ComplaintsforFlores & Associates

• Initial Complaint

  09/11/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I separated from my employer on Aug 26th 2024 I registered with Flores for *************** on Aug 26th I paid my COBRA premium to Flores on Aug 28th 2024 (Over $1700 for 30 days of coverage for my spouse and I)I was denied service from my provider from Sept. 1 - Sept. 11 2024 because the Insurance provide Cigna had not yet reinstated my coverage. This resulted in having to travel to medical appointments only to be rescheduled because my Cigna coverage was inactive according to Cigna After hours on the phone and both Flores and Cigna blaming each other for the delay in updating my coverage remains inactive after 10 working days from my premium payment to Flores. On September 11th I continue to be denied service with no recourse or partial refund for a service I paid for and it has taken a toll on my mental and physical health. Neither Flores or Cigna can give me a definitive answer on why I can't get medical service when money was deducted from my bank account over 14 days ago and we are 11 days into a 30 day coverage cycle. This is a scam....Flores continues to tell me they disclose it can take UP TO ******************************************** Cigna's system and coverage is retro active....hmmm what they don't tell you is you medical provider will not see you if your insurance is not active. Also, there is no recourse...they will not refund you for the days you were denied service. In this day and age, no update should take more than 24 hours. I paid for a service that I had no access to for 11 days out of a 30 day coverage cycle.

  Business response

  09/17/2024

  ****** **** elected and paid for COBRA on 08/28/2024.  On 09/03/2024, we sent a system automated file to ***** requesting that Cigna reinstate Teresas medical coverage on COBRA as of 09/01/2024 .  The eligibility file was resent to Cigna on 09/102024.
  Cigna processes updates on a first come first serve basis and their turnaround time can vary depending on how busy they are.  It can take 7-10 business days to the update to the insurance coverage.  An email was sent to ****** confirming that we received her payment which included the following verbiage:  
  
  A COBRA payment was posted to your account on: 08/28/2024. Please note it may take 7-10 business days to be reflected with your insurance carrier.  To see the details of how your payment was applied, please visit: *****************************************
  
  ****** contacted Flores on 09/11/2024 as her benefits with Cigna were not active yet.  She spoke to **** who then sent an email to ***** asking for an urgent update.   We did not receive a response from Cigna by Wednesday the 12th so **** called Cigna and was able to speak to representatives that confirmed that the coverage was reinstated.  **** called ****** and let her know that her benefits were now active retroactively back to 09/01/2024.   Any covered services that the participant incurred as of 09/01/2024 can now be submitted to Cigna.   
  COBRA Federal regulations allow participant a 60 day election period from the date their benefits end to elect COBRA then an additional 45 days to remit their first payment with the requirement that coverage would be reinstated retroactively back to the date coverage originally ended and any services incurred by the participant during that period would then be coverage by the carrier.

• Initial Complaint

  08/02/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I have an HRA through Flores through my employer. We had medical services occur at the end of 2023 (Dec. 30). The hospital had a mistake on our bill, so it had to be re-processed. This took months, and the bill was not available to be paid until April 30, 2024. I paid it on May 2 and then submitted the claim to Flores for reimbursement a couple days later. They denied the claim stating that it was past the deadline to submit (which was somewhere around the end of February 2024). We could not have paid the bill any earlier or submitted the claim earlier. Flores owes us $1200+ and I am very disappointed with how they handled our situation.

  Business response

  08/07/2024

  My name is *************************, and I am the Director of *********** Services at Flores and Associates. I sincerely apologize for the frustration and inconvenience you have experienced regarding your medical claim reimbursement.
  I acknowledge the challenges you faced with the delayed billing from the hospital and the subsequent processing time. We understand how critical timely reimbursement is, especially for substantial amounts.
  Our records show the claim was submitted after the plan's specified deadline, leading to its initial denial. According to plan rules,claims must be submitted within a certain period after the end of the plan year, typically around the end of February. This rule ensures timely processing and financial management.
  However, we recognize that extraordinary circumstances, such as billing errors and delays beyond your control, can make adhering to these deadlines challenging.
  Re-evaluation of Your Claim:
  We will re-evaluate your claim, considering the delays caused by the hospital's billing error. Please provide any additional documentation that supports the timeline of events, such as communication with the hospital and the corrected bill's issuance date.
  Improved Communication:
  We are committed to improving our communication and support processes. We will review how we handle similar situations and provide clearer guidance to participants facing unexpected delays from service providers.
  Please provide your contact information and the best way to reach you, and I will have a member of our team contact you to assist with your questions. You can respond to this email with this information, and I will ensure you receive a quick follow-up.
  We deeply regret any stress and inconvenience this situation has caused. Our primary goal is to support our participants and ensure they receive the benefits they are entitled to. Thank you for your patience and understanding as we work to resolve this matter.

  Customer response

  08/07/2024

  Attached are two documents proving my case. One is a statement from the hospital from April 30, 2024. That was the date I was able to pay my balance online, and then the second document shows the receipt for when I paid the balance on May 2, 2024.
  Thanks for your help with this.

  Business response

  08/08/2024

  Good Afternoon

  Thank you for submitting the additional documentation. We are pleased to inform you that we have received approval for a one-time exception to process the 2023 dates of service after the filing deadline.

  The claims department has processed the reimbursement request, and a check for $1,513.79 will be mailed to the address on file. Please allow up to 10 business days for the check to arrive.
  

  I will continue to monitor your account until the check has been cashed. If you have any further questions or concerns, please feel free to reach out using my email address *************************************************.

  Thank you 

  *************************

  *******************************************************

• Initial Complaint

  07/08/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I have been trying to reach my account manager about the balance due on my cobra coverage. This business has ONE 800 phone number and NO email address - just snail mail or fax! In my attempts to reach the account manager, I was only able to speak to one human who could not help me nor offer any additional resources for resoling my issue. Almost every time I call, I get immediately put on hold and then sent to a general voice mail box. I have only once been put through to the account manager and that was to their voice mail. No return call either. In the meantime, my coverage has been cancelled. I need to get this resolved and would like someone to please call me back.

  Business response

  07/10/2024

  Thank you for bringing your concerns to our attention. We sincerely apologize for the inconvenience and frustration you have experienced in trying to reach your account manager regarding your COBRA coverage. As the Director of *********** Services at Flores and Associates, I take these matters very seriously and am committed to ensuring that our clients receive prompt and effective assistance.

  First and foremost, I apologize for the difficulty you have encountered in reaching our team. We understand the importance of timely communication, especially for critical matters such as healthcare coverage. We are taking immediate steps to improve our accessibility and responsiveness.

  COBRA Payment Timeliness: It is crucial to make COBRA payments on time to ensure continuous coverage. According to federal regulations, COBRA participants must pay their premiums on or before the due date. Failure to do so can result in the termination of coverage, as it ensures the health plan can operate effectively and all participants receive their entitled benefits. Missing the payment deadline means coverage can be retroactively canceled to the last date for which a timely payment was made,leaving you without essential healthcare protection.

  Next Steps: I will personally ensure that your case is addressed immediately. One of our senior account managers has sent an email with our COBRA Appeal form, and should have provided clear guidance on any outstanding payments and steps to reinstate your coverage, if possible.

  Please accept our sincere apologies for any distress this situation has caused. We are committed to improving our customer service processes to prevent similar issues in the future. If you have any further questions or need additional assistance, please contact me directly at *************************************************.

  
  Thank you for your patience and understanding.
  Sincerely,
  *************************

• Initial Complaint

  06/13/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I signed up for dependent care through Flores to have funds dedicated for my childs daycare. Things went smoothly until I was assigned a new agent and I changed my bank info for direct deposit. Because my bank changed they issue checks that can take weeks to be received. Because I didnt want to have to wait on my checks I went in and updated my bank info for the following months exchange. I did this in a month advance because for whatever reason it takes 10 business days before your bank info to be approved. When the funds were showing available through the app, I called customer service to confirm that my direct deposit info was updated and good to go for the transaction. She asked for the last 4 of my account number which I gave her and she told me that I was good and I would be receiving something the next day. A whole week goes by and I receive an email saying that another paper check has been issued causing me to have to wait weeks till I actually get the reimbursement of the funds that were taken out of my account for my childs daycare. ***** care is expensive and I was depending on these funds to be in my account and confirmed with them before submitting my claim that I did everything correctly to receive my direct deposit. When contacting them to find out why a paper check was sent they told me something was wrong with my account number but couldnt tell me what and I would have to resubmit it which would take another 10 days before being confirmed. They could not give me an estimate on when I would get my check nor could they rush the check. After calling again I spoke to an account manager who went through my bank info so I could confirm it was the right info and it was. They also told me that they would get a new check processed to me to be sent to an updated address within 24 hours so that I could access it as I wont be home. The next day when trying to confirm that happened I was told that it takes a couple of days to process the checks.

  Business response

  06/29/2024

  Dear ***,
  
  Thank you for bringing your concerns to our attention. We deeply regret the inconvenience and frustration you have experienced with your dependent care reimbursement. As the Director of *********** Services at Flores and Associates, I take these matters very seriously and am committed to ensuring you receive the best possible service.
  
  First, I apologize for the delay and confusion regarding your direct deposit information and the issuance of paper checks. I understand the importance of timely reimbursements, especially for essential expenses such as childcare. 
  
  Pre-Note Process for Account Security: The delay in updating your direct deposit information is due to the pre-note process we implement to ensure the security and accuracy of your banking information. This process involves sending a test transaction to your bank to verify account details, which can take up to 10 business days. This step is crucial to prevent fraudulent activities and ensure funds are deposited correctly.
  
  Addressing Your Specific Situation: Despite updating your bank information in advance and confirming it with our customer service team, a paper check was issued. This should not have happened, and we are investigating the error. The difficulty in receiving timely updates and accurate information about your reimbursement is also unacceptable, and we are addressing this.
  
  Immediate Actions and Resolution:
  ~Improved Communication: We are enhancing our communication protocols to ensure timely and accurate updates about transactions.
  ~Account Verification Review: We will review and streamline our account verification process to reduce delays while maintaining high security standards.
  
  We are committed to supporting you and resolving this matter promptly. If you have any further questions or need additional assistance, please contact me directly at *************************************************.
  
  Thank you for your patience and understanding as we work to improve our services.
  
  Sincerely,
  ******

• Initial Complaint

  05/20/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  1. No details on the rejection of reimbursement on the ************** FSA was available on the website.2. Follow up request on the following two claims rejected has not been resolved after multiple requests. 1) Reimbursement rule was applied inconsistently. With one receipt covering 2022/2023 expense, partial reimbursement up to *************** was received in 2022, but rejected in 2023. $5,000 max ****** for 2023 was set based on the claim covering 2023 expense with the same receipt. The account managers I spoke with advised this will be escalated to the senior manager. 2) Summer camp used for dependent care was not reimbursed. 3 account managers confirmed verbally this will be reimbursed in a few days.

  Business response

  06/12/2024

  
  In response to *****'s complaint Flores can provide the following information:
  
  When Flores rejects or approves a claim, claim transaction detail is made available on our participant website, www.flores247.com. Claim rejection notices were also emailed to ***** on 5/2/2024, 4/29/2024, 4/23/2024, 3/12/2024 and 12/5/2023. Details for each denied 2023 ************** request are below:
  
  Doc #******** - received 12/3/2023 - this request was denied because expenses must be employment related and primarily custodial in nature to qualify for reimbursement; educational expenses are not eligible. The claim included a tutoring invoice and invoices for online/virtual courses, which are not eligible for ************** reimbursement.
  
  Doc #******** - received 4/24/2024 - this request was denied because the claim and supporting documentation lacked a 9-dgit Tax ID for the provider, MedStar Capitals.
  
  Doc #******** - received 4/30/2024 - this request was denied because must be employment related and expenses must be primarily custodial in nature to qualify for reimbursement; educational expenses are not eligible. The claim included a tutoring invoice and invoices for online/virtual courses, which are not eligible for ************** reimbursement.
  
  Doc #******** - received 4/30/2024 - this request was denied because extracurricular activities/lessons are considered educational, not custodial in nature. The claim includes invoices for Medstar Capitals, ice plex/hockey program. Please see below -
  
  Under IRS regulations, expenses reimbursed through a DCRA must be incurred to allow you (and your spouse, if applicable) to work or look for work. While some activities may appear extracurricular, they can be considered eligible if they enable you to maintain employment. However, to ensure we are compliant with IRS guidelines, we need to verify that the expense meets the criteria for work-related dependent care. Please provide a detailed explanation and any supporting documentation that clearly states how the expense allows you to work. This could include:

  1. A statement from the care provider specifying the nature of the service.
  2. A description of how the service directly relates to your ability to work.
  3. Any other relevant information that supports the necessity of the expense for employment purposes.

  This participant has contacted Flores several times, but there is no record of any agent confirming any of the denied claims listed above would be reimbursed. For the extracurricular activity, if the above criteria can be met and additional documentation provided to prove the expense was eligible for ************** reimbursement, we will promptly reprocess the request.
  
  Best Regards,

  
  
  --
  ***********************,
  
  

• Initial Complaint

  04/04/2024

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  I received health coverage through a new employer starting April 1st, Flores will not cancel my cobra coverage as requested online or refund me the payment already made for ****** I have tried to cancel 4 times, account manager ***************************** ************ refuses to return calls that always goes to her voicemail and she never picks up.my flores account is PID# *********

  Business response

  04/05/2024

  We apologize for the delay, your contact was not in the office.  All updates have been processed and reflected on www.flores247.com.  A refund of $702.93 has been generated to the customer, and is scheduled to be mailed Monday to the address on file.  

• Initial Complaint

  02/13/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  When i call their listed number for help, it tries to sell me products i clearly don't need or use. Then it hangs up. There is no way to actually get in touch with anyone to get help. They push me through endless prompts and try to sell me things that have nothing to do with me.

  Business response

  02/15/2024

  ***********************************, enrolled in the *********** Flexible spending Account (HCFSA) in 2023.  The plan year ran from 1/1/2023 to 12/31/2023.  We are showing per our records that Mr. ********* had not reached out to Flores prior to today since 2022.  ************************ has also had access to the companys website and contact number via his benefits card,website, and any documents he receives from Flores.  While we cannot see the last time he logged on, we can see that ************************ created a personal username.  It looks like he reached out to our office via email with a request on how to submit claims, and his email was addressed timely and information was provided as to how claims can be submitted.  According to the plan set up for ************************ s employer, there is a claim filing deadline to submit claims for dates of service incurred in 2023, that is 2/28/2024.  This means employees who were enrolled in the 2023 plan year HCFSA, has until 2/28/2024 to submit claims for dates of service incurred in 2023, that they did not use their HCFSA card for.

  Customer response

  02/15/2024

   
  I am rejecting this response because:
  When i try to call you, you advertise to me instead of having someone answer the phone that can provide me with help. This is not right... i pay you good money for help.. and you pressure me to buy things i dont need. 

• Initial Complaint

  01/12/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Fraudulent charges with a total of $5661.04 occurred on our HSA Master Card that is managed by Flores-Associates (F-A). Charges occurred on 10/2/23 scores 10 different transactions and 2 different merchants. All charges occurred on the same day. No warnings, the system continued to allow the charges despite they were in the same amount per merchant. Dispute of these charges was submitted on 10/17/23. Flores-Associates acknowledged all disputed charges/forms and claimed they were forwarded to Master Card. Since then we periodically reach out to F-A to get updates but the only response we get is, that the dispute is still under review with no news. Our latest call to F-A was on 1/11/24. Representative said that we need to reach out directly to our account manager (but said he was not available at the moment) and transferred the call to his voicemail. I left the message but no response. Our latest email to F-A was on 1/5/24 to both generic account and our account manager but no response from either. It has been 87 days since the dispute was filed. Seeking: 1. Funds to be returned to our account in the amount of $5661.04. 2. Implement better security measures when suspicious/repeating transactions are occurring within same day and notify card holder immediately with temporary card block. - this is inline with other card businesses. 3. Issue refunds immediately while investigation is in progress - this is inline with other major card businesses.

  Business response

  01/17/2024

  On 10/26/2023 ************ contacted Flores about suspected fraudulent benefit card activity on their HSA account. ********************** had ************ complete and return a Debit Card Transaction Dispute for, which we then forwarded to our banking partner for review. Since then, Flores inquired with our banking partner on 11/13/23, 12/14/23, and 1/16/24 for an update to on the status of this dispute. Each time we have been told that disputes are processed in the order theyre received and this is still pending review, as well as communicated this same information to ************* While the Flores benefit card functions similarly to a credit card, they are not the same, and not subject to the same application of provisional credits.
  

• Initial Complaint

  01/12/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  For the 2023 year I paid into my *** account and dependent care account with **********************. I left my previous company in February 2023 with a little over $1500 between my *** account and my dependent care account. When I tried to file my first claim to pull the *** account out, I was told by an account representative that I could only get the money out if my charges fell within the time ****** of my previous employment. I did not have any healthcare expenses during that time ****** so I lost all the money I had paid into my *** account and I understood that. Later when I filed to get my dependent care out, my claim was denied twice but I never received an explanation why. Talking to the receptionist she said that I had 90 days after my previous employment to file a claim. I asked to speak to an account representative. I spoke to *******, who told me that the 90 days was not an issue and that I would be receiving my money, because my dependent care expenses fell within my time of employment. Five months have gone by *** called and left six messages and sent six emails to the dedicated account manager:" *********************. She has yet to give me the decency of response. Today I was finally able to speak to a gentleman that said he was an account manager that claims the 90 days is definitely a factor according to my old employer's contract (attached). When I asked him if he could provide me with 90 days grace ****** information he could not. He said the money was returned to my old employer in **** for nonuse. In summary, according to Flores I cannot be refunded my money that I paid in for expenses that I endured during the 2023 year- when the dependent care expenses fell within my employment with my old employer. To end the call the account manager told me to take it up with the *****

  Business response

  01/18/2024

  The enrollment through your employers Flexible ********************** plan allows reimbursement of childcare expenses up to 90 days after your termination of employment. Upon further review of the receipts submitted, we do agree that you are due reimbursement of the funds contributed while actively employed and participating in the plan.

  Customer response

  01/19/2024

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to my complaint, and find that this resolution is satisfactory to me.
  
  Thank you. 
  

• Initial Complaint

  01/11/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I am writing to file a formal complaint against Flores 247 Transportation Benefits regarding a severe lack of customer service and unaccounted funds within my account.Despite numerous attempts to resolve this issue by contacting customer service representatives, I have encountered persistent difficulties in obtaining accurate information or assistance. Upon reviewing my account, I discovered an unexplained discrepancy of $554 that remains unaccounted for. This unresolved amount is preventing me from accessing my funds as expected.Furthermore, the customer service department has consistently transferred my calls without providing any concrete solutions or offering assistance. This continual runaround and lack of clarity have caused undue stress and financial inconvenience.I have made diligent efforts to resolve this matter directly with Flores 247 Transportation Benefits to no avail. I hereby request your intervention to investigate this discrepancy and ensure the immediate return of the unaccounted funds to my account.

  Business response

  01/19/2024

  The 2023 Transportation account sponsored by **************************** allows for employees to contribute their desired amount of tax-free dollars to the account to be used for any eligible parking and/or transportation expenses incurred during the calendar plan year 1/1/2023-12/31/2023. It is noted in the plans Legal Documents that any funds remaining in the account at the close of the plan year will be forfeited back to the employer. This participant contributed $1014.00 to the 2023 transportation account. Of these contributions, $460.00 was used for qualifying expenses, leaving a current balance of $554.00 that can be used for any additional parking/ transportation services that were incurred in 2023. The plan allows participants until 4/30/2024 to claim any remaining funds. 

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