E123
If an agent says "there are no products showing on my enrollments site" what does this mean?
They do not have their licenses loaded into E123.
Where will individuals complete their working owner activities once we launch?
What does PHD stand for?
Personal Heath Dashboard
How many plans do we currently offer?
18 Plans
What must members "hit" before their copays kick in on the Million Dollar Plans?
Their deductible
When does the initial premium taken? And when does the recurring premium taken monthly?
Initial premium is taken at time of application. The recurring premium is taken on the 20th of each month.
When something is not working correctly in USHC Technology or we need additional features, add-ons, SSOs, etc built, how do we request this from the DEV team?
We submit a ticket via axosoft to the DEV team.
If someone calls in that their name is spelled wrong on their PHD, what are all the steps/places this must be changed?
UMS, E123, and Salesforce.
Which plans have "My Live Doc" as their PBM option?
Million Dollar Plans
Are the phone numbers to contact Member Services for America's Choice & GigCare plans the same?
No, there are two different phone numbers. America's Choice is 866-815-6001. GigCare is 866-200-2513.
How many signatures/initials are needed when signing the America's Choice application?
11
What has to be completed before a new hire can have access to PHI?
Their HIPAA training.
To check America's Choice member's PHD accounts, electronic ID cards, and if they are in USHC platform.
Can members change the type of health plan they are on anytime of the year?
No, they can only change during OEP.
Do we allow members to cancel and reenroll in different health plans?
No, members can only make changes to their health plan through a QLE (add/term members) or change their plan during OEP.
If a member NSFs/has a declined recurring payment for next month's coverage, and does not make it up before the 1st, what happens to their account?
There is an eligibility hold placed on their account until payment is made up. All claims will be held.
What is USHC's wellness program called?
Healthelives Program
If the help desk looks up a member in UMS and they are not showing, what steps do we take to look into this?
1.) Look in E123/Salesforce to see when the member was sent and uploaded into Sales force.
2.) If they were sent within the last day/uploaded in the last day, they most likely did not come over to UMS yet, and the member needs to wait another 1-2 days for their PHD account to be built.
3.) If they were not sent to Detego, then we need to send them over that day or next eligibility file.
4.) Communicate what is going on to the client.
What are the three current qualifications that a member must have to be a suitable working owner?
1.) They must fit the age bands
2.) They must "pass" the 11 knockout questions
3.) They must hold a self-employeed, 1099 tax status of some sort.
If an agent/member is having extreme difficulties with their plan for any reason, and has tried all phone numbers, and they reach out to an AC Team Member, who do we email?
escalations@detegohealth.com
Why do we have a "client ID" associated with agents and the business they write?
The client ID is an identification number from Salesforce that puts all of that agency's business under the same account. This is used to identify which member falls under which FMO so we can easily locate when needed.
How much do I currently earn monthly by participating in the USHC Wellness program?
$96 per month (just for employee)
Where do we go, to make edits for the new PHD?
PAS > PHD Layout Editor
30-60 days.
What is the term we use for the amount of a group's potential future spend or claims costs?
Risk Burden