HR Tools

What do I do if my insurance card is lost or damaged?

Contact the Member Services Department at your insurance carrier to request a new ID and they will send you a replacement ID card

How do I file a claim?

When you use participating providers in your carrier's network, you should not have to complete a claim form as participating providers are generally required to submit claims directly to the carrier. If you must go to a non-participating physician or hospital because of an emergency, you may have to pay for the service and file a claim for the service to be repaid. When you pay the bill, ask for a receipt, an itemized statement and any medical records associated with your care. Mail these to the claims department at the address shown on your ID card. It is recommended that you retain a copy for your records.

How do I find out if my doctor is on the list?

If you want help choosing a primary care physician or assistance in determining whether your physician participates in your employee sponsored group health plan, you may contact the Member Services Deptartment by calling the number located on your ID card. You may consult your provider directory or view the carrier site online for a current provider listing.

What is co-insurance?

Co-insurance is the part of a health care bill that is shared between the insurer and the patient. Most policies use co-insurance to reduce the insurer's share of smaller claims.

How do I add my newborn/adopted child to my policy?

In regards to a newborn or adopted child, notice must be provided within 63 days after the child’s birth. If notice is given within the 63 day period, Florida group health plans may not charge an additional premium for the first 31 days of coverage. However, if notice is not given within the 63 day period, a newborn or adopted child will be considered a late enrollee and may or may not be granted coverage. We recommend enrolling the baby as a dependent within 30 days.

How do I add/delete my spouse and/or dependents from my coverage?

Eligible dependents include your husband or wife and unmarried children. A child for whom you are the legal guardian is also eligible for coverage. To add or delete a spouse or dependent during the benefit year, ask your employer’s benefits representative for an enrollment change form.

When can I add/delete my spouse and/or dependents from my coverage?

Changes in coverage due to marriage, divorce or the birth or adoption of a child must be done within 31 days of the event. If you add a dependent after the 31-day period, your dependent may be subject to late enrollment provisions. Contact your employer’s benefits representative for an enrollment change form.