PHOENIX (3TV / CBS 5) – Jewel Johnston and her husband were lucky enough to have their first child, Jacob, five years ago.
âIf you put something in his hands he’s pretty happy and you can get a good photo,â she said, showing 3 On Your Side a photo of Jacob. âOtherwise, you’re out of luck.
But Johnston says that just a few years ago she noticed something was wrong with Jacob.
âI started noticing these behavioral issues that can usually be attributed to the terrible two, but they weren’t really going away,â she said.
Johnston eventually took Jacob for evaluation, and it was determined he had autism. Realizing that she needed to focus more on her son, Johnston quit her job.
“I just felt with all these struggles that he needed his mother. He needed me to be there for him.”
When she left her job, Johnston accepted what is known as COBRA insurance which allows families to continue their health insurance coverage but at a much higher rate. As for Johnston and his family, their COBRA coverage was administered by a company called WEX.
“So this third party company called WEX is supposed to take care of all the paperwork, and that’s who you make your COBRA payments to, and you’re supposed to have insurance?” 3 Gary Harper of On Your Side asked. “That’s right,” she replied.
But Johnston says she has no health insurance, despite paying WEX more than $ 1,700 a month for the past four months. And without insurance coverage, Johnston cannot make the necessary medical appointments for Jacob. Johnston says she’s spent hours on the phone trying to resolve the issue, but no one wants to listen to her.
“It’s very frustrating,” she said.
3 On Your Side got involved and Gary Harper got his hands on WEX. After reviewing the issue for me, Johnston says she immediately received a phone call from WEX saying her issue had been resolved.
“I started crying on the phone because all I wanted was to be able to make these appointments for my son. Now I can do it and I can provide him with the health care he needed.” , she said.
Johnston says she’s thrilled to know that she now has insurance and says it only happened with the help of 3 On Your Side.
âI think it’s amazing that you are doing this for the people in the community who have these kinds of issues,â Johnston said of 3 On Your Side. “We can’t reach the people we need to talk to, but you can reach them, and it’s absolutely amazing.”
WEX was very responsive to 3 On Your Side and quickly resolved the issue for me. The emails below from WEX and Blue Cross / Blue Shield explain why this viewer had issues.
I wanted to follow up to make sure you got the news that this issue had been resolved. More importantly, we are so grateful that Mrs Johnston brought this issue to our attention and we are sorry that we had to wait for her issue to be resolved. I also wanted to give you a full picture of the situation.
Once Ms Johnston’s situation regarding her inactive COBRA coverage was escalated, a senior member of the WEX Benefits team visited her by phone. The WEX Benefits team member explained the situation to Ms Johnston, then followed up shortly thereafter to let her know that her coverage was active with the carrier. During that call, Ms Johnston said she had just received a call from the carrier confirming this. The WEX Benefits team member also sent an email confirming Ms Johnston’s coverage was active with the carrier, and Ms Johnston indicated that she had received this email. Ms. Johnston has the personal contact details of the WEX Benefits team member for any concerns in the future.
The cause of this issue was that the carrier did not notify us when the account manager of our account and the email address we sent the reinstatement notices to changed. We sent the carrier the appropriate reinstatement notices when Mrs Johnston first opted for COBRA coverage and then sent urgent update reinstatement notices both times Mrs Johnston called to inquire about her coverage. . It appears that these reinstatement notices were not processed by the carrier due to the change of notification address. We have now confirmed the current contact details of the carrier. Please note that all of Ms. Johnston’s premium payments were forwarded on a timely basis to her employer for payment to the carrier.
I hope this explains sufficiently why this unfortunate incident took place. WEX is committed to providing superior service to all of our customers. Please do not hesitate to contact me if you have any questions or need additional information. Thank you.
Blue Cross / Blue Shield provided the following statement:
Have a good Monday, and thank you for giving us some time to study this. After speaking with our internal team, we are happy to inform you that the member has been reinstated without interruption of coverage. There was a delay in confirming coverage as we were waiting for the necessary information from the previous employer, members and COBRA administrator. We contacted the member directly to inform him of his reinstatement and also sent him his ID card.
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