APTC). On November 2, 2016 an invoice was mailed to Mr. [redacted] with the new premium amount of $484.00, because Mr. [redacted] updated his information with the Marketplace Exchange his APTC increased to $484.00.
 
On January10, 2017 Sendero received an escalated ticket from the Marketplace Exchange advising us that the member’s APTC had increased, and to make the necessary updates as we had not received and updated file with the APTC. Mr. [redacted]’s account was updated on January18, 2017, and a letter was sent to the member advising him of the update. Sendero tried to contact the member via the number listed account which is what Sendero received from CMS. The attempts to reach Mr. [redacted] were not successful because the rings busy / unreachable.  Sendero’s last attempts to reach Mr. [redacted] was today, January 19th at 8:30 AM and January 18th at 12:10 PM. 
 
The overage of $82.00 that Mr. [redacted] paid for January has been credited to his amount due for February.
 
Sendero understands how important member experience and satisfaction is. We will use this situation to assist us with improving our processes going forward.
Again, thank you for the opportunity to respond to this complaint.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.
Regards,
[redacted]

January 8, 2016
0pt;">
[redacted]
Revdex.com Corporate Office
1005 La Posada Drive
Austin, TX 78752
On December 31, 2015, Sendero Health Plans (Sendero) received complaint ID [redacted] which was filed with the Revdex.com on December 8, 2015. We appreciate the opportunity to respond and provide you the resolution to the complaint presented.
The complainant obtained active health coverage with Sendero on June 1, 2015.  The complainant’s health coverage was canceled for non-payment on September 16, 2015; per CMS guidelines, the complainant’s health benefits termed on August 1, 2015.  On September 17, 2015 the complainant submitted one monthly premium payment after his coverage canceled which initiated Sendero’s refund process. 
Sendero’s refund process can take up to 6 weeks after the request is received and validation is complete.  On October 14, 2015, the refund request was sent to Sendero’s finance department, and the complainant’s refund was mailed on December 2, 2015.  Two days after this complaint was filed with the Revdex.com the refund was deposited/cashed on December 10, 2015. 
Sendero understands how important member experience and satisfaction is.  We apologize for the length of time it took to process this refund, and we will use this situation to assist us with improving the process going forward.
Again, thank you for the opportunity to respond to this complaint.