|
Q:
|
Who is eligible for EXEC-U-CARE?
|
|
A:
|
Each employer establishes classifications of eligible employees
and dependents. Please contact your company representative to
determine eligibility.
|
|
|
|
Q:
|
What is the student age?
|
|
A:
|
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.
|
|
|
|
Q:
|
How do I add a dependent?
|
|
A:
|
To add a dependent spouse or child, submit a completed claim form
for their expenses. It is critical that the correct birth date
be provided on the claim form.
|
|
|
|
Q:
|
How do I update a change of last name or change of beneficiary?
|
|
A:
|
Submit a new enrollment form with the correct information.
Write "CHANGE" across the top of the enrollment form before
submitting to EXEC-U-CARE.
|
|
|
|
Q:
|
Can I list my company as the beneficiary on my EXEC-U-CARE plan?
|
|
A:
|
No, The Lincoln National Life Insurance Company does not allow the company to be a
beneficiary for purposes of the AD&D coverage.
|
|
|
|
Q:
|
How do I change a birth date or Social Security Number?
|
|
A:
|
EXEC-U-CARE must receive a written request to make these changes.
|
|
|
|
Q:
|
How does EXEC-U-CARE handle COBRA issues?
|
|
A:
|
EXEC-U-CARE follows the same COBRA guidelines as any other 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.
|
|
|
|
Q:
|
What services are covered?
|
|
A:
|
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.
|
|
|
|
Q:
|
How do I complete a claim form?
|
|
A:
|
Please see instructions for completing a claim form at www.exec-u-care.com.
|
|
|
|
Q:
|
What is the mailing address for claims?
|
|
A:
|
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.
|
|
|
|
Q:
|
What is the monthly claim cutoff?
|
|
A:
|
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 such weekend or holiday.
Generally, a check is mailed to the company or covered employee
(as applicable) within 1 business day following Exec-U-Care's
receipt of premium with respect to such billings.
|
|
|
|
Q:
|
What is the deadline to file claims?
|
|
A:
|
The filing deadline for any calendar year is March 31 of the following year.
Please see the EXEC-U-CARE certificate for additional information.
|
|
|
|
Q:
|
How can I find out the status of my claim?
|
|
A:
|
Please contact EXEC-U-CARE at 800 552 1213.
|
|
|
|
Q:
|
I submitted a claim and my approval letter shows a different amount. Why is that?
|
|
A:
|
Multiple claims may be added together and included on the same letter. If a portion of any claim is denied, a letter of explanation will follow this acknowledgment. This letter will detail the specific reason for the denial and what additional information is required. Once you have received this letter, if you still have questions you may contact EXEC-U-CARE at 800 552 1213 to review claim discrepancies.
|
|
|
|
Q:
|
How do I get more forms?
|
|
A:
|
You can obtain forms at www.exec-u-care.com or by calling 800 552 1213.
|
|
|
|
Q:
|
When will I receive payment?
|
|
A:
|
Bills are sent to the company around the 20th of each month. Once the bill has been paid, checks are issued to the individuals.
|
|
|
|
Q:
|
How are checks mailed?
|
|
A:
|
Checks are mailed via first class mail through the US Postal Service.
|
|
|
|
Q:
|
Where are checks mailed?
|
|
A:
|
Checks are mailed either to the company contact or to the employee's home address as the company instructs.
|
|
|
|
Q:
|
How can I get a check reissued?
|
|
A:
|
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.
|
|
|
|
Q:
|
How do I file an appeal?
|
|
A:
|
Please send a written appeal to EXEC-U-CARE. Include as much detail as
possible such as the claim detail, claim amount and the reason for the appeal.
Appeal procedures are more fully set forth in the Claims Procedures of the certificate of coverage.
|
|
|
|
Q:
|
What is the Per Occurrence limit?
|
|
A:
|
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. Refer to your certificate to determine the dollar amount of the Per
Occurrence limitation.
|
|
|
|
Q:
|
What information is needed once a person reaches the Per Occurrence limit?
|
|
A:
|
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.
|
|
|
|
Q:
|
Can I fax forms into EXEC-U-CARE?
|
|
A:
|
Claims and enrollment forms are not accepted via fax. A hard copy must be submitted.
|
