LifeX Offers Group Health Plans!

Q: When do employee benefits recurring payments come out?
A: Your benefit payments are automatically drafted around the 15th of each month, making it easy for you to stay on top of things without having to worry about missing a payment! 

Q: How does the pre-certification process work?
A: When you need a pre-certification, your healthcare provider will submit a request directly. We’ll review it to make sure it’s medically necessary and covered by your plan. You’ll receive an approval or denial, a nd if needed, you can appeal the decision. We’ll even arrange a peer-to-peer conversation to make sure everything is thoroughly reviewed. There are no network limitations for care, so LifeX's Group Health Plans  work with any facility to ensure your care is approved at the right rates. 

Q: How do I file an appeal?
A: If you need to file an appeal, simply send a letter to our Third-Party Administrator (TPA), Benefits Health Plan Inc., explaining the issue and including any supporting information. This will kick off the appeals process and get everything reviewed. 

Q: How do I look up my current providers to make sure they’re in the network?
A: It’s easy to check! Just visit your Personal Health Dashboard™ and use the search function. You can also check with your provider directly to confirm they’re in the network, as PHCS PPO, Cigna PPO, and Anthem BC/BS PPO update their lists regularly.

PHCS PPO

Cigna PPO

Anthem PPO

Q: Can I get an electronic version of my Medical ID Card while I wait for the physical card?
A: Absolutely! You can access your electronic Medical ID Card right in your Personal Health Dashboard™. Cards go out by the 24th but nott before the effective date so a PDF will be provided. Brokers will have access to this as well.

Q: How do I register for OurLiveDoc (telemedicine)?
A: It’s simple! Just log in to your Personal Health Dashboard™, go to Benefits > Telemedicine, and follow the easy steps to activate your account. You can also call us at 940-LIVEDOC for assistance. 

Q: How do I know the specific limits on drugs?
A: You can easily find the formulary for your plan by checking the links below, depending on your plan type.

• For MM or HSA plans: Advantage Formulary & Advantage Tiered Formulary
• For VL plans: VL Formulary 
• For all employees: Telehealth & Mail Order Formulary
  Additionally, don’t forget to review the Pharmacy Exclusions for any specific details you may require.

Q: How do I know the specific limits on drugs?
A: You can easily find the formulary for your plan by checking the links below, depending on your plan type.

• For MM or HSA plans: Advantage Formulary & Advantage Tiered Formulary
• For VL plans: VL Formulary 
• For all employees: Telehealth & Mail Order Formulary
  Additionally, don’t forget to review the Pharmacy Exclusions for any specific details you may require.

Q: When is the cutoff date to enroll?
A: You must be fully enrolled by the 24th of each month to start on the first of the following month.

Q: Does LifeX's offered major medical plan have open enrollment?
A: Yes. If you want to change your plan, you will have to wait until open enrollment, which is November 1st- December 5. Keep in mind, you can start a plan any time of the year. Once you enroll, you can stay on the plan through age 65 if you wish. No need to keep enrolling every year!

Q: Does LifeX's offered major medical plan drop me if I encounter a significant health issue?
A: No. You are not applying for a new policy every year, so you can stay on the plan you are on after major health issues as long as you are in good standing and are paying your premiums on time. This is a significant benefit of a major medical health plan offered by LifeX.

Q: Can I pay my contributions for the whole year upfront?
A: Unfortunately, paying for the whole year upfront isn’t an option at this time, but we’re always working on ways to make things easier for you!

Q: Can I make changes to my policy, like adding dependents, adjusting plan levels, or changing effective dates?
A: You can make changes during the Open Enrollment period. If you need to make changes outside of that time, it’ll require a Qualified Life Event (QLE). Don’t worry—you can easily find the QLE form here in your Personal Health Dashboard™.

Q: Can I cancel my plan at any time? What are the restrictions?
A: Yes, you can cancel your plan at any time. Just note that cancellations don’t come with partial refunds. For example, if you cancel on November 15th, you’ll be covered for the rest of the month, but won’t be charged again after that, and your coverage will end on December 1st.

Q: Do copays count toward my deductible?
A: Copays don’t count toward your deductible, but they do contribute to your maximum out-of-pocket costs.

Q: If I choose not to complete activities, will I be terminated?
A: While completing activities is optional, we strongly encourage participation. These activities help you stay on top of your health, lower healthcare costs, and reduce the risk of serious health issues. If you choose not to complete them, it could lead to termination of your employment.

Q: What happens if I cancel or withdraw from the employee benefit plans? Can I move to an ACA plan?
A: If you decide to cancel or withdraw, it’s best to reach out to an ACA specialist to help you with transitioning to a different plan.

Q: How do I submit a claim?
A: Submitting a claim is easy! Simply download the reimbursement form from your Personal Health Dashboard™, follow the instructions, and submit it. Clean claims are typically processed within 7-10 business days and paid out within two weeks.

Self-employed individuals may be eligible for tax benefits when purchasing health insurance. You must consult with an accountant or CPA to determine eligibility.