Update on billing/invoices and appeals

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Update on billing/invoices and appeals

Billing/invoices

Your second SEBB invoice will be available today, January 16.

You will see that some corrections have been made. Others have not, but we continue to work on them as quickly as possible in addressing the changes requested by:

  • The benefits administrators via FUZE.
  • Employees via appeals.
  • Plan carriers via discrepancy reports.

Our top priorities are to get subscribers and their dependents (including newly eligible employees) enrolled in health plan coverage, and remove terminated employees from benefits.

Also, the Supplemental long-term disability insurance rates that impact subscriber payroll deductions have been corrected in this month's billing/invoice file. 

Adjustments

As we shared with you in the December 20, SEBB Update:

Adjustments are a common occurrence as your employees’ eligibility and enrollment changes, but the data cleanup efforts after open enrollment resulted in a higher number of adjustments than we anticipate going forward.

As adjustments are made to employees’ eligibility, our eligibility and billing system will recalculate what was billed for the employees’ coverage month(s) affected. You will see billing adjustments on the following month’s invoice.

An example of how adjustments will appear on your bill is reflected on the sample billing file spreadsheet. The spreadsheet was originally shared at the December 16 webinar, but additional text has been added in response to inquiries made by districts.

Appeals

We continue to adjudicate and work on appeals received. We appreciate your patience as we work though the backlog of FUZEs and appeals.

Thank you.