Update: February 7, 2007
I received an explanation of benefits letter dated January 21, 2007 from Delta Dental stating I am responsible for my expenses. I received a letter dated January 24, 2007 from the CobraServ National Service Center stating "the cancellation of your COBRA continuation coverage has been rescinded, with no lapse in coverage." It appears Delta Dental and Ceridian (COBRA) are not communicating with each other, and guess what, I am suffering from it.
Update: January 17, 2007
I received a very detailed professional response from Ceridian. It appears Ceridian performed their duties as outlined in their agreements. I have not received a response from Delta Dental.
Update: January 8, 2007
I called Delta Dental today. Delta Dental representative, Ms. Anna reports my account is now active. Ms. Anna reports my account is retroactive to September 1, 2006.
January 7, 2007
Dr. Robert E. Dennison
President & CEO
Delta Dental of Illinois
801 Ogden AvenueLisle, IL 60532
Mr. John Shade
President & CEO
Ceridian Benefits Services
3201 34th Street South
St. Petersburg, Florida 33711-3828
Re: Dental Insurance/Coverage
Dr. Dennison:
On or about December 1, 2006 my employer(s) Gateway Foundation, Inc. (Gateway) and WestCare Foundation, Inc. (WestCare) entered into an agreement for Cobra insurance with Ceridian Benefits Services (Ceridian). According to Ceridian employees, Ceridian submitted confirmation of my Cobra insurance documentation to Delta Dental of Illinois (Delta) on or about December 20, 2006 with a retroactive/effective date of December 1, 2006.
I attended a dental appointment at Sears Dental (Sears), Calumet City, Illinois, who is my network provider, on December 14, 2006. Because Sears reported I was not covered by my Cobra insurance, on December 14, 2006 I paid $173.00 for my initial dental service with Sears. After calling Ceridian about my premium and finding out it had not been paid on December 14, 2006, I personally sent and Ceridian received a payment of $47.58 for my premium.
As of today, January 7, 2007, my account with Delta is still inactive. As of today, January 7, 2007, I have not received the payments I rendered to Sears of $173.00 and Ceridian of $47.58. As of today, January 7, 2007, Delta has not been able to provide me with any information other than my account being inactive since November 30, 2006.
This is an account of what has happened to me.
On or about November 1, 2006 Gateway relinquished its contract with the Illinois Department of Corrections (IDOC) at Sheridan Correctional Center (Sheridan). On or about November 1, 2006 WestCare engaged in contractual services with IDOC at Sheridan. I had and have Delta Dental of Illinois as my primary service with Gateway and WestCare, respectively. WestCare picked up the insurance responsibility for the employees of this Sheridan contract. I received Cobra insurance through Ceridian Benefits Services (Ceridian) as of December 1, 2006. Gateway and WestCare agreed upon payment for my insurance.
WestCare paid my insurance on or about December 18, 2006, which was retroactive to December 1, 2006. Ceridian entered this information into their computer system on or about December 20, 2006. I have called Ceridian and Delta everyday, except for the holidays of Christmas and New years, having no results to continue my dental services or to get a refund of the money I have spent for my contracted services. I have requested my calls documented by Ceridian and Delta. I have been informed by Ceridian and Delta that my calls have been documented.
When I found out my company had paid my premium on or about December 18, 2006 I verbally requested, on or about December 18, 2006, a refund from Ceridian for my payment of $47.58. I was informed by Ceridian employees my payment of $47.58 would be returned to me. After not receiving my refund by January 1, 2007 I called Ceridian again. Ceridian representatives informed me my payment of $47.58 was applied to my January 2007 payment. Ceridian representatives also informed me I would get a refund or receive credit from Sears for my payment of $173.00 when my insurance was confirmed by Delta. As of January 7, 2007, when calling Delta, Delta has not been able to provide me with any information other than my account being inactive since November 30, 2006.
On January 4, 2007 I talked to Account Specialist Rebecca who informed me I could not receive a refund for the premium I paid if I had not rendered a written request for it. I informed Rebecca no one from Ceridian informed me I had to submit anything in writing for this refund. On January 6, 2007, my last call, Ms. Ashley of Ceridian informed me Ceridian has updated my account three times, which is documented in the Ceridian system, sending the last update of January 5, 2006 to Delta’s “Eligibility Department.” Ms. Ashley also gave me two other departments, which Ceridian might have sent my eligibility requirements to in the Delta system. I have been asking this question of where my eligibility status was sent to in the Delta system since December 20, 2006. No one had the answer except Ms. Ashley. Ceridian’s Account Specialist Rebecca did not have this information for me when I requested it.
Therefore, Dr. Dennison and Mr. Shade I would appreciate an eligibility update immediately. I also request an immediate refund of $47.58 and a credit with my primary dental provider or refund of $173.00, to which I am entitled. I will post this letter on my websites. When I informed a Ceridian employee over the phone I would write and post this letter on my website, he laughed at me.
Respectfully submitted,
Fred L Nance Jr., ABD, MA, CADC, NCRS
cc: http://click.townhall.com/, http://clickforjusticeandequality.blogspot.com/
