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Q:
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What is the commission rate?
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A:
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Commission is $9.00 per life per quarter.
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Q:
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How are commissions paid?
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A:
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Commissions are paid on a quarterly basis.
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Q:
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What are the requirements to obtain EXEC-U-CARE?
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A:
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You must have a base medical plan that provides an annual deductible not to exceed $5000 per person.
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Q:
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Who is eligible for EXEC-U-CARE?
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A:
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Full-time employees within the designated class as stipulated on the participation agreement and their eligible dependents.
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Q:
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How much is the premium?
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A:
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The cost is $62.50 per employee per quarter. There is no separate premium for dependents.
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Q:
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What is the administration fee?
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A:
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You will be billed 11% in addition to the amount of each claim. This is the administration fee and covers the costs associated with processing the claims.
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Q:
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Where can I find additional information and create a proposal?
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A:
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The website www.exec-u-care.com has information for brokers and an area to create proposals.
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Q:
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What effective date can be used?
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A:
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Employees can be effective on the first of the month following their date of hire. Company's can be effective on the 1st of the month following receipt of a completed participation agreement, enrollment forms, and the first three months premium. It is not possible to backdate an effective date.
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Q:
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How do we set up our company?
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A:
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Decide which class of employee you wish to offer the coverage to. Complete a participation agreement and enrollment forms for each member. Submit these items with a check for the first three months premiums to EXEC-U-CARE.
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Q:
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What is the premium factor table?
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A:
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Actuaries assign a premium factor for each member based upon the group size and policy amount. The premium factor is multiplied by the number of employees on the plan. The total is considered the "annual maximum premium". Please see the EXEC-U-CARE brochure for additional details.
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Q:
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How can I check to find out if my application has been received and whether my welcome packet has been mailed?
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A:
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Please call 800 552 1213.
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Q:
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How do we enroll a new member?
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A:
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You can mail in a new enrollment form for a member. For a dependent spouse or child submit a claim with their expenses (make sure the birth date is correct).
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Q:
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How do we remove someone from the plan?
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A:
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Notify EXEC-U-CARE in writing on company letterhead.
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Q:
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How does EXEC-U-CARE handle COBRA issues?
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A:
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EXEC-U-CARE follows the COBRA guidelines just like any insurance
plan. The company must notify us of any members who are on COBRA.
The benefits and claims procedures remain the same. COBRA provides
a continuation of coverage only for Covered Health Care Expenses.
AD&D Insurance may not be continued.
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Q:
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What is the student age?
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A:
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The EXEC-U-CARE certificate
defines an eligible dependent child as an unmarried child who meets
the definition of a dependent of the Insured Employee under the
provisions of the U.S. Internal Revenue code.
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Q:
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Is a surviving spouse eligible for EXEC-U-CARE?
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A:
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Yes. You will need to submit an enrollment form for this member and the quarterly premium will apply.
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Q:
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Who is the underwriter?
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A:
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The Lincoln National Life Insurance Company.
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Q:
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What is the underwriter's rating?
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A:
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To view the most current Lincoln Financial Group ratings
please visit http://www.LincolnFinancial.com
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Q:
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What services are covered?
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A:
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Exec-U-Care provides health coverage to supplement base medical insurance that an employer makes available to its employees. It will cover deductibles and coinsurance amounts not paid by the base plan. Charges are payable for the diagnosis and treatment of illness or injury. Charges must be for services that are medically necessary. Qualifying medical, dental, vision, and prescription services are covered. Cosmetic services are excluded. Please see the list of exclusions on this site.
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Q:
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How does the billing process work?
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A:
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Claims received by the 14th of the month are processed on that month's bill which is mailed out around the 20th. Once the company has paid the bill, checks are issued. Claims received after the 14th of the month will be processed on the following month's bill.
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Q:
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How do I complete a claim form?
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A:
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Please see instructions for completing a claim form at www.exec-u-care.com.
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Q:
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What is the monthly claim cutoff?
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A:
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Claims received by the 14th of the month will be processed on the bill that is mailed out around the 20th. Claims received after the 14th will be included on the following month's bill. Please note that if the 14th falls on a weekend or holiday claims must be received by the last business day before.
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Q:
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What is the deadline to submit claims?
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A:
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The filing deadline for any calendar year is March 31 of the following year.
Please see the EXEC-U-CARE certificate for additional information.
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Q:
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Can I fax forms into EXEC-U-CARE?
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A:
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Claims and enrollment forms are not accepted via fax. A hard copy must be submitted.
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