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Employer Frequently Asked Questions
Find quick, easy answers, to Employers' most frequently asked questions right here at your fingertips.
- How long does it take to enroll an employee and to issue identification cards once the application is received?
- As an employer, what can I do to help avoid enrollment delays for my employees?
- What happens if the employee does not receive his/her identification cards prior to the effective date of coverage?
- What is a Special Enrollment or Qualifying Event?
- Who is eligible to enroll when a "loss of other coverage" event occurs?
- When does coverage end for the employee?
- How is a verbal termination handled by DHP?
- Does DHP allow retroactive terminations?
- When should changes be received by DHP in order to have them noted on the next billing statement?
- As an employer, how much do I need to know about group continuation?
- Whose responsibility is it to notify the employee or dependent when the group continuation coverage will end and their options after it ends?
- When are renewal rates prepared?
- If, as an employer, we have questions concerning the Medicare Eligibility of our employees, who should we talk too?
- What if I still have questions?
Q. How long does it take to
enroll an employee and to issue identification cards once the application
is received?
A. If the application is complete, the employee will be enrolled and an
ID card mailed to the employee's address within 2 to 3 weeks
from receipt of the application. If the application is incomplete,
enrollment will be delayed until we receive the necessary information.
Q. As an employer, what can
I do to help avoid enrollment delays for my employees?
A. Try to review each application to see if it is complete before
sending it to DHP. Please pay special attention to the following areas:
- Date(s) of hire
- Social security number(s)
- Date(s) of birth
- Primary care provider(s) election (Not required for Point Plans)
- Signature and date
- Phone number
The phone number isn't required, but it is helpful since DHP makes Welcome Calls to new members to explain benefits and answer any questions. Remember, applications that are not signed or dated will be returned to the employee. This may delay the application unnecessarily, so please double-check this section before sending applications to us.
Q. What happens if the employee
does not receive his/her identification cards prior to the
effective date of coverage?
A. The "yellow employee copy" of the Group Application Form may be
used as a temporary identification card until he/she receives the ID
card. Keep the "pink employer" copy of the form for your files.
Providers can also call the DHP Customer Service Department to
verify the coverage date of the employee/dependent. Please note that
the employee's social security number is used as the identification
number for the employee and his/her dependents. Your employees
should know this in case the provider asks for his/her member number
to verify coverage.
Q. What is a Special Enrollment
or Qualifying Event?
A. A special enrollment or qualifying event is an event that allows
an employee to enroll in the insurance plan after having initially
waived the coverage, or allows an employee to add a spouse or
dependent(s) to his/her plan. Qualifying events
are sometimes referred to as "life events" or "family status changes."
Q. Who is eligible to enroll
when a "loss of other coverage" event occurs?
A. When a loss of other coverage occurs, only the employee and/or
dependents who were covered by this other group plan immediately
prior to the termination of the coverage are eligible to apply for
coverage by DHP. The employee may not add any dependents who were
not previously covered under the prior health plan.
Q. When does coverage end for
the employee?
A. You may terminate an employee's coverage with DHP by:
- Mailing or faxing a memo to the Enrollment Department with the employee's name, social security number and date of termination.
- Calling your DHP Enrollment Representative to verbally terminate coverage. A written confirmation of the phone call will be mailed to you as a record of the phone call.
- Making a note on the monthly billing statement.
- Having the employee complete a Group Application Form and send it to our Enrollment Department. However, DHP does not require this form to terminate an employee's coverage.
Please note that using one of the first two methods (fax or verbal terminations) will ensure the changes are reflected in a more timely manner on your bill.
Q. How is a verbal termination
handled by DHP?
A. You may call your Enrollment Representative directly to
terminate coverage for an employee and/or dependents
(see Section II in your Administration Manual for your
Enrollment Representative's name). The Enrollment
Representative will take down the information over the
phone and process the changes immediately. As a follow-up,
the Enrollment Representative will send a confirmation
letter to you and the employee to ensure the termination was
handled correctly. Please review the confirmation letter to
make sure it is accurate and keep the copy for your records.
If you reconcile your bill each month (as opposed to paying as billed),
please make sure to note the termination on your billing
reconciliation form.
Q. Does DHP allow retroactive
terminations?
A. DHP will refund or adjust premiums for retroactive terminations
for up to three months. The month the request for retroactive
termination is received is counted as one month.
Q. When should changes be
received by DHP in order to have them noted on the next billing
statement?
A. We prepare bills at the end of the month prior to the mailing date,
which is about the second week of the month prior to the coverage
month. Therefore, in order for changes to be processed and noted
on the next billing statement, they must be received by DHP no
later than the 20th of the month prior to the mailing date.
For example: if changes are received by February 20, they will be
noted on the April bill, which is mailed approximately
the second week of March.
Q. As an employer, how much
do I need to know about group continuation?
A. As the employer, you are responsible for notifying your employees
and their dependents in writing of their rights to COBRA and
Wisconsin continuation coverage. Therefore, you must be familiar with
which events are qualifying events for group continuation to be
offered to an employee or dependent. In addition, if your employee or
dependent chooses to continue coverage, you need written
documentation of their decision to continue. Therefore,
you need to know the time guidelines that an employee has to elect
group continuation. Finally, you are responsible for collecting the
monthly premium payments from the employee or dependent and then making
payment to DHP. Again, you will need to know the guidelines regarding
when payments can be required from the employee or dependent and when
a person can be terminated for nonpayment of premium.
Q. Whose responsibility is it
to notify the employee or dependent when the group continuation
coverage will end and their options after it ends?
A. DHP will notify the employee/spouse/dependent by sending a letter
several months prior to the end of their group continuation coverage.
The letter states when the coverage will end and the options for
purchasing conversion health insurance available to the
employee/spouse/dependent through DHP. You can forward any questions
regarding plan options after group continuation to the DHP
Customer Service Department.
Q. When are renewal rates
prepared?
A. The process begins three months prior to your plan's anniversary
date, when you will receive a letter and a Renewal Request Form (RRF).
The RRF must be completed and returned to DHP by the end of the month in which it is mailed; the due date is noted on the top of the RRF. Rates can not be prepared or released until the RRF is received by DHP.
Sixty days prior to your anniversary date, you will receive your renewal package. For example, if your anniversary date is January 1, we will mail or deliver your renewal package by November 1. This package includes your renewal rates, benefit changes sheet and plan documents such as the Health Service Agreement, Member Certificate and Schedule of Benefits for your upcoming contract year. If you need the renewal prior to the 60-day mailing date for budgeting purposes, please note this on the RRF or call your Marketing Service Representative.
Q. If, as an employer, we have questions
concerning the Medicare Eligibility of our employees, who should we talk too?
A. Please call the DHP Medicare Analyst at 1-608-836-1400, extension 4594 or toll
free at 1-800-356-7344, extension 4594. You may also be able to determine answers
through the contact of your Marketing Account Manager.
Q. What if I still
have questions?
A. Dean Health Plan Customer Service is available Monday through
Thursday, from 7:30 a.m. to 5:00 p.m., and Friday, 8:00 a.m.
to 4:30 p.m., to answer your coverage questions. Just call 800-279-1301 or 608-828-1301.
If you prefer, you may also call your Dean Account Manager.
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