Frequently Asked Questions
1. HOW DO I ORDER A MEDICAL CARD?
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2. HOW DO I ADD/DROP A DEPENDENT?
In order to add or drop a dependent, obtain a form from hr.conocophillips.com and submit to ConocoPhillips within 30 days of the qualifying event.
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3. HOW IS ELIGIBILITY DETERMINED FOR DEPENDENT CHILDREN?
Your eligible
dependents are children under age 25, provided they:
· Are not married.
· Receive at least 50% of their financial support from you.
· Are not employed. (summer
and part time excluded)
· Are not on active duty in the US Armed Forces.
Please refer to additional notes in the Medical Summary Plan Description.
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4. HOW DO I CHANGE MY ADDRESS?
Active employees should report address changes as follows: Step 1: Access HR Express and select "My Personal Info" from the left menu. Step 2: Click on the Home Address tab. Changes made through HR Express will change your address for personnel records at the company as well as at the insurance vendors. If you don't have access to HR Express, contact HR Connections at 800-622-5501 or 918-661-5500
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5. WHAT IS
THE INDIVIDUAL DEDUCTIBLE / FAMILY
DEDUCTIBLE?
This is the amount ($700) you must pay in a calendar year before the plan pays benefits. The deductible is made up of covered medical expenses that are incurred by each individual while covered. An exception occurs when the family deductible ($2,100) is met by any combination of covered family members, even if no member of the family meets or exceeds an individual deductible amount.
Amounts applied
towards the individual deductible the last three months of the calendar year do
not carry forward to the next year.
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6. WHAT IS OUT- OF- POCKET (COINSURANCE)?
The Traditional medical plan option has a coinsurance limit. The coinsurance limit is $2,500 for individuals and $5,000 for a family. This is the maximum amount you must pay in a calendar year in deductibles and coinsurance, but excludes amounts you pay that exceed "reasonable and customary" amounts. Once the limit has been reached, the plan pays in full, not to exceed the reasonable and customary, for covered services for the remainder of the year.
Amounts applied
towards coinsurance limits in the last three months of the calendar year do
not carry forward to the next year.
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7. WHAT IS REASONABLE & CUSTOMARY
(R&C)?
The maximum allowable amount to be covered based upon the plan contract provisions, type of procedure, date of service and geographical location of the provider.
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A physician, hospital, health professional or institution that provides a health care service.
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9. DOES MY PLAN OFFER "COORDINATION OF
BENEFITS"?
If your spouse works for another employer, he or she may also have medical coverage and be able to cover you and your children as dependents under that plan. One of the two plans is designated the primary plan for each covered person. The other plan is secondary for that person. The primary plan pays benefits as if there were no other coverage. The secondary plan makes up the difference up to the total covered expense of that plan, but neither will pay more than it would have without "coordination of benefits".
Please refer to
additional notes in the Medical Booklet.
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10. WHO DO I CONTACT IF I WANT TO APPEAL
HOW A CLAIM WAS PROCESSED?
Please write or e-mail within 180 days of the claim processing notice The Claims Trust, P.O. Box 6600, Bartlesville, OK 74005 or cs@theclaimstrust.com. Or call us at 866-664-3577 or 918-337-4200.
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11. WHAT ARE MY MATERNITY BENEFITS?
The Traditional medical plan option pays up to 80% of the reasonable and customary (R&C) after the individual deductible of $700 has been met.
Payment of the
expenses for the newborn child will be determined by the newborn’s status as a
covered dependent under the plan. See the eligibility section in the Medical
Summary Plan Description booklet.
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12.
WHAT ARE MY DURABLE MEDICAL EQUIPMENT (DME) BENEFITS?
The Traditional medical plan option pays up to 80% of the reasonable and customary (R&C) after the individual deductible of $700 has been met. The plan will pay in some cases for supply/equipment if the purchase price is less than the rental price.
Please refer to
additional notes in the Summary Plan Description booklet.
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13. WHAT ARE MY MENTAL HEALTH / SUBSTANCE
ABUSE BENEFITS?
Mental Health and Substance Abuse inquiries should be directed to Value Options: 1-866-241-4080
Please refer to
additional notes in the Summary Plan Description booklet.
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14. WILL MY PLAN COVER FLU & PNEUMONIA
SHOTS?
Yes, they are covered under the plan's preventive care benefit.
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15. WHO DO I CONTACT REGARDING MY FLEXIBLE
SPENDING ACCOUNT?
Please contact Aetna for information on your flexible spending
account balance or reimbursement request at 888-238-6226. Contact ConocoPhillips HR Connections for information on or changes to your monthly
contribution at 918-661-5500 or 800-622-5501.
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16. WHO DO I CONTACT FOR MY DENTAL
COVERAGE? Please contact your dental plan claims adiminstrator for questions concerning your dental
coverage. wTopw
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17. DO I HAVE VISION COVERAGE BENEFITS? Yes, The plan provides one
routine eye exam every 12 months. Initial pair of eyeglasses or contact
lenses as a result of cataract surgery are covered one time. The
Eyewear Discount Program (EyeMed) provides discounts to you through a national
network of eye care providers. You can contact EyeMed at 877-226-1115 or
visit their website at http://www.eyemedvisioncare.com wTopw
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18. WHAT IS MY MEDICAL ID NUMBER? The ID
card will show 918066 as The Claims Trust group number.
Your provider needs this number to file claims. ID
Cards will all be issued with the employee or COBRA participant's name.
Each dependant will also receive a card with their name on it. wTopw
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19. DO I
NEED TO NOTIFY THE CLAIMS OFFICE IF
MY CHILD IS ATTENDING COLLEGE IN ANOTHER COMMUNITY? No. There are no
network requirements for the Traditional plan option; therefore, your dependent can have
medical coverage in their college community without network penalties. wTopw
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20. WILL MY PLAN COVER PREVENTIVE CARE
PROCEDURES? Yes. The plan pays
100% of the first $1000 per person of “Reasonable and Customary charges”
if the service is within the specified time schedule. After that benefits are subject to regular Plan benefits, however, no deductible applies to preventive care. wTopw
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2004
