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Silverberg Group - Bringing Your Employee Benefits into Focus

August 2013 Newsletter

Students & Dependents

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Are your children still covered under your group benefits plan?

The sights and sounds of “back to school” time are everywhere. Soon, students will be spotted with their crisp new clothes and clean backpacks hesitantly walking toward the yellow school bus, while others balance their new lunch box as they ride their bikes with friends.

This is also a great time to review the health insurance of your dependents. Once a dependent child reaches age 21, insurer carriers will terminate them as an eligible dependent under your Health and/or Dental benefits. Coverage can be re-activated on the day they commence attending an accredited educational institution, college or university as a student, on a full-time basis.

One thing to remember is that the enrollment & eligibility of students varies depending on your insurance carrier; some require paperwork, which takes time to process, so make sure to contact your Silverberg Account Manager for the process specific to your carrier.

 

Submitting Health & Dental Claims

Paper, Direct Billing, E-Claims & Mobile Apps

While certainly still an option, the submission of Health and Dental claims via mail is becoming more obsolete due to technologies available with insurance companies.

The ability for dental clinics and pharmacies to direct bill to the insurance carrier has been around for years. Many insurers now allow health care providers to bill them directly for services such as vision care, eye examinations, chiropractors, physiotherapists and massage therapists. Check with your Silverberg Account Manager to determine if your insurer allows direct billing, and for what types of benefits. It is important to note that it continues to remain the prerogative of the service provider to require you to pay the bill at the time of service, and for you to be responsible for the claims submission.

When payment is required by you at the time of service, other options exist for prompt processing of your claim. Employees have the ability to electronically submit certain expenses themselves, online, by registering with the insurance carrier. This includes claims for drugs, paramedical practitioners, eye examinations, vision care and dental.

Most recent technology allows for submission of claims via mobile phone applications. A picture of the receipt is taken with your cell phone and submitted via the mobile application, directly to the insurance company.

In either of these cases, you may elect to have payment deposited directly to your bank account, often with a 24 – 48 hour turnaround.

With ongoing technology advances, it is expected that submission of claims will continue to become easier and faster, for both employees and service providers.