Direct Bill
What is a Direct Bill?
Direct Bill is when a ppt goes on leave or does not make enough money in their paycheck to cover their benefits. We will send a bill to the ppt. The ppt is then responsible for paying the bill to continue benefits.
What is COBRA?
COBRA is a continuation of medical, dental and vision coverage offered to a participant who loses active coverage.
Can a Retiree waive benefits?
Yes, they may waive benefits, however, always check the TipSheet to see if they can be reinstated later.
Name 5 things can you find under the “Profile” tab.
1.Security Information
2.Registration Code
3.Payment due date
4.Benefits
5.Effective Date
6.Event Type
A retiree calls in and wants to enroll for his retiree benefits, but you see that he only has COBRA. Why would this be?
Either the ppt was not eligible for Retiree benefits, or we have yet to create the account.
When in doubt, always escalate to confirm.
How often is the ppt billed for their Direct Bill?
On a monthly basis.
What triggers a ppt to be offered COBRA?
COBRA is offered for a loss of coverage that is caused by one of these qualifying events:
Termination of employment
Reduction in work hours (full time to part time)
Becoming an ineligible dependent
Divorce
Death
When searching for a Retiree in WEX COBRAPoint, which type of “member” do you search by?
SPM-Special Plan Member
Where can you find a payment the ppt made in COBRAPoint?
In the “Payments” tab.
Can a ppt have both a Retiree account and a COBRA account?
Yes
When searching for a direct bill ppt in COBRAPoint, which type of “member” do you search by?
SPM-Special Plan Member
When searching for a COBRA ppt in WEX COBRAPoint, which type of “member” do you search by?
QB- Qualified Beneficiary
Are all retirees offered retiree benefits?
No. Retiree benefits depend on the client.
Where can you locate if a ppt has a subsidy?
This can be located in the “Subsidies” and “Notes” tabs.
Ppt calls in to confirm who is under their benefits. Where is this located?
This will be under the “Dependents” tab.
While on Direct Bill, does the ppt pay 100% of the premium or their active employee rate?
Ppt will pay their active employee rate. Their billed on a monthly basis.
What does it mean when an account in COBRA has an E?
Ppt has enrolled for benefits.
Where would you be able to locate the ACH information?
Under the "Recurring Payment" tab in COBRAPoint.
Where can you locate what benefits the ppt is enrolled in?
Under Current Plan Information in the “Profile” tab, and in the “Plan” tab.
Ppt calls in and wants to enroll and you see TE. What does this mean?
The member was previously covered under the plan, however, the plan is now terminated. This could be because they did not make a payment within the required timeframe, they are no longer eligible for the benefits, or they requested the account to be terminated.
Can a ppt change benefits while on Direct Bill?
Typically no; however, always check the TipSheet.
If a ppt is enrolled in ACH, when are the funds pulled.
Processed the last day of the month prior.
Appears in bank account on the 1st of the month or next business day.
A retiree calls in and wants to get a copy of the coupons. Where would you locate this?
Under the communication tab. Make sure to send the most up to date one.
Where do you go to impersonate a ppt in WEX COBRAPoint?
As long as the ppt has registered, there will be a “View Member Portal”.
Ppt calls in and wants you to email them the paper that was mailed out. Where can you locate this?
This will be under “Communications” tab.