Choice 100+ Frequently Asked Questions Brokers and Producers

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Roberta Jones
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1 Choice 100+ Frequently Asked Questions Brokers and Producers 1

2 Choice 100+ Frequently Asked Questions Q: Who do members call for assistance for medical, pharmacy, dental, or vision? A: For questions about their health care coverage, members should call ASK-BLUE ( ), Monday through Friday, between 8 a.m. and 8 p.m. For questions about Guardian products, members should call Q: Who do members call for assistance for Guardian s Life, Accident, Short and Long Term Disability, and Critical Illness insurance products? A: For questions about Guardian s Life, Accident, Short and Long Term Disability, and Critical Illness insurance products, members should call Q: Who should members contact with questions about how to complete the online enrollment process? A: Members should call ASK-BLUE ( ), Monday through Friday, between 8 a.m. and 8 p.m. Q: How do members apply? A: Applying is simple and secure via the online tool. In addition, online applications are processed more quickly and members can check the application status at any time. Q: How long will it take to apply and enroll in a health plan via the online tool? A. On average it takes up to minutes to apply and enroll for a health plan depending on the member s needs. Q: Can members change passwords? A: Yes, they can change passwords by clicking the Forgot your user name or password? link on the login page of the online shopping tool. Doing so will walk members through the necessary steps to reset a password or retrieve a username. Q: When do members need to purchase health insurance? A: Members must complete benefits elections during the start and end dates selected by the employer. Q: If a member logs out, will he or she be able to log back in? A: Yes. Members who log out prior to completing enrollment will be able to log back in using the password they created and complete the enrollment process. Q: If a member logs out, will the information already entered be saved? A: Yes, if a member logs out of the online shopping tool before completing enrollment, all the information entered up to that point will be saved. Q: What information is needed to complete the enrollment process? A: To complete the enrollment process, members will need the following information: A personalized Authentication ID, which was provided in the Open Enrollment Welcome Announcement The Social Security Number(s) for the registering member and all covered dependents (i.e., spouse/partner, child[ren], etc.) The first name and last name(s) of all the member s covered dependents (i.e., spouse/partner, child[ren], etc.) 1

3 The date(s) of birth for the member and all covered dependents (i.e., spouse/ partner, child[ren], etc.) Policy number(s) of Medicare or any other coverage that the member is also covered under Q: Where does a member get an authentication ID number? A: Each member s personalized Authentication ID was included in the Open Enrollment Welcome Announcement sent by their employer. Q: Why does a member need to provide Social Security numbers for dependents? A: As a part of the Affordable Care Act federal regulation, as of January 1, 2015, Independence Blue Cross is required to obtain Social Security numbers. This online platform uses the latest security methods to protect any information members provide. Q: What if a member doesn t have an address? A: There are many free services where members can register for an account. Some examples are Gmail and Yahoo Mail. If the member prefers not to create an address, paper applications are available by request. Members can request a hard copy application by calling or accessing our secure web-based form. Q: What are the terms of use? A: The terms of use for this online shopping platform are rules that make the intended use of the tool clear. Q: Can a member apply for health coverage for his or her family? A: Yes. Members can apply for health coverage as a(n): individual; individual and spouse; individual and child(ren); or family. Q: Where/how can a member add a dependent? A: Members can add a dependent in the enrollment portion of the application process on the online shopping tool. Q: How does a member enroll a disabled dependent over age 26? A: Handicapped dependents over the age of 26 cannot be enrolled via the shopping exchange. Parents and guardians of handicapped dependents should reach out to the Customer Service telephone number on their ID card and request the Handicapped dependent forms. The forms must be completed by a medical doctor and returned to Independence Blue Cross for review by our Medical Department. An approval/denial letter will be mailed to the member and group customer. Q: Can same-sex spouses be added to a health plan? A: Yes, a member can add a same-sex spouse dependent in the enrollment portion of the application process on the online shopping tool. Q: Can domestic partners be added to a health plan? A: A member may be able to add a domestic partner depending on the options selected by the employer. Members should contact their benefits administrator for more information. Q: Can a member add a fiancée (female) or fiancé (male) to the health plan? A: No. Once members are married, they can request that their spouse be added to existing coverage. Q: Can members add parents, grandparents, or siblings to a health plan? A: No, members can only cover spouses and dependent children under a health plan. 2

4 Q: Can members elect different benefit selections for themselves and their dependents? A: The benefits elected must be the same for the subscriber as well as all their dependents. This includes Medical/Rx, Vision, and Dental. Q: Can members apply for multiple plans? A: No. Members may only select one plan for each type of coverage such as Medical/ Rx, Vision, and Dental if they are being offered. Q: How much does an employer contribute to a member s benefits? A: The amount that an employer contributes is indicated on the Employer Contribution page. It is also displayed at the bottom of each product s display card. As members proceed with benefits election they will also see the employer contribution amount populate in the bottom line box in the upper right hand corner of the screen. Q: How can a member see more details concerning the benefits of the plans being offered? A: After completing the personal information and who the member wants to cover sections of the enrollment process via the platform, the member will see the plans being offered and be able to click on a plan summary for each plan offering that will display more details. Q: Can members waive coverage? A: Members may be able to elect to waive coverage for all the benefits being offered depending on the options selected by the employer. Members should contact their benefits administrator for more information. Q: Can members waive medical/rx benefits and still enroll in Vision and or Dental benefits? A: If members waive medical/rx coverage, they can still enroll in Dental if it is being offered, but cannot enroll in Vision. A member may be able to waive medical/rx benefits and still enroll in Vision if it is being offered depending on the options selected by the employer. Members should contact their benefits administrator for more information. Q: How can members compare the plans being offered? A: The online shopping tool enables members to compare plans by selecting multiple plans and clicking the option to compare from either the plan summary cards or the plan list when viewing all of the plan offerings. Q: How much do the plans being made available actually cost? A: The actual cost of each plan being offered is indicated on the plan summary card for each option. Q: How will members know how much they have to pay for each benefit option being offered? A: The plan summary card for each benefit will indicate the amount members will have to pay for that option. When viewing all of the plan offerings, the plan list also indicates how much members will have to pay for each option available. Q: Where can a member see his or her per pay period costs for the selected benefits? A: The online shopping tool provides a cost breakdown indicating the cost of each selected plan in addition to the total amount members will have to pay per pay period. The cost breakdown section is located on the right side of the tool and will update the costs as members elect their benefits. 3

5 Q: Why are members being asked for information on Medicare and other health coverage? A: Members are being asked whether or not they have Medicare or other health coverage to support the coordination of benefits of all available health coverage. Q: How can members review a summary of benefit selections before completing the enrollment process? A: Once members have made benefit selections, a summary of benefits, personal information, covered individuals and plan costs will be displayed. Members will be asked to review their coverage choices and sign the coverage terms and conditions prior to submitting the application. Q: How can members review and print a summary of benefit selections after completing the enrollment process? A: Members will be able to review and print a summary of benefit selections from the enrollments section of the employee dashboard portion of the shopping tool. The employee dashboard will be displayed after members have received confirmation that they have completed the enrollment process. In addition, after completing the enrollment process members will be able to log back in to the shopping tool with their username and password to view the dashboard. Q: How can members change their selections once submitted at the end of the enrollment process? A: It is best to make sure members have made final decisions before submitting their enrollment. If a change is required after submission, members can contact their benefits administrator. Q: How will members know that they have been enrolled? A: Members will receive an ID card about 15 days before their benefit effective date. On or after the effective date, members will be able to log in to the member portal at ibxpress.com and access their benefit information. Q: How can members find a doctor and check to see if that doctor is in-network? A: The find a provider portion of the online shopping tool enables members to find a doctor and also add doctors to a list to determine if the doctor is in-network while shopping for plans. Once search criteria is entered into the find a provider tool and results are displayed, members can add a doctor to their provider list or click on a doctor to view additional provider information, including in-network plans. For any primary care physicians (PCPs) added to the provider list, a badge will show on the plan summary card when shopping for plans, indicating the number of PCPs that are in-network for the plan. The badge will also show for each plan when viewing the list of all plan offerings, indicating the number of providers that are in-network for each plan. Q: Can members choose any doctor? A: If a member has an HMO plan, he or she is only covered for doctors and hospitals within the HMO network. With a POS, DPOS, or PPO plan, members are covered for doctors and hospitals both in and out of network. If the doctor or hospital a member chooses is out of network, then members generally will have to pay additional costs/expenses for the covered health service. Q: Can members change their PCP after choosing one? A: Yes. After becoming a member, it s easy to change to a new PCP. Members should simply log in to to make the change, or call ASK-BLUE ( ). PCP changes become effective 15 days after the request is submitted or on the first day of the following month. 4

6 Q: How do members get new ID cards? A: ID cards can be requested by calling ASK-BLUE ( ) or logging in to the member portal at ibxpress.com on or after the effective date and printing out a copy of their member ID card. Q: Can members add a spouse or child at a later date? A: Yes. Members can apply to add a spouse or child at a later date if they experience a significant life event, such as marriage, birth or adoption of a child, or change in employment. Q: How can a member add a spouse or child at a later date? A: If a member experiences a significant life event, such as marriage, birth or adoption of a child, or change in employment after submitting his or her benefits, members can contact their benefits administrator. Products are underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Some products may not be available in all states. Policy limitations and exclusions apply. Optional riders and/or features may incur additional costs. Documents are the final arbiter of coverage. Life Insurance Policy Form #GP-1-R-EPOPT-96 et al.; Critical Illness Policy Form #GC-CI-11 et al.; Long-Term Disability Policy Form #GP-1-LTD07-1.0, et al.; Short-term Disability Policy Form #GP-1-STD07-1.0, et al.; Accident Insurance Policy Form #GP-1-AC-IC-12 et al.; Cancer Insurance Policy Form #GP-1-CAN-IC-12 et al.reply # (exp. 11/17) Independence Blue Cross offers products through its subsidiaries Independence Hospital Indemnity Plan, Keystone Health Plan East and QCC Insurance Company, and with Highmark Blue Shield independent licensees of the Blue Cross and Blue Shield Association (12/15)

Application for Group Coverage

Application for Group Coverage Instructions: Thank you for applying for coverage from Independence Blue Cross (IBC). Follow the instructions below to complete your application. 1. Carefully review and