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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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What do I do if I have a question about my bill?
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A:
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You can view your billing statement online by logging in to our
Online Billing Application or by speaking to an Exec-U-Care
Account Coordinator at (800) 552 1213.
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Q:
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How can we get our payment to EXEC-U-CARE faster so that our members will be paid more quickly?
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A:
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Sign up for ACH, wire transfer, or pre-fund your account.
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Q:
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What is the mailing address for payments?
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A:
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EXEC-U-CARE, PO Box 533204, Charlotte, NC 28290-3204. For express
mail please send to: JPMorgan, Attn: Exec-U-Care Box #533204,
806 Tyvola Road, Suite 108, Charlotte, NC 28217
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Q:
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How can we receive a refund of the credit on our company's account?
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A:
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Submit a request, in writing, on company letterhead. The letterhead or letter must include the company's current address.
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Q:
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How do I request a change of broker?
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A:
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Please submit a written request to EXEC-U-CARE.
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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 generally provides health coverage to supplement base medical insurance that an employer makes available to its employees. Covered expenses are exclusively described in the Exec-U-Care certificate.
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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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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 mailing address for claims?
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A:
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EXEC-U-CARE, PO Box 4540, Iowa City, IA 52244-4540. For express
mail please send to 2610 Northgate Dr., Iowa City, IA 52245-9564.
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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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Q:
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How do I get more forms?
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A:
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You can obtain forms at www.exec-u-care.com or by calling 800 552 1213.
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Q:
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What do I do if I have a question regarding a claim amount?
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A:
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Call 800 552 1213.
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Q:
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When will I receive payment?
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A:
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Bills are sent to the company around the 20th of each month. Once the bill has been paid, checks are issued to the individuals.
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Q:
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Where are checks mailed?
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A:
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Checks are mailed either to the company contact or to the employee's home address as the company instructs.
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Q:
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How are checks mailed?
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A:
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Checks are mailed via first class mail through the US Postal Service.
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Q:
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How can I get a check reissued?
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A:
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If the check has not been cashed, write VOID across it and return it to EXEC-U-CARE with an explanation. EXEC-U-CARE will then void and reissue the check. If a check is missing, call EXEC-U-CARE at 800 552 1213 and we can stop payment and reissue the check.
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Q:
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How do you adjust a reimbursement check that is incorrect?
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A:
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If the check has not been cashed, write VOID across it and return it to EXEC-U-CARE with an explanation. EXEC-U-CARE will then void and reissue the check. If a check is missing, call EXEC-U-CARE at 800 552 1213 and we can stop payment and reissue the check.
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Q:
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What is the Per Occurrence limit?
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A:
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The Per Occurrence Limit is a specified dollar limit in a calendar year for the
same or related diagnoses, treatment, condition, illness, injury, surgical procedure,
or period of confinement. Benefits will not be payable after the Per Occurrence
Limit is met. Claims submitted to EXEC-U-CARE are sorted by type and diagnosis.
For example, claims can fall into medical, dental, or vision categories. Claims
without diagnosis information are placed in a "general medical" category.
Once a member reaches the Per Occurrence limit they are notified in writing by
EXEC-U-CARE. Please review your certificate to determine the dollar amount of
your Per Occurrence limit.
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Q:
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What information is needed once a person reaches the Per Occurrence limit?
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A:
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EXEC-U-CARE will notify the member, in writing, once the per occurrence maximum is met. If additional information is needed, it will be requested in the letter.
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Q:
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How do I file an appeal?
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A:
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Please send a written appeal to EXEC-U-CARE. Include as much detail as possible
such as the claim amount and the reason for the appeal. Appeal procedures are
more fully set forth in the Claims Procedures of the certificate of coverage.
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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 and their eligible dependents who belong to the particular class of employees designated by the company in the participation agreement.
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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 month's fixed premiums to EXEC-U-CARE.
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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 much is the premium?
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A:
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The premium consists of a fixed and variable portion. The fixed premium is $62.50 per employee per quarter. There is no separate premium for dependents. The variable premium is calculated as 111% of eligible claims up to the annual maximum premium set forth in the certificate of coverage (see below).
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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". For additional information, please see the EXEC-U-CARE brochure.
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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 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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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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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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How do I update our company contact designee?
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A:
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Submit the new information to EXEC-U-CARE in writing on company letterhead.
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Q:
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How do I update my address information?
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A:
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Please submit a written request to EXEC-U-CARE.
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Q:
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What is the privacy letter of understanding?
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A:
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When this document is completed and signed, it authorizes EXEC-U-CARE to discuss protected health information with the designated people.
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Q:
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How do I obtain or revise our privacy letter?
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A:
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Download a form from www.exec-u-care.com, complete the form, and send to EXEC-U-CARE. This form can be submitted via fax or regular mail.
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Q:
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How do I update a change of last name or change of beneficiary?
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A:
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Submit a new enrollment form with the correct information. Write "CHANGE" across the top of the enrollment form before submitting to EXEC-U-CARE. Please note that you cannot designate the company as your beneficiary.
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Q:
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How do I change a birth date or Social Security Number?
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A:
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EXEC-U-CARE must receive a written request to make these changes.
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Q:
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How do I terminate our plan?
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A:
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Submit your request to EXEC-U-CARE, in writing, on company letterhead. Include the date that you wish coverage to terminate.
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