Using benefits guide

Using benefits guide

Using Your Benefits

Your enrollment is now complete and your benefits will soon be in effect. Here’s an overview of the benefits you may have enrolled in, along with key carrier information. Remember, your benefits marketplace, gallaghermarketplace.com, is your year-round destination to view and manage the benefits you have selected. Please note that insurers and vendors can take up to 30 days to process enrollments. After your plan effective date, if you have an appointment before your coverage is set up, there is a chance that you will need to pay out of pocket and submit a claim for reimbursement from your insurer.

Note that your company’s situs state is Indiana

Using your marketplace year round:

Life Events

You can re-enter the marketplace at any time throughout the year to make changes to your enrollments due to any significant “life events,” such as marriage or the birth of a child. Go to your marketplace’s Home page, and click on the “Life Event Requests & Updates” tab.

Guidance Resources & Health Champion Program - ComPsych

The Gallagher Marketplace gives you two free and confidential benefits regardless of what insurance programs you purchase. The ComPsych GuidanceResources® program provides free, in-person counseling, unlimited telephone consultation with attorneys and financial professionals and assistance finding child care, elder care, moving services and more. The ComPsych HealthChampion® program empowers you to make better health care choices. Experienced health care advocates provide unlimited consultation to explain bills, medical diagnoses and find payment plans or negotiate fees. Call 24/7 for support!Visit: www.guidanceresources.comWebID: Gallagher

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Health Summary

Benefit

Provider

Group #

Website

UHC

904854

www.myuhc.com

Medical

www.assurantemployeebenefits.com

Assurant Employee Benefits 5480232

Dental

www.assurantemployeebenefits.com

Assurant Employee Benefits 5480232

Vision

Sun Life

5480232

www.sunlife.com

Accident

Sun Life

5480232

www.sunlife.com

Critical Illness

Teladoc

www.teladoc.com

Telemedicine

Read below for further benefit details if you enrolled in the following:

Medical Coverage

You will receive a new medical insurance card from your insurer in the mail, which you should present to your doctor or provider at the time of service. You can begin using your benefits on your effective date, even if your ID card is not yet available. If this is the case, at the time of service, you may need to pay out of pocket but you can later file a claim with your insurer for reimbursement.

Dental Coverage

Your dental plan is “paperless” which means you won’t need an ID card when you visit your dentist or other provider. Just tell the office your name, date of birth and social security number. In the event that you have a dental appointment before your coverage is set up, you’ll need to pay out of pocket and submit a claim for reimbursement from your insurer.

Vision Coverage

Your vision coverage is “paperless” which means you won’t need an ID card when you visit your eye doctor or other provider. Just tell the office your name, date of birth and social security number. In the event that you have a vision appointment before your coverage is set up, you’ll need to pay out of pocket and submit a claim for reimbursement from your insurer.

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Accident Coverage

Accident insurance pays fixed benefits for injuries (e.g., fractures or dislocations), treatments (e.g., emergency room visits, follow-up doctor appointments, or ambulance rides), and loss due to a covered accident.

How to file a claim

Please take the following steps to submit your Accident insurance claim by fax or mail:

1. Visit www.mysunlifebenefits.com

2. Under “My Accident Insurance Benefits,” click “Download paper forms and applications” and select “Miscellaneous” from the “I’d like a form for” drop-down menu.

3. Select Accident Claim Statement. Complete and print the Accident Claim Statement, which includes the Employee Statement, Attending Physician Statement, and Authorization Statement. 4. Have your doctor complete and sign the Attending Physician Statement, or you may submit your hospital bill, medical EOB, Emergency Room Report, or other evidence that supports a claimable event. 5. Ensure that your paperwork is complete. It is your responsibility to make sure that the forms are accurate and submitted to Sun Life in order for us to evaluate your claim request.

6. Fax or mail all completed forms to Sun Life: Fax: 781-304-5537 Mail: Sun Life Assurance Company of Canada Group Accident Claims P.O. Box 81915 Wellesley Hills, MA 02481

What happens after you file a claim?

Review Once we receive your completed claims information, a claims professional will evaluate your Accident claim. During the evaluation process, we may request additional information from your employer for confirmation of your enrollment for this coverage.

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Determination You can check your claim and payment status or see if there are messages posted about your claim at www.sunlife.com. You will need your claim number and Social Security number.

Critical Illness Coverage

Critical Illness insurance pays you a lump sum cash benefit if you are diagnosed with covered condition.

How to file a claim

Please take the following steps to submit your Accident insurance claim by fax or mail:

1. Visit www.mysunlifebenefits.com

2. Under “My Accident Insurance Benefits,” click “Download paper forms and applications” and select “Miscellaneous” from the “I’d like a form for” drop-down menu.

3. Select Accident Claim Statement. Complete and print the Accident Claim Statement, which includes the Employee Statement, Attending Physician Statement, and Authorization Statement. 4. Have your doctor complete and sign the Attending Physician Statement, or you may submit your hospital bill, medical EOB, Emergency Room Report, or other evidence that supports a claimable event. 5. Ensure that your paperwork is complete. It is your responsibility to make sure that the forms are accurate and submitted to Sun Life in order for us to evaluate your claim request.

6. Fax or mail all completed forms to Sun Life: Fax: 781-304-5537 Mail: Sun Life Assurance Company of Canada Group Accident Claims P.O. Box 81915 Wellesley Hills, MA 02481

What happens after you file a claim?

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Review Once we receive your completed claims information, a claims professional will evaluate your Accident claim. During the evaluation process, we may request additional information from your employer for confirmation of your enrollment for this coverage. Determination You can check your claim and payment status or see if there are messages posted about your claim at www.sunlife.com. You will need your claim number and Social Security number.

Telemedicine Plan

To get started and set up your account: 1. Visit the Teladoc website at www.teladoc.com 2. Click "Set up account". 3. Provide the required information.

4. If selecting “No, I don’t know my username” select the “My employer or insurance provider offers me access to Teladoc” option and enter your company name in the “Company Name” box.

Money Summary

Benefit

Provider

Website

Self Admin

Please Contact your HR Department

Health Savings Account

Read below for further benefit details if you enrolled in the following:

Health Savings Account (HSA)

If you are a new enrollee, you will receive your HSA debit card directly from your HSA administrator in the mail. Please contact your employer for additional information. If you already have an HSA through your employer, you can view your account status by visiting the website provided by your employer. Note that as a current account holder, you may continue to use your existing HSA debit card for qualified purchases.

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Protection Summary

Benefit

Provider

Group #

Website

Sun Life

5484338

www.sunlife.com

Life Insurance

Assurant Employee Benefits

Short Term Disability

www.assurantemployeebenefits.com

5484338

Assurant Employee Benefits

Long Term Disability

www.assurantemployeebenefits.com

5484338

Read below for further benefit details if you enrolled in the following:

Life Insurance

Based on your benefit and coverage selections, you may be required to complete an Evidence of Insurability (EOI) for yourself and/or your dependents. You will be informed, at the time of enrollment, whether you will need to submit EOI as a result of your elections. After the enrollment period closes, you will receive an Evidence of Insurability Packet via U.S. mail from Sun Life Financial. This packet will include your group policy number and specific instructions on completing your Evidence of Insurability online through Sun Life’s online web portal for Plan Members. In order to complete the online Evidence of Insurability application, you will need your group policy number, your location/division if your employer has more than one location, coverages, height, weight, and recent medical history for you and any dependents, if applicable. What happens after I submit my EOI application? Once you have completed the online EOI application via Sun Life’s web portal, an e-mail alert will be sent to you and your employer to confirm that we received the application. A quick EOI decision is made—usually within minutes—on applications for which the employer has confirmed coverage: Approved Sun Life will send a decision letter via U.S. mail with approved coverage amounts. The effective date is either the date of approval for EOI or the date of eligibility for coverage per the group contract, whichever date is later.

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Auto-Approved If you qualify for an auto-approval based on your online EOI application, Sun Life will send you an e-mail notification with an automatic approval.

Denied Sun Life will send a decision letter via U.S. mail with appeal instructions.

Pended If additional review is required, Sun Life will send a “pend” letter via U.S. mail with additional requirement(s) to you. It will be important for you to return any additional information as requested. If we do not hear from you after 90 days, the file will be closed. Life insurance pays a benefit to beneficiaries in the event of the death of a covered person. Accidental Death & Dismemberment (AD&D) pays a benefit to you or your beneficiaries if you suffer from a covered accidental injury or a covered accidental death. How to update your beneficiary designations During your online enrollment, you should have selected one or more beneficiaries to receive your insurance benefit in the event of your death. If you haven’t already done so you may add or update your beneficiaries at any time throughout the year. How to file a claim Please take the following steps to file a claim in the event of the death of a covered employee or dependent: Contact the employer to report the death of the covered employee/dependent and to confirm eligibility.

Complete “Section B: Claimant Statement” and “Section C: Authorization” in the Sun Life Group Death Claim Packet.

1. The Group Death Claim Packet can be found on www.mysunlifebenefits.com by clicking on “Download Paper Form and Applications” under My Life Insurance Benefits. Select Life and AD&D from the “I’d like a form for” drop-down menu.

2. Submit the completed and signed “Claimant Statement” and “Authorization” and a certified copy of the death certificate to your employer. The employer will complete “Section A: Employer Statement” and will submit the entire claims packet to Sun Life for processing.

All inquiries or follow-up questions can be directed to Customer Service at 800-247- 6875, Monday through Friday, from 8:00 a.m. to 8:00 p.m. ET.

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Short Term Disability Coverage

You can view a summary of your benefits and related information by clicking on the name of the plan on your marketplace’s Home page, and going to the “Important Information” tab. Note you will not be receiving any plan information in the mail.

Long Term Disability Coverage

You can view a summary of your benefits and related information by clicking on the name of the plan on your marketplace’s Home page, and going to the “Important Information” tab. Note you will not be receiving any plan information in the mail.

If you have any questions about your benefits, please visit your marketplace at gallaghermarketplace.com to review plan and program details, or contact your HR administrator. ?

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