Response From International Association Of Benefits

The following is a letter from Shane Madigan, spokesman for International Association of Benefits, to Call 6's Rafael Sanchez regarding a story Sanchez ran on Feb. 20.

First of all I want to thank you for following up and following thru with the request to you from our previous association member, Amanda Duncan.

We have completed a full investigation into the matter that you have faxed and e-mailed to Terry Tullo, president of New Benefits Inc,. and to Joel Ray, CEO of New Benefits Inc. I received an e-mail last evening from Terry regarding the complaint to you. New Benefits is one of our contracted network providers for both the benefits and customer service for the medical discount products. The membership that Ms. Duncan had is called the Premier Plus membership.

This membership included limited insured benefits. What Ms. Duncan purchased is a membership into our Association. As a member of our association, with the Premier Plus membership, she had access to both the insured indemnity benefits that are underwritten by a licensed insurance company for our association. It is true that as a member of IAB she did have insured benefits as well as medical savings benefits. This membership gave her access to the network contracted rates, which reduce a physician sickness visit from 10 –30 percent and sometimes more.

In her letter she mentioned that her doctor was part of a network we used to use called Team Health, and whom NPPN was the provider for these medical savings benefits. However, she also had insured medical benefits that she could use over and above this. Sometimes people do get these two confused. If she used both, she would save even more money.

We did in fact change our network to Galaxy. This is not uncommon in our industry as we diligently try to find the best providers for all of our members on a national basis. Ms. Duncan mentioned that her doctor was not part of the Galaxy network. Unfortunately, she cancelled her membership at that point.

We believe it is important to realize that she did in fact have both insured and medical savings benefits through her membership. Had she have kept her membership, she would have been able to utilize the our hospital room indemnity benefit of $100 a day, and if in intensive care $1,000 a day, as well as access to the network contracted rates. Even though her physician was not in the Galaxy network, we could have called to seek her personal doctor's participation in the network. That way Ms. Duncan would have still been able to receive the same reduced price as she had with the Team Health Network. Also, if she kept the membership after her pregnancy, her newborn would immediately been a member as she was on the family membership plan. This means that she would have receive twice the amount of the insured medical benefits, for both herself and her newborn.

I also investigated into her request on a June 1, 2005 letter, to our office, to whom it may concern. This letter was logged in. However, our membership services manager had just been diagnosed with cancer and was on leave of absence. When she returned weeks later, she did not know anything about it.

With regards to both her association membership book and her association membership card, on the back of the card it specifically states that "Members Are Responsible For Network Contracted Rates incurred." We also request that our members send us their medical bills to be repriced. This method allows our members the ability to have their physician bills repriced, using the AMA's CPT coded repriced rates. With this situation, we could have done this.

We truly care about every member of IAB. Unfortunately, we could not help her when we did not receive any of her bills for repricing and she cancelled her membership prior to delivering her newborn.

However, we do want to directly take care of her request in this matter. We have already issued a full refund for all her membership dues from the beginning date when she became a member all the way through to her cancellation date.

Even though it has been over a year, we will still do what we are able to assist in repricing her medical bills up until the time she cancelled her membership with us.

Shane Madigan IAB Spokesman