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Who
is Eligible to Participate?
All Field Staff employees are eligible to enroll. Eligible
dependents include spouses and unmarried children or
stepchildren, under age 19. Full-time students at an
accredited school and under the age of 23 are also eligible
to participate.
How Are Premium Payments Made?
Premiums will be taken through weekly payroll deduction. If
you miss a payroll deduction as a result of absence or lack
of work, no benefits will be extended for the following
period. However, if a claim is incurred during a period of
time when premiums were missed, the missed premium will be
subtracted from the pended claim, maintaining a continuity
of coverage. If a claim is not incurred during the missed
premium timeframe, missed premium does not need to be made
up. However, if you miss 5 consecutive weeks of premium,
coverage will be terminated and you will not be eligible to
re-enroll until the next open enrollment period unless you
experience a qualifying event.
What Happens if the Provider Charges More Than The
Scheduled Benefit?
If the provider charges more than the scheduled benefit, the
covered person must pay the provider the difference.
What Happens if the Provider Charges Less Than the
Scheduled Benefit?
The insurance company pays the insured the difference
between the amount billed and the scheduled benefit.
What Is An Indemnity Benefit?
It means that the insurance company will pay a set amount
each time the insured receives a covered service. The same
amount is paid regardless of the fees charged by the
provider.
Where Can I Get More Information?
You visit www.arcadiaenroll.com or call 1-800-815-7380.
When Does Coverage Begin?
Coverage for you and your eligible dependents begins on the
Monday following your first payroll deduction (unless
dependent coverage is added at a later time). However, if
any dependents are totally disabled on the usual effective
date, their coverage will be deferred until they cease to be
disabled.
When Will My Coverage End?
Your coverage will end when you no longer qualify under the
plan or when your premium payments are 5 weeks behind,
whichever comes first. Coverage on dependents ends on either
the date they no longer meet the definition of a dependent
or, the date your coverage terminates, whichever comes
first.
Can I Sign Up For Coverage At Any Time?
No. You must sign up for coverage in the first 30 days of
your date of hire. Your coverage will begin the Monday
following your first payroll deduction. If you do not elect
coverage in the first 30 days, you will not be able to
enroll until the next open enrollment period unless you
experience a qualifying event.
Can I Cancel Coverage At Any Time?
No, because of the pre-tax deduction. You can only cancel
your coverage if you experience a qualifying event. If you
do cancel your coverage due to a qualifying event, you will
not be able to enroll until the next open enrollment, unless
you have another qualifying event.
When can I expect to receive the Member Kit with the ID
Cards?
The medical member kit will typically be mailed to you no
later than the last week of the month prior to your
effective date. Please allow three weeks for this kit to
arrive in your mailbox. The dental and vision member kits
are mailed separately; please allow 5-6 weeks from your
policy effective date for these to arrive in your mailbox. |