Health Savings Account
We're here to answer your questions.

Helpful Hints for Members 

New Enrollees
Regarding Pre-Existing: Most plans have a provision that excludes benefits for conditions that were present and/or treated prior to enrollment. These are called "pre-existing conditions

However, the Health Insurance Portability and Accountability Act (HIPAA) provides that previous/current healthcare coverage (including Medicaid, Medicare, Blue Cross, Tricare, etc.) can be credited toward the pre-existing time period in this plan. (Exception: As allowed by statute, some public entities can still apply their pre-existing provision even if you have previous creditable coverage.)

When an individual terminates coverage, that healthcare plan is required to provide a "Certificate of Creditable Coverage". In order for that previous coverage to be credited toward this plan’s pre-existing provision, we must have a copy of that Certificate.

PLEASE PROVIDE YOUR CERTIFICATE OF CREDITABLE COVERAGE UPON ENROLLMENT UNDER THIS NEW PLAN. This will enable us to process your claims promptly upon receipt, rather than going through the time-consuming process of determining if a pre-existing condition exists.

Timely Filing
Most plans have a "timely filing" provision. Many require that claims be submitted within 90 days from the date services are provided. CHECK YOUR PLAN.

If complete information is provided with your claim, most reimbursements are mailed within fourteen calendar days of receipt.

EOB and Comments
Be sure to read your Explanation of Benefits (EOB) carefully, especially the "Comment" section. This provides information about how the claim was processed; and, more importantly, why something was not covered. The Comment section refers you to the page in your plan document that explains how the claim was paid or why denied.

A GENTLE REMINDER. Your first claims of the year will have deductible applied. If you receive an EOB and no check, it may have all been applied to your calendar year deductible. CHECK THE COMMENTS SECTION OF YOUR EOB.

Accident Claims
If you are submitting a claim for an injury or accident, be sure to fill out the "Incident Report" available on the website. Unfortunately, the bills from the provider don't always indicate how or where the accident occurred, and the claims examiner must be able to document how the accident occurred before the claim can be processed. Be precise when completing the form and give complete information including: How did the accident happen? Where did it occur, at home, work, playground, school, etc.? Was anyone else involved? If so, who? Was it a motor vehicle accident? Were you on a four-wheeler, a snowmobile, an ATV?

If you include an "Incident Report" that includes a complete explanation of the accident with the bill, the time it takes to process the claim can be reduced substantially.

You and Your Spouse Both Have Insurance and the Coordination of Benefits Rules
Neither you nor your spouse has the option of determining which plan pays first. Healthcare plans have established rules that must be followed. Note: If your spouse works and is covered under an employer-sponsored health plan, that spouse’s plan is always primary for her/him.

Note too, that there are also rules regarding dependent children and how primary coverage is determined when they are covered under two plans.

To assure accurate processing of all claims –-and to reduce the chance of you having to refund any money due to overpayments -– please be sure to provide all information regarding any other health insurance coverage.

If another insurance plan is primary, wait until the primary insurance has completed processing the claim. Then, when you’ve received their "Explanation of Benefits (EOB), send it along with a copy of the itemized bill (HCFA form 1500 or UB-92) to us for further consideration under this secondary plan.

Please do not submit "statements." The statement does not provide the information necessary to process the claim.

Coverage for College Students and Continuation of Coverage under COBRA
If you are filing a claim on a dependent child who is over 19 years of age, full-time student status must be established before a claim can be paid.

Your dependent must be a full-time student at the time charges are incurred to be considered by the plan.

It is not uncommon for a college student to drop a class after the semester begins, resulting in a change from "full-time" to "part-time" status. COBRA continuation of coverage is available if notice is given to your employer that your child is no longer an "eligible" dependent within 60 days of the "qualifying event" (drop from full-time to part-time student status or graduation).

However, if this notice is not given within the 60 days, insurance will automatically terminate for the student, and the ability to elect continued coverage under COBRA is lost. Make sure your college student understands the impact this change can have on their eligibility for benefits.

Customer Service
Our customer service staff is always available to help you with any questions you might have about your plan and the processing of your healthcare claims.  Regular business hours are from 8:30 am to 4:30 pm CST, Monday through Thursday; and from 8:30 to 4:00 pm CST on Friday.

Springfield, Missouri