Search FAQs
|
||||||||||||||||||||||||||
|
A BeniComp Select policy reimburses eligible medical expenses not otherwise covered by health insurance. Generally, if an expense is medically necessary and qualifies under Section 213(d) of the Internal Revenue Code, it would be eligible for reimbursement under this insurance plan. Some covered charges include, but are not limited to:
No benefits are payable unless the individual is under the direct care of a legally qualified physician for reasonable and necessary treatment. Non-prescription drugs Losses due to war Expenses the individual is not legally obligated to pay in the absence of insurance Charges for appointments not kept Hospitalization, services, treatments or supplies furnished by the U.S. or foreign government agency, unless otherwise prohibited by law Service contracts or warranties relating to vision care Custodial care Accident or illness for which the individual is entitled to benefits under any worker’s compensation or occupational disease law Health club dues or exercise equipment Blood Storage Hospital charges for confinement in a long-term care unit or skilled nursing facility unless confinement commences within 14 days after discharge from a qualifying hospital confinement Baby sitting, childcare, and/or nursing services for a healthy child. You cannot include any amount paid for childcare even if this enables you, your spouse, and/or dependent(s) to receive medical treatment.
No. If vision, dental, and hearing are not covered by the underlying plan; BeniComp Select can still reimburse the charges. Yes, master social services and psychologists are covered by BeniComp Select, even if the services are not covered by the underlying plan. Generally, if an expense is medically necessary and qualifies under Section 213 (d) of the Internal Revenue Code, it is eligible for reimbursement. Elective procedures that are not medically necessary are not covered by BeniComp Select.
You cannot include membership dues in a gym, health club, or spa as medical expenses, but you can include separate fees charged there for weight loss activities. You cannot include the cost of diet food or beverages in medical expenses because the diet food and beverages substitute for what is normally consumed to satisfy nutritional needs. You can include the cost of special food in medical expenses only if:
The amount eligible for reimbursement is limited to the amount by which the cost of the special food exceeds the cost of a normal diet. Due to IRS regulations, BeniComp Select will no longer reimburse any premiums effective January 1, 2016 including, but not limited to:
For more information and to view the revised policy form, please click here. |
||||||||||||||||||||||||||
|
Supporting documentation must be included with any expense submitted for reimbursement. The Explanation of Benefits (EOB) supplied by the primary plan needs to be included with every medical claim to show the services provided went through the primary plan first. If the service provided is explicitly not covered by the primary plan, please submit the Summary Plan Description explaining the service is not covered. Further examples of supporting documentation include, but are not limited to:
All supporting documentation, including photocopies, must be legible and include the patient's name, date and type of service, and the dollar amount. Claims cannot be processed from:
Yes. Claims can be printed when reviewing your claim by using the "Print" function in your browser.
The group name is the name of the employer submitted on the application. If you do not know your group name, please click here. The group number is the number assigned to your group and can be found on the first page of your Certificate. If you do not know your group number, please click here. You can submit up to 10 claim items on each claim form. No, you do not need to upload each claim item's supporting documentation separately. You can upload all of the supporting documentation one time under Supporting Documentation Upload. Accepted file types include pdf, png, jpg, gif. bmp, and tiff. We do not accept xls, xlsx, csv, txt, zip, or doc. Please simplify the file name of your supporting documentation and exclude special characters. Submitting claims is based off your policy year. You have 90 days past your renewal to submit claims for the previous policy year. See below for how this affects your group:
BeniComp Select can send your reimbursement by direct deposit if you have submitted an EFT form. EFT forms can be filled out by clicking here. Yes, when you submit your claims online they go directly into BeniComp's system for processing. This results in fewer handwritten processing errors and much faster reimbursement.
I received an email saying my Explanation of Benefits can now be viewed online; what does this mean?
When you sign up for Direct Deposit you are also enrolled in eBeniComp, which you can access by going to www.eBeniComp.com to view your Explanation of Benefits (EOBs) online. The Explanation of Benefits provides details for what claims have been processed; including both approved and denied claims. Your entire claims history is stored in eBeniComp in the form of EOBs and can be accessed at any time. For log in information, please refer to the confirmation email you received when your Direct Deposit was initially set up. If you do not have Direct Deposit and would like to enroll, please go to www.benicompselect.com/eft to sign up. If you cannot find your confirmation email, please call our customer service line at 866-797-3343 for assistance. Yes, as long as your group is domiciled in the United States and offers a group health plan, a participant can incur a claim outside of the United States' borders. In order to process these claims, the participant is responsible for translating the supporting documentation to English and converting the funds to American Dollars. |
||||||||||||||||||||||||||