William J. Stewart Contractor

March 16, 2018Dear [redacted] :We acknowledge receipt of your letter dated 3/2/regarding the above complaintWe appreciate this opportunity to respond to the items presented.For your benefit, I would like to first clarify our respective roles; WellNet was contracted to provide administrative services on behalf of the [redacted] Health Plan, which is a self-funded medical health planThis agreement went into effect October 1, and services were terminated September 1, The services include but are not limited to claims administration, provider contracting, plan documents, distribution of member material, and customer support.Date of service 9/29/was received on two claim submissionsClaim [redacted] for $was received on 10/25/The claim was returned from pricing on 11/1/and completed processing the same dateClaim [redacted] for $was received on 10/24/and returned from pricing on 10/30/This claim completed processing on 10/31/Claim [redacted] for date of service 03/06/$was received on 10/18/and returned from pricing on 10/24/This claim completed processing the same date.This plan is a Self-Funded Health PlanWhile we have recently received funding from the plan, we are still awaiting funding from the reinsurance carrier in order to release these claimsUpon receipt of the funds from the reinsurance carrier we will be able to release all pended claims.Should you have any additional questions regarding this inquiry please feel free to reach out to us at ###-###-####.WellNet Appeals Department

March 16, 2018Dear [redacted]:We acknowledge receipt of your letter dated 3/2/18 regarding the above complaint. We appreciate this opportunity to respond to the items presented.For your benefit, I would like to first clarify our respective roles; WellNet was contracted to provide...

administrative services on behalf of the [redacted] Health Plan, which is a self-funded medical health plan. This agreement went into effect October 1, 2016 and services were terminated September 1, 2017. The services include but are not limited to claims administration, provider contracting, plan documents, distribution of member material, and customer support.Date of service 9/29/2017 was received on two claim submissions. Claim [redacted] for $524.36 was received on 10/25/17. The claim was returned from pricing on 11/1/17 and completed processing the same date. Claim [redacted] for $109.66 was received on 10/24/17 and returned from pricing on 10/30/17. This claim completed processing on 10/31/17. Claim [redacted] for date of service 03/06/17 $275.97 was received on 10/18/17 and returned from pricing on 10/24/17. This claim completed processing the same date.This plan is a Self-Funded Health Plan. While we have recently received funding from the plan, we are still awaiting funding from the reinsurance carrier in order to release these claims. Upon receipt of the funds from the reinsurance carrier we will be able to release all pended claims.Should you have any additional questions regarding this inquiry please feel free to reach out to us at ###-###-####.WellNet Appeals Department