Locating a Provider

• Do I need to name a Primary Care Physician (PCP)?
• How do I change or elect my Primary Care Physician (PCP)?

Out-of-Network Coverage

•  My doctor wants me to have a test or see a specialist out-of-network. What can I do?

Member ID Cards

•  I lost my member ID card(s). How do I get a new one?
• My medical/dental insurance just started with the County. How long should I expect to wait to receive my member card(s)?
• What should I do if I need to see my doctor, get prescriptions filled, etc. and I haven't received my cards yet or I am waiting for a new card?
• What are my group numbers?
• Where will my cards come from and how many will I get?
• What if I need additional cards for out-of-area dependents?

Member Services

•  How can I contact Member Services?

Claims & Charges

• Where can I get a claim form?
• Where do I send my claim (medical or dental)?
• What should I do if Aetna denied my claim?
• How can I check on the status of my claims?
• I got a bill from my doctor and he/she applied the charges to my deductible. I didn't think we had a deductible. What should I do?

Urgent Care

• What can I do if I am sick but my doctor can't see me?
• Where can I find the nearest Lee Convenient Care center?

Quest Lab

• Do I have to pay Quest Diagnostic Lab in advance for my lab services? They asked me to pay $40.00 or give them my credit card for billing.

Coverage When Traveling

• I'm planning a trip out of the country – will my health insurance cover me?
• What if I'm on vacation out-of-state and my child has a medical emergency (i.e. bad cold, fever, severe allergy attack)?

Life Insurance

• How do I change my life insurance beneficiary?

Adding/Dropping Family Members to/from My Plan

• What is a Qualifying Event?
• What events are not considered Qualifying Events?
• I just got married. Can I add my spouse and/or dependent(s) to my plans?
• I just got married. How long do I have to add my spouse and/or dependent(s) to my plan(s)?
• How do I add my spouse and/or eligible dependent(s) to my insurance plan(s)?
• I just got married and added my spouse and/or eligible dependent(s) to my plan. When will the coverage become effective?
• I am getting a divorce. How do I drop my ex-spouse from my plan(s)?
• What will happen if I notify Human Resources of an ineligible spouse or dependent after the 60 day qualifying event period widow?
• I'm having a baby. How do I add my baby to my medical plan?
• Can my grandchild be covered under my health plan? If so, what do I need to do?
• Can I add other family members (e.g. niece, nephew, mother-in-law) as dependents to my plan(s)?

Change of Name

• I just got married. How do I change my name?

Vision Insurance

• Do I need Vision Insurance?
• How do I sign up for the vision plan?
• When I sign up for the vision plan, how does it work?
• I didn't sign up for the vision plan. Do I have any vision coverage under the Aetna medical plan?

Leaving Your Job

• I'm leaving my job. When does my insurance coverage stop?
• What is COBRA continuation health coverage?
• What benefits can I continue under COBRA?
• What do I need to do to get COBRA coverage?
• When does COBRA coverage begin?
• What's a HIPAA certificate and why do I need one?
• What is the cobra subsidy?

Retiring Soon

• I'm retiring next month. What do I have to do?

Retirees

• I am already retired. I/my spouse will be going on Medicare soon. What do I need to do?
•  I am retired and want to terminate my insurance coverage with Lee County. What do I have to do?
• I'm retired and live outside of Lee County. How do I find out what Doctors to go to?

Dependent Coverage

• How long can my dependents remain covered under my plan?
• My dependent child is 26 years old. Can I keep them under my insurance plans? Is there an additional cost?
• My child is no longer an eligible dependent. How can I remove him/her from my plan?
• My child is going away to school. Can he/she still be covered under my plan?
• How do I find care for my son or daughter who goes to college outside of the area?
• What is an Affidavit of Eligibility Form?

Premiums

• Does it cost more for me to cover more than one child?
• What are pre-tax premiums? Why would I NOT want to elect this option?
• How can I know that my premiums are being deducted pre-tax?

Flexible Spending Accounts

• How do I sign up for a Flexible Spending Account (FSA)?
• How do I file a claim to be reimbursed through my FSA?

Short-Term Disability

• How do I enroll in short-term disability (STD)?
• I am going to have surgery next month and would like to use my Short-Term Disability (STD) plan to cover my time out of work. How do I file a claim?
• How long will it take to receive my short-term disability (STD) benefit checks once I have submitted the claim forms?
• How will my benefit plan premiums be paid if I am out of work not receiving a County paycheck?

Benefits Statements

• I just received my annual Benefits Statement and it doesn't show that I have Optional Life insurance, STD, and/or Vision coverage?
• My annual Benefits Statement showed that I have 120 hours of vacation time, but my pay stub shows only 47.5?

Miscellaneous

• What is OASDI?
• My doctor says I need the Shingles vaccine; does our plan cover this vaccine?