What information is on the Explanation of Benefits (EOB)?

This sample EOB will give you a better understanding.

How can I sign up for paperless EOBs?

Email BenefitSupport@trusteedplans.com using the subject line “Paperless EOB Request”, or dial our Member Services Center at 1.800.426.9786. Provide your 5-digit Group Number located on the front of your ID Card, and we’ll make the switch for you! Please specify the email address where you’d like us to deliver your Paperless EOBs.

More information can be found on our Paperless EOB flyer.

What types of preventive care are covered in my plan?

The preventive care services list provides a summary of services covered by non-grandfathered plans.

What is a grandfathered plan?

This is a health plan that was in place when the Affordable Care Act was signed March 23, 2010. Grandfathered plans do not need to comply with all the rules of the new law, but will be folded in to compliance over time.

Where can I find a list of preferred providers in my area?

Look on the front of your ID card or check your plan booklet to find which PPO Networks are in your plan. Then find your network on our PPO Networks page and click on a logo to find a provider.

How can I add a provider to my PPO Network?

The process and requirements vary from network to network. Refer to your PPO Network website for details.

Where should I refer providers who request eligibility and benefit information?

If the provider has signed up to receive patient information, they can call 800.426.9786 and press 4 to receive faxback instructions on individual eligibility. Otherwise, you or your provider can speak to our Member Services Team at 800.426.9786.

How can I file a claim?

Your provider should submit the claim using the information provided on the back of your ID card. If you pay out-of-pocket for a service, please fill out a medical, dental, vision, or prescription drug claim form located on the Forms & Notices page.

Why have my claims been denied?

Each case is different and our Member Services Team would be happy to provide you with answers. Please call us at 800.426.9786.

Where can I get a copy of my plan booklet?

Plan booklets are located in the member login area for ease of access. A paper copy can be requested from your HR department.

How do I get another ID card?

Call our Member Services Team at 800.426.9786 for assistance on ordering a new card.

Which dependents can I put on my plan?

Your plan booklet will have the details about dependent coverage for your specific plan. An eligible dependent may include a covered person’s spouse or qualified domestic partner and unmarried children under the age of 19. Some plans allow for unmarried children to be covered up to age 26.

How do I change the number of dependents on my plan?

Please contact your HR Manager.

Why did I receive an accident questionnaire?

This is due to a claim with a diagnosis that could be related to an injury. If you need assistance completing this form, please call Member Services at 800.426.9786.

What is coinsurance?

This is a percentage of the charge for medical care that you must pay. If your plan’s coinsurance for a given service is 20%, the plan will pay 80% and you will owe the rest.

What is a formulary?

This is a list of drugs that your health plan will cover, either fully or partly.

Formularies will vary by plan and are also referred to as a preferred drug list (PDL).