Frequently Asked Questions
What do I do if I haven’t received my new ID card
and need to see a doctor or have a prescription filled?
A
call to the client services manager will help you determine your
enrollment status. Once this is established you will be advised how
and when to process your claim.
What do I do if I have received a bill for medical services
that is incorrect and should have been covered by my insurance
plan?
The employee should first call the insurance company
to seek resolution. Before calling your insurance company, you
should have the: Social Security Number or Member ID Number of
the Employee, the Patient Name’s,
the Date of Service, and the Provider’s Name and Phone Number. Please
call ARI if the insurance company doesn’t resolve your issue
on the first attempt.
When can I enroll or make changes to my plan?
There
are three times at which you may enroll
The Initial Enrollment as a New Employee - Once you have satisfied
the initial waiting period established by your employer you will have
your first chance to enroll in the group’s insurance plan.
A Qualifying Event – Enrollment under a Qualifying Event can
happen at any time during the year provided the specific criterion
is met. In the occurrence that you do have a Qualifying Event you
must submit your request for changes to your Employer no later than
30 days after the Qualifying Event takes place. The next
opportunity to make changes would be during your company’s annual “Open
Enrollment” period.
Open Enrollment - Open Enrollment is the annual event, for certain
benefits, where you and your eligible dependents can request changes
in your election and apply for coverage.
What is a Qualifying Event?
Examples are Marriage,
Divorce, Birth, Adoption, Death, or Your Spouse Losing Coverage. Check
with your Employer to confirm if your situation is a Qualifying
Event.
What is a Certificate of Credible Coverage:
This
is a certificate that is mailed to you from the insurance company after
leaving a medical plan. You will need to give this certificate to your
new medical insurance company so that it may apply toward any time
requirements for potential pre-existing condition limitations.
Is my Full Time Student covered?
Most insurance
carriers will allow you to carry a full time student on your until
the student reaches the age of 25. At the requirement of the carrier
you must submit a certificate from the school showing proof of their
full time enrollment.
Can I change my PCP?
You may change your PCP at
any time by contacting your insurance provider. It should be noted
that PCP changes should be done in advance of seeking medical attention.
What do I do if I am Struggling,
Stuck, or Stymied with my insurance plan?
Simply pick up
the phone and call the Client Services Department
of ARI.
