Question:
Insurance Handbook help

I just started a new job and asked the HR person for an employee insurance handbook. She said they don't have them as the plan changes so often it's not cost effective...and I should just call the no. on the back of my insurance card...or read the plan summary (a two pager) does that sound strange?? I thought plans only changed once a year and that a handbook would be available. Personally I want to be able to read what the plan says about WLS and reconstructive surgery in the privacy of my home, not have to give my member no. to a customer service rep. There is only one HR person at my location though there is a corporate hr in another state. I guess I am worried about making waves as I just started there, but is it usual to have a benefits handbook. I asked my manager, but she just refered me to HR....any suggestions... Thanks much!!!    — Princess D. (posted on January 17, 2003)

January 16, 2003
Find out if your insurance company/plan is available on-line and if so try and see if they have the handbook out there. Otherwise call the insurance company and tell them you need a handbook for your plan. I believe they will have to supply it, but not sure. If your plan is not self-insured then they should have one already printed they can send.
   — zoedogcbr

January 16, 2003
When I was starting out, I asked our HR person for a comprehensive benefits book, instead of the small booklet that we all have. She said if we had one of those, it would fill up an entire office. So I had to call the customer service number to get started. I was surprised, too, that I couldn't read all of this on my own and not have to rely on the reps over the phone. I don't know if they have to give you a book or not, but it would be better in my opinion. Most of the customer service reps are pretty nice, though, and you don't have to give them any specific information. I just asked them if gastric bypass surgery was a covered service on my policy. I received a verbal response, and then also asked them to send me a letter stating what the coverages are, which they did. It took a while to get the letter, though.
   — Carlita

January 16, 2003
Your story sounds all to familiar to me. [It's called a Benefits and Summary Plan] and it is not a 2 pager it's as large as the provider book and it explains in great detail the plan. My job tried to give me that crap too whn I called HR they said the it was included in my packet-not true. I got a 2 page summary and that's it-probably the same thing they gave you. You are absolutely right though, they tell you to call the 800# and they can answer any specific questions that you have. I experienced the same thing when I started my new job. I didn't want to ask those specific ?'s because you have to give them information and I wanted to keep my anonymity. When I called HR they jumped around for abut 20 minutes back and forth about is there any specific ?'s you have about whats covered. My response was no and to please send me a copy of the Benefits and Summary Plan. They have to send it to you (they don't like to). It explains in greater detail what your plan covers and don't then you have a hard copy. Because they can tell you anything over the phone that might discourage you. Also if you live in GA any policy issued have to cover it according to Senate Bill (SR24)I think thats the one.
   — Patricia T.

January 17, 2003
HR should be able to get you a Summary Plan Description. That is just plain laziness or ignorance on their part. We mail a new SPD to all of our members, plus everyone got a copy with the benefit re-enrollment info last October. Our company is self insured, but we probably have 50,000 to 60,000 members, so the cost effective deal is BS, too. Also, since our company is self insured, they put in a little clause that says the plan can be changed anytime, and changes do happen, but the entire SPD is not reprinted everytime. I don't think you are making waves at all! We have had people request information about coverage before deciding to take a job with the organization. You are entitled to know what your insurance covers, as well as knowing the rules you need to be aware of, as far as network providers and if referrals are necessary before procedures, co-pays and out of pocket expenses etc. Insist on having a copy!
   — koogy

January 17, 2003
Thanks for you comments. I called the insurance co and they told me electronic copies should be available. I am planning on emailing corporate HR and checking there.
   — Princess D.