Frequently asked questions about administering your health benefits program

Invoices and billing

Q: How do I read my invoice?
A: Here is a sample monthly invoice. There is an invoice date in the upper right corner of your invoice. Payments and or enrollment changes made after the invoice date will be reflected on the next invoice. Under the Account Summary section, you’ll see the billed amount from the previous month, payments received since the last invoice, and enrollment adjustments since your last invoice. 

Q: I am no longer getting an invoice. Why? 
A. You may no longer be receiving a mailed invoice if one or more of the following occurred:

  • Your mailing address changed. If you have recently changed your mailing address, please notify your billing specialist. 
  • You recently signed up for our online billing and enrollment portal. When you register for our online billing and enrollment, you are agreeing to view your invoices online. When doing so, we send a one page payment coupon to you in the mail. You will need to use this to pay your bill. To review your bill and see the total amount due, please log into your secure online billing and enrollment portal. 

If you wish to continue to receive your invoices in the mail, please contact your billing specialist. 

Q: Why do I have retro adjustments on my invoice?
A: Retro activity refers to any eligibility changes that happen after the most recent invoice generates. This can include new enrollments, terminations, changes in family (additions/subtractions), and class/plan/subgroup changes.

  • Carefully review your monthly invoices for any discrepancies and to ensure your adjustments are correct. Often times a person will appear on an invoice if there is a retro adjustment. The retro adjustment occurs when an eligibility change is made after the most current invoice generates. To avoid this, you will want to make all eligibility changes prior to your billing invoice date. You can find this on page one of your monthly invoice.
  • You will want to always pay from the Ending Balance each month and discuss any billing discrepancies with your billing specialist as soon as possible. 

Q: What is the online billing and enrollment portal and how do I use it?
A: Providence offers an online billing and enrollment resource to allow employer accounts to review eligibility, billing details and make payments, process new member eligibility, terminate coverage, etc. For more information, visit here.

Q: When is my payment due?
A: Payment is always due on the first of each month. 

Q: What happens if I cannot make my payment on time?
A: If your payment is not posted by the 25th of the month, your group coverage will be terminated due to delinquency.

Q: Will I get notified if my payment is late?
A: Yes. If payment is not posted by the 12th, an automated delinquency and termination letter will be sent. This is your only notice.

Q: Can I pay online?
A: Yes; you can pay after logging into our online billing and enrollment portal or after logging into our electronic payment system.

Q: Can I set up auto pay?
A: Yes; log into the online billing and enrollment portal or our electronic payment system to see instructions for setting up a recurring payment. 

Enrollment forms and eligibility

Q: How do I fill out an enrollment form?
A. Complete all fields on the form and ensure handwriting is legible.  

Q: Do I need to provide SSN’s for all family members?
A: Social security numbers are not required to have medical insurance unless you are selecting the Health Equity option; however, if a social security number is not received, we will send a letter asking for this information. This is important for the 1095-B forms we issue to members each year for tax purposes.

Q: What is a qualifying event?
A: A qualifying event is a change in employment, such as a rehired eligible employee, marriage, divorce, death, adoption, and involuntary loss of other coverage.

Q: How do I get a replacement card ordered?
A. There are a number of ways to get a new member ID card. Call customer service, use the online billing and enrollment portal or request one after logging into myProvidence