FREQUENTLY ASKED
QUESTIONS
Can't get your question answered here? Call our broker at 864-235-9999 or email mailbox@regroupusa.com.
©2014 Resource Equity Group
©2014 Resource Equity Group
www.rcmoldingbenefits.com
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GENERAL ENROLLMENT FAQS
Q. Who is eligible for coverage?
Full time employees and their family, including spouse, and dependent child(ren) up to Age 26.
Q. When does my coverage become effective?
A person is eligible for coverage on the first day of the month after 60 days of
full time employment.
Q. When am I eligible to enroll?
-When you are first hired, or
-If you lose other coverage (spouse's, etc), or
-When available, at open enrollment (April, effective May 1)
Q. When should I enroll?
Send in your completed paperwork shortly after you are hired to assure that you receive your ID cards by your effective date. Do not wait until after your waiting period has expired. Send paperwork to our broker: Resource Equity Group
P.O. Box 5556, Greenville, SC 29606, or fax to 864-242-0698, or email to mailbox@regroupusa.com.
Q. Who can I call for assistance with enrollment and ongoing customer service?
Call our broker in Greenville at 864-235-9999, or you may call the carrier directly:
Health Insurance / Allied National 800-825-7531
Dental Insurance / BCBS of SC 855-404-6752
Life Insurance / Companion 800-753-0404
Vision Care /Eyemed (Companion) 866-939-3633
MEDICAL COVERAGE FAQS
Q. What coverage is available during my waiting period?
You may have an option under your previous employer's plan to continue coverage under Cobra, or if you were employed by a firm with under 20 employees, the state mandated continuation provision under the plan. Contact your prior carrier, or you may call our broker at 864-235-9999 for assistance,
and to obtain a "bridge" policy.
Q. Are pre-existing conditions covered?
A pre-existing condition is a condition that was treated prior to your effective date. Pre-existing conditions are covered immediately on your effective date of coverage, regardless of whether you had prior coverage.
Q. Are referrals to specialists required?
No, referrals are never required under the plan, however, prior authorization must be obtained prior to a hospital admission, and under certain circumstances. Your network provider is responsible for obtaining prior authorization.
Q. Am I covered while traveling out of state?
Yes, you many use any provider in the country. There is no "network".
Q. What medical providers do I use?
You may use any provider in the country. There is no "network". Claims are
based on a multiple of the Medicare allowance for the services rendered.
Q. How do I file a medical claim?
Providers will file your claim for you. Simply present your ID card to the provider on the date of service.
Q. Are prescription drugs covered?
Yes, prescription drugs are covered through your retail pharmacy as well as through the mail service program. Click here to find the online forms and click here to visit the Southern Script site.
DENTAL COVERAGE FAQS
Q. What dentists do I use?
You may go to any dentist for full coverage.
Q. Are there any waiting periods?
Yes, there is a six month waiting period for "Major" expenses (crowns, root
canal, dentures, etc). If you had prior dental coverage, that coverage may count toward your waiting period. To get credit, fax your "Certificate of Creditable Coverage" from your prior carrier to 864-242-0698.
For "Preventive" and "Basic" expenses, you are covered as of the effective date. (outline of coverage)
Q. How do I file a claim?
Most dentists will file your claim for you. Simply give them your Blue Cross ID card, and they will process, and bill you for any balance due after your coverage has paid. If your dentist does not file claims, complete a claim form and mail to Blue Cross at the address on your ID card with the itemized charges attached.
Q. Why am I getting billed by the dentist for Preventive charges that were covered at 100%?
Your claim payments are based on the "Reasonable & Customary" charges for the same procedure in your area. Some dentists may charge higher than this amount, resulting in a balance due the patient.
VISION COVERAGE FAQS
Q. What vision care providers can I use?
Coverage is provided in the EyeMed Vision Care network (Access network). A lower level of coverage is available out of network.
Q. How do I process a vision care claim?
Simply present your EyeMed/Companion Vision Care ID card to the provider, and they will file your claim and collect the appropriate copay. If you don't have
your ID card, give the provider the employee's social security number, and tell them you are a member of EyeMed.
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