Using Your Benefits
You've attended the Benefits Orientation and turned in your completed benefit enrollment paperwork. Now you'd like to make a doctor's appointment. Here are a few tips to help you:
Tips for using your benefits for the first time
Benefits are usually effective the first of the month following the date your enrollment forms were received by Human Resources Benefits, with an exception to Flexcash, Health Care/ Dependent Care Reimbursement Accounts, and Salary Reduction Agreement forms. Contact Human Resources Benefits for these specific deadlines.
If you are unsure of your benefit effective date, please contact Human Resources/ Benefits at ext. 4426. A confirmation letter will be mailed to you with your benefit effective date once your enrollments have been processed.
Once your enrollments have been processed by Human Resources Benefits, the information travels through many systems before it reaches the carrier's database, where your doctor will verify your eligibility.
NOTE: If you need services during this time and the doctor's office/ pharmacy says you are ineligible, it most likely means your enrollments are still being processed. Please give Human Resources/ Benefits a call at ext. 4426 for assistance. You may be asked to pay for services up front and submit a claim form to the carrier later for reimbursement.
You are able to view your medical, dental, and vision enrollments, as well as dependent coverage information online in CMS Student/HR. Should you find any discrepancies, please contact Human Resources - Benefits at ext. 4426. You may also review and update your address and emergency contact information.
You can look up your CSUMB username if you're not sure what it is. From the menu, select MB Employee Self Service > Benefits > Health Care Summary. If you have trouble signing in, please call the IT Help Desk at 582-HELP (ext. 4357).
Benefits are tied directly to your paycheck. If benefit carriers do not receive payment, they will terminate your benefits.
Should your benefit deductions not show on your pay stub, it may mean the State Controller's Office (SCO) is still processing them or there was an electronic error. If this is the case, please contact Human Resources - Benefits at ext. 4426 so we can troubleshoot the issue.
The doctor's office and pharmacy may request a copy. If you do not have your medical ID card, you may be asked to pay for services up front and will need to fill out a claim form for reimbursement at a later date.
ID cards are issued for medical and DeltaCare USA enrollees only within 7 - 10 working days from when the carrier processes your enrollment.If you have not received your medical ID card within 3-4 weeks of submitting your enrollment forms, please contact the health insurance plan directly. Contact information can be found on the Benefits Contacts Information webpage.
The doctor's office will need to know them for billing purposes. Group numbers can be found on the Benefit Contact Information page of the UP website.
A provider search can be done on the appropriate benefit carrier's website, all of which are listed on the Benefit Contact Information page of the Human Resources/ Benefits website. You can also access this information by visiting the 'Benefits Plans and Programs' section of the Human Resources/ Benefits website and select the appropriate benefit (i.e. health, dental, or vision).
Preferred providers may change without notice. Please verify with the provider you select that they take your insurance BEFORE scheduling your appointment or utilizing services.
Have the doctor's office verify your eligibility with the insurance carrier PRIOR to your actual appointment.
If there is an issue with your eligibility, please contact Human Resources - Benefits at ext. 4426 for assistance. We will verify eligibility and if necessary, contact the carrier and have them update your information in their system.
Following are a list of scenarios that may require you to submit a claim form for reimbursement. All claim forms are found on the Human Resources Benefits Forms page.
- Anytime you have to pay upfront for services.
- Your doctor's office will not bill your insurance for you.
- If you need to use services and you are not showing in the carrier's database yet.
- You have not received your ID card yet. (If this is the case, call Human Resources - Benefits at ext. 4426 for assistance.)
- You obtain services out-of-state or out-of-country.
Please bring the appropriate vision claim form with you to your appointment should you meet one of the following scenarios:
- You go to a non-VSP preferred provider.
- You are eligible and are using the Computer Vision Care vision benefit.