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1. How can I find out what is covered under the Medical Plan or Dental Plan?
You have several options for learning more about what is covered under the plans. You can refer to your Choice Benefits Enrollment workbook (available at www.uc.edu/hr/benefits). You can refer to the Plan’s Summary Plan Description (available at the same website). Or, you can contact Humana directly with any questions you have about a specific service, treatment or expense. You can reach Humana at 1-800-4Humana.
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2. How do I print a copy of my Humana Identification (ID) cards? What is the Humana phone number?
In order to print a Humana ID card, follow this process: Go to the Humana website, (http://www.humana.com), select Members, scroll down to Quick Links on right hand side, click on View ID Card, and fill in the information requested on right hand side of the screen.
The phone number for Humana is 1-800-4-HUMANA.
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3. I lost my Humana identification (ID) card, how do I obtain a new one?
You can contact Humana and request a new card or you can request a new card online.
The phone number for Humana is 1-800-4-HUMANA. The website for requesting a new card is www.humana.com.
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4. I checked with Humana regarding a medical claim and was told I don’t have coverage. What do I do?
If you are a new employee, please note that enrollment and eligibility information is sent to Humana on a weekly basis. It may be that we have not yet submitted your coverage information to Humana. You can confirm your enrollment online by accessing Employee Self Service and printing a Confirmation Form. Note that your coverage is not effective until the first day of the month following 28 days of employment. If your Confirmation Form shows that you are currently covered, contact the Human Resources Department for additional assistance. The number is (513) 556-6381.
If you are not a new employee, be sure that the provider submitted your claim using your current Humana member ID number. Many times with the first claim of a new calendar year employees forget to use their new card which may have a new group number. If the claim was submitted to Humana under the wrong member ID number, you’ll need to ask your provider to resubmit the claim.
If you need further assistance, contact the Human Resources Department for additional assistance. The number is (513) 556-6381.
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5. I checked with Humana regarding a claim for my dependent and I was told my dependent is not covered. What do I do?
If you are a new employee, please note that enrollment and eligibility information is sent to Humana on a weekly basis. It may be that we have not yet submitted your coverage information to Humana. You can confirm your enrollment online by accessing Employee Self Service and printing a Confirmation Form. Note that your coverage is not effective until the first day of the month following 28 days of employment. If your Confirmation Form shows that you are currently covered, contact the Human Resources Department for additional assistance. The number is (513) 556-6381.
Has your dependent reached the maximum age limit for coverage? (Limiting age is 23 or 25, depending upon employee group.) If your dependent is over age 19, you are responsible for providing proof of ongoing eligibility. Documentation is requested approximately 45 days prior to the dependent’s birth date by Humana Resources. If you need further assistance or if you uncertain if you have submitted the necessary information, contact the Human Resources Department for additional assistance. The number is (513) 556-6381.
If you are not a new employee and your dependent is not over the limiting age, be sure that the provider submitted your dependent’s claim using your current Humana member ID number. Many times with the first claim of a new calendar year employees forget to use their new card which may have a new group number. If the claim was submitted to Humana under the wrong member ID number, you’ll need to ask your provider to resubmit the claim.
If you need further assistance, contact the Human Resources Department for additional assistance. The number is (513) 556-6381.
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6. My claims are not being paid. Why?
Be sure that the provider submitted your claim using your current Humana member ID number. Many times with the first claim of a new calendar year employees forget to use their new card which may have a new group number. If the claim was submitted to Humana under the wrong member ID number, you’ll need to ask your provider to resubmit the claim. If you need further assistance, contact the Human Resources Department for additional assistance. The number is (513) 556-6381.
Have you received an explanation of benefits indicating the claim is not covered?
In this case, you should contact Humana for details regarding claim denial. If you have already spoken with Humana and the issue wasn’t resolved, contact the Human Resources Department for additional assistance. The number is (513) 556-6381.
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7. What is the Spousal Surcharge? It is being deducted from my paycheck and I don’t think it should be. How do I stop the deduction?
A monthly spouse/domestic partner surcharge will be added to your monthly contribution for medical coverage if you elect to cover your spouse/domestic partner and your spouse/domestic partner is eligible for coverage through his/her employer but chooses not to enroll in employer-provided coverage. If your spouse/domestic partner loses or obtains medical coverage through his/her employer, you must notify Human Resources within 31 days of such change.
If you elect to cover your spouse or domestic partner while enrolling online, you will be prompted to indicate whether or not the surcharge applies to you. If you elect SURCHARGE NOT APPLICABLE, the surcharge will not apply.
If you elect SURCHARGE APPLICABLE, the monthly surcharge will apply and will continue to be deducted until you notify Human Resources of a change in your spouse/domestic partner’s coverage status. You must notify HR within 31 days of a change.
You will NOT be able to complete your enrollment in a university medical plan without indicating whether or not the Surcharge applies to you.
The Spousal Surcharge DOES NOT APPLY in the following situations:
• Your spouse/domestic partner does not work, or is self employed.
• Your spouse/domestic partner is also an employee of the University of Cincinnati.
• Your spouse/domestic partner is covered on your University of Cincinnati sponsored medical plan, and does not have medical coverage available through his/her employer.
• Your spouse/domestic partner is covered on your University of Cincinnati sponsored medical plan, and is also enrolled in medical coverage through his/her employer.
The Spousal Surcharge applies if your spouse/domestic partner is covered on your University of Cincinnati sponsored medical plan, and has medical coverage available through his/her employer but has elected not to enroll in his/her employer's medical coverage.
If you are being charged for the Spousal Surcharge and don’t feel as though you should be, contact the Human Resources Department for additional assistance. The number is (513) 556-6381.
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8. My spouse just had a baby. How do I add the baby to my health insurance coverage?
In order to process the change, it will be necessary for you to contact Human Resources. You will be instructed to access UCFlex Employee Self Service (ESS) in order to add your new dependent. The website is www.ucflex.uc.edu. You will need to add your dependent to your record as well as elect the desired coverage (medical, dental, life insurance) and levels of coverage (employee and one dependent, family coverage, etc.).
You must make any desired changes with 31 days of the effective date of the qualified status change. If you miss the 31-day deadline, you must wait until the next annual enrollment period in order to add the dependent.
In addition to the above, it is necessary for you to submit a copy of the child’s birth certificate.
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9. I just got married. How do I add my new spouse to my health insurance coverage?
In order to process the change, it will be necessary for you to contact Human Resources. You will be instructed to access UCFlex Employee Self Service (ESS) in order to add your spouse. The website is www.ucflex.uc.edu. You will need to add your dependent to your record as well as elect the desired coverage (medical, dental, life insurance) and levels of coverage (employee and one dependent, family coverage, etc.). Instructions are attached.
You must make any desired changes with 31 days of the effective date of the qualified status change. If you miss the 31-day deadline, you must wait until the next annual enrollment period in order to add the dependent.
In addition to the above, it is necessary for you to submit a copy of the marriage certificate. If the documentation is not submitted, your dependent will be removed from coverage retroactively.
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10. I don’t understand how much I am paying for medical coverage. My paycheck is so confusing. How much am I really paying?
On your paycheck you will notice two entries: Medical EE Pre-tax and Medical Contr ER. The difference between these two amounts is what you are paying per pay period. You can also go to this website for employee contribution information: http://www.uc.edu/hr/documents/benefits/2009_Workbooks/2009
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11. How can I find out my discounts for vision care (eyemedvisioncare.com)?
In order to learn more about the EyeMed Vision Plan, go to this website: http://portal.eyemedvisioncare.com/wps/portal/emweb/members. Select Members, Log-in/Register, scroll down to Discount Plan Members, select “H”, and then select Humana Discount Access. Select Locate a Provider, select Access in drop down box, enter zip code, submit, enter security text, submit.
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12. I am a former employee and I have not received my HIPAA Certificate. What do I do?
HIPAA certificates are mailed with the COBRA application. If you haven't received your COBRA application, please contact Human Resources at 513-556-6381.
If the termination has been processed, the COBRA application and HIPAA certificate are generally sent out within 3 weeks following processing of termination. Visit the Benefits Department for further assistance.
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13. I am a retiree. Why does my medical plan cost so much more than my friend’s medical coverage?
Your medical insurance is only offered to participants in the grandfathered retirement plans (TIAA/Fidelity/Vanguard). This plan must be self-sufficient—the university cannot subsidize it. Premiums for this group are actuarially determined based on the prior claims experience. Since the number of people in the group is relatively small, the premium per person is higher than a plan which has a large number of people among whom to spread the risk.
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