Action 9

Consumers say they paid premiums for inactive health insurance

Fernando Vera and his family have endured so much. His wife is battling cancerous mesothelioma.

“Right now, she’s hospitalized and she’s awaiting surgery,” Vera said.

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In order to be there for his family, Vera had to make adjustments at his job.

“I still work reduced hours but left my full-time shift so I could take care of her and still be able to work,” Vera said.

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His wife has her own health policy, but Vera signed up for COBRA insurance through his employer, that would continue to provide medical coverage for him and his kids.

But when he tried to schedule doctor appointments, he was told he didn’t have insurance, so he tried to get answers from the company taking his premiums.

“It just became a nightmare from then on because there was nobody that I could talk to,” Vera said.

He had paid PlanSource, the insurance administrator, nearly $5,000, but he claims the money was not sent to the actual insurance provider.

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“They’re basically taking your money that you’re giving them to turn on the benefits and they’re doing something with the money but not using it for what’s intended,” Vera said.

PlanSource is rated B at the Better Business Bureau, they have 9 complaints in the last year and 4 of those involve customers claiming they paid for COBRA insurance that was not activated.

Florida’s Insurance Consumer Advocate, Tasha Carter, says that even if another company is taking the payments, when it comes to COBRA coverage, the employer would still be on the hook.

“If they contracted with a third-party administrator and that administrator has dropped the ball and is not forwarding those payments, ultimately it is the responsibility of the employer,” Carter said.

Action 9 contacted PlanSource, a spokesperson said millions of consumers are served by the company and while issues are rare, they are promptly addressed and resolved as in Vera’s case.

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Vera did finally get his insurance policy activated, after telling PlanSource he had contacted us.

“The next day magically, I go to my insurance and I check the website and they’re turned on,” Vera said.

Since COBRA is a government regulated program, consumers have options. File a complaint with the US Department of Labor, that’s the agency in charge of the employer-based health coverage.

Todd Ulrich

Todd Ulrich, WFTV.com

I am WFTV's Action 9 Reporter.