Answers to Frequently Asked Questions
Our client’s dedicated VistaNational Account Managers and Account Executives receive questions every day. Read below for some of the Frequently Asked Questions along with answers. If you have a question that isn’t addressed, don’t hesitate contacting us for a quick and accurate answer from one of our professionals.
Q1: Sally covers her children on her plan and her spouse also covers the children through his employer’s plan. How does this work and which plan would pay first?
Q3: If my spouse and I are both offered a health care FSA and day care FSA plan through our employers, how much can we each elect?
Q4: I had a wellness exam and tests conducted by my Doctor and received my explanation of benefits showing it was applied to my deductible. Is that right?
Q5: I hear a lot of buzz from my employees about healthcare reform. How can I properly educate my employees so they know what the buzz is all about?
• Birth, adoption or placement for adoption of a child
• Obtaining legal guardianship of a child
• Loss of eligibility for other health coverage for you or your dependent if:
a. The other coverage was in effect when you were first eligible to enroll for this coverage;
b. The other coverage is not terminating for (such as failure to pay premiums or making a fraudulent claim); and
c. Where required, you stated in writing that coverage under another group health plan or other health insurance coverage was the reason for declining enrollment in this coverage.
• This includes, but is not limited to, loss of coverage due to:
a. Legal separation, divorce, cessation of dependent status, death of an employee, termination of employment, or reduction in the number of hours of employment;
b. In the case of HMO coverage, coverage is no longer provided because an individual no longer resides in the service area or the HMO no longer offers coverage in the HMO service area in which the individual resides;
c. Another group health plan no longer offering any benefits to the class of similarly situated individuals that includes you or your dependent;
d. When Medicaid or Children’s Health Insurance Program (CHIP) coverage is terminated as a result of loss of eligibility; or
e. When you or your dependents become eligible for a premium assistance subsidy under Medicaid or CHIP.
• Termination of employer contributions towards your or your dependent’s other coverage.
• Exhaustion of COBRA continuation coverage or state continuation coverage.
Q11: Am I able to term/add an employee and/or dependent, request id cards, change addresses on the carrier’s website?