As a new employee or an employee who did not enroll with the group during open enrollment, when can I be added to Benefit Management Services?

If you are a new hire or chose not to enroll during your group’s open enrollment period, your group leader may add you to the group’s Benefit Management Service plan at the following times:

1. New Hire Date – An enrollment form must be submitted within 31 days of the date the employee became eligible. Forms must be signed prior to the effective date.

2. Annual Open Enrollment - Employees and their eligible dependents who are Late Enrollees will be able to enroll in the plan.

3. If your plan allows late entrants, please refer to your group plan document, section “Late Entrants,” for more details.

Other than during Open Enrollment, when can I make changes to my coverage?

You may change single coverage to family coverage to include a newborn child or other newly eligible dependent(s), such as a new spouse or stepchild(ren). However, the addition must take place within 31 days of the date the dependent(s) became eligible, as determined by date of birth, marriage, adoption, etc. This applies only to newly eligible dependents. Other existing family members, if applicable, cannot be added until the next open enrollment period.

Plan Participant must complete an Adding Additional Dependent Card and submit it to their employer.

If I am terminated from the company, can I continue my coverage?

Yes, under certain circumstances you can. For specific information, please refer to the COBRA section of the group’s plan document.

Who determines the actual effective and termination dates?

The employer group determines both the effective and termination dates. If the group extends coverage for any reason beyond the date employment terminated, the date to which you have extended coverage should be indicated on the Termination of Coverage Form. For example, if an employee terminates in the middle of the month but coverage is to be valid through the month, you should indicate the 1st day of the subsequent month as the effective date of the change (termination).

How do I add a newborn to my existing BMS coverage?

A newborn child must be added to existing family coverage by submitting an Adding Additional Dependent Card form within 31 days of birth. If you have single coverage, you must change to dual or family coverage to add the newborn child. This must be done within 31 days of the child’s birth. Failure to do so will result in denial of coverage.

To what age can I continue to cover a dependent who is also a full-time student?

Please refer to the Eligibility Section in your Benefit Booklet for the limiting age applicable to your group. Generally, dependents enrolled as full-time students in an accredited institution are eligible until the age outlined in the plan document.

Can a dependent continue coverage after he/she reaches the limiting age?

Yes, under one of the following conditions:

1. If the dependent is an unmarried, full-time student, a completed and signed Dependent Certification Form is required each semester.

2. The dependent is not a full-time student and wishes to convert under COBRA regulations or wishes to convert to an individual membership.

3. If the dependent is unmarried and is incapable of self-sustaining employment due to a mental or physical handicap and is chiefly dependent on the plan participant/employee for financial support and maintenance.

The plan participant/employee is responsible for keeping BMS informed of changes in dependent status. Proof of the status change may be required.

What should I do if I receive a bill for services?

Although our participating providers have agreed to submit bills for services directly to us and not to the participants, it can happen. If you receive a bill for services, please instruct your employer to send the bill, with a note of explanation to the BMS Claims Department at BMS, P.O. Box 98044, Baton Rouge, LA 70890-9044.

However, there are several circumstances when it is appropriate for the provider to bill the plan participant. For example, if you are covered by another health plan and that plan as the primary carrier may be billed. The plan participant must submit a copy of the primary carrier’s explanation of benefits in order for BMS to consider secondary benefits.

If your company has selected a deductible plan, each plan participant/family unit must satisfy their deductible before benefits are payable. Charges applied to a plan participant/family unit’s deductible may be billed by the provider of the service to the plan participant/family unit and are the financial responsibility of the plan participant/family unit.

Do I have a choice of doctors? Where can I find a list of doctors?

BMS will provide a Participating Provider Directory for plan participants to use to choose a physician.