Cal Choice and Valley Oaks Complaint

Insurance malpractice, fraud and ignorance of coverage rules - Health Insurance

- Sacramento/Roseville
I asked Valley Oaks Insr brokers to see if I could sign up for my company group health plan to get coverage for myself and my disabled adult daughter in July 09. At the time I was in the process of selling my company and wanted to know if I could get COBRA for both of us or for my Daughter individually. The brokers told me I would have to apply retroactively to March 1st as I had not elected the coverage at the beginning of the coverage period because I had Medicare.

I told the brokers I would not decide if I wanted the insurance until I knew the cost and whether COBRA was available. When I found out the cost (over $7,000) and the fact we could not get COBRA because the new owner would eventually close the group plan and convert to their own. I told the brokers to tell the carrier Cal Choice that I did not want the coverage. Several months later after I sold the company, I found out that Cal Choice had fraudulently taken over $8,000 including late payment penalties out of the company insurance premium for current employees to pay for coverage I had clearly told Valley Oaks and Cal Choice I did not want and would not pay for. This action caused the company to lose it's healthcare coverage for all the employees for failure to pay the full premium. I have not been able to get redress or even a response to help me solve this problem from either Valley Oaks or Cal Choice in spite of many efforts to do so. The new owner of the company charged me the full cost over $8,000 for something I never got.

When I looked into the matter further I found out that anyone with Medicare, which both my Daughter and myself had when the application was made cannot be covered by COBRA under any circumstances. If either Valley Oaks or Cal Choice had been knowledgeable, the application would never have been made and this would never have happened in the first place. I believe the brokers and the insurance company is guilty of negligence, fraud and illegal practices. I want my money back.

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