ABC's of Commercial
What 3 networks do our individual and family plans use?
Navigator, Voyager, and Aenta
Navigator network is used for Montana, Oregon and parts of Idaho plans.
Other parts of Idaho use the Voyager network. (Benewah Bonner, Boundary Clearwater, Idaho, Kootenai, Latah, Lewis Nez Perce, And Shoshone)
Aenta Signature Health for outside our state covered area.
What is the timeline for QLEs for special enrollment?
Prospective members have 60 days from the QLE to enroll in health insurance directly or with the Marketplace.
90 days with Medicaid term only on Marketplace
How would you handle a call if an Exchange member wants to pay their monthly premium payment?
Individual
Can a member travel to Florida and still be able to see a chiropractor that will process in network?
Yes, as long as the provider is in network with Aenta Signature Health
What Was the first Pixar Movie
Toy Story
What network is assigned to policies for members that reside in Clearwater County, Idaho
Voyager
What Department processes enrollments for direct polices?
Individual
Current member wants to look for providers that are in network? Which department would you send them to?
Commercial Customer Service.
What is the benefit for tier 3 RX on Montana Standard Sliver?
$80 copay AFTER deductible of $5000 is met.
What was the most watch documentary on Netflix during quarantine?
Tiger King!
What document will provide a general breakdown of all plans for each state?
Plan Comparisons
Where can you do a direct online application?
Quote to Card AKA Our PacificSource Agent portal
Where would you send a current dental member asking about in network dental providers and dental benefits
Dental Customer Service
What state do we not sell individual plan in but used to?
Washington
Which of these movies do NOT have sequel??
Pirates of the Caribbean
Love and Basketball
Bad Boys
Barber Shop
Love and Basketball
Where do you do enrollments for an Idaho that wants to use taxes credits
Your Health Idaho
Where can you find Exchange/Market Place completed applications?
Mat/EMS
Provider calls to check claim status where do you send them?
Check ID and send to correct customer service department
What would the benefit be for an PCP office visit with an in-network provider on the Oregon Navigator Bronze 7000?
1st three visits are a $5 copay no deductible after those 3 visits it is a $75 copay no deductible.
In the Movie Titanic, where did Jack Dawson grow up?
Chippewa Falls, Wisconsin
What are the preventive services that are covered 100% In network?
Annual physicals
well baby checks
Annual women's check up
Preventive Mammograms
Preventive Colonoscopies
Immunizations
Prostate cancer screening
How does a Exchange vs a direct member term their policy?
Marketplace/ Either call or online
Direct: Email to Individual with member information such as name DOB ID and term date request.
Current Direct Member's plan was termed last week for non-payment. Where can we send them for reinstatement?
Individual Department
What is the in-network benefit for acupuncture on ID Voyager Sliver 3600?
$25 copay no deductible 18 visit limit combined with chiropractic.
What song playing when Regina George's sister is dancing to TV
"Milk Shake"