Medical Mutual Complaint, Example 6 – Accountability

"0" Premium before tax credit. November 27, 2015 credit shown for $62,000 income
$0 Premium before tax credit. Sign me up!

During last week’s preview week on healthcare.gov, Medical Mutual  offered duplicate plans, same name but one serial number off from other plans, that cost nothing. Zilch. $0. And then I couldn’t believe how much my premium was going up on the mirrored plan that was not $0. What a great deal – those $0 plans! So I called Medical Mutual to ask more details about the $0 Premium before tax credit offerings on healthcare.gov, because the $0 plan was clearly offered to me. These are direct quotes from Naomi in the Medical Mutual sales department on October 27:

You have to talk to the Marketplace. I don’t see the plan. I can’t look it up by plan number. You just popped up on the line and I answered your call.

I cannot look up plans by plan number, you have to go back to the Marketplace. Marketplace is administrating the plan.

Your premium went up because the federal government regulates that and they increased everyone’s premium.

You’re asking me to look up a plan on a different company’s website that I can’t see.

You want me to have all the answers as to why there is a free plan on the healthcare.gov website and it is offered to you.

We don’t have info on the plans offered on healthcare.gov, you have to go to them. It’s a different entity.

I can’t give you false information. I can but I’m not going to do that.

I cannot look up a policy that we do not offer.

It’s federally facilitated, different from Medical Mutual.

I can’t answer your questions because they are offered through healthcare.gov.

Sounds like it’s for medicaid.

We have no information on it. Nobody answers questions about plans on healthcare.gov. It’s through the government. You need to contact healthcare.gov because it’s offered through healthcare.gov. For this plan you have to call healthcare.gov.


When I spoke to Stacey at healthcare.gov on October 27, he duplicated everything I did on his screen and came up with the same results I was getting and these are his direct quotes:

I thought that was their job. (He said when I told him Medical Mutual told me I had to ask healthcare.gov about their plans.)

I would think that, and I’m putting them side by side, they are identical.

I don’t know why it says “child” because it covers adults and children.

This plan has costs and this doesn’t. I don’t understand, I really think that Medical Mutual should have been able to tell you some basic information.

I see this plan and all the details that it consists of, and it would seem you would pay “0” dollars.

This seems like the one to get, and when its says premium before tax credit is “0” you don’t even need a tax credit.

It’s like a trick, like smoke and mirrors.

It is very bizarre. They are nearly identical to the other plan, they are only one number off in the plan ID so I understand your concern.

I have never really experienced this in this way.

It seems as if it is supposed to be “0” dollars, or it is a trick.

It’s ridiculous, it’s their plan, it’s their company and they won’t talk to you about it.

Here’s a phone number you can call, Ohio Department of Insurance, let them know what is going on. Let them know what we discussed, that I see the same thing you see.


So I took healthcare.gov’s advice, and after speaking with the Ohio Department of Insurance, I filed a consumer complaint against Medical Mutual for pricing and accountability and false advertising.

Page one of my consumer complaint, no. CSD-0034217
Page one of my consumer complaint, no. CSD-0034217

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