EmployerAccess Plan administration online manual anthem.com/ca

Transcription

1 EmployerAccess Plan administration online manual anthem.com/ca 4058CAEENABC Rev. 0/7

2 Table of Contents Introduction... Getting Started...4 EmployerAccess Overview...5 Helpful Tips for Adding New Employees...6 New Enrollment...7 Member Information (Add Dependents)...8 Select Coverage...8 Life Coverage...9 Assign Coverage...0 Other Coverage... Enrollment Verification... Name Match... How to Correct an ID...4 Existing Member Maintenance... 5 Member Search...5 Employee/Dependent Details...5 Add Dependent(s)...6 Assign Coverage...7 Change Coverage...8 Federal COBRA...9 Cancel Coverage... 0 Re-Enrollment... Edit Personal Information... Change a Primary Care Physician (PCP)... Request ID Card or Materials...4 View/Print ID Cards...4 Group Function... 5 View Employee Roster... 5 Pending Activity... 6 View Employer Details... 6 Benefit Details... 7 Billing... 8 Manage Employer s Bank Account(s)... 8 Billing... 8 Action Dropdown Box... 8 Invoice Details... 9 Manage Billing Addresses... 0 Manage Employer s Bank Accounts... Invoice/Membership Details... Pay Online... EmployerAccess: Scheduled Payments... Reinstate...

3 Introduction EmployerAccess at anthem.com/ca everything you need for more efficient plan administration of your Anthem group benefits. Anthem Blue Cross (Anthem) is making it easier for you to do business with us. In addition to the helpful resources already available at anthem.com/ca, we have plan administration tools to provide: Intuitive navigation. New functionality and tools. Integrated benefits management. Access to view and pay premium bills online. Online bill pay. No checks to write, no postage to pay. It takes just a few minutes to set up your account. Then you ll be able to pay your premiums online with a few simple selections. The new EmployerAccess offers you even more control over employee information, including increased information and accurancy on life insurance claims. You ll receive error messages that signal missing or incomplete information and electronic prompts to guide you from one step to the next. This manual offers step-by-step instructions for using EmployerAccess. Please note that Anthem forms need to be completed before submitting any enrollments, terminations, and changes through EmployerAccess. Additional learning resources are available online at EmployerAccess and include Frequently Asked Questions, plus an online demo to show how easy it is to use all the tools and features. For more information about administering your Anthem group benefits, please consult your group administrator manual or contact your Anthem representative.

4 Getting Started After you complete the self-registration process, you ll receive a link to EmployerAccess. Click on the link. Or, type the link in your browser Enter your User ID and case-sensitive password. Select your Group. Please note: If there is a Site Administrator already set-up with your group, he or she will need to add the new user(s). 4

5 EmployerAccess Overview The Membership main page is called EmployerAccess Overview. Think of it as home base. Here you can start the enrollment process for new employees (subscribers), access pending activity, perform a search for a current subscriber, or navigate easily using the tabs at the top. Tabs to Membership, Employer Details, Billing, and Reports are embedded at the top. They give you quick access to any of these screens. Note: The Admin tab will only be visible to users with Site Administrator access. EmployerAccess Overview displays your pending activity. To access all your pending activity, select View All tab on the right. 5 4 Resume or delete pending activity using the hyperlinks to the right of the specific activity. All incomplete work is automatically saved in Pending Activity. Note: Pending activity is work that you have saved to complete at another time. You can also access pending activity from the Reports tab. To access benefit information or make changes to a current employee s benefits, enter the member ID number (typically their Social Security number) or Health Care Identifier (HCID) in the blank box under View/Change Member Information, then select Search. 4 5 To add a new employee, enter the member ID number (typically the Social Security number) in the blank box under Add New Subscriber, then select Submit. And don t forget to check the Open Enrollment (OE) Mode box at the top of the page to apply the OE effective date for all employees making OE changes. Note: Once your annual renewal is completed at your anniversary date, transactions effective prior to your anniversary cannot be processed via EmployerAccess and must be submitted via paper. Tip: Steps are numbered to tell you where you are in the enrollment process. All steps must be completed before an employee s enrollment application can be submitted. If at any time you select Save and Exit, your work will be saved in Pending Activity. Once you ve completed the steps, a message bar will appear on the Overview page, letting you know you have successfully completed the transaction. 5

6 Helpful Tips for Adding New Employees Enrollment General: An Open Enrollment effective date is automatically assigned if the box under Open Enrollment Mode is selected on the EmployerAccess Overview page. An incorrect date of hire may produce a wrong eligibility effective date. You cannot correct this error through EmployerAccess. Please contact your Anthem Enrollment and Billing representative to correct the wrong date. After you Submit the transaction, you will receive a message saying the transmission was successful. The Processing Date is the date that Anthem successfully receives the information. All transactions should be reviewed after submission for accuracy. Dependent To enroll a dependent due to adoption or a change in legal guardianship, you must submit a completed paper enrollment form to Anthem. Medical/Dental/Vision: During Open Enrollment, you may make eligibility changes for: New Enrollment. Add Coverage. Add Dependent(s). Change Coverage. Re-Enroll. Retroactive additions allow a -day window to process. The -day period is based upon the current date. Changes beyond this time frame must be submitted to Anthem (not through EmployerAccess). Retroactive terminations allow a 60-day window to process. The 60-day period is based upon the current date. Changes beyond this time frame must be submitted to Anthem (not through EmployerAccess). Life Products: Life products are not available for selection in Open Enrollment Mode. Adding Life at any time other than the new hire or rehire date must be submitted by paper for review and processing. Select Basic Life when enrolling an employee only in one or more life products. Select Dependent Life when enrolling an employee and respective dependents in one or more life products. Dependent(s) information is not required when only enrolling in life product(s). There might be a reduction in benefit amount for employees aged 65 and older. }Evidence } of Insurability is required if the calculated benefit amount is over the Guaranteed Issue Amount. } } Employees (subscribers) must enroll in Basic Life to enroll in Optional Life. 6

7 New Enrollment Step. Member Information This is the beginning page to start the enrollment process. To enroll an employee (subscriber), enter the requested information into each blank box or field. Fields with red arrows (>>) beside them indicate required information. The signature date must be equal to or prior to the calculated effective date. Note: If the employee s address is more than 4 characters, the address will need to be split between the Care of field and the Address field. Next, choose whether or not you want to state the existing members preferred language. If there are no dependents to enroll, select Continue. Note: If you have only one probationary period, the effective date of coverage is calculated based on the date entered in the Hire Date field. If you have multiple probationary periods,* based on employee type (for example, hourly or salaried employees), select the appropriate Probation Type from the drop-down box. The employee s effective date of coverage will be calculated based on the date entered in the Hire Date field and the information selected in the Probation Type field. * Employees must meet eligibility requirements and satisfy their waiting period (referred to as probationary period) as defined in your Group Administrator Manual. 7

8 Member Information (Add Dependents) This step is applicable only if you want to add dependents to the employee s benefits. Select Add Dependent. Fields requesting dependent information appear below the employee information. Complete the information and select Add Another Dependent for any additional dependents. The Social Security number is required for employee, spouse or domestic partner. Select Continue. Step. Select Coverage Use this screen to select coverage for employees (subscribers) and, if applicable, dependents. To complete this step, simply select the drop-down arrow for the appropriate medical, dental, vision, life and/or disability plan and select the coverage. When finished, select Continue. 8

9 Life Coverage If you have selected life coverage, you may be directed to the following screen: Select the Subscriber Benefit Value from the drop drown menu and fill out the information as needed. When finished, select Continue. 9

10 Step. Assign Coverage 4 Now, you can assign coverage and enter the provider number, if applicable. The information on this page is based on the products the employee has chosen. Most medical plans now allow a provider to be selected if the employee so chooses. However, it s important to note that some products require a provider and you must make a selection. You have two options when enrolling an employee s dependents: Check the box to enroll all dependents in selected benefits. Or if individual dependents should be enrolled in a specific benefit plan, simply check the corresponding box to select coverage for that member. This screen displays the employee s benefit selections. If you missed something or selected the wrong benefit plan, you can go back by selecting Previous. If everything looks right, select Continue. Note: To help employees find Provider information, you may select the Provider Finder link located at the top of this page. 4 0

11 Step 4. Other Coverage This is the final screen in the new enrollment process. Selecting No for these questions will automatically activate No in the corresponding check boxes below. Selecting Yes for these questions prompts you to complete the necessary information below. Indicate Yes or No by selecting the corresponding circle. Enter the appropriate information. 4 This is the last step in the enrollment process. Select Continue to verify the enrollment information. 4

12 Step 5. Enrollment Verification A verification page will appear and ask you to check the information you entered for accuracy. 4 If the information is correct, select Submit. To make changes, use the Previous button located at the bottom of the page rather than your browser s back function. Once the information is verified and submitted, a message will confirm that the data was submitted to Anthem. Please review all transactions submitted for accuracy by keying the member ID/SSN in the View/Change Member field and selecting the Search button. The Employee/Dependent Details page will display and will reflect the information as it saved on the mainframe. 4

13 Name Match You can enroll a subscriber who had previous coverage with us. Enter the termed subscriber ID in Add New Subscriber section. Select Submit. Enter the last name, first name and birth date. This information must match the member s previous enrollment. If the information does not match, you ll receive an error message and you ll need to call your EmployerAccess representative for assistance.

14 How to Correct an ID If you notice an error in the ID number while you are on the Member Information page, you can: Select Change Member ID on the Member Information page. Enter the correct ID number in the blank field on the page that appears and select Submit. You will return to the Member Information screen for continued work. You can access the Change Member ID hyperlink only through this screen. Note: You can only change the ID number during the new enrollment process. You cannot change an ID number once the new enrollment has been submitted. 4

15 Existing Member Maintenance Member Search To perform maintenance on a specific employee and/or dependent, first search for the employee in EmployerAccess. To access benefit information or make changes to a current employee s benefits, enter the Member ID number (typically the Social Security number) or Health Care Identifier (HCID) in the blank box under View/Change Member Information, then select Search. Employee/Dependent Details Employee/Dependent Details offers a quick overview of employee and dependent information, including coverage, name(s), address, birth date(s), relationship code for dependents, effective/cancellation dates and provider information, where applicable. This screen displays a list of enrolled members and their benefits. You can easily access prior enrollment information where available if the member s name appears as a hyperlink. If the member s name is not a hyperlink, they do not have any prior enrollment information. 5

16 Add Dependent(s) Simply select Add Dependent on the Employee/ Dependent Details page to access this screen. On this page, you can add a new or previously enrolled dependent to an enrolled employee s (subscriber s) coverage. Enter the event reason. Enter the event date. If you wish to add a new dependent, complete the New Dependent Information section. 4 5 Whether you re adding a previously enrolled dependent or adding a new dependent, make sure the box next to Include Dependent is checked. Select the Language Preference. Select Continue. Note: You can only add a previously enrolled dependent on this page if the dependent is not active in any other plan. If the dependent is active in another plan, the Add Coverage option should be used. 4 A separate transaction is required when adding new or previously enrolled dependents. 5 6

17 Assign Coverage To add coverage for listed dependents, simply check the Cover this Member box. It s that simple. Other Coverage for Dependents Here, you ll indicate other coverage, including prior coverage and health care benefits received from Medicare for the listed member/dependent. If you answered yes to any questions on this screen, please provide additional information where requested regarding other and additional coverages. 7

18 Change Coverage Simply select the Change Coverage button on the Employee/Dependent Details page to make changes to existing benefit coverage. Select Change Coverage. Select Continue to complete the transaction. On the Assign Coverage page, you must check the Cover This Member box next to members who should be moved to new product, otherwise they will cancel. Note: Changing an employee s benefits can only be done in open enrollment mode. 8

19 Federal COBRA When an employee qualifies for Federal COBRA, you can move the employee into COBRA coverage. 4 Select Change Coverage. Enter the COBRA qualification date and COBRA reason and select Continue. The employee will be updated in the current plan indicating the COBRA begin date. 9

20 Cancel Coverage On the Employee/Dependent Details page, select the Cancel Coverage button to cancel the subscriber and/or dependent coverage. Enter the event date for the cancellation. The cancellation date will be calculated based on your company policy. If it is a date of event termination, the cancellation date will be the event date plus one day. If it is a first of the month following date of event termination, then the cancellation date will be the first of month following the event date. You can view your company s cancellation policy on the Employer Tab. 4 5 Under Cancellation Reason, select a reason from the drop-down menu. Be sure you check the box next to all affected dependents. Review your cancellation on the screen before you complete the termination, then select the Continue button to complete your transaction. When coverage is canceled per subscriber s request, additional information is required. Select the appropriate reason for declining coverage

21 Re-Enrollment To re-enroll a member whose coverage has been canceled, select Re-Enroll from the Employee/Dependent Details page. (Re-enrollment follows the same process as new enrollment.) To re-enroll an employee (subscriber), enter the requested information into each blank box, or field. Fields with red arrows (>>) beside them indicate required information. If the employee has dependents to re-enroll, select Add Dependent and fill out the necessary information. Select Continue. The remaining steps of the re-enrollment process mirror the steps in the new enrollment process (see page 7). If the member has not provided a primary care physician (PCP), you can use the auto-pick function for the system to assign a PCP.

22 Reinstate To reinstate a member with no lapse in coverage, select Reinstate from the Employee/Dependent Details page. To reinstate an employee and dependents, check the box marked Reinstate Member. Once you select the subscriber, all dependents will automatically be selected. Select Continue. Be sure to verify your changes before submitting the new information. Note: No dependents can be reinstated on canceled contracts unless the employee (subscriber) is reinstated. Benefits may be reinstated within 60 days of the cancellation date.

23 Edit Personal Information Simply select Edit Personal Information on the Employee/Dependent Details page to access the option to change employee (subscriber) and dependent personal information, such as address, phone number, etc. A dependent s Social Security number can be added or edited, but not removed. You can also add or update a subscriber or dependent s address. Note: You will need to verify your changes before submitting the new information. Change a Primary Care Physician (PCP) To change a member s PCP, choose the Select New Primary Care Physician box. Select the Reason for Change, and then add the PCP ID. Note: If you need to change a PCP for a past date, please have the member contact Customer Service.

24 Request ID Cards or Materials Choose the member who needs the ID card. Then, select the Submit button. A confirmation screen will let you know your request has been received. Note: When you request an ID card, the subscriber s ID card will be generated. If you need to request a dependent ID card, contact Customer Service. View/Print ID Cards You can also print a temporary ID card. Simply select the member from the drop-down menu. The temporary ID card is valid for 0 days. 4

25 Group Function Billing This tab allows you to view and pay your premium bills online. You can also access information on open invoices, monthly activity, invoice numbers and the amount currently due on your group health plan premium. See page 8 for instructions about using our Online Group Billing feature. You can also turn off your paper bills. Reports Use this tab to generate reports, view the Employee Roster, access Life and Disability tools and more. View Employee Roster You can view all employees within a group by selecting the Reports tab, or using the hyperlink on the membership page under Quick Links. The Employee Roster report enables you to quickly view all active employees in the group as of the current date. Future active employees and benefits will display on or after their effective date. Note: If you have multiple groups in your company, you must access them separately through their specific group account information. 5

26 Pending Activity This example shows how your Pending Activity folder might look. Selecting Delete on a transaction on this page allows you to cancel the transaction that was in process and saved. It does not cancel any existing coverage for the subscriber/dependent. If you leave before a task is completed, your work is automatically saved. When you return, you can either continue or delete the activity by choosing the desired link. If you have work in progress (WIP), the grid on this page is linked to the Membership/ Overview page and your activity is displayed there. If there is no WIP, the Membership/Overview page will not show the link and the grid on this page will be vacant, stating there is no pending activity. If the pending activity was entered in Open Enrollment Mode, you must select the Open Enrollment Mode box before resuming the activity. Note: To ensure full access to subscriber information and accurate records, please be aware of pending activity and process or delete pended transactions in a timely manner. View Employer Details Here, you ll review your company s information, including open enrollment dates, new hire employees/probation types and group details. If the Waiting Period says 99 under the Group Details section, please refer to the New Hire Employees/Probation section below for details. 6

27 Benefit Details On this plan-specific page, you can view your group s medical Benefit Summary, Certificate and amendment. To view group benefits, select the View Group Benefits link on the Employer Tab. 7

28 Billing Manage Employer s Bank Account(s) If you have set up one or more bank accounts for online payments, you can manage them here, as well as pay bills online, modify or delete account information, and even add new accounts. Billing Here, you can view all open invoices for your billing entity. Select the View Details link to pull up the Invoice Details screen. Actions Dropdown box Use this link for additional options, such as Pay Online Now, Schedule Payments, View Scheduled Payments, View Past Invoices, View Past Payments and more. You can also turn off your paper bills. 8

29 Invoice Details To access the Invoice Details screen, click on the View Details hyperlink next to the invoice. This page includes: Bill Summary: Shows the amount due for the current month, as well as a summary from the previous month. Billed Adjustments: Shows any adjustments, such as late or reinstatement fees. COBRA: Lists COBRA subscribers. Over-age Dependent: Lists any dependents approaching the maximum age of the policy. Eligibility Changes: Highlights retroactive adjustments on a subscriber or dependent level. Note: If you have multiple groups in your company (for example, billing locations), they must be accessed separately through their individual group account information. 9

30 Manage Billing Addresses EmployerAccess allows you to establish notification about online billing activity from the Manage Billing Addresses screen. To assign an contact when you establish bill payment: Select Add Group . Enter the complete address. Select Submit to complete the transaction. Tip: The online bill pay option requires that you set up one or more bank accounts from which you can assign bill payment. Begin by identifying the contact information for the authorized user(s) assigned to receive notifications, alerts and transaction confirmations related to online group billing activity. 0

31 Manage Employer s Bank Accounts Enter valid bank account information to complete the online bill pay set-up process and begin making payments online. Select Add New Account from the Manage Employer s Bank Account screen. Enter the financial information for the bank account. Name of financial institution, institution s full address and account type are among the information required. Select Add Account to complete the transaction. You may add multiple bank accounts as needed. Simply return to the Manage Bank Accounts screen and select Add New Account. Note: Only the user who adds a bank account can see the bank account information and can select the bank account in order to make or schedule a payment. Invoice/Membership Details 4 Here you can view each employee within your group by selecting the Membership Details link. You can view additional information about an invoice by selecting from the additional links in the Invoice Details section. To view any billed adjustments for your group, select Eligibility Changes. 4

32 Pay Online With the pay online option, you can cover multiple invoices with one payment. Select the desired payment amount, the account from which to pay, then confirm your information on the authorization screen. Choose the best option under Select Payment Amount Entry Method. Select Continue. Next, you will be able to select a bank account and authorize your payment. You ll receive confirmation that the payment is being sent to the bank. If you want to make sure your payment went through, you can always View Past Payments in the Actions drop-down menu. The invoice will show as Open until the payment has posted to the processing system, usually within - business days. Note: You are still required to pay all invoices in a timely manner in accordance with the terms of your group contract. EmployerAccess: Scheduled Payment(s) To schedule a payment: Enter the payment date in the First Payment Date field in a MM/DD/YYYY sequence. AND Select a payment frequency. Select Continue. Once the payment has been submitted, the payment cannot be canceled. On the following pages, the schedule can be set to be a fixed amount each month or allow the system to determine the payment amount, based upon invoices open at the time of each payment. Note: Recurring monthly payments can be set for a specific number of months or with no end date established. To remove a future recurring payment, simply view the scheduled payments and select Delete. Tip: You have the option to pay online from almost any screen in the Billing section. Look for the Pay Online Now button.

33 Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association.