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INSURANCE




How do I file a claim for insurance?
Present your insurance card at every service provider visit. Most will file your charges to your insurer, if you go to a participating provider. If not, you may be required to file your own claim. In that case, use the group number, your identification number and the claim office address indicated on your insurance card.

For Allegiance Benefit Plan Management (ABPM) $400 and $575 Deductible Plans, you are responsible for paying charges up to your selected deductible amount. After your deductible is met, ABPM pays either 80% or 75%, of allowable charges (depending on the type of provider and service involved)*, and you pay either 20% or 25% of charges, if you see a participating provider. If you visit a non-participating provider, you are also responsible for charges over and above the Network-negotiated allowable amount.

For New West or Blue Cross Managed Care plans, if you use a participating provider you are responsible for the office visit ($15), emergency room ($75) and urgent care ($25) co-payments. For other types of in-network services, you are responsible for paying charges up to the $300 In-Network deductible and then, the plan pays 75% and you pay 25%. If you visit a non-participating provider, you are responsible for an additional $500 non-Network deductible, and then, the plan pays 65% and you pay 35%. You may also be responsible for the difference in charges over and above the Network-negotiated allowable amount. For urgent/emergent care, network participation is waived for emergency services, but not for follow-up care.

* See your Choices benefits guide for specific co-payment amounts.




How do I add/delete a dependent to my insurance coverage?
You will be required to complete a new CHOICES form including the Mid-Year Change Information section within 31 days of the event. Major Life Event.




As a new employee, when do my insurance benefits go into effect?
If you are in an insurance benefits eligible position, your insurance benefits begin the day you begin work at The University of Montana.




If I terminate, when do my benefits end?
Your medical, dental and optional vision benefits will end on the last day of the month in which you work. Your life insurance, long-term disability and accidental death and dismemberment (AD&D) benefits will end on the last day that you work.

By federal law, you will be offered a COBRA extension plan in which you can continue medical, dental and/or vision coverage for up to 18 months by self-paying the premiums. Your medical insurer will automatically send you information on this coverage. You then have 60 days to elect this coverage. If elected, COBRA coverage will begin immediately after your group coverage ends.




Our life insurance plan has a portability clause that allows terminating employees the option to continue their life insurance coverage by self-paying. You must apply for this coverage within 31 days of your last day worked. Information, application forms, and rates are available in HRS. See also: Life Portability Rates




What kind of insurance coverage do I have when traveling overseas?
Whether you travel for business or pleasure, 100 or 10,000 miles from home the Medex Travel Assist Program provides the necessary coverage: See: Medex Travel Assist



RESOURCES




Human Resource Services

Emma B. Lommasson Center
Room 252

The University of Montana

Missoula, MT 59812

Phone: 406-243-6766

Fax: 406-243-6095