FAQs
1. When do my benefits begin?
2. How are premiums deducted?
3. How much does the insurance cost?
4. How do I know if a provider participates in a plan?
5. When can I make changes to my existing benefits?
6. Do I have to participate in the medical insurance to receive dental or vision?
7. What is Section 125?
8. How do I know which plan I'm on?
10. My doctor has ordered a diagnostic procedure for me. Do I need to call the insurance company first?
11. How do I know what is or isn't covered on my plan?
Benefits begin the first of the month following the second month of employment (i.e. your hired in August, benefits begin October 1; your hired in September, benefits begin November 1, etc.)
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Premiums are deducted once a month directly from your paycheck. Example: A deduction is taken out of your September paycheck to pay for insurance for the month of October.
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How much does the insurance cost?
The cost is based on whether you are full time or part time and which benefits you choose to participate in. Schedule of Premiums
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How do I know if a provider participates in a plan?
You can contact the vendor directly or go to their website. List of vendor numbers and web sites.
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When can I make changes to my existing benefits?
You can make changes during open enrollment (April/May every year) or if you have a qualifying event only. For more information please visit the Critical Information section of the Benefits Guidebook.
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Do I have to participate in the medical insurance to receive dental or vision?
No. You are able to pick the benefits that best meet your needs.
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Section 125 means that you are able to use "pre-tax" dollars to pay for certain benefits that you may have previously paid for with "after-tax" dollars.
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How do I know which plan I'm on?
You can check your most recent pay stub via the Employee Portal or create a sign-on for accessing your claims history and other information with the insurance carriers (web addresses are listed on page 2 of this Guidebook, or there are links from the Benefits web page [www.hsd2.org, click on Departments, click on Finance, click on Benefits, click on Providers] as this also provides you with the type of plan you're enrolled in, or contact the Benefits Office at 579-2037.
My doctor has written a prescription for me for 10 pills, but the pharmacy says they can only give me 3 pills. What should I do?
Certain drugs require that your physician complete a preauthorization form and submit it to the insurance carrier prior to your prescription being filled. Should you arrive at the pharmacy with a prescription and are told that there is a limit on the drug you need filled, contact your doctor's office and tell them that the drug requires an override. If your physician's office does not have the necessary override form, they can call Anthem Blue Cross and Blue Shield at 1-800-542-9402 to obtain a copy of the form.
My doctor has ordered a diagnostic procedure for me. Do I need to call the insurance company first?
Certain procedures require that your physician complete a preauthorization form and submit it to the insurance carrier prior to the procedure being performed. Ultimately it is your responsibility to ensure this has happened before moving forward with the procedure.
How do I know what is or isn't covered on my plan?
A copy of the Summary Plan Document/Certificate for each plan is available on the Benefits web page under Summary Plans. When in doubt, contact the insurance carrier with the information specific to your situation and they may be able to assist you.