When do my benefits start?
They begin on the first of the following month if you enroll by the last day of the month.
How many employees do I need to enroll?
You need at least 1 person enrolling.
When can I enroll throughout the year?
You may enroll at any point throughout the year, with an effective date of the first of the following month.
Are these plans Guaranteed Issue?
They are not. These plans require underwriting approval before enrollment.
What is underwriting?
Underwriting is the process insurers use to evaluate risk before approving coverage. Some insurance plans require underwriting, while others offer guaranteed-issue coverage with no medical review.
What is the underwriting process like?
It involves filling out a health questionnaire covering medications and medical history over the last 5 years. It takes about 7 business days to receive a final decision, so we typically recommend planning 3–4 weeks ahead of your current insurance renewal date.
Will my rates change after underwriting?
Rates may change after the underwriting review. There are 7 tiers of rates, with tier 4 being the rates published on the website. Underwriting may return a more favorable tier depending on your health history.
What happens if I am denied coverage?
You have two other options: the ASID Advanced Health Plan is Guaranteed Issue, or you can set up an appointment with Nina to explore Marketplace plans (BCBS, UHC, Aetna, etc.).
Didn't the ACA rule that insurance plans must be Guaranteed Issue?
It did — but that only applies to Marketplace plans. With the addition of health questionnaires, Triad Benefits can offer more favorable rates than typical Marketplace plans.
Do I need a referral to see anyone?
No referral needed. These are PPO (Preferred Provider Organization) plans, so you have more flexibility choosing your provider. You'll pay the least within the Cigna Network.
Do I need to reapply every 3–5 years to maintain my plan and premium?
No. These plans continue as long as you'd like. At each annual renewal you'll be presented with the next year's rates. Only contact customer service if you'd like to change plans or cancel your coverage.
Can I switch my plan?
You can switch plans during Open Enrollment. To switch before then, you must have a qualifying life event.
Do these plans cover maternity?
Yes. For more information, see the Summary of Benefits and Coverage on the website.
Do these plans cover IVF?
Unfortunately, there is no coverage for IVF at this time.
Do these plans meet ACA requirements for tax penalties?
Yes.
