TEAMINATION ON RETAIL POLICIES
RETAIL
General Termination Guideline: Terminations will occur the first of the following month.
Example:
If the insured calls 01/08/2020 and request the policy is terminated.
First attempt to save it. If unsuccessful review a few important points with the insured.
The termination date will be 02/01/2020 (first of the following month).
The last EFT is non-refundable.
Unless insured is on Medicare & we have a copy of the Medicare card showing the effective date of Medicare is 01/01/2020.
All other reasons, the EFT will not be refunded. That would also include any NSF fees the insured incurred.
Please see these Termination Instructions. Please also use these suggested techniques for saving the policy.
When you get a call to terminate a policy. Please attempt to retain the business.
Ask open ended questions.
PICK ONE:
How do you plan to cover the co-pays and deductibles left behind by your primary?
What attracted you to our supplement plan?
What’s causing you to make this change in your healthcare coverage?
LISTEN TO WHAT THEY SAY
Then give the insured a benefit of our supplement to attempt to save the business.
With our supplement we cover the co-pays left behind by your primary. One major life event can wipe out a savings account.
We will reimburse you for your RX. This is a great way to save money and care for your family.
IF cost is reason for cancel… We know the most important thing in your life is your family, we want to be here to help you protect them and your finances.
If you are successful with saving the policy document the records who called, what they wanted and what you advised.
If the primary insured or sponsor wants to terminate the policy, please explain the termination date will be the first of the following month.
We do not refund premium when the insureds request to terminate early.
Direct Bill (direct premium notice or EFT). This can be a Corporate insured or a Retail insured, as long as they pay us directly.
Send an email to Billingworkflow@selmanco.com. Format the subject line as shown in the example below.
“P000123456 – John Smith – TRICARE – Term Cov”
In the body of the email, ask to terminate coverage based on the telephone request. Our Billing team will terminate on the first of the month following the request or an earlier date if payment is not made. Our billing team can also terminate on a later date (1st of the month) if you provide the specific instructions to do so.
If the request is not to terminate the entire record but to delete a family member, please modify your message.
Please send your email to billingworkflow@selmanco.com, always cc Jutte Hiley.
Note: If the member desires a non-standard termination with a non-standard refund, he/she must send us a signed request. The request should be very clear so that Billing does not treat it as a routine request. In these cases, do not email billingworkflow@selmanco.com. Instead, ask the caller to send the request in writing.
CORPORATE POLICIES
List Bill – General Dynamics
There are organizations that allow the insured to make changes.
Mantech
General Dynamics
General Dynamics insureds may only terminate if there is a qualifying reason such as divorce, termination of employment, moving from full-time to part-time, death, etc. If there is no qualifying reason, please refer the caller back to his/her benefits office.
If there is a qualifying reason, please send an email to Twanna and cc Jutta Hiley. Format the subject line as shown in the example below.
“P000123456 –John Smith – TRICARE – General Dynamics – Term Cov”
Be sure to include General Dynamics in the subject line. In the body of the email, Twanna Tilghman to terminate coverage based on the telephone request and please tell him the qualifying reason and the date of the event.
Laine will terminate on the appropriate date based on the group rules.
If the request is not to terminate the entire record but to delete a family member, please modify your message to Twanna Tilghman,
List Bill – Okaloosa County Schools, P31 Incorporated, ManTech, The SI Organization
Please send an email to Twanna Tilghman and cc Jutta Hiley. Format the subject line as shown in the example below.
“P000123456 – John Smith – TRICARE – Name of Group Here – Term Cov”
Be sure to include the name of the group in the subject line. In the body of the email, ask & Twanna to terminate coverage based on the telephone request. Ron will terminate on the appropriate date based on the group rules.
If your request is not to terminate the entire record but to delete a family member, please modify your message to & Twanna Tilghman.
Encourage the Insured to wait for the file feed to arrive at Selmanco to make the termination or change to the policy.
Set clear expectation with the insured to not send in any premium until they received our LB to DB letter. They should return the letter with the new APO form competed to continue the coverage
List Bill –All Other Groups Please direct the caller back to his/her HR to terminate the coverage or to add/delete a family member. Please open and read your Corporate Group Rate Manual.
STEPS TO FOLLOW:
Check If policy Retail or Corporate
- If Corporate check the Corporate Rate Manual for Special Handling. If no Special Handling, check to see if File Feed. If so, send the insured back to ER/HR to have the changes sent to Selmanco via the file feed. This is on your desktop, if not let me know right away.
- Please set very clear expectations with the insured DO NOT send any premium, please wait for our age 65 letter to arrive and return it with APO completed. You can email it to the insured, the letter is in archive documents.
- Check HelpJuice. There are approximately 5-10 ER groups that allow their insureds to call us and make changes. Check HelpJuice.
- American Systems Corporation/ Client ID number 0001557. Currently does not have special handling, IS on file feed, and the premium was being paid by GRPPRM (Group Premium) which is the same as List Bill. You can not send emails to make changes to the policy. You must direct the insured back to his/her ER/HR group.
- Once we get the age 65 letter back and the APO. Place the document in Imagenow, advised the insured to allow 7-10 business days for the new policy to be created for the spouse etc…
- Create an Outlook reminder 5 business days out from the date you get the document back, and place it in Imagenow.
- If the reminder pops up on the 5th day. Check Inspro for the new P number, if no new p number, send and escalation email for the new p number to me.
- Selmanco has signed a contract with this ER group, that we will not make any changes to any policies unless the ER group sends us a file feed. Due to the email you placed us in violation of the signed contract. This can not happen again. In the event this should happen again, a verbal warning will be issued.
Under Age 65 and on Medicare:
RETAIL
If the person is requesting a refund because he or she is under age 65 but eligible for Medicare, the CSR should ask the caller to send a copy of the Medicare ID card showing the effective date of Medicare.
The CSR should also email billingworkflow@selmanco.com so that coverage can be terminated immediately before additional claims are paid.
MEDICARE:
When the insures reaches 65, there is no action required to terminate the policy. It is the insureds responsibility to notify us if their Medicare/Tricare for Life will have a different date. Our billing team will automaticly schedule the policy to terminate the first of the month following the 65th birthday.
If the insureds wants to terminate the policy sooner please send and email to billingworkflow.com please state the date the insured/sponsor wants the policy terminated.
CORPORATE
Check the Corporate Rate Manual, you are to review the special handling section. Read the instructions and advised the insured. If there are no special handling, look to see if the group is file fee. If the group is file feed, the changes must come from the ER/HR group. Please instruct the caller to the HR department. Keep in mind this rule applies when the insureds policy is on List Bill (LB).
MEDICARE:
When the insures reaches 65, there is no action required to terminate the policy. It is the insureds responsibility to notify us if their Medicare/Tricare for Life will have a different date. Our billing team will automatically schedule the policy to terminate the first of the month following the 65th birthday.
If the insureds wants to terminate the policy sooner please send and email to billingworkflow.com please state the date the insured/sponsor wants the policy terminated.
Upon receipt of the Medicare ID card, Billing will adjust our termination date to match the effective date of the Medicare policy.
Please be sure to place a copy of the Medicare ID card in Imagenow.
Premium refunds will be issued, but our claim payments will be deducted from the refunded amount. This process should not affect other members of the family who are not Medicare eligible. Their coverage will remain intact.