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Frequently Asked Questions - Employer
This information is provided as a general guideline only. Your company may have its own unique processes and procedures that are different than those shown below. Contact your company's Human Resources or Employee Relations department for specific instructions.
Helping your Plan Members with Claim
Inquiries
How do I
file a claim?
When should I file a claim?
Why is Additional Information Sometimes Requested?
How will additional Claim Information be Requested?
What Are the Most Common Reasons for Requesting Information?
Why Was my Claim Denied for Services that my Doctor
Suggested I Should Receive?
My claim was denied. How do I
appeal this decision?
Why are claims that have been
submitted several times still not in the system?
Why did
you pay my claim as non-PPO?
What does over Usual and
Customary Mean?
What is a PPO Discount?
My claim was submitted, but I cannot find it in the system. What
should I do?
I am responsible for handling my mother's
(father's) affairs and need to see if some claims were paid by the insurance,
can you help me?
What is an EOB?
What is the status of my claim?
I think my
claim was processed incorrectly. How can I find out if it is correct?
I did not receive a check for reimbursement of my claim. Why
not?
Helping Plan Members Understand their
Benefits
Medical Management
What is Utilization Review?
How does pre-certification work?
What is
Case Management?
Benefit Plan
Limitations
What's the difference between a deductible,
a copayment and out-of-pocket expenses?
I've met
my deductible. Why aren't my claims paid at 100 percent?
I've met my deductible for the year. Why did you take another
deductible from my spouse?
I paid my deductible to my
doctor, but I noticed you applied my deductible against the hospital bill. How
will this be resolved?
What is a Deductible Carry-Over
Credit?
How does the Coordination of Benefits work?
I am covered by two group health plans. My other plan
has better benefits; can I select which plan is primary?
If I have two group health programs, why are my claims not paid in
full?
What is a pre-existing condition?
How
long does the pre-existing condition limitation apply?
My deductible was already taken from my paycheck. Why was
another deductible applied on this claim?
My
deductible has already been met. Why did you apply a co-payment to my doctor's
office visit?
What is an exclusion?
What is a maxumum?
What does Usual &
Customary (U&C), Reasonable & Customary, or Usual & Reasonable
mean?
Can a Pre-existing condition limitation be
offset? If so, how?
Pharmacy and Other Benefit
Coverages
How do I obtain a new/replacement ID card for
medical benefits? For Pharmacy benefits?
How do
I obtain a new/replacement ID card for medical benefits? For Pharmacy
benefits?
The FDA has just approved a new drug for
treatment of a condition that I have. How do I find out if it is covered under
my plan?
What is an Employee Assistance program? Do I
have one? How do I access it? What does it cover?
Do I
have coverage if I am traveling out of the country and become sick or injured?
If so, how do I file that claim for reimbursement?
The
pharmacy was not able to process my prescription when I presented my ID card.
What should I do?
I am trying to order a prescription
from my pharmacy vendor and they are telling me I am not eligible. What should
I do?
I am currently on COBRA and the pharmacy was not
able to process my prescription. What should I do?
Could you explain the orthodontic benefits on my plan?
I want to find out if something is covered under my plan, but I do
not find it listed in my Plan document. How do I find out?
What is the correct billing address: the PPO or Benesight?
Eligibility, Enrollment
and COBRA Continuation
What is a waiting period?
What is enrollment?
When do my
benefits go into effect?
My spouse, who was the enrollee
on this plan, is recently deceased. Can I still keep the coverage?
Can I add my mother, who is dependent upon me for support, be added
to my plan?
My son/daughter is over the covered age for
dependents, but is totally disabled. Can he/she still be considered a covered
dependent under my plan?
I am on a COBRA plan which ends
soon and am interested in a conversion policy. Would you please let me know if
this is possible?
I've just lost my job (or, my company
is closing, or, my company is closing the plant that I work at). Will I lose my
benefits? If so, when? Can I keep my benefits?
I just
got married. Can I add my new spouse to my plan? How?
I
just had a newborn child. Can I add my new child to my plan? How?
I'm about to adopt (or have just adopted) a child. Can this child
be added to my plan? How?
Have you received my COBRA
premium payment?
How do I complete the COBRA Election
Notice?
Where do I send the COBRA Election Notice
I received a letter from the COBRA Department and I
have questions about its contents.
I need to add a
dependent to my COBRA benefits or extend my benefits because of a
disability.
I am on a COBRA plan, which ends on
September 20, 2000 and am interested in a conversion policy. Would you please
let me know if this is possible? Please let me know the particulars.
Making Changes in
Benefits
Can I change my benefits to obtain a smaller
deductible? If so, how and when?
Can I change my
benefits so that I can participate in a different Preferred Provider
Organization? Is so, how and when?
Can I drop my dental
coverage, but keep the medical coverage?
Can I change my
benefits so that I have a lower payroll deduction from my paycheck?
My neighbor, who does not have coverage, likes my coverage. Can
they buy it from you?
Does Benesight sell a Medicare
Supplemental plan?
How do I get a HIPAA Certification
Letter?
My name is spelled wrong. My birth date is
incorrect (denying deps as over covered age).
What does
"in-network" mean?
What does "out-of-network"
mean?
What does "family out-of-pocket" mean?
Help With
Reports
Individual Specific Analysis
(ISA)
Paid Claims Analysis
Monthly
Check Register
Reinsurance Census Report (RCR)
Coverage Analysis Report
Find a Provider or PPO?
Can I use any provider I want to?
What is a
Preferred Provider Organization? How does it affect my benefits?
How do I find out if a provider is part of my Preferred Provider
Organization?
Can you help me find a provider, or, why
can't you help me find a provider?
My provider is not
listed in my provider directory. What do I do to get them added?
Help Using the Benesight Web Site
I forgot my password. What do I do?
I'm having trouble downloading
Adobe Acrobat Reader. What do I do?
How can I save
the file I open in Acrobat Reader to my hard-drive?
I
just downloaded a form. Can I complete it online and email it back?
When I send a question via email, how long will it take to
receive a response?
I enter Benesight through an AOL
connection. Why am I having trouble?
What's the
optimal screen resolution for this site?
How should
I set the font size on my screen for best viewing?
Why do I get an alert about the site certificate when I log in
to Benesight?
Why do I get these "server/page not
found" errors in Internet Explorer 5?
Why do some photographs and other graphics display poorly?
Why is the page cut off at the bottom? I can't
scroll to move it up.
Is it safe to view my private
health information over the Internet?
Help Understanding Healthcare-Related Law
What is HIPAA?
What is COBRA?
Help With A Claim
How do I file a claim?
To file a medical or dental claim, please download
and print a Benesight claim form. Follow these important tips to ensure
your claim is processed accurately and efficiently:
Complete all applicable items on the Benesight Claim
Form
Include your original
itemized bill(s). Your health care provider should give you an itemized bill(s)
that contains the following information:
Employee's Name
Patient Name
Provider Name and Address
Dollar amount of charge(s) for services rendered
Type of service (CPT-4 codes)
Date(s) of service
Type of treatment or diagnosis (ICD-9 codes)
Time spent (for registered nurse services)
Anesthesia time (if anesthesia was used)
Type of work done (for X-ray & laboratory services)
If Benesight is the
secondary carrier, we will also need the primary carrier's explanation of
benefits (EOB).
Make a photocopy of
the claim form and all itemized bills and receipts for your personal records.
Receipts cannot be returned to you.
Mail this form with any itemized bills to Benesight at the
appropriate address.
To ensure prompt service:
Submit a separate claim
form for each covered family member each time you have a claim. For example,
do not include your child's receipts or bills with a claim form for yourself.
Use a new claim form
for each illness or injury.
If you receive additional
bills in connection with this claim after you have mailed this form, do not
complete another form. Simply identify the bills or invoices by noting the following
information on the bill and send to address on the back of your ID Card:
Employer's Name
Employee Name
Employee Social Security Number
Patient Name
Generally, health care providers will complete and file Benesight
claims for members. Members do not need a claim form if your physician
is filing the claim for you. However, in instances when the provider does
not file the claim, members should submit the claim to Benesight at the
appropriate address.
When Should I File a Claim?
When your doctor or the provider will not bill Benesight
or the PPO directly and you are being asked to pay the claim.
Claims should be filed with Benesight within 3 months
of the date service was incurred. Benefits are based on the Plan's provisions
at the time that the charges were incurred. Claims filed later than that date
might be declined unless it was not reasonably possible to submit the claim
within that timeframe.
Why is Additional Information
Sometimes Requested?
Benesight processes claims according to the requirements
outlined in your summary plan description. To determine whether or not a claim
meets those requirements, we sometimes need more information than what appears
on the bill.
How will Additional Claim
Information be Requested?
The claims
analyst sends a letter requesting the necessary information for a specific
claim. The letter is usually sent to the employee for a response, although
occasionally the doctor or provider will be asked for additional information.
Two attempts will be made to obtain the requested information. If a response is
not received within a 30-day period, a third and final letter will be sent
indicating no further action will be taken until the requested information is
received.
What Are the Most Common Reasons
for Requesting Information?
The
following are the most common reasons a request for additional information is
made:
1. To determine if the patient has other health coverage. If a patient is covered under two health plans, Benesight must determine which plan is the primary payer. This information is usually requested only once or twice a year.
2. To obtain accident information. Some plans provide higher benefits for accident claims, and some injuries (such as workers' compensation claims) may not be covered under the health plan. To determine the benefits available, we need to know when and how the accident occurred.
3. To determine Student Status. Most plans cover unmarried, full-time college students. Benesight must have documentation showing that a child is a full-time student during each college quarter or semester for which a claim is incurred.
Back to
top
Why Was my Claim Denied
for Services that my Doctor Suggested I Should Receive?
Some services are excluded from your Plan. For specific
items, please refer to the exclusions listed in your summary plan description.
Covered services under the plan are subject to a medical necessity review
to determine if they are medically appropriate and necessary based on national
medical practice guidelines. Some services require specific diagnosis or
criteria to be considered as medically necessary and, therefore, covered
by the Plan. Most plans exclude services that are either experimental or
investigational. When in doubt, please contact your customer service representative.
You have the right to have the provider submit a Prior Authorization Request
(AKA Pre-determination) before services are rendered. The Prior Authorization
Request is then reviewed for medical necessity criteria to determine if
the service is an eligible expense under the Plan. If it is not an eligible
plan expense, you will be notified so you can decide if you would still
like to have the services. This Prior Authorization of Service is not a
guarantee of coverage and DOES NOT meet your requirements for Pre-certification
with the Utilization Management company. You must contact the Utilization
Management company prior to receiving services if required by your Plan.
My Claim was denied. How do I
appeal this decision?
Appeal a denial
of benefits within 60 days from the date of the notification of denial. You
must:
1. Request that Benesight (as the Plan Administrator) review the claim for benefits. Your request must include the name of the employee, his or her social security number, the name of the patient and the group identification number.
2. File the request for review in writing, stating in clear and concise terms the reason or reasons for this disagreement with the handling of the claim.
The Plan Administrator will respond in writing typically within 60 days. Please reference your summary plan description for more information.
Why are claims that have been
submitted several times still not in the system?
To allow adequate time for the provider to complete
their billing process and submit your claim to Benesight, please allow at least
20 business days from the date of service for Benesight to receive your claim.
If it has been more than 20 business days from the date of service, please contact
your provider. Please be aware that if your plan uses a preferred provider organization
(PPO), your claim may have been sent to the PPO first for negotiated fee discount
processing. This may cause a slight delay in Benesight receiving your claim.
Check back periodically to verify receipt and/or processing of your claim(s).
Why did you pay my claim as
non-PPO?
This might happen due to a
variety of reasons. We will need additional information to assist you. Please
contact our customer service center or use our online secure mail service. In
order to research your claim and respond appropriately, please have the
following information available.
Employee SSN
Employer's name or
Group number
Patient Name
Date of Service
Provider's Last Name
Type of charges in question or at issue
Your relationship to the
Employee
What does over Usual and Customary
Mean?
Charges for the services received
exceed the Usual and Customary guidelines which appear in your Plan Documents.
What is a PPO Discount?
The contracted fee the provider has
agreed to charge for its services in return for being part of a PPO.
My claim was submitted, but I
cannot find it in the system. What should I do?
Please contact our customer service center or use our
online secure mail service. In order to research your claim and respond
appropriately, please have the following information available:
Employee
SSN
Employer's name or Group number
Patient Name
Date of Service
Provider's Last Name
Type of charges in question or issue
Your
relationship to the Employee
I am responsible for handling my
mother's (father's) affairs and need to see if some claims were paid by the
group medical plan, can you help me?
In
order to assist you, we will need:
The Power of Attorney paperwork
Employee SSN
Employer's name or Group number
Patient Name
Date
of Service
Provider's Last Name
Type of charges in question or the
issue If you do not have a Power of Attorney, we will be unable to release the
information to you due to the confidentiality of medical records. Your mother
(father) will have to contact us to receive the information.
What is an EOB?
An Explanation of Benefits is simply the statement explaining
your health care benefits activity. You will receive an EOB anytime you or a
family member receives services. The EOB will include information about the
services provided, the amount billed and the amounts paid, if any. Learn how
to read an EOB.
What is the status of my claim?
The status of claims that have been submitted to Benesight
can be verified quickly and easily through the Claim
Status feature of Benesight.
To allow
adequate time for the provider to complete their billing process and submit
your claim to Benesight, please allow at least 20 business days from the date
of service for Benesight to receive your claim.
If it has been more than 20 business days from the date of service, please
contact your provider. Please be aware that if your plan uses a preferred
provider organization (PPO), your claim may have been sent to the PPO first
for negotiated fee discount processing. This may cause a slight delay in
Benesight receiving your claim. Check back periodically to verify receipt
and/or processing of your claim(s).
I think my claim was processed
incorrectly. How can I find out if it is correct?
If you believe your claim was processed incorrectly,
please contact our customer service center or use our online secure mail
service. In order to research your claim and respond appropriately, please
have the following information available:
Employee SSN
Employer's name or Group number
Patient
Name
Date of Service
Provider's Last Name
Type of charges at issue
Your relationship to the Employee
I did not receive a check for
reimbursement of my claim. Why not?
Check your EOB or our online Claim Status feature to verify
if there was an amount owed to you. This will determine if a check was actually
issued. If a check was issued, please verify the name and address on the check
to ensure we have the correct information on file. To make changes in your
address or other information, please go to the Plan Enrollment section.
If your claim did not result in a check, it is possible that there was a
deductible that was owed before the plan would make payment. Contact Us
if you still have questions about your claim.
Help Understanding Benefits
What is the Utilization Review?
Utilization review is a program
designed to help ensure that al plan participants receive necessary and
appropriate health care while avoiding unnecessary expenses. The program
typically consists of pre-certification of certain services (as defined in your
plan), retrospective review of emergency services, concurrent review of
inpatient services and planning for discharge from a medical facility.
Pre-certification is not a guarantee of benefit payment by the plan.
How does pre-certification
work?
Before a plan participant enters a hospital or other
medical facility on a non-emergency basis or receives other listed services
(as defined in your plan), the patient, member or provider must contact
the utilization review company by calling the number on the front of your
Benesight medical plan ID card.
The utilization review company will pre-certify that the inpatient service
is medically necessary according to accepted medical practices.
Pre-certification is not a guarantee of benefit payment by
the plan.
What is Case Management?
The process of identifying patients with
specific health care needs and working with them and their physicians to
determine and coordinate a treatment plan that promotes the best health
outcomes with efficient use of health care resources.
What's the difference between a
deductible, a copayment and out-of-pocket expenses?
Deductible. The amount the plan participant is
responsible for paying each year before the plan will make payment for eligible
benefits.
Copayment. The plan participant pays a specified
amount for a specified service, such as $20 for an office visit. Usually the
plan participant is responsible for payments at the time services are rendered.
Out-of-pocket expenses. The portion of health service payments
required to be paid by the plan participant which may include deductibles,
copayments and coinsurance, before the plan will pay at a higher benefit level.
I've met my deductible. Why
aren't my claims paid at 100 percent?
Once the deductible is met, payments will be made at
the rate shown under Percentage Payable in the Schedule of Benefits. A higher
benefit level may apply when the Out-of-Pocket maximum is met for the plan
year.
Back to
top
I've met my deductible for the
year. Why did you take another deductible from my spouse? Does the deductible
apply to me or does my whole family have to meet it?
Typically, there is one deductible amount per covered
person for every Plan Year and also a family deductible maximum. Once an
individual has met their Plan Year deductible, the plan will make payments
for eligible benefits for that individual. Expenses applied toward an individual
deductible by any covered family member can satisfy a family deductible.
The individual deductibles of all members of that family unit will be considered
satisfied once the family deductible is met. See your Schedule of Benefits
for deductible amounts and family unit maximums.
I paid my deductible to my
doctor, but I noticed you applied my deductible against the hospital bill. How
will this be resolved?
Benesight
processes claims in the order in which they are received. Therefore, we applied
your deductible to the first bill we considered. We had no way of knowing that
you had paid anything to another provider until we received the claim from the
provider showing you had made a payment. In this situation, the doctor would be
paid the balance due (if it did not exceed the normal benefit), and the member
would be issued any remaining benefit.
What is a Deductible Carry-Over
Credit?
If specified in your Plan, charges applied to the
deductible for services performed during the last three months of a plan year
may be used to satisfy the following year's deductible during the first three
months of the new plan year. After the first three months of the new plan year,
the deductible would be reset at zero.
How does the Coordination of
Benefits work?
When a person is covered
under more than one group medical program, payment of benefits may be
coordinated to eliminate over-insurance or duplication of benefits. The Primary
Coverage is the plan that considers and pays first any eligible expenses
without consideration of any other coverage. The plan that has the
responsibility for payment of a portion of all or any remaining eligible
charges not covered by the primary benefit plan is considered the Secondary
Carrier.
I am covered by two group health
plans. My other plan has better benefits; can I select which plan is
primary?
No, each employer group specifies
the order of benefits determination. Generally, as the covered employee, your
group plan is primary for yourself. For covered dependents, the rules may vary
based on either the birth date rule or the gender rule. Please refer to your
summary plan description for more information.
If I have two group health
programs, why are my claims not paid in full?
It depends on the type of coordination of benefits
(COB) provision the second plan has adopted. Each employer group selects one of
the three COB types for its entire group. Here are examples of how claims would
be handled if Benesight's Plan were secondary:
1. Carve-out COB. With this option, Benesight computes the normal benefit under the plan. Then the primary plan payment is subtracted from this figure. The benefit to be issued is the remainder. If the primary plan paid up to our more than our normal benefit, then there is no additional payment.
2. Exclusion COB. Benesight takes the submitted charges and subtracts the primary plan's payment and write-off amount. Then we compute our normal plan benefit on the remainder.
3. Standard COB. Here we compute what our normal benefit is and we will issue the balance remaining after the primary carrier payment as long as it does not exceed our normal benefit.
What is a pre-existing
condition?
A condition for which
medical advice, diagnosis, care or treatment was recommended or received prior
to a member's effective date of coverage. Pre-existing conditions may not be
covered for a specified period of time as defined in your Summary Plan
Description (usually six to 12 months).
As a result of HIPAA, an
individual can only be required to satisfy a pre-existing waiting period once.
As long as members maintain continuous group health coverage with one or more
carriers, they can request a Certificate of Credible Coverage (CCC) or a HIPAA
Certificate from their prior employer to waive the pre-existing condition
exclusion.
How long does the pre-existing
condition limitation apply?
This is plan-specific. Your summary plan description
includes information about your pre-existing condition limitation.
My deductible was already taken
from my paycheck. Why was another deductible applied on this claim?
A Deductible is the amount the plan
participant is responsible for paying each year before the plan will make
payment for eligible benefits.
The amount deducted from your paycheck
was for your Plan Contribution, which is the amount you pay to your employer
toward the cost of coverage to provide medical benefits for yourself and/or
your dependents.
Please see your Human Resource Department for more
information about your Plan Contribution.
My deductible has already been
met, but you applied a co-payment to my doctor's office visit. Why?
Some plans require the plan participant to
first meet a Deductible each year before the plan will make payments for
eligible benefits. In addition the plan may also require a Co-payment at the
time services are rendered. Please refer to the "Schedule of Benefits" section
in your Plan Document for further information.
What is an
exclusion?
Benefits, conditions, or
expenses which are not covered by the Plan. Exclusions are listed in the Plan
Document.
What is a
maximum?
A dollar or frequency limit
established for a benefit. Any expense that exceeds this limit is not covered
by the Plan.
What does Usual & Customary
(U&C), Reasonable & Customary, or Usual & Reasonable mean?
The amount charged by a percentile of
physicians in a specified zip code area where a service is performed. The
percentile of physicians on which the usual and customary charge is based will
vary depending on the plan: the plan may select any percentile over 50 percent.
Another term for this is Reasonable and Customary or Usual and Reasonable.
Can a Pre-existing condition
limitation be offset? If so, how?
Yes,
as a result of HIPAA, an individual can only be required to satisfy a
pre-existing waiting period once. As long as they maintain continuous group
health coverage with one or more carriers, the employee can request a
Certificate of Credible Coverage (CCC) or a HIPAA Certificate from their prior
employer to waive the pre-existing condition exclusion.
PHARMACY AND OTHER BENEFIT COVERAGES
How do I obtain a new/replacement ID card for medical benefits?
For Pharmacy benefits?
After you have
completed your initial enrollment process with your employer, you will receive
ID cards within a couple of weeks.
I just heard about a new medical
treatment on the news. Is it covered under my plan?
To determine the amount the plan will reimburse for a
service, a covered employee may choose to submit a claim before they actually
receive the service. Such claims are called pre-determination. Your provider
can submit the predetermination to Benesight for review. Generally,
Experimental and or Investigational services are not covered. Please see your
Plan Document under "Exclusions" for more information.
The FDA has just approved a new
drug for treatment of a condition that I have. How do I find out if it is
covered under my plan?
To determine the
amount the plan will reimburse for a service, a covered employee may choose to
submit a claim before they actually receive the service. Such claims are called
pre-determination. Your provider can submit the predetermination to Benesight
for review.
Back to
top
What is an Employee
Assistance program? Do I have one? How do I access it? What does it cover?
An EAP (Employee Assistance Program) is a
benefit that may be offered by your employer. It provides assistance with
personal issues that may affect your health or productivity. Please contact
your Human Resource Department for further information.
Do I have coverage if I am
traveling out of the country and become sick or injured? If so, how do I file
that claim for reimbursement?
As each
Benefit Plan covers this issue differently, please refer to your Schedule of
Benefits in your Plan Document under Non-PPO or Out-of-Network benefits. If
your Plan does cover these services, please refer to "How do I file a claim"
for further information.
The pharmacy was not able to
process my prescription when I presented my ID card. What should I do?
Your ID card should have a customer service
phone number for the prescription drug program. Please call the number to see
why they have denied your claim. If the prescription drug carrier states that
the medication needs a medical necessity override/ authorization, contact your
provider to obtain a letter of medical necessity and forward this letter to the
prescription drug program for review.
I am trying to order a
prescription from my pharmacy vendor and they are telling me I am not eligible.
What should I do?
This might happen due
to a variety of reasons. We will need additional information to assist you.
Please contact our customer service center or use our online secure mail
service. In order to research your claim and respond appropriately, please have
the following information available:
Employee SSN
Employer's name
or Group number
Patient Name
Date you submitted the prescription
Name of drug you are trying to get filled
Your relationship to the
Employee
I am currently on COBRA and the
pharmacy was not able to process my prescription. What should I
do?
It's possible that we have not
received your most recent COBRA premium. COBRA questions should be directed to
our toll-free number: 1-888-224-3704.
Could you explain the orthodontic
benefits on my plan?
Check your Summary
Plan Description to verify if your Plan covers orthodontic benefits.
If
your plan covers this benefit, upon your first visit to the orthodontist, the
doctor will provide you with a total case fee for the services. This will be
broken down into an initial placement fee (down payment) and a monthly payment
plan that would coincide with the number of months required to obtain proper
teeth alignment.
Instruct the orthodontist to send this information to
Benesight for a predetermination of dental benefits. At this time, Benesight
will send both the orthodontist and the covered employee a determination of
benefits in relation to this specific treatment request. It will state how much
will be applied to the deductible, the coinsurance reimbursement rate and the
lifetime maximum allowed by the Plan for the orthodontic services.
The
orthodontist then returns the predetermination to Benesight with the date that
the treatment is started. Then we will reimburse for the initial placement fee.
The provider will need to send monthly bills for the monthly adjustments until
either the lifetime maximum has been exhausted or the total case fee has been
considered.
I want to find out if something
is covered under my plan, but I do not find it listed in my Plan document. How
do I find out?
Check under the
"Exclusions" section, listed in your Plan Document, to see if the
diagnosis/procedure is listed. If you still do not see the diagnosis/procedure
you can have your provider submit a claim before you actually receive the
service. Such claims are called pre-determination because no benefits will be
paid, but it will determine the amount the plan will reimburse for a service if
it is a covered benefit.
What is the correct billing
address: the PPO or Benesight?
This will
depend on your Plan. Please refer to the Plan Contacts section or your ID card
for further information. Generally, if you see a PPO Provider, the claim should
be sent to the PPO. If you see a non-PPO provider, then the claim would be sent
to Benesight.
Eligibility, Enrollment and COBRA
Continuation
What is a waiting period?
The time between the first day of employment and the
first day of coverage under the plan. The Waiting Period is counted in the
Pre-existing condition exclusion time.
What is enrollment?
A process in which the employee can enroll
for various benefits through their employer to cover themselves and/or their
family members.
When do my benefits go into
effect?
Please refer to your Plan
Document under the section "Eligibility" as each plan has different
requirements.
My spouse, who was the enrollee on
this plan, is recently deceased. Can I still keep the coverage?
Yes, you have just described a Qualifying Event, which
is a condition that requires an employer to provide continued coverage to their
employees as part of COBRA. The length of time employers must offer continued
coverage is determined by the qualifying event. Qualifying events and the
length of time coverage can be continued for, for each reason are listed
below:
- Death of covered employee (coverage for dependents) 36 months
- Termination of employment 18 months
- Termination of employment or reduction in working hours: 29 months
- Reduction in working hours 18 months
- Divorce or legal separation from covered employee 36 months
- Employee becomes eligible for Medicare (coverage for dependents) 36 months
- Dependent no longer meets eligibility requirements 36 months
- Employer files for Chapter 11 bankruptcy petition* *Note: Continued coverage must be offered to all retirees and beneficiaries whose coverage is substantially reduced within a year before or after the employer files for bankruptcy. Retirees and widows or widowers of retirees who die before the bankruptcy filing are entitled to lifetime continuation coverage. Surviving spouses and dependent children of retirees who die after the bankruptcy filing my elect up to 36 months of continuation coverage.
Can I add my mother, who is
dependent upon me for support, be added to my plan?
No. A dependent is defined as a covered employee's
spouse and unmarried children from birth to the limiting age of 18 or 19 years.
My son/daughter is over the
covered age for dependents, but is totally disabled. Can he/she still be
considered a covered dependent under my plan?
Yes, if the Dependent child who is Totally Disabled
meets the definition of being incapable of self-sustaining employment by reason
of mental retardation or physical handicap, is primarily dependent upon the
covered Employee for support and maintenance, is unmarried and covered under
the Plan when reaching the limiting age.
Please see your Plan Document
under "Eligibility, Eligible Classes of Dependents" for more details.
I am on a COBRA plan which ends
soon and am interested in a conversion policy. Would you please let me know
if this is possible? Please let me know the particulars.
Because Benesight administers health benefits for self
insured employer groups (employers who pay for their employees' medical
expenses out of their own funds) we do not offer conversion policies. We would
recommend that you contact a local insurance agent to assist in finding you a
cost-effective medical benefits plan to participate in when your COBRA
expires.
I've just lost my job (or, my
company is closing, or, my company is closing the plant that I work at).
Will I lose my benefits? If so, when? Can I keep my benefits?
You have just described a Qualifying Event which is a
condition that requires an employer to provide continued coverage to their
employees as part of COBRA. The length of time employers must offer continued
coverage is determined by the qualifying event. Qualifying events and the
length of time coverage can be continued for, for each reason are listed below:
- Death of covered employee (coverage for dependents) 36 months
- Termination of employment 18 months
- Termination of employment or reduction in working hours 29 months
- Reduction in working hours 18 months
- Divorce or legal separation from covered employee 36 months
- Employee becomes eligible for Medicare (coverage for dependents) 36 months
- Dependent no longer meets eligibility requirements 36 months
- Employer files for Chapter 11 bankruptcy petition* *Note: Continued coverage must be offered to all retirees and beneficiaries whose coverage is substantially reduced within a year before or after the employer files for bankruptcy. Retirees and widows or widowers of retirees who die before the bankruptcy filing are entitled to lifetime continuation coverage. Surviving spouses and dependent children of retirees who die after the bankruptcy filing my elect up to 36 months of continuation coverage.
I just got married. Can I add
my new spouse to my plan? How?
Yes, please
contact your Employer's Human Resource or benefits representative within 30
days for the necessary forms and/or procedures.
I just had a newborn child.
Can I add my new child to my plan? How?
Yes,
please contact your Employer's Human Resource or benefits representative within
30 days for the necessary forms and/or procedures.
Back to
top
I'm about to adopt (or
have just adopted) a child. Can this child be added to my plan? How?
Yes, please contact your Employer's Human
Resource or benefits representative within 30 days for the necessary forms
and/or procedures.
Have you received my COBRA
premium payment?
Please contact the
COBRA department at 888-224-3704 to verify receipt of your premium
payment.
How do I complete the COBRA
Election Notice?
Check or elect the
coverage you wish to continue on the form. Then sign and date the bottom and
mail it to:
Your Employer: If you received the form from your Employer,
please return it to your Human Resources Department.
Benesight :
If Benesight is handling COBRA for your group, the form can be returned
to: Benesight, P.O. Box 9305, Minneapolis, MN 55440.
If you have
further questions regarding this form, please contact the COBRA department at
888-224-3704.
Where do I send the COBRA
Election Notice?
If you received the
form from your Employer, please return it to your Human Resources
Department.
If Benesight is handling COBRA for your group, the form can
be returned to: Benesight, P.O. Box 9305, Minneapolis, MN 55440.
If you
are unsure as to who is handling the Election Notice form, please call our
COBRA Department at 888-224-3704 for clarification.
I received a letter from the
COBRA Department and I have questions about its contents.
Please contact the COBRA department at
888-224-3704.
I need to add a dependent to my
COBRA benefits or extend my benefits because of a disability.
Please send all changes in writing to:
Your
Employer: If you received COBRA information from your Employer or normally send
all correspondence in regards to your COBRA premium is sent to your Employer,
please send it to your Human Resources Department.
Benesight: If
Benesight is handling COBRA for your group: Benesight, P.O. Box 9305,
Minneapolis, MN 55440.
If you are unsure as to who is handling the
COBRA for your group, please call our COBRA Department at 888-224-3704 for
clarification.
I am on a COBRA plan, which ends
on September 20, 2000 and am interested in a conversion policy. Would you
please let me know if this is possible? Please let me know the particulars.
Benesight administers health benefits for
self-insured employer groups, and does not offer conversion policies. We would
recommend that you contact a local insurance agent to assist in finding you a
cost-effective medical benefits plan to participate in when your COBRA benefits
expire.
Can I change my benefits to obtain
a smaller deductible? If so, how and when?
Because Benesight administers health benefits for
self-insured employer groups we do not control your benefit level. Please
contact your Human Resource Department for further information.
Can I change my benefits so that
I can participate in a different Preferred Provider Organization? Is so,
how and when?
Generally you do not have an
option in which PPO to use. Please contact your Human Resource Department for
further information.
Can I drop my dental coverage, but
keep the medical coverage?
As each
Benefit Plan covers this issue differently, please contact your Human Resource
Department for further information.
Can I change my benefits so that I
have a lower payroll deduction from my paycheck?
Because Benesight administers health benefits for
self-insured employer groups we do not control your benefit level. Please
contact your Human Resource Department for further information.
My neighbor, who does not have
coverage, likes my coverage. Can they buy it from you?
Benesight administers health benefits for self-insured
employer groups and does not offer Individual policies. Your neighbor should
contact a local insurance agent for assistance in finding a cost-effective
medical benefits plan.
Does Benesight sell a Medicare
Supplemental plan?
Benesight administers
health benefits for self-insured employer groups and does not offer other types
of policies. Contact a local insurance agent for assistance in finding a
cost-effective medical benefits plan.
How do I get a HIPAA Certification
Letter?
Please contact your Human
Resource Department for assistance.
My name is spelled wrong. My
birth date is incorrect.
Please contact your
Human Resource Department to correct your information.
What does "in-network" mean?
In-network refers to a health care
provider that participates with the preferred provider organization (PPO)
network that your employer selected for your health plan.
What does "out-of-network"
mean?
Out-of-network refers to a health
care provider that does not participate with the preferred provider
organization (PPO) network that your employer selected for your health plan.
What does "family out-of-pocket"
mean?
The maximum amount a family, as a
unit, is expected to pay in a plan year. Please refer to the "Schedule of
Benefits" section in your Plan Document for further information.
Help with Reports
Individual Specific Analysis (ISA)
What are the normal report data time frames?
[Calendar year, Policy Year, Rolling 12 months, etc.?]
Policy / Plan Year as it relates to the Reinsurance
Contract Year.
Can the normal report time frames be
changed, and if so, what are the options for this report?
Usually run at 50% of the Specific Deductible. Time
frames can be customized, but must be consistent each month.
Do the report figures include pooled and
non-pooled claims? If pooled claims are included, do they include specific
violations?
This report includes
pooled claims and is the report in which you would see specific
violations.
If pooled claims are included, do they
include aggregate violations?
Yes,
aggregate violations including specific violations up to the deductible amount
and aggregate reimbursements.
Do the report figures include specific
run-in claims from prior policy periods?
No, they do not. Each ISA is Contract-Specific.
However, you can order an ISA for the prior contract year by
request.
Do the report figures include aggregate
run-in claims from prior policy periods? If optional, how does one know?
[ANSWER TO COME]
Explain exactly how, when, and from where
the data for the report is collected. For example:
· Does the report include pended
claims?
No
· Does the report include processed claims
that are awaiting a check run?
No
· Does the report
include processed claims that are on hold pending specific
reimbursement?
Yes, if the client has funded the claim. No, if the
claim is an advance reimbursement.
· For clients with
accommodation, does the report include processed claims that are on hold
pending aggregate reimbursement?
Yes, for all claims for which checks
have been issued and released.
· Does the report include only
claims for which checks have been issued and released?
[ANSWER TO COME]
For reports involving claim summaries, list
the component segments that make up each of the report's categories. For
example, exactly what claims are included under "Hospital Inpatient" or
"Outpatient Medical"?
Claims for
Hospital Room and Board, Ancillary Services would be "Hospital Inpatient". If
you visit your doctor and he bills an office visit, injection, blood tests and
an x-ray, there are codes for each of those services, but the general category
would be Doctors Services/Medical Claims.
How are the claim component segments
(Hospital inpatient, hospital outpatient, surgical, etc.) coded and who is
responsible for coding them?
The claim
is processed with a specific benefit code assigned. For example, "PV" is
assigned by the claims analyst when an Office Visit is billed. If the claim is
for an Outpatient Surgical Facility the analyst would code the claim
"MO".
If the report includes prescription drug
claims, do the Rx numbers include just the raw prescription drug charge or:
· Do they include the ProVantage
dispensing fee?
· Do they include Benesight's administration
fee?
Yes, but only when the Specific covers Rx Claims.
Can
this report be run by location codes with a summary totaling all location
codes?
Yes, if your plan was built by locations other than active and
cobra.
Paid Claims Analysis and Monthly Check Register
Do the figures include pooled and non-pooled
claims?
· If pooled claims are included, do they include specific
violations?
· If pooled claims are included, do they include
aggregate violations? If optional, how does one know?
This report includes any paid claim within that monthly
time frame. All paid claims are reported including specific violations and
aggregate violations. You have the option to order by paid, incurred or
incurred and paid as a choice report.
Do the report figures include specific
run-in claims from prior policy periods? If optional, how does one know?
This report includes paid claims within
that month. You have the option to order incurred and paid, etc., as a choice
report.
Do the report figures include aggregate
run-in claims from prior policy periods? If optional, how does one know?
This report includes paid claims within
that month. You have the option to order incurred and paid, etc., as a choice
report.
Explain exactly how, when, and from where
the data for the report is collected. For example:
· Does the report include pended
claims?
This report does not include pended claims.
·
Does the report include processed claims that are awaiting a check run?
This report does not include processed claims that have not had a check issued
(prior to the weekly run)
· Does the report include processed
claims that are on hold pending specific reimbursement?
This report
does not include processed claims that are on hold pending specific
reimbursement - unless a check has been issued.
· For clients
with accommodation, does the report include processed claims that are on hold
pending aggregate reimbursement?
This report will include claims paid
by the client waiting for reimbursement by the reinsurance carrier as aggregate
accommodation.
· Does the report include only claims for
which checks have been issued and released?
This report will include
claims that a check has been issued and released.
For reports involving claim summaries, list
the component segments that make up each of the report's categories. For
example, exactly what claims are included under "Hospital Inpatient" or
"Outpatient Medical"?
Claims for
Hospital Room and Board, Ancillary Services would be "Hospital Inpatient". If
you visit your doctor and he bills an office visit, injection, blood tests and
an x-ray, there are codes for each of those services, but the general category
would be Doctors Services/Medical Claims.
How are the claim component segments
(Hospital inpatient, hospital outpatient, surgical, etc.,) coded and who is
responsible for coding them?
The claim
is processed with a specific benefit code assigned. For example, "PV" is
assigned by the claims analyst when an Office Visit is billed. If the claim is
for an Outpatient Surgical Facility the analyst would code the claim
"MO".
If the report includes prescription drug
claims, do the Rx numbers include just the raw prescription drug charge or:
· Do they include the ProVantage
dispensing fee?
· Do they include Benesight's administration
fee?
The Paid Claims Analysis does report the prescription drug claims
if with a card service or paid under the medical plan. If you have ProVantage,
the dispensing fee is included in the paid claims. The administration fee is
also paid as a claim.
Can this report be run by location codes with a
summary totaling all location codes?
Yes, the RPC can be run by
location if when your group was installed locations were established. For
example, you can run the report to summarize the claims associated with
employees in Monterey, Marina, and San Jose.
· If pooled
claims are included, do they include specific violations?
·
If pooled claims are included, do they include aggregate violations? If
optional, how does one know? If you did not have specific locations built
you cannot receive by location. Most plans are setup with Active and COBRA
locations.
Do the report figures include pooled and
non-pooled claims?
It shows all checks
actually issued during that month.
Do the report figures include specific
run-in claims from prior policy periods? If optional, how does one know?
Yes
Do the report figures include aggregate
run-in claims from prior policy periods? If optional, how does one know?
Yes
Explain exactly how, when, and from where the data for the report is
collected. For example:
· Does the report include pended
claims?
No
· Does the report include processed claims
that are awaiting a check run?
No
· Does the report
include processed claims that are on hold pending aggregate
reimbursement?
No
· Does the report include only
claims for which checks have been issued and released?
Yes
If the report includes prescription drug claims, do the Rx numbers
include just the raw prescription drug charge or:
· Do they include
the ProVantage dispensing fee?
· Do they include Benesight's
administration fee?
Yes
Can this report be run by location
codes with a summary totaling all location codes?
No
Reinsurance Census Report (RCR)
What are the normal report data time frames?
[Calendar year, Policy Year, Rolling 12 months, etc.?]
Contract Year
Do the report figures include pooled and
non-pooled claims?
· If pooled claims are included, do they include
specific violations?
· If pooled claims are included, do they
include aggregate violations? If optional, how does one know?
Pooled claims are included
Do the report figures include specific
run-in claims from prior policy periods? If optional, how does none know?
No
Do the report figures include aggregate
run-in claims from prior policy periods? If optional, how does one know?
No
Explain exactly how, when, and from where
the data for the report is collected. For example:
· Does the report include pended
claims?
No
· Does the report include processed claims
that are awaiting a check run?
No
· Does the report
include processed claims that are on hold pending specific
reimbursement?
No
· For clients with accommodation,
does the report include processed claims that are on hold pending aggregate
reimbursement?
No
· Does the report include only
claims for which checks have been issued and released?
Yes
If the report includes prescription drug
claims, do the Rx numbers include just the raw prescription drug charge or:
· Do they include the ProVantage dispensing fee?
· Do they
include Benesight's administration fee?
Yes
Can this report be run by location codes
with a summary totaling all location codes?
No
Do the report figures include pooled and
non-pooled claims?
· If pooled claims are included, do they include
specific violations?
· If pooled claims are included, do they
include aggregate violations? If optional, how does one know?
Yes, pooled claims are included.
Yes, it includes
aggregate violations.
Do the report figures include specific
run-in claims from prior policy periods? If optional, how does one know?
Based on the selection of the time period
requested.
Explain exactly how, when, and from where
the data for the report is collected. For example:
· Does the report include pended
claims?
No
· Does the report include processed claims
that are awaiting a check run?
No
· Does the report
include processed claims that are on hold pending specific
reimbursement?
No
· For clients with accommodation,
does the report include processed claims that are on hold pending aggregate
reimbursement?
No, unless the check was issued
· Does
the report include only claims for which checks have been issued and
released?
Yes
How are the claim component segments
(Hospital inpatient, hospital outpatient, surgical, etc.) coded and who is
responsible for coding them?
The
dollars are segmented based on how the claim was paid.
If the report includes prescription drug
claims, do the Rx numbers include just the raw prescription drug charge or:
· Do they include the ProVantage dispensing fee?
· Do they
include Benesight's administration fee?
Yes
Can this report be run by location codes
with a summary totaling all location codes?
No
Can I use any provider I want
to?
Yes, but to get the highest benefit
possible from your Benefit plan, you must use the Preferred Provider
Organization network designated by your plan. You can choose to see any
provider you wish outside of the network, but your benefits may be reduced or
not covered depending on your plan. Please refer to the Schedule of Benefits
section of your plan document for specifics.
What is a Preferred Provider
Organization? How does it affect my benefits?
A network of physicians and facilities with which
Benesight or one of its clients has contracted to offer medical care at reduced
rates.
If you use a provider within the PPO network, your benefits will
be paid at the highest level for your plan. If you choose to see a provider
outside of the network, your benefits may be reduced or not covered depending
on your plan. Please refer to the Schedule of Benefits section of your plan
document for specifics.
How do I find out if a provider is
part of my Preferred Provider Organization?
You can access your PPO provider listing via a toll
free number or an Internet site. Please refer to our "Find a Provider" site for
more information.
Can you help me find a provider,
or, why can't you help me find a provider?
You can access your PPO provider listing via a toll
free number or an Internet site. Please refer to our "Find a Provider" site for
more information.
My provider is not listed in my
provider directory. What do I do to get them added?
It is possible your provider recently contracted with
the PPO and is not yet listed in their provider directory. Call your provider
and ask them if they are a Participating Provider with your PPO. If they are
not, your provider will need to contact the PPO directly to become a
Participating Provider. That process can take up to one year depending on the
Provider and the PPO.
Help Using the Benesight Web Site
I forgot my
password. What do I do?
If you are an
employee member, you can view the password hint that you established when you
first registered with Benesight. If you are an Employer Client or
Broker/Consultant, contact your Benesight Customer Web Manager.
I'm having
trouble downloading Adobe Acrobat Reader. What do I do?
Adobe® Acrobat® Reader™ is free, and
freely distributable, software that lets you view and print Adobe Portable
Document Format (PDF) files. With Acrobat Reader, you also can fill in and
submit PDF forms online, as well as download encrypted content from the Web and
unlock it with Web Buy.
If you are having difficulties, please visit their web site for additional
information.
How can I
save the file I open in Acrobat Reader to my hard-drive?
From the toolbar within Acrobat Reader, select File
then Save. Enter the location where you want to save the file (Save in:) and
the name of the file (File Name) and press Save.
Back to
top
I
just downloaded a form. Can I complete it online and email it
back?
No, at this time it is not
possible to send forms to Benesight by email. Please mail the form to the
appropriate address on the back of your ID card.
When I send
a question via email, how long will it take to receive a
response?
Generally, we will respond to
your inquiry within 24 hours or on the next business day.
I enter
Benesight through an AOL connection. Why am I having trouble?
Benesight tries to maintain a good balance between high
color, attractive graphics and fast, simple page design. Some Internet Service
Providers, such as AOL, will compress and cache graphics. Compression reduces
the size of graphics. Caching stores them on your hard drive. This conserves
your provider's server capacity and improves your Internet session. The bad
news is it can also reduce the number of colors in graphics and make them look
blotchy. Unfortunately, there is often no way to fix this on your computer. One
thing you can control is graphic compression. You can change your AOL
preferences to set your graphic compression to 100% (no compression). This will
allow the Internet graphics to display as they were intended.
Another
good practice is to download and install a full version of Microsoft Internet
Explorer or Netscape Communicator. (The version of Internet Explorer that comes
with AOL is a smaller, modified version. It's not the same thing as the
standard Internet Explorer.) You can then sign onto AOL as usual and minimize
the window. Launch Internet Explorer or Netscape Navigator and surf the
Internet using that browser. Another tip is to refresh your screen. Because AOL
often cache Web pages, you may not be looking at the updated version of a Web
site. Just refresh or reload your screen to make sure you're seeing the most
recent version.
What's the
optimal screen resolution for this site?
We designed our site for the resolution and font
settings which fit the majority of computers that visit our site while giving
us a good amount of space to display information. Most computers and monitors
made within the last decade can be reset to these specifications.
Windows 95/98/NT
Click on Start, then Settings, then Control Panel,
then Display, then Settings. Or, click your right mouse button on any empty
area on the desktop. Select Properties, then Settings.
Slide the
desktop area Screen Resolution indicator up until 800 x 600 or higher is
displayed. Use the drop down menu under font size to select small fonts. Click
Ok and you're ready to go! If you can't select it, or if you get an alert box
explaining your system can't display that resolution, then you won't be able to
view our entire site.
Mac OS
From your lower left
toolbar, click on the icon for Multiple Scan Display. Choose the display
settings closest to 800 by 600.
How should
I set the font size on my screen for best viewing?
The Screen Resolution indicator should be set at 800 x
600 or higher.
Why do I
get an alert about the site certificate when I log in to
Benesight?
For your protection,
Benesight relies on secure sockets layer (SSL) encryption technology. The
industry standard, SSL encryption technology is among the safest software
available today for secure transactions. It encrypts all the personal
information you send and receive so someone else can't read it as it travels
over the Internet. If you have ever used your credit card on a Web site,
chances are you've used the same technology!
Any company that wants
to encrypt information over the Internet applies for a digital certificate.
When your browser finds a certificate for the first time, you will receive an
alert message. You'll be able to see who owns the certificate, and make sure
that company is one you trust. If it is, approve the certificate. Your browser
will walk you through the process. Your computer will then "remember" this site
so you won't have to approve the certificate again.
Why do I
get these "server/page not found" errors in Internet Explorer 5?
Areas of this site use new technology to generate Web
pages specific to your requests. If you let your browser cache history pages
for better performance, you may find that a page you viewed the last time no
longer exists on the system. Usually, the browser recognizes content changes
and would display the new page rather than the cached copy in your history
file. Under some circumstances, though, the change goes unnoticed until you try
to navigate to a connected page. If you wish to avoid this, follow your
browser's Help instructions to make sure you automatically refresh pages each
time you visit a site.
Why do
some photographs and other graphics display poorly?
Benesight tries to maintain a good balance between high
color, attractive graphics and fast, simple page design. Some Internet Service
Providers, such as AOL, will compress and cache graphics. Compression reduces
the size of graphics. Caching stores them on your hard drive. This conserves
your provider's server capacity and improves your Internet session. The bad
news is it can also reduce the number of colors in graphics and make them look
blotchy. Unfortunately, there is often no way to fix this on your computer.
One thing you can control is graphic compression. You can change your
AOL preferences to set your graphic compression to 100% (no compression). This
will allow the Internet graphics to display as they were intended.
Why is the
page cut off at the bottom?
I can't
scroll to move it up. We designed our site for the resolution and font settings
which fit the majority of computers that visit our site while giving us a good
amount of space to display information. Most computers and monitors made within
the last decade can be reset to these specifications.
Windows
95/98/NT
Click on Start, then Settings, then Control Panel, then
Display, then Settings. Or, click your right mouse button on any empty area on
the desktop. Select Properties, then Settings.
Slide the desktop area
screen resolution indicator up until 800 x 600 or higher is displayed. Use the
drop down menu under font size to select small fonts. Click Ok and you're ready
to go! If you can't select it, or if you get an alert box explaining your
system can't display that resolution, then you won't be able to view our entire
site.
Mac OS
From your lower left toolbar, click on the
icon for Multiple Scan Display. Choose the display settings closest to 800 by
600.
Is it safe
to view my private health information over the Internet?
We take your privacy seriously. For your protection,
Benesight relies on secure sockets layer (SSL) encryption technology. The
industry standard, SSL encryption technology is among the safest software
available today for secure transactions. It encrypts all the personal
information you send and receive so someone else can't read it as it travels
over the Internet. If you have ever used your credit card on a Web site,
chances are you've used the same technology!
If your browser is set
up to alert you, then you may get a warning message when you enter Benesight.
This message tells you that you are about to enter a secure site. Even if you
do not get this alert box, Benesight is still secured.
To complete
your protection, remember to guard your selected user name and password. This
is your personal lock on all your information. You also need to be careful if
you are using the Internet at a public place, such as the library or your place
of business. Just remember to log out of Benesight by clicking on the logout
button in the upper right corner of the site. This will prevent someone else
from looking at your data. It's just like leaving your keys in the car ... be
sure to take them with you when you leave!
Help Understanding
Healthcare-Related Laws
What is HIPAA?
Health Insurance Portability and Accountability Act of 1996. This act sets
federal requirements for group health plans that let individuals carry over
credit for coverage from one carrier to another. This may reduce or eliminate
the member's pre-existing condition limitations under a new plan.
What is COBRA?
Consolidated Omnibus Budget Reconciliation Act.
A federal law that allows the continuation of health care benefits
for employees whose employment has been terminated. Employers are required
to notify employees of these benefit continuation options, or the employer
will face penalties and fines. The enrollee pays the premiums (cost of coverage).