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Redwood Empire Retiree Medical Trust (RMT) Claim Issues

Started by bryan_londo, Sunday March, 08, 2020, 15:34

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bryan_londo

Below you will find the email string I received from Melissa Elmer, who manages OUR money for the RMT, regarding my request for documentation. She denies claims and states she has no requirement to provide us with the information we need to resolve the issue causing the denial or any documentation explaining the denial. Apparently she is only required to give a generic reason which is of no help at all. If you speak with her regarding the issue, you get the same explanation. In my opinion she is purposely avoiding a paper trail, which should be of great concern to all of us who have thousands of OUR dollars tied up in this wonderful program.

If anyone has had same or similar problems, please contact me.


Redwood Empire Public Safety Medical Trust via bensolinc.onmicrosoft.com
Feb 11, 2020, 10:31 AM
to Bryan, Stacie, Suzan

Hello Bryan,

Thank you for your inquiry. Per the Trust rules the requirements for claims is listed within the Summary Plan Description, which can be found at https://redwood.simon365.com. The Trust is not required to provide further explanation. If you would like to ask for further explanation I am happy to have a conversation with you.

Additionally, the Trust is not required to provide copies of claims that are denied. Again, if you would like additional information I am happy to have a conversation with you and provide you the review of the documentation you submitted.

You are entitled to file an appeal, as stated in the letter as well as the Summary Plan Description. If an appeal is submitted it will be discussed at the next Board of Trustees meeting.

Please let me know if you have additional questions.

Thank you,
MELISSA ELMER

Customer Success Coordinator
Vimly Benefit Solutions
T +1 855-796-6978
redwood@vimly.com


From: Bryan Londo <blondo@comcast.net>
Sent: Monday, February 10, 2020 6:46 PM
To: Redwood Empire Public Safety Medical Trust <redwood@vimly.com>
Subject: [External Email] Letter dated 2/5/2020

Mrs Elmer


I am in receipt of your letter dated 2/5/2020 denying my claims. Once again you have failed to provide an itemized list of what is required "further documentation" to meet your requirements. Additionally you have failed to provide copies of the claims you claim are not "within the 90 day of the end of the plan year" "not eligible" etc

I have asked you repeatedly to provide this information and you refuse to do so. To deny claims and then refuse to tell me what it is I need to provide is counter productive and in violation of your fiduciary responsibility to the Redwood Empire Medical Trust.

You leave me no choice but to seek a legal remedy.

Bryan Londo
DSA RMT Trustee

jay_farmer

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