Page 20 - 2019 Heico Core Benefits Guide
P. 20
2019 | The Heico Companies Enrollment Guide
QUESTION ANSWER
What should I do if I go in for preventive care Your doctor needs to understand you have preventive care paid at 100%� If your doctor finds a condition
and my doctor finds something and puts that during the same visit or test, both the condition and preventive diagnosis for the test should be coded on
diagnosis on my claim? the claim submission�
I had colon polyps several years ago� My doctor Colonoscopy tests that are part of a preventive care exam will be paid at the preventive level as long as the
ordered a colonoscopy as part of my preventive test falls within the frequency of preventive care guidelines and your doctor codes the test as preventive�
exam� How will it be paid?
If I’m at my doctor's office for a follow-up on Preventive care benefits are paid based on how your doctor codes the claim when being submitted to BCBS�
a recurring ailment or surgery and my doctor If you have a recurring ailment and are at the doctor’s office for a routine follow-up and receive a flu vaccine
performs a preventive service, how will the or a cholesterol test, those two tests should be covered as preventive, as long as the physician codes them as
preventive test be paid? such�
What does “recommended by your doctor” mean Some preventive screenings do not need to be performed every year� Your doctor and the National Guide
and how does it affect preventive care services? for Screenings decide when and how often preventive care screenings should be performed� Tests that
are coded as preventive and do not exceed the annual limit should be paid at the preventive care level of
100%� If the test is to check the progress of a diagnosed condition, the screening will be paid subject to the
deductible and coinsurance�
Tobacco Surcharge
QUESTION ANSWER
What is the tobacco surcharge? The tobacco surcharge is a $75 monthly pre-tax surcharge on medical premiums for employees who use
tobacco products� At this time, the surcharge does not apply to covered spouses or dependents�
Why is there a tobacco surcharge? The goal of this surcharge is to support the health and wellness of employees by discouraging the use of
tobacco products�
Who has to pay the surcharge? An employee who currently uses tobacco products on a regular basis, i�e� at least once a week on a
recurring basis, and is enrolled in the medical plan, will have to pay an additional $75 per month for medical
contributions�
My spouse and I both currently use tobacco, You will have to pay $75 per month in addition to your regular medical plan deduction� The $75 surcharge
how much do I have to pay? is applied only to covered employees enrolled in the medical plan who choose not to engage in a tobacco
cessation program�
What is considered a tobacco product? Tobacco products include but are not limited to: cigarettes, cigars, cigarillos, pipes, chewing tobacco, snuff,
dip, E-cigarettes, and loose tobacco smoked via pipe, hookah or hand-rolled cigarettes�
How do I certify that I am (or am not) a regular All employees enrolling in the medical plan will have to sign an affidavit� An affidavit will also need to be
tobacco user? completed for those employees whose tobacco status has changed�
Spousal Surcharge
QUESTION ANSWER
What is the spousal surcharge? If your spouse is eligible for medical insurance through their employer and you elect to enroll them in the
Heico plan as a dependent, you will be subject to a $75 monthly pre-tax Medical Spousal Surcharge in
addition to the regular premiums deducted from your paycheck�
If my spouse is employed but they are not No� If your spouse is not eligible for medical insurance you will not be charged the surcharge�
offered medical insurance, will we need to pay
the spousal surcharge if I enroll them in the
Heico plan?
If my spouse is eligible for Medicare, is that If your spouse is eligible for Medicare and you enroll them in the Heico plan, you will not be
considered being eligible for other coverage? responsible for the spousal surcharge�
What if my spouse changes jobs in the middle of You need to notify Human Resources and update the affidavit within 31 days of this change of status� If you
the year and is now offered benefits when they would like to keep your spouse on your benefits, you will now be responsible for the spousal surcharge�
didn’t have it before?
20
QUESTION ANSWER
What should I do if I go in for preventive care Your doctor needs to understand you have preventive care paid at 100%� If your doctor finds a condition
and my doctor finds something and puts that during the same visit or test, both the condition and preventive diagnosis for the test should be coded on
diagnosis on my claim? the claim submission�
I had colon polyps several years ago� My doctor Colonoscopy tests that are part of a preventive care exam will be paid at the preventive level as long as the
ordered a colonoscopy as part of my preventive test falls within the frequency of preventive care guidelines and your doctor codes the test as preventive�
exam� How will it be paid?
If I’m at my doctor's office for a follow-up on Preventive care benefits are paid based on how your doctor codes the claim when being submitted to BCBS�
a recurring ailment or surgery and my doctor If you have a recurring ailment and are at the doctor’s office for a routine follow-up and receive a flu vaccine
performs a preventive service, how will the or a cholesterol test, those two tests should be covered as preventive, as long as the physician codes them as
preventive test be paid? such�
What does “recommended by your doctor” mean Some preventive screenings do not need to be performed every year� Your doctor and the National Guide
and how does it affect preventive care services? for Screenings decide when and how often preventive care screenings should be performed� Tests that
are coded as preventive and do not exceed the annual limit should be paid at the preventive care level of
100%� If the test is to check the progress of a diagnosed condition, the screening will be paid subject to the
deductible and coinsurance�
Tobacco Surcharge
QUESTION ANSWER
What is the tobacco surcharge? The tobacco surcharge is a $75 monthly pre-tax surcharge on medical premiums for employees who use
tobacco products� At this time, the surcharge does not apply to covered spouses or dependents�
Why is there a tobacco surcharge? The goal of this surcharge is to support the health and wellness of employees by discouraging the use of
tobacco products�
Who has to pay the surcharge? An employee who currently uses tobacco products on a regular basis, i�e� at least once a week on a
recurring basis, and is enrolled in the medical plan, will have to pay an additional $75 per month for medical
contributions�
My spouse and I both currently use tobacco, You will have to pay $75 per month in addition to your regular medical plan deduction� The $75 surcharge
how much do I have to pay? is applied only to covered employees enrolled in the medical plan who choose not to engage in a tobacco
cessation program�
What is considered a tobacco product? Tobacco products include but are not limited to: cigarettes, cigars, cigarillos, pipes, chewing tobacco, snuff,
dip, E-cigarettes, and loose tobacco smoked via pipe, hookah or hand-rolled cigarettes�
How do I certify that I am (or am not) a regular All employees enrolling in the medical plan will have to sign an affidavit� An affidavit will also need to be
tobacco user? completed for those employees whose tobacco status has changed�
Spousal Surcharge
QUESTION ANSWER
What is the spousal surcharge? If your spouse is eligible for medical insurance through their employer and you elect to enroll them in the
Heico plan as a dependent, you will be subject to a $75 monthly pre-tax Medical Spousal Surcharge in
addition to the regular premiums deducted from your paycheck�
If my spouse is employed but they are not No� If your spouse is not eligible for medical insurance you will not be charged the surcharge�
offered medical insurance, will we need to pay
the spousal surcharge if I enroll them in the
Heico plan?
If my spouse is eligible for Medicare, is that If your spouse is eligible for Medicare and you enroll them in the Heico plan, you will not be
considered being eligible for other coverage? responsible for the spousal surcharge�
What if my spouse changes jobs in the middle of You need to notify Human Resources and update the affidavit within 31 days of this change of status� If you
the year and is now offered benefits when they would like to keep your spouse on your benefits, you will now be responsible for the spousal surcharge�
didn’t have it before?
20
