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Benefits Open Enrollment 2009
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Frequently Asked Questions

faqs

Lee County Employee Benefits

Useful Definitions

LOCATING A PROVIDER
bulletpoint Do I need to name a Primary Care Physician (PCP)?
bulletpoint How do I change or elect my Primary Care Physician (PCP)?

OUT-OF-NETWORK COVERAGE
bulletpoint My doctor wants me to have a test or see a specialist out-of-network. What can I do?

MEMBER ID CARDS
bulletpoint I lost my member ID card(s). How do I get a new one?
bulletpoint My medical/dental insurance just started with the County. How long should I expect to wait to receive my member card(s)?
bulletpoint 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?
bulletpoint What are my group numbers?
bulletpoint Where will my cards come from and how many will I get?
bulletpoint What if I need additional cards for out-of-area dependents?

MEMBER SERVICES
bulletpoint How can I contact Member Services?

CLAIMS & CHARGES
bulletpoint Where can I get a claim form?
bulletpoint Where do I send my claim (medical or dental)?
bulletpoint What should I do if Aetna denied my claim?
bulletpoint How can I check on the status of my claims?
bulletpoint 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
bulletpoint  What can I do if I am sick but my doctor can't see me?
bulletpoint  Where can I find the nearest Lee Convenient Care center?

COVERAGE WHEN TRAVELLING
bulletpoint  I'm planning a trip out of the country – will my health insurance cover me?
bulletpoint 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
bulletpoint How do I change my life insurance beneficiary?

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

CHANGE OF NAME
bulletpoint  I just got married. How do I change my name?

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

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

COBRA SUBSIDY
bulletpoint  What is the cobra subsidy?

RETIRING SOON
bulletpoint  I'm retiring next month. What do I have to do?

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

DEPENDENT COVERAGE
bulletpoint  How long can my dependents remain covered under my plan?
bulletpoint  My child is no longer an eligible dependent. How can I remove him/her from my plan?
bulletpoint  My child is going away to school. Can he/she still be covered under my plan?
bulletpoint  What about my dependents covered under my plan? How do I find care for my son or daughter who goes to college outside of the area? 
bulletpoint  Are overage dependent affidavits really required? 
bulletpoint  When do I need to turn in my overage dependent affidavit to HR?
bulletpoint  What happens if I forget to return the dependent affidavit during open enrollment, or it is received in HR after the closing day of Open Enrollment?

bulletpoint  What is an Affidavit of Eligibility Form? 
bulletpoint  Is a premium required for dependents between the ages of 19 - 30?
bulletpoint  Are overage dependent affidavits really required? 
bulletpoint  When do I need to turn in my overage dependent affidavit to HR?
bulletpoint  What happens if I forget to return the dependent affidavit during open enrollment, or it is received in HR after the closing day of Open Enrollment?  

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

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

SHORT TERM DISABILITY
bulletpoint  How do I enroll in short term disability (STD)?
bulletpoint  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?
bulletpoint  How long will it take to receive my short term disability (STD) benefit checks once I have submitted the claim forms?
bulletpoint  How will my benefit plan premiums be paid if I am out of work not receiving a County paycheck?

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

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



Lee County Human Resources
2115 Second Street, First Floor 
Fort Myers, FL 33901-0398
239-533-2245