Frequently Asked Questions

Consumer Directed Health Plans

Q. What is an HSA?

A. An HSA (Health Savings Account) is a tax-exempt account established specifically for the purposes of paying qualified medical expenses (both current and future) for the account holder, their spouse, and their dependents.

Q. What are the eligibility requirements for an HSA?

A. Any person who has an IRS-qualified High Deductible Health Plan (HDHP) is eligible to open an HSA.

Q. What is an HRA?

A. An HRA is a Health Reimbursement Account. HRAs are paid solely by your employer. Dollars allocated to the account are available to reimburse an employee or dependents for a portion of his/her deductible.

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Independence Blue Cross Plans

Q. When can dependents be added to my policy?

A. January 1st is the only time each year when eligible dependents may be added to your policy. The only exceptions would be for lifestyle changes such as marriage, adoption, or birth. Please call for more details if adding a dependent outside of Open Enrollment.

Q. How long can dependents remain on my policy?

A. A dependent is eligible up to the age of 19 unless an unmarried, full-time student, in which case they may remain until age 23 or 25 depending upon the rider selected. In most cases, IBC will be able to verify student status, however, if you are asked to supply verification of full-time status, it is critical you do so immediately to avoid a lapse in your dependent's coverage. Dependents are aged and student verified in April and October. If they are no longer a student or have aged out, they will be removed either April 30 or October 31.

Q. I have an employee over 65 years old and eligible for primary Medicare since my company has less than 20 employees. What plans are available to this employee?

A. You may offer one of the available Medicare Supplemental plans to active employees 65 years or older who are eligible for primary Medicare. The employee must have both Part A and Part B of Medicare. There are multiple options available to Medicare eligible individuals; including Keystone 65 plans, Personal Choice 65 plans, and Security 65 plans. The enrollment material should be submitted at least 60 days prior to the requested effective date for the Personal Choice 65, Keystone 65 and Security 65 plans.

Q. Are there limitations on when I can make changes to my plan?

A. Most changes are limited to the January 1st effective date; however there are situations where a change may be permitted later in the year. No change will be accepted by the carrier unless all required paperwork is received. The carrier requires paperwork be submitted at least 40 days prior, if the requested effective date is after January 1st.

  • Medical plan and Prescription Drug plan changes: January 1 2009 is the only time you may up-grade. Downgrades have historically permitted from January through June.
  • Dependent Rider may only be changed on January 1st and requires the group to be re-quoted.
  • Dental and Vision may only be added, removed, or changed effective January 1st.
  • Eligible dependents may only be added effective January 1st except in cases of a life event change, such as marriage, birth, or adoption.
  • Domestic Partner Rider may only be added January 1st and must be requested no later than October 31st.
Q. Are there guidelines or limitations on the number of plans or combination of plans I may offer?

A. Yes, the following carrier guidelines must be adhered to in choosing you plans:

  • Groups with 2-9 participants may select up to 2 medical plans (one Personal Choice and one Keystone plan) and 1 drug plan. The same drug plan would apply to both medical plans.
  • Groups with 10 or more participants may select up to 3 medical plans and 2 drug plans. No more than 2 of the medical plans may be of the same type, for example two Keystone plans and one Personal Choice plan would be permitted; however three Personal Choice plans would not be approved.
  • You may not have both a standard drug card (2 tier co-payment) and a select drug card (3 tier co-payment) in one company.
  • A group may only offer one dental plan and one vision plan.
  • A group may only select one dependent rider.
Q. When can ancillary coverage be added?

A. Open Enrollment is the only time you may add one of the custom UCCI dental plans or the IBC Free Standing vision coverage. Both products require at least 75% participation and may not be cancelled until next Open Enrollment.

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Highmark Blue Shield Plans

Q. Are there limits on how many plans I may offer?

A. Yes, gruops with 1 to 10 participants may elect 1 medical plan, 11 to 50 participants may elect 2 plans: groups with 51 + participants may elect 3 plans.

Q. I have an employee age 65 or older. Should that employee be insured under the Signature 65 program?

A. If you have less than 20 employees according to government guidelines, carrier guidelines require that the Medicare eligible employees be insured under the Signature 65 with the Blue Rx. Carrier guidelines will not permit a Medicare eligible individual to be insured under a standard policy. The employee must have Medicare Part A and Part B. This would apply to the dependent of an employee if insured under the plan. If you do not currently have an insured under the Signature 65 plan, please contact our Medicare Unit at 1-866-888-6736 for information, or you can email your request for information to medicalmailbox@usi.biz.

Q. Are there any restrictions to when the dental and vision can be changed?

A. January 1st is the only time you may change or terminate the dental and vision plans.

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