HRBA
What Mentor doc would you use if you had questions on HRBA
HRBA overview
What Mentor doc would you use if the agent/ BA is asking for an access to care?
ATC OVERVIEW
What Mentor doc would we use when someone calls in to terminate coverage
TERMINATION OF MEMEBER CALL
DEFINE COBRA
a federal-run program
what do you look for to determine if a plan is employee sponsored or voluntarily
E
V
(T/F) It is okay to delete a dependent from the dependent page in HRBA?
F
If the member is not enrolled but needs dental services within the next 5 days is that considered an ATC
NO
NEXT 4 DAYS
The agent calls on 6/16/25 to terminate a member whose last day of work was 5/31/25.
Group WP- Immediate
Issue State- CO
What is the member’s termination date? What Mentor doc would assist with this call?
Termination of Employee for Colorado
06/30/2025
DEFINE STATE CON
a state run-program
Name 3 state that has specific dental waiting period
CA
ME
NM
NY
In HRBA open events what does ‘In Process’ or ‘Complete’ mean?
IN-PROCESS is when you open an event and did not finsih it
complete is when the event is through and was submitted
What is the turnaround time for an ATC to be completed?
1 BUSINESS DAY
If the member is still living what do we need to verify prior to terminating the member
ADDRESS
DOES CAL -COBRA offer cobra
state contuation
Define dental waiting period
A waiting period is the length of time (usually 6 or 12 months) after enrollment that a member must wait before they are eligible for certain services.
In HRBA when would you use Terminate a Subscriber vs Modify Subscriber?
terminate sub to terminate all lines of coverage
modify remove all lines of coverage
No matter if the member is part of a group who enrolls through PEC or by sending in an enrollment form- what needs to be completed by us to request the ATC for a timely enrollment?
IMS TICKET
An agent is calling in (6/16/25) to complete a voluntary termination for Donna Horne Perez on group 680563. The last day worked is 4/05/25, what will their termination date be? What type of continuation would this member be able to be on?
04/30/2025
COBRA
if i live in Texas can i continue my coverage after my i retire from my company?
no
only for labor dispute
what services can have a waiting period
7. Agent is calling to terminate a dependent off a policy effective 6/30/25, in HRBA what effective date would you tell them to enter?
MTVX
DEFINE ACCESS TO CARE
The agent calls on 6/12/25 to terminate a member whose last day of work was 5/12/25.
Group WP- FM
Issue State-TX
Plan types- Dental PPO and life
05/31/2025
WHAT are my go to docs to give information on cobra and state continuation
State Continuation Overview
COBRA Guidelines for Qualifying Events
I want to enroll in a DHMO policy
group 10+
timely = YES
do i have a waiting period?
no
DHMO NO WAITS