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Employers

Frequently Asked Questions


Employers

When can we add new employees to our group coverage?
Why do our employees receive so many Coordination of Benefit (COB) forms?
What is an Employer?
How do we add new employees to our group coverage if we use PlusBilling?
Our Employee waived his/her coverage initially. When can we add the employee to our group?
When will we receive our group bill?
When are Secure Services available


How do we add new employees to our group coverage if we use PlusBilling?

This addition requires an "Application to Enroll or Change Enrollment" form, along with a "PlusBilling" form. If you are not a PlusBilling group, please contact Group Services.

Our Employee waived his/her coverage initially. When can we add the employee to our group?

Groups can add new members or change enrollment under the following circumstances: 1)initial eligibility is determined by Employer/Group; 2) during open enrollment, which precedes the group's initial effective date, or the group's annual renewal rate; or 3) if a valid life status change is determined by Capital BlueCross.

The more common life status changes include, but are not limited to: marriage, the birth or adoption of a child, divorce and a change in employment status.

What is an Employer?

An Employer is a business or organization that contracts with Capital BlueCross to provide health insurance coverage for its employees/members.

When are Secure Services available

Availability of Secure Services varies from service to service.  Regular availability times can be obtained by clicking on the "Availability" tab located on the top menu within each secure service.

When can we add new employees to our group coverage?

If your company imposes a waiting period after an employee is hired, that waiting period must be served before an addition can be made. The employee may be added effective the following month, according to your group's billing cycle. If no waiting period is required, the employee's coverage will be effective the 1st or the 15th of the month following the employee's date of hire.

When will we receive our group bill?

Your bill well be prepared and mailed to your office, approximately 15 days before the due date.  If you are on the first of the month billing cycle, your premium will be due on the first of the month.  If you are on the 15th of the month billing cycle, your bill will be due on the 15th.

Why do our employees receive so many Coordination of Benefit (COB) forms?

COBs are a cost containment mechanism used to prevent duplicate payments that can cause group premiums to rise, while efficiently providing benefits for eligible services. They are based on identifying primary and secondary payers when a subscriber or dependent has more than one health insurer.

When we do not have other coverage information on our files and a claim is received, we need to investigate for other coverage. “COB Questionnaires” are generated from our Claims Processing System and sent to the subscriber as part of this investigation. We may generate a COB Questionnaire on any dependent, when claims are received. Lastly, if a response is not received on the first questionnaire, duplicate questionnaires will continue to be sent and claims may be denied until the information is returned.