Billing, Enrollment and Termination

 

We follow state and national guidelines for determining which employees and their dependents are eligible for group health insurance on your company plan. In this section, you'll find instructions on how to determine eligibility and how to enroll or terminate employees and their dependents.

In this section

Billing and enrollment

How to register

  • Click Register for online billing and enrollment
  • You’ll see the Employer Group Registration page
  • Provide group information, including company name, group ID, username and title, email address and any additional users who should have administrative access

You will have access to online billing and enrollment within two business days of submitting your registration form. We will send you two emails confirming your registration. The first contains a unique username and the second a secure password. Save the username and password in a secure place.

Please note: If you misplace the login information, contact call 503-574-5791 or 888-816-1300 to speak to a Membership Accounting team member to have the password manually reset.

Things you can do

New Enrollment

New Enrollment allows users to manage all of the company’s new enrollment needs. Some new enrollment tasks include:

  • Add a subscriber including name, date of birth, gender, marital status, and contact information.
  • View and select medical plan options from pre-populated medical plan choices. Only the medical plans available for that subscriber will be active.
  • Enter dependent information including name, date of birth, relationship to subscriber and other personal information. For each new dependent enrollment, select Add New Dependent.
  • Elect dependent coverage for each dependent, if needed. If users do not enroll the dependent for coverage, indicate whether the dependent has other medical coverage.
  • View and review the summary of enrollment choices to confirm selections.
  • Confirm enrollment choices and record the unique confirmation number. Use this number to maximize the Track Requests feature, which allows users to follow transactions in process.
Open Enrollment

Open Enrollment allows users to see the Subscriber Search screen. From this screen, manage all of your company’s open enrollment needs. Begin by fi nding a specific subscriber (either by subscriber ID or a subscriber’s last name).

Select the subscriber to be updated and choose one of the following open enrollment options that meets the subscriber’s health benefi t needs for the upcoming year:

  1. Begin Enrollment, which will take users to the New Enrollment page. Follow prompts to enroll the subscriber.
  2. Keep Existing Coverage, which will automatically take users to the Summary page to review existing coverage elections. If the elections are correct, confirm the elections. If the elections are not correct, select Cancel and return to the Group Home page to select another open enrollment option.
  3. Decline Coverage, which will automatically display the Decline confirmation page. Next to the appropriate reason for declining coverage, highlight the circle then enter the alternate health plan name in the corresponding fi eld, if applicable. At the bottom of the screen, select confirm to complete the enrollment or back to move to the previous page to change the open enrollment selection.

After completing any of the above transactions, users will receive a unique confirmation number. Save this number for your records.

Please Note: If a Subscriber’s status or coverage is not changing for the upcoming year, users do not need to do anything during open enrollment. The subscriber’s current coverage automatically carries over to the upcoming year. If a subscriber’s coverage is terminating, users will need to select the Decline Coverage option and follow the prompts to complete the transaction.

Additional Enrollment Features

From either the New Enrollment or Open Enrollment screens, users can also:

  • Update personal subscriber information, such as address, dependents and provider information.
  • Update coverage information, such as terminate and reinstate subscribers.
  • Order ID cards.
Billing and Reconciliation Tools
  • View your subscriber roster by group, subgroup or prospective subscribers.
  • View a current invoice by invoice number to see invoice details. You can also make invoice adjustments if subscriber or dependent coverage changes. Select Adjust Invoice on the bottom of the Invoice Screen to update coverage information and reconcile your bill.
  • Make payments either online or by mail. Select your desired payment method by choosing either Pay Online or Pay by Mail and follow the prompts to make a payment.
  • Search all invoices either by date and subgroup or perform a Quick Search if you know the invoice number.
  • Request a re-bill after making adjustments to subscriber or dependent coverage.

These billing functions are integrated with the enrollment functions. Some changes made to subscriber and dependent coverage and enrollment are reflected immediately on the group roster and allow real-time billing reconciliation.

How to find premium payments

From online billing and enrollment:

  • Step one - Go to Billing
  • Step two – Click Search Invoices on the right side of the screen
  • Step three – Enter desired date range and click Search. Invoices for the date range will appear
  • Step four – Choose an invoice and select Download subscriber list. The monthly billed amount for that individual will be downloaded into an Excel spreadsheet.
  • Step five - Compile the data either by copying and pasting or subtotaling

Please note that there is more downloadable invoice detail including billed amount, amount received and outstanding balance. If you register for online billing and enrollment today, your company’s entire history is available.

Additional resources

Billing questions

Call your group Membership Accounting representative; this information is listed on your Group Billing page. If you aren’t logged in or haven’t registered yet, call 503-574-5791 or 888-816-1300 to speak to a Membership Accounting team member.

Termination