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FAQ

Health Insurance - Contact Information

  • How and when does an eligible employee get their Pharmacy Benefit Manager (PBM) card? There have been instances when employees have not received their cards timely.

Submission of the advance carrier ply of the Health Insurance Application/Change Form (ET-2301) is meant to expedite insurance processing and the issuance of insurance and pharmacy benefit cards. If there is an unreasonable delay in receipt of an employee's cards, contact the health plan (for health insurance card) or the PBM and cards will be issued as soon as possible. If you encounter additional delays, feel free to contact ETF.

  • Occasionally employees inform us that they have problems getting in touch with their plans regarding claims, etc. The employees then contact us, the employer, but the plans are limited by HIPPA regulations in what they can discuss with us. It is also very difficult and time consuming navigating through the plans' automated voice systems. What can employers do in these situations?

Contact ETF whenever you have difficulty dealing with the health plans.

  • Who should employees contact regarding coverage issues?

    Employees should always contact their plan initially. If they don't get satisfaction after contacting the plan they can then contact ETF.

  • How does an employer's WRS agent designate a health insurance representative so ETF will contact them directly rather than the Agent when health insurance related issues arise?

    The Designation of Agent form (ET-1313), has a section for designating insurance contacts for the employer. ETF will then contact that person when there are health insurance related questions. However, all ETF mailings are sent to the designated WRS Agent.

  • Do employers get a report of dependents that are coming off their employees' insurance following resolution of the student status letters?

    Yes, the findings of the student status survey are sent to the employers.

  • Does an employer typically have just one WRS Agent or can they have multiple agents?

    Each employer has just one designated WRS Agent but can assign representatives or contacts for specific insurance programs. Employers may also designate an alternate agent.

  • When an employer changes Health program options do they have the responsibility to notify annuitants, continuants, etc.?

    Yes, when an option change occurs, ETF provides the employer with a list of all covered employees, continuants, annuitants, etc. The employer must locate and notify them of the program change.

 

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