1. What are provider benefits?
2. Who is eligible for provider benefits?
3. What is the cost of provider benefits?
4. How long does it take to get insurance once an application is submitted?
6. How do providers who lose medical and dental insurance enroll in COBRA? What's the process?
8. How do I apply for COBRA after I am terminated from regular insurance benefits?
9. What is the cost of COBRA coverage?
11. What is the Purchaser/Enrollment Unit Number on the Kaiser COBRA application?
1. What are provider benefits?
Provider Benefits include consist of medical and dental insurance through reputable insurance providers. Medical insurance is available from Kaiser Permanente and Dental dental insurance is available from Delta Dental and Pacific Union Dental. .
2. Who is eligible for provider benefits?
Provider Benefits are available to all IHSS providerProviders who meet eligibility requirements:
Only IHSS providers are covered by provider benefits. There is no dependent or spouse coverage available.
When an application for provider benefits is submitted, the Benefits Administrator at the Public Authority places eligible IHSS provider providers on a waiting list in the order in which the applications was are received.
When an open benefits “slot” becomes available, the provider at the top of the waiting list is awarded benefits.
3. What are the costis the cost of provider benefits?
HSS providers pay a low monthly premium co-pay for access to a high value medical and dental plan: $16 a month for medical insurance, and $6 a month for dental insurance. If providers were paying for this coverage directly, their cost would be roughly $400 a month for medical and $30 a month for dental. Altogether, provider medical and dental insurance is a $5160 a year value.Provider benefits are worth over $4000 a year.
Providers enrolled in medical insurance are only responsible for paying a $10 premium co-pay each month, and providers enrolled in dental insurance are only responsible for paying a $5 premium co-pay per month. This Tco-pay is deducted he State of California automatically deducts these premium co-pays from provider pay checks based on enrollment information provided by the Public Authority through the Union. from the providers pay check once a month. In addition to the monthly co-pay, providers may also be responsible for a co-pay at the time of service as outlined in: Provider Benefits Overview for Medical Insurance and Provider Benefits Overview for Dental Insurance.4. How long does it take to get insurance once an application is receivedsubmitted?
In general, eligible IHSS providers who submit a correctly completed medical and dental insurance application are processed upon receipt. . HoweverUsually, there is a long waiting list for insurance benefits and most providers are on the waiting list for a minimum of six to twelve monthscan wait anywhere from 1 to 3 months for the insurance to be awarded. Once a provider reachesat the top of the waiting list, he or she willa provider is be assigned the next openenrolled in insurance as an insurance slot becomes available; and benefits will commence on the first day of the subsequent month.5. How does the Public Authority get information about the name and number of hours a provider is actually working for a consumer?
The Public Authority gets data on the number of hours IHSS providers work in a given month from the State of California. Each month, IHSS provider payroll data is extracted from the statewide system known as Case Management Information and Payrolling System (CMIPS) and sent to the Public Authority of Marin. In turn the Public Authority uses this data to determine IHSS provider eligibility for insurance benefits. The Public Authority’s data is only as good as what is submitted by IHSS provider on their timesheets to the County of Marin. When timesheets are submitted late, the Public Authority may not get the correct hours until the next month. All IHSS Providers are encouraged to submit timesheets on a regular and timely basis.
IHSS providers are responsible for resolving payroll issues directly with Adult Social Services at the County of Marin. To start the process, call the Payroll Hotline at 415-499-7487.
6. How do providers who lose medical and dental insurance enroll in COBRA? What's the process?
Providers who no longer meet eligibility requirements and lose medical and dental insurance are automatically eligible for COBRA insurance coverage. A provider will be notified of termination of benefits by the Public Authority of Marin. . Shortly thereafter, the COBRA Administrator Integrated Benefits Services will send a COBRA application by mail. Upon receiving this application, the provider most must complete the form complete and return it as directed to the Integrated Benefits Services.
To contact Integrated Benefits Services directly, call (800) 681-9998 x 11.
7.What happens to my medical and dental insurance benefits when I am terminated from regular coverage for any reason?
Pursuant to the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985, IHSS providers who are terminated from regular insurance benefits with Kaiser Permanente, Delta Dental and Pacific Union Dental are eligible for continued coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985. COBRA allows providers who are no longer eligible for regular coverage can continue their insurance for up to 18 months[1] by bearing the full cost of the premium and paying it directly themselves. Currently, Kaiser is roughly $400 a month, Delta Dental is $30 and Pacific Union Dental is $30.
Under COBRA, there are a number of protective rules including:
IHSS providers most be notified of their eligibility for COBRA within fourteen (14) days from the date the Public Authority notifies the Integrated Benefits Services of the qualifying event (planned termination)8. How do I apply for COBRA after I am terminated from regular insurance benefits?
Providers who are voluntarily or involuntarily terminated from regular insurance benefits through the Public Authority are eligible to apply for COBRA coverage. COBRA coverage is identical to regular coverage. However, providers are responsible for paying the full cost of the benefits directly. Kaiser premiums are paid directly to Kaiser and dental premiums are paid to the Integrated Benefits Services.
Upon being terminated from regular benefits, providers will be sent a COBRA Election Form by the COBRA Administrator Integrated Benefits Services. To get the COBRA cover, a provider fills out and returns the Election Form to the Integrated Benefits Services. The Integrated Benefits Services will send Kaiser Election Forms for processing. Kaiser is solely responsible for processing these forms and direct billing the provider. The Integrated Benefits Services processed dental COBRA Election Forms and issues payment coupons. Thereafter, the provider is responsible for prompt payment to insure continued COBRA coverage.
9. What is the cost of COBRA coverage?
As of February 1, 2006, COBRA coverage costs per month:
10. What’s the deadline for enrolling in COBRA after a provider is terminated from regular insurance benefits?
As noted under 7 above, IHSS providers have 60 days in which to “elect coverage” by completing and submitting a COBRA election form application for COBRA insurance coverage. After electing COBRA coverage, providers have 45 days in which to make their first premium payment and bring their account “current.”
11. What is the Purchaser/Enrollment Unit Number on the Kaiser COBRA application?
The Purchaser/ Enrollment Unit Number on the Kaiser COBRA application is the Public Authority policy number which is 600504-00. To avoid confusion, providers are strongly encouraged to enter the Purchaser/Enrollment Unit Number of the Kaiser COBRA application before sending it to Kaiser Permanente through the Integrated Benefits Services.
[1] COBRA is also available for up to 29 months if a provider is disabled for Social Security purposes at the time he or she is deemed ineligible for benefits; or if disabled within 60 days of COBRA coverage. Additionally, CAL-COBRA may extend certain benefits for an additional 18 months, for a total of 36 months of COBRA coverage. CAL-COBRA coverage extensions are not the responsibility of the employer/administrator; they are provided by the insurance providers.