Training Materials
Contents
1. 02 37 54 PM Resume Delete 123456789 JOHN SMITH New Enrollment JSMITH123 09 4 2005 12 28 22PM Resume Delete 123456789 JOHN SMITH New Enrollment JSMITH123 10 20 2005 02 16 37 PM Resume Delete 123456789 JOHN SMITH New Enrollment JSMITH123 10 28 2005 05 04 41 PM Resume Delete 123456789 JOHN SMITH New Enrollment JSMITH123L 11 01 2005 03 14 02PM Resume Delete 123456789 JOHN SMITH New Enrollment JSMITH123 11 01 2005 03 34 35PM Resume Delete 123456789 JOHN SMITH New Enrollment JSMITH123 11 04 2005 05 13 00 PM_ Resume Delete 123456789 JOHN SMITH New Enrollment JSMITH1 23 11 09 2005 03 24 42 PM Resume Delete 123456789 JOHN SMITH New Enrollment JSMITH123 11 22 2005 02 41 15PM Resume Delete 123456789 JOHN SMITH Change Coverage ITH123 02 10 2006 01 20 29PM Resume Delete C1 EN CI IER CT IE LT IC CT IER CT IEM CT IER CI Provider Finder Help ContactUs Log out Group Billing Tip Billing Entities also provides access to invoices and their details Group Billing Transaction Selection Select the group number from the Billing Entities page Billing home page to access a number of transactions on the Open Invoices page Welcome John Smith Activities Er Onliog Hove Billing Entities Preferences Manage Billing Email EmployerAccess Provider Finder Help Log out gt Contact Us Sm UNICARE A Hoatthy Dose of Innovation Forms Reports Profile Pay Online Now Invoices Click on an in2. EMPLOYERACCESS Online User Manual a UNICARE A Healthy Dose of Innovatione Table of Contents Introduction to EmployerAGUGeSs ii eere re ror bnt ET beaseackersesasardsaninseave page 2 New Enrollment ceo din tu tot dead er page 6 Existing Member Maintenance uir pet Meunier arde ata ean NEM rub cue art page 16 Add Deepender sieaa s MM ME E page 17 LusbPo ccr MER PD page 19 Change mg o tates decebat end ud bo page 20 Ae RM D page 21 Fe NAA esar meson MM ee page 22 Change Personal Door sissies re mu RR Ra hir Rec page 23 Request ID Card eee e ere e RT Om page 24 Etc ong Disability e iu cuiii dnd RU tM M E I uU Ra RUE page 25 gy FUNCHOM T A page 27 Group Billing oa e at niue neni tiet at NM RU tUe page 29 Frequently Asked Questions uostri RF PERF RTEHUN PUER ERR UM Ptr EN UbIUE Saunas page 33 Introducing EmployerAccess EmployerAccess at www unicare com your health insurance management Web portal UniCare is making it easier for you to do business with us In addition to the helpful resources already available on www unicare com our online transaction service EmployerAccess has been updated to provide Enhanced content Improved availability Faster response times e And a brand new look We ve added Life amp Disability management allowing you to manage more at your convenience The new EmployerAccess offers you even more control over employe
3. 123456 and or dependent benefits Qualification Date Cancellation Reason zl Select Reason IIT y Y Y Actual effective date will be the First of the Month following this date Indicates a Required Field TX PERFORMANCE CH1000 80 1165 EE mp Name Relationship JOHN SMITH Subscriber Active 08 01 2005 JANE SMITH Spouse Active 08 01 2005 JOAN SMITH Child Active 08 01 2005 IL SG Vision CH1000 80 T165 Name Relationship Effective Date JOHN SMITH Subscriber 08 01 2005 IL SG Vision CH1000 80 T165 Name Relationship JOHN SMITH Subscriber Active 08 01 2005 Re enroll From the Employee Dependent Details page you can also re enroll an employee To re enroll a member whose coverage has cancelled enter the signature date the hire date and confirm the employee s group number Be sure to click the Include Dependent check box for each member to be re enrolled When you are finished click Continue Select the coverage from the drop down menu and click Continue Complete the Assign Coverage and Other Coverage screens and click Submit Please refer to the Enrollment Section for details Note The signature date is the date that the employee signed the application It cannot not be over 120 days from the date of hire or re hire date Edit Personal Information gt Contact Us gt Simply click the button on EmployerAccess UNICARE the Employee Dependent Welcome UNISG UI Provider Finder Log
4. JOHN 123456789 SMITH JOHN 123456789 SMITH JOHN 123456789 SMITH JOHN 123456789 SMITH JOHN 123456789 SMITH JOHN 123456789 SMITH JOHN 123456789 SMITH JOHN 123456789 SMITH JOHN 123456789 SMITH JOHN 123456789 SMITH JOHN 123456789 SMITH JOHN 123456789 SMITH JOHN 123456789 SMITH JOHN 123456789 SMITH JOHN 123456789 SMITH JOHN 123456789 SMITH JOHN 123456789 SMITH JOHN 123456789 SMITH JOHN 123456789 SMITH JOHN 123456789 SMITH JOHN 123456789 SMITH JOHN 123456789 SMITH JOHN 123456789 SMITH JOHN Subtotal ILSG30CP ILFFSDNH ILPPODNH LIFE150K ILSG30CP ILFFSDNH ILSG30CP ILPPODNB HMOINFER LIFE150K ILSG30CP ILPPODNB LIFE150K ILSG30CP ILFFSDNH HMOINFER ILPPODNH LIFE150K ILSG500 ILFFSDNH HMOINFER LIFE150K HMOINFER ILFFSDNH LIFE150K A QU QD amp L D L 2A L 2i L 2A ON ND 2A N c3 2A 23 2A ND OD CD Rate Change Legend B New Age Rate E Next Bill Reflects new Age Rate F New Area Category amp Next Bill Reflects New Age C New Area Category Rate D New Age Rate amp Age Category Provider Finder ContactUs Log out Tip You have the option to pay online from almost any screen in Billing Look for a green button that says Pay Online Now Pay Online EmployerAccess offers you the convenience and flexibility of paying your monthly bill s online You have the option to pay multiple invoices at one time o Enter the amount you would like t
5. buttons displayed Employee Dependent Details Subscriber Name JOHN SMITH Group Name ABC CO Member ID 123456789 Group Number 123456 Add Dependent s HCID 123456789 Simply dick the Add Dependent button het hte to add or re enroll dependents to an evened os E enrolled employee s subscriber s BARRINGTON IL 60010 IIT ploy Phone Number 847 437 9999 coverage Newborns and new Spouses are eligible for coverage on the event date i e birth date or date of marriage us SRR OS ROSCA TORO Ee eee Date ID JOHN SMITH Active Subscriber 05 9 1949 12 01 2005 12345678 Prior Enrollment Information New spouses or newborn dependents may be SELM Active Female Spouse 0341952 12 01 2005 12345678 Information added through EmployerAccess within 31 days SMITH Active Child 06 10 1993 12 01 2005 12345678 Prior Enrollment of marriage or birth A dependent spouse Infarnation 4 JOAN SMITH Active Female Child 06 10993 12 01 2005 12345678 and or child ren may only be added during snae the group s open special enrollment period Loss of dependent s coverage cannot be ER a ERES Relationship Birth Date Effective Cancel Network D D D Date Date ID completed online For more information on JOHN SMITH rive Male Subsorber OSH9M949 1201 2005 12345678 Prior Enrollment the addition of dependents please consult your wamaisn JANE SMITH Active Female Spouse 0311 1952 12 01 2005 12345678 UniCa
6. o Click on the Change Member ID link n on the Member Information page EmployerAccess MEME Welcome UPI Administrator Provider Finder Help Log out Enter the correct Member ID number in the blank field on the Membership Member Information Change ID page not shown and Member Information for Enrollment click the Submit button tep 2 S optional step 4 step 5 Select Life Assign Other Coverage Coverage Coverage Coverage You will return to the Member Member ID 123456789 o Group Name ABC CO amp Change Member ID Group Number 123456 Information screen to continue working You can access the Change Member amu 5 omy A A First Name Hebie ID hyperlink only through this screen pa ih Gender Male C Female ie ea Note You can only change member Care oF oe mall information during the enrollment process bi hi l I 1 Il d ith City re Probation Type Select One If an employee is enrolled with an e incorrect Member ID number you will a 4 need to cancel that coverage and re add amoa mmidd yyy the employee You cannot change member aana information once the new enrollment has p Actual City and State names are determined by US Postal Zip Code been confirmed on the verification screen and submitted ovider Finder Help ContactUs Log out After you click Continue the Verification page appears and asks you to check the information you ente
7. 627 8797 Provider Finder Help Contact Us Log out Invoice Membership Details Here you can view each employee and dependent within your group o To view any billed adjustments for your group made by UniCare click the Billed Adjustments link gt Contact Us Sm UNICARE A Healthy Dose of Innovation EmployerAccess Welcome UNISG UI Provider Finder Log out Membership Employer Forms Reports Profile Billing Entities Open Invoices Invoice Details Invoice Details Pav Onine Now Ga Downioaa Bin ce November 2006 1234567891011 x 123456 EMPLOYER ACCESS MARIBEL Billing Entity Number Billing Entity Name 1234567891011 11 01 2006 12 01 2006 07 18 2006 11 01 2006 Invoice s Billing Period Date Billed Payment Due Date Number Rate ciber Dependent Prem Covered Chg Amount Amount Amount 225 29 0 00 225 29 30 00 0 00 30 00 30 00 0 00 30 00 30 00 0 00 30 00 225 29 0 00 225 29 30 00 0 00 30 00 225 29 0 00 225 29 19 50 0 00 19 50 253 99 0 00 253 99 37 50 0 00 37 50 207 10 0 00 207 10 19 50 0 00 19 50 37 50 0 00 37 50 225 29 0 00 225 29 30 00 0 00 30 00 643 50 0 00 643 50 30 00 0 00 30 00 229 50 0 00 229 50 261 92 0 00 261 92 30 00 0 00 30 00 442 89 0 00 442 89 37 50 0 00 37 50 513 81 0 00 513 81 30 00 0 00 30 00 129 00 0 00 129 00 3 974 37 0 00 3 974 37 123456789 SMITH JOHN 123456789 SMITH
8. Continue Gender C Male C Female Number Care Of Phone Number Email Street mall City r Probation Type Select One E State Zip Code Birth Date mm ddiyyyvy Indicates a Required Field p Actual City and State names are determined by US Postal Zip Code L Add Dependent o f A Cancel Transaction Provider Finder Help Contact Us Log out Tip If you did not complete all required information an error message will appear telling you which field needs to be completed You won t be able to continue to the next screen until completing the required fields o If you have multiple probationary periods i e an exempt employee is eligible for coverage on the first day ofthe month following their date of hire and a non exempt employee is eligible for coverage on the first day of the month following the date they complete three months of continuous employment see note below click the drop down box for Probation Type and select the appropriate type The employee s effective date of coverage will be calculated based on the Hire Date and the Probation Type Note Employees must meet eligibility requirements and satisfy their waiting period referred to as probationary period as defined in your Group Administrator Manual gt Contact Us Sm UNICARE A Healthy Dose of Innovation EmployerAccess Welcome UPI Administrator 83 Provider Finder Help Log out Me
9. Field Subscriber Information JOHN SMITH Relationship Subscriber This member has prior coverage C Yes No If Yes enter the information below Begin Date mmiddiyyyy End Date Prior Carrier Name This member has other coverage C Yes No If Yes enterthe information below Group ID S C e Indicates a Required Field Carrier Name Policy ID Effective Date mmiddiyyyy If Yes enter the information below m m This member has other coverage C Yes No If Yes enterthe information below Group ID e 5g n CN C O JE Indicates a Required Field Begin Date mm ddlyyyy End Date mmiddiyyyy Prior Carrier Name Carrier Name Policy ID Effective Date mm delyyyy Gender Male Birth Date 01 01 1970 This member has Medicare coverage C Yes No If Yes please check the following Part C Yes C No Effective Date E mmiddiyyyy PartB C Yes C No Effective Date El mmiddiyyyy Medicare Identification Number If Yes please check the following PartA C Yes C No Effective Date fl mm ddlyyyy PartB C Yes C No Effective Date mmiddiyyyy Medicare Identification Number 3 Cancel Transaction 13 How to Correct an Incorrect Member ID Social Security Number If you notice an error in the Member ID Social Security number while you are in the Member Information screen you can gt Contact Us
10. questions will automatically activate No in the corresponding check boxes below Clicking Yes to these questions prompts you to complete the necessary information below If you clicked Yes above enter the appropriate begin and end date for each member who had prior coverage If no prior coverage information is provided enter the hire date as the prior coverage begin date and leave the end date blank Note Pre existing data cannot be changed in EmployerAccess after a member has been added Please submit pre existing data verification such as a certificate of creditable coverage to UniCare Small Group for processing Step 6 Submit Changes This is the last step in the enrollment process Click Continue to see the verification screen EmployerAccess Welcome UPI Administrator 8y Provider Finder Help Contact Us aS UNICARE A Healthy Dose of Innovation Log out Membership ue ean Profile Membership Member Information Select Coverage Life Coverage Assign Coverage Other Coverage Other Coverage for Enrollment Emm du dU d JOHN SMITH 123456789 Subscriber Name Member ID Other Coverage Group Name Group Number Does any member being added have other coverage C Yes No Does any member heing added have prior coverage C Yes No Does any member being added have Medicare coverage C Yes No Indicates a Required
11. 1 2006 04 01 2006 Cancel Transaction Provider Finder Help Contact Us Log out D Member Maintenance Access Member Information and Open Enrollment Options To perform maintenance on gt Contact Us a specific employee and or c dependent first search for the EmployerAccess poh employee in EmployerAccess Welcome UPI Administrator Provider Finder Help Log out Membership Pau T Forms Reports Profile Enter the employee s Group Name ABCCO Member ID number Social Ul ag v Group 123456 Security Number Click EN E SER u state of the art benefits management Search spelen Pending Activity Member Subscriber Name Type User ID ID 123456789 JOHN SMITH Add JSMITH1 23 Coverage 123456789 JOHN SMITH Add JSMITH1 23 Coverage 123456789 JOHN SMITH Re JSMITH1 23 Enrollment 123456789 JOHN SMITH Change JSMITH123 Coverage View Change Member Information Member ID Add New Subscriber Billing Entities Billing Entity Number T Amount Due Member ID 123456 8 599 86 Total Amount Due 8 599 86 Provider Finder Help ContactUs Log out gt Contact Us Your search will bring up an Employee Dependent Details page from EmployerAccess UNICARE which you can view specific information Welcome UPI Administrator Provider Finder Hep E Log out about an employee and easily access different benefit options by using the Membership Employee Dependent Details
12. 23456789 JOHN SMITH en JSMITH123 Member ID spec c activity 7 Incomp lt e 123456789 JOHN SMITH Change JSMITH1 23 work is automatically saved in E Pending Activity and always appears Billing Entities Member iD in EmployerAccess Overview peiiini iti Note You can also access Pending Activity from the Reports tab lw sen Any pending activity that was started in a previous version of EmployerAccess will not be shown or available 8 599 86 Provider Finder Help ContactUs Log out e To access benefit information or make changes to a current employee s benefits enter the 4 To add a new employee enter the Member ID Member ID b ileti number typically the Social Security Number in the A cereus ae d i blank box under Add New Subscriber then click blank box under View Change Submit The first page in the new enrollment Member Information thenclick process Member Information will appear Search 4 If the person with the Social Security Number you entered has had prior coverage with UniCare even with a previous employer you will see this screen This screen is meant to verify the Social Security Number entered Simply enter the employee s information in the fields provided and click Search EmployerAccess Welcome UNISG UI 81 Provider Finder Log out OLATA Employer ELIT Membership Name Match Name Match gt Contact Us A UNICARE A Healthy Dose of Innovat
13. ID Card mailed EmployerAccess Cima Uz n gt UNICARF A Heat Meat Joa ct Irnovates vdlcune UPI Aut immiste aor Provider indzr I lel oqo Membesship MESCE T Forms Repos Profde Meiiber ship Employses Dope lien Details 20 suus ID Card ur Malziialz Request ID Card or Materials Eubscrb ri amo JOHN SMITH Gup dave Mziubu IE 123156769 Gup Mus ber Select All Applicahle tems Winch Products T iD card Wesivsl Evide ce of Sove z ge 2e tal Mad 10 Ardrass C Surse ber Grou e gt gt v der Finga E ABC CO 123156 p Je Lus uy Tip For all claims other than Short Term Disability once you have completed your online entries you will be able to print the claims form for signature and completion Life and Disability To initiate a claim or to view a claim s status click the Life and Disability button on the Employee Dependent Details page Initiate a Claim Click the Initiate Life amp Disability Claim link on the Claims Tools page Listed on the next page are several different kinds of claims you can initiate gt Contact Us ICARE Dose of Innovation EmployerAccess Welcome UNISG UI 8l Provider Finder Log out Membership Employee or Dependent Details Claims Tools Claims Tools Initiate a life or disability claim online and download necessary forms Status of Employee claims Check the status of a par
14. NICARE A Healthy Dose of Innovation Welcome John Smith BY Provider Finder Help Log out es Billing Forms Reports Profile Billing Entities Open Invoices Invoice Details Invoice Details EI EZ ETC g Period Invoice July 2005 1234567891011 v Billing Entity Number 123456 Invoice 1234567891011 Billing Entity Name ABC CO Billing Period 07 01 2005 07 31 2005 Date Billed 06 21 2005 Payment Due Date 07 01 2005 Membership Billed 1 Overage Eligibility Details Adjustments Dependents Changes Amount Due Amount Paid Plan Name 776 538 59 766 538 00 10 000 59 Plan Name 778 453 13 769 253 13 9 200 00 Subtotal 1 554 991 72 1 535 791 13 19 200 59 Current Billing Plan Name 776 538 59 10 000 59 Plan Name 778 453 13 9 200 00 Subtotal 1 554 991 72 19 200 59 Total Amount Due 38 401 18 F ents Policy Payments are due and payable in full upon receipt Payments received after the first day of the month for which coverage is in effect are deemed late and penalties may apply Premiums must be paid in full by the end of the grace period in order for coverage to continue Reinstatement is at the absolute and sole discretion of UNICARE Life amp Health Insurance Company and reinstatement fee will apply Please note that the depositing of a check does not constitute acceptance of premium or a guarantee of coverage For UNICARE Life amp Health Insurance Company billing questions call 1 800
15. NM Resume Enzllmznt Pelote 123452789 JOHN SMITH Chae ge JSMITH123 Besume 4 Profile Cuyeraze Delate Use this tab to change your e mail address password and or your secret question mw der Findcr Help Contacts _og cut Pending Activity gt Contact Us This example shows how your pending activity folder might look EmployerAccess idet rtm Welcome UPI Administrator Provider Finder amp Help Log out Clicking Delete on this screen only removes the action from Reports Pending Activity Pending Activity it does not cancel Pending Activity the subscriber s coverage Cancel Coverage can be accessed from the Sra Narbet ost Employee Dependent Details page Pending Activity g View All Results Note Subscriber info cannot be Member ID Member Name Type Time Actions accessed if that subscriber has work 123456789 JOHN SMITH Add Coverage JSMITH123 0517 2005 03 40 29PM Resume Delete N a S 123456789 JOHN SMITH Add Coverage JSMITH123 07 19 2005 11 19 34 AM Resume Delete pending in Pending Activity To 123456789 JOHN SMITH Change Coverage JSMITH123 08 08 2005 09 27 59PM Resume Delete ensure full access to all subscriber 123456789 JOHN SMITH New Enrollment JSMITH123 08 11 2005 02 18 57PM Resume Delete D DAL 123456789 JOHN SMITH New Enrollment JSMITH123 08 11 2005 02 21 44 PM Resume Delete info please keep pending activity up to date and to a minimum 123456789 JOHN SMITH New Enrollment JSMITH123 08 11 2005
16. a third party on their behalf UniCare will need to approve the use of this third party administrator The Internet Eligibility Agreement and the Third Party Agreement will need to be signed by the group and the administrator An HIPAA designated representation form will also be required If the group has multiple subgroups can the administrator process eligibility for all subgroups Yes UniCare s system is designed to use the subgroup number to determine what groups will be viewable to the group What is the turnaround time once a group administrator has processed activity through EmployerAccess Once the group administrator receives the message that the requested action was successfully completed the information is in the UniCare system immediately Are groups required to submit membership forms i e enrollment change etc once activities are processed through EmployerAccess No The group is responsible for maintaining the eligibility documentation This is noted in the Internet Eligibility Agreement under Section IV Part A Establishment and Retention of Membership Information Should I select Schedule Payments as an option if my group has a lot of monthly eligibility maintenance No Pay Online Now is probably a more reliable option to avoid risking the scheduled payment not being enough to cover your monthly premium Does UniCare have a minimum browser requirement Yes Inter
17. e information claim in formation and accuracy Error messages signal missing or incomplete information and elec tronic prompts guide you from one step to the next This manual offers step by step instruction on how to use EmployerAccess effectively If you have specific questions refer to the Table of Contents or the Frequently Asked Questions page in the back of the manual Getting Started Visit wae www unicare com BE ms RB and click the WELCOME TO Tour the Employer Employers tab Access System poy 3 A UNICARE A comprehensive demonstration of the te D Agents Brokers many features inside the Look for the Login To enter site click here EL eee box Select Small Providers Group from the Employers Emer drop down menu no click Login REN M m For Groups of 2 50 signup Access your personalized n E 3 now and enjoy secure employer services gt Discounts amp Savings Need to find a access to Employer gt Healthy Living Doctor or Hospital E U ID Information G ot Check the Online o9 nter your User ee Provider Directory and Password then Login Wy noe click Login y Now you re rea dy Learn More Dioyers Spotlight Find an Agent Updated company news public and media resources to begin using HIPAA for Employers UniCare offers BasicChoice benefit plans for large groups Frequently Asked Questions EmployerAccess Glossary Pharmacy Tip You can navigate Emplo
18. ion Forms Reports Profile Enter verification information for this ID No FirstName LastName Birth Date mmidd yyyy sear face Provider Finder ContactUs Log out New Enrollment Tip Steps are numbered to tell you where you are in the enrollment process All steps must be completed before an employee is enrolled If at any time you click Save and Exit your work will be saved in Pending Activity Please note that the new enrollment is not complete until you have clicked Confirm on the Enrollment Verification Screen Step 1 Member Information gt Contact Us This is the beginning page to start the EmployerAccess Titani enrollment process A Healthy Dose of Innovation Welcome UPI Administrator S3 Provider Finder Help Log out Membership 2171572 a LT Forms Reports Profile To enroll an employee Membership Member Information Member Information for Enrollment Enter the requested information into each blank box or field Fields with m oe red arrows gt gt beside them indicate JEEP pom Coverage m coveraue required information Member ID 123456789 Group Name mber Group Number e If the employee has dependents to enroll click Add Dependent Subscriber formation Last Name Signature Date First Name mmiddiyyyy Hire Date o If there are no dependents to enroll Middle Initial an ocial Securit click
19. k this box to enroll subscriber and all dependents with the same medical Primary Care Physician Check this box to indicate that all members are existing patients of the medical Primary Care Physician Check this box to indicate that the individual family member is an existing patient of the selected Primary Care Physician f your plan allows enter your Women s Principal Health Care Provider in this field gt Contact Us S UNICARE A Healthy Dose of Innovation EmployerAccess Welcome UPI Administrator Provider Finder Help Log out Membership 21 15 eg rn Forms Reports Profile Membership Member Information Select Coverage Life Coverage Assign Coverage Assign Coverage for Enrollment Step 5 I Other Coverage Subscriber Name JOHN SMITH Member ID 123456789 Group Name Group Number Enroll all members in coverage selected Same Medical PMG IPA for all members Provider Finder PMGIIPA Existing Patient Name Relationship Gender Birth Date JOHN SMITH Subscriber MALE 12 13 1966 12 01 2006 PMGIPA Existing Patient JANE SMITH Spouse FEMALE 01 01 2005 12 01 2008 PMG PA Existing Patient c Prevous OBIGYN ID Provider Finder Help Contact Us Log out Step 5 Other Coverage This is the final screen in the new enrollment process Indicate Yes or No by clicking the corresponding circle Clicking No to these
20. l subscriber and all dependents in selected coverage Check the box to enroll subscriber and all dependents with the same medical Primary Care Physician Indicates that all members are existing patients of the medical Primary Care Physician Q Check the box to enroll individual dependents in each coverage type You will need to enter a provider number in the PMG IPA box provided If the individual is an existing patient of the provider check the Existing Patient box Comment Us UNICARE A Mealy Jox ct Irnovoten EmployerAccess dour UPE Aui imita stor Provider indzr BS lel oq o 1 Membership 62 721 E LIS Forms Reporls Profde Membership f Member formation Select Cover auc Lite Coveraua ssizn Coveraze Assign Coverage for Enrollment en Other m fubs bzrh ame JOHN SMITH Mambe It 124456 09 Grup Mave inp Mae her roll all memzets ncoceiags se eced ime weist MCI Atar sl 7 emira d 31 V cl A Provid r Fi der I E is ing Fatisnt I eain mp Orn Ar Lath l rva7 er Caner is Cole Verts 19 rH H CA 16 Hs A 1 Existing Fabent WN o AA HS PWA y Exissing F atiznt aimi ubsnbzr VALI ARE EET t pane 11 MAJ SE Ex PrudzwrF nde Hulp Cunlsci s Lagui Step 4 Assign Coverage cont This screen appears if you are enrolling in an HMO plan Check this box to enroll subscriber and all dependents in selected coverage Chec
21. mbership 2171572 a rey Forms Reports Profile Membership Member Information Member Information for Enrollment Step 3 optional Step 4 tep 5 Life Assign Other Coverage Coverage Coverage Coverage Member ID ch mber 123456789 ABC CO 123456 Group Name Group Number Subscriber Information Last Name Signature Date mmiddiyyyy Hire Date mm ddlyyyy First Name Middle Initial Social Security C Male C Female Number ERE Phone Number Email Street Hist City LI Probation Type State g Zip Code 7 Indicates a Required Field P Actual City and State names are determined by US Postal Zip Code Add Dependent Gender Care Of Select One z Birth Date mm ddiyyyy EY I Provider Finder Help Contact Us Log out Step 1 Members Dependents z Contac Ue This step is applicable only if you want EmployerAccess a N to add dependents or add coverage for existing enitn dependents to the employee s benefits This option is only available for new enrollees Welcome UPI Administrator Provider Finder amp Help Log out Membership 2 71 72 E LT Forms Reports Profile Membership Member Information Member Information for Enrollment Complete the employee s Select ure P other Coverage Coverage Coverage Coverage information and click Add Dependent if the employee has M ad Su more dependents to enroll Fields requesting dependent info
22. n Select Coverage Select Coverage for Enrollment Step 3 optional e Life Coverage Subscriber Name Member ID Step 4 Assign Coverage Step 5 Other Coverage JOHN SMITH 123456789 Group Name Group Number ABC CO 123456 Effective Date 11 01 2006 Signature Date 11 01 2006 Medical Coverage Select One x Dental Coverage Select One x Short Term Disability Select One z Basic Life Coverage Indicates a Required Field Provider Finder Help gt Contact Us Step 3 Life Coverage Optional The Life Coverage screen only applies T EmployerAccess UNICARE to employees covered under one or E T ads Wey Dont reat more life coverages If not applicable leave blank and click Continue members S00 i Geen Goes Membership Member Information Select Coverage Life Coverage Life Coverage Assign Other Coverage Coverage Subscriber Name TEST TEST Group Name TEST GROUP A3 Member ID 123456789 Group Number 123456 Selected Coverage Subscriber Benefit Value NM65 IL SMALL GROUP LIFE PRODUCT 150 000 lt Any benefit amount over 15 000 will require evidence of insurability c provos Save ana Eit Provider Finder ContactUs Log out Step 4 Assign Coverage You have two options when enrolling an employee s dependents You can choose to enroll all members in all coverage types or you can enroll each dependent separately Check the box to enrol
23. net Explorer 6 0 or higher Does UniCare use passwords Yes A user ID and PIN are assigned for each of our customers as they register to use the website What is your encryption process UniCare uses 128 bit encryption starting at the login page This means that no usernames or passwords pass across the Internet in clear text Do you use Secure Socket Layer SSL Yes 128 bit SSL certificates are installed on the server supporting the website ensuring an encrypted channel is established between a customer s browser and our website The vendor we use is Verisign Note Ifthe member s health plan is insured or health maintenance organization coverage the coverage is provided by one of the following companies UniCare Life amp Health Insurance Company UniCare Health Insurance Company of the Midwest IN and IL only UniCare Health Plans of the Midwest Inc HMO in IN and IL only UniCare Health Insurance Company of Texas TX only or UniCare Health Plans of Texas Inc HMO in TX only amp Registered Mark of WellPoint Inc
24. nt Information 5MTH JOE Male Female Last Name First Name Middle Initial Gender V Include Dependent m Totally Disabled Last Name Male Female First Name Middle Initial Gender Totally Disabled ndicates a Required Field Add Another Dependent Provider Finder Help Birth Date 10 02 970 10 02 1970 Birth Date mmiddiyyyy 12 20 1988 Child E Full Time Student Relationship Social Security Number Birth Date mmidd yyyy Relationship Select One m FullTime Student Social Security Number Cancel Transaction Save and Exit Contact Us Log out 18 Add Coverage Simply click the Add Dependent button on the Employee Dependent Details page to add or re enroll dependents to an enrolled employee s subscriber s coverage Newborns and new spouses are eligible for coverage on the event date i e birth date or date of marriage To add coverage Q Confirm the effective date Select the new coverage from the drop down menu o Click Continue gt Contact Us Sa EmployerAccess UNICARE A Healthy Dose o Innovation Welcome UPI Administrator Provider Finder Help Log out Membership ZOCR Forms Reports Profile Membership Member Information Select Coverage Select Coverage for Enrollment Subscriber Name JOHN SMITH Group Name ABC CO Member ID 123456789 Grou
25. o pay in the Payment Amount Selected box 2 Choose to pay using a single account or multiple accounts D Click Continue Note You are still required to pay all invoices in a timely manner in accordance with the terms of your group contract gt Contact Us UNICARE A Healthy Dose of Innovation EmployerAccess Welcome John Smith Provider Finder 8 Help Log out Du uns Billing Forms Reports Profile Billing Entities Open Invoices Select Payment Amount Select Payment Amount Group Number 123456 Group Name ABC CO Billing Entity Current Period Current Invoice Amount 3 232 54 Billed Amount 3 232 54 Amount Due 3 232 54 Billed Amount 3 232 54 Amount Due Eee 3 4 233 04 Payment Amount Selected ee Pay using a Single Account Pay using Multiple Accounts 123456 June 2006 1234567891 May 2006 1234567891 Provider Finder Help ContactUs Log out Frequently Asked Questions Can there be more than one administrator at a group who can process eligibility on Employer Access Yes One administrator may register online per group If additional administrators are required they must be added manually by the group s UniCare representative Each administrator will create their own user ID and PIN with their representative Can a group s third party administrator process the eligibility e Yes We require a written request from the group if they use the services of
26. oss of Sight Dismemberment Group Number 123456 Group Name Once you have completed your s FirstName FIRST online entries you will be able to pee ER print the claims form for signature Memberip 123456789 and completion Indicates a Required Field What type of claim is this Life Claims Disability Claims C Life or Dependent Life C Short Term Disability Accelerated Death C Long Term Disabilty Life Waiver of Premium C Loss of Sight Dismemberment Provider Finder ContactUs Log out Group Function o Employer Details Aaii Review preferences and ber group EmployerAccess Um ARE information here D o Provizor Finzo Help E Log out o NEN o Billing i This tab allows you to view EmployerAccess ong TU ick summary information Overview sss A uu N mbor for all open invoices In MENS ene 1 addition this functionality provides details on monthly gems activity invoice number Bil ing Enty Number Tamzunt DLA and total amount due 1733155 St 599 H5 View Change Reports LLL You can use this tab to MurnzurlD view Employee Rosters Pending Activity m warhar Subscriber kame Tv a iE aiins generate Activity Reports 123455789 JOHN SMITH amp d JSWITH123 Resume and help employees find g i Coverare Delete Mem erld physicians using our 123455789 JOHN SMITH amp zd J8MITH123 Resume Cnvrrate Delete online Provider Directory AAMAR HEINE EMIL Ise J
27. out Details page to access the membership CEE m er ea lta option to change employee Membership Employee Dependent Details Edit Personal Information subscriber and dependent Egit Personal Information personal information such Subscriber Name JOE SMITH Group Name TEST GROUP A3 as address phone number Member ID 123456789 Group Number 123456789 etc Note Be sure to verify your Last Name f Birth Date mm dd yyyy i First Name x Hire Date 2 changes before submitting the Middle Initial Social Security Number new information Gender Cus ree Home Phone Number Care Of Street 123 ABC St City oP IT State F Zip Code 90510 Ind equired F p Actual City and State names are determined by US Postal Zip Code eld Last Name j Relationship pw First Name Social SecurityNumber Middle Initial Totally Disabled ves C No Gender Mae Female Full Time Student C yes No Birth Date IRS Dependent Child yes Chro Indicates a Required Field Fr Actual City and State names are determined by US Postal Zip Code Save and Exit Cancel Transaction Provider Finder ContactUs Log out Request ID Card Simply click the Request ID Cards button on the Employee Dependent Details page to access this screen and order ID cards for a member Check the ID Card box e Indicate for which products an ID Card is needed Choose the address to which you would like the
28. p Number 123456 Effective Date 04 01 2006 e Signature Date 03 07 2006 Medical Coverage Dental Coverage Select One X Select One x Life and Disability v Save and Exit Cancel Transaction o9 Provider Finder Help ContactUs Log out Change Coverage is not available online for UniCare Small Group Please mail or fax the Group Change Form to the UniCare membership department EmployerAccess gt Contact Us Ea UNICARE A Healthy Dose of Innovation Welcome UPI Admin Provider Finder Log out Plum Membership Miura T Forms Reports Profile Membership Employee or Dependent Details Change Coverage Change Coverage Open Enrollment Mode Subscriber Name JOHN SMITH Member ID 123456789 Cancel Transaction Group Name ABC CO Group Number 123456 Provider Finder Contact Us Log out Cancel Coverage On the Employee Dependent Details page find the Cancel Coverage button and click it The Cancel Coverage page appears gt Contact Us Key in the cancellation effective date here EmployerAccess UNICARE Welcome UPI Administrator Provider Finder Help Log out Click the drop down menu under Cancellation Reason Membership Employee Dependent Details Cancel Coverage and choose a reason Cancel Coverage Be sure to click the box Subscriber Name JOHN SMITH Group Name ABC CO next to the affected employee Member ID 123456789 Group Number
29. re group administrator manual or call Barano UniCare customer service at the number listed on your UniCare premium invoice Name Gender Relationship Birth Date JOHN SMITH Active Male Subscriber 05 19 1949 12 01 2005 Prior Enrollment Information Plan Type Short Term Disability IL SG UNICARE HSA COMP A MAT V28100 Add Dependent s cont Here you can re enroll a dependent who has previously been cancelled and has no active coverage The required fields will be pre populated Here you can adda new dependent Click the check box next to Include Dependent Uncheck Include Dependent box es on any blank dependent information 4 Click the Continue button Note This option is only available during open enrollment gt Include Dependent EmployerAccess Welcome UPI Administrator m Provider Finder o Help Membership KZD ICAR I Membership Employee Dependent Details Add Dependents Add Dependents Step 2 Add Dependents Assign Coverage gt Contact Us S UNICARE A Healthy Dose of Innovation Log out Profile Other Coverage JANE SMITH 123456789 Subscriber Name Member ID Group Name Select One x Event Reason Indicates a Required Field Current Members Group Number ABC CO 123456 Event Date mmiddiyyyy 5 8 Name Relationship Gender JANE SMITH Subscriber JOHN SMITH Spouse Inactive Depende
30. red for accuracy If correct click Submit o If not click Previous and make changes Once the information is verified and submitted a feedback page will confirm whether the employee has been successfully enrolled If the data was not successfully transmitted to UniCare you will receive an error message gt Contact Us Sa UNICARE A Healthy Dose of Innovation EmployerAccess Welcome UPI Administrator S3 Provider Finder Help Log out Membership ZDI O 2 9 er Forms Reports Profile Membership Member Information Select Coverage Life Coverage Assign Coverage Other Coverage Enrollment Verification Enrollment Verification Subscriber Name Member ID Hare JOHN SMITH JANE SMITH JESSE SMITH JOHN SMITH 123456789 Relationship Subscriber Spouse UNICARE GOLDPREMIUM 25 PD89 Name JOHN SMITH JANE SMITH JESSE SMITH Basic Supplemental Relationsh ip Subscriber Spouse Child TX SMALL GROUP LIFE PRODUCT NMB7 TX SMALL GRP SUPP LIFE PRODUCT PD78 Group Name Group Number s correct please click Submit to complete the tton to make changes before ansaction If th ompleting the transaction Gender Birth Date 01 01 1970 04 01 2006 02 02 1971 04 01 2006 03 03 2000 04 01 2006 Gender Effective Date Male 01 01 1970 04 01 2006 Female 02 0211 971 04 01 2006 Male 03 03 2000 04 01 2006 Life Coverage E 04 0
31. rmation Last Name gt Signature Date appear below the employee a MP Hire Dat information MWIBSIETHEST p DANAA Social Security Gender C Male C Female Number Phone Number e Complete the information and click mim 5 Street Add Another Dependent for each dE EN BrobalionType elect Ona dependent to enroll Otherwise n EN click Continue Zoe 3 Birth Date qmm mm ddiyyyy Indicates a Required Field p Actual City and State names are determined by US Postal Zip Code ma O o Provider Finder Help Contact Us Log out Step 2 Select Coverage Use this screen to select the applicable products for your group For example medical life and or dental coverage for employees subscribers and if applicable dependents o To complete this step simply click the drop down arrow and select the appropriate medical or dental coverage Q If your group offers Life amp Disability products please indicate here e When finished click Continue Step 5 Life Coverage Optional The Life Coverage screen not shown only applies to employees covered under one or more life coverages If not applicable leave blank and click Continue Contact Us UNICARE A Healthy Dose of Innovation EmployerAccess Welcome UPI Administrator Provider Finder 8 Help Log out Membership gullies LR Forms Reports Profile Membership Member Informatio
32. ticular employee s claim s Status of Group claims View the status of all claims for your group Disability Claims Statistics Report View statistical information about disability benefits your gruop may have purchased Initiate Claim gt Contact Us You can initiate a life and or disability EmployerAccess tice claim for your employees here Fill in Welcome UNISG UI Provider Finder Log out dic dd the required information and select a claim at the bottom Membership Wau und Forms Reports Profile Membership Life amp Disability Claims Tools Initiate Claim Life Claims Initiate Claim e Life or Dependent Life As the Group Administrator you can initiate Life and or Disability Claims for your employees here For all claims other than Short Term Disability once you have completed your on line entries you will be able to print the claims formfor signature and Accelerated Death Accidental Death i You will need to print the claims form for signature and completion e Life W alver of Premium It will still be necessary for you or the member to submit a completed and signedpaper form and all documentation for the claim to be paid For Short Term Disability claims your entries will be submitted to our claims department for processing and follow up o Disability Claims Now we ll walk you through the claim by asking you a series of questions e Short Term Disability e Long Term Disability L
33. voice number to view details Addresses Group Number 123456 Group Name ABC CO 123456 ABC Company of the invoice Using the links on the left side of the screen you can pay your bills online schedule payments view past invoices and more Q You can also access some of the above June 2006 May 2006 Total Amount Due 150 022 33 functions using the buttons on the screen EmployerAccess Welcome UPI ADMIN 8 Provider Finder Log out Membership Employer Activities gt Pay Online Now gt Schedule Payments gt View Scheduled Payments Past Activities gt View Past Invoices gt View Past Payments Preferences gt Manage Employer s Bank Account s gt Manage Billing Email Addresses Billing Entities Open Invoices Open Invoices Billing Entity Number 123456 Billing Entity Name EMPLOYER ACCESS MARIBEL Invoice June 2006 0001234564 2 May 2006 000123456B Total Amount Due oeoa 000123456A 38 401 18 000123456B 23 523 13 Help Contact Us Log out UNICARE A Healthy Dose of Innovation Forms Reports Profile Pay Online Now 38 401 18 23 523 13 150 022 33 29 Invoice Details After selecting an invoice number to review a number of options are available This screen displays your current invoices and the total amount due All the information on this page appears on your statement gt Contact Us Sm EmployerAccess U
34. yerAccess using tabs or breadcrumbs What are bread crumbs Hansel and Gretel used the real thing to mark their trail EmployerAccess marks your trail using an electronic version Below the tabs are titles of pages you ve visited which appear as links These are called breadcrumbs and they show you where you ve been If you want to get back to any one of them just click the link The Membership main page is called EmployerAccess Overview Think of it as home base Here you can start the enrollment process for new employees subscribers access pending activity perform a search for a current subscriber or navigate easily using the tabs at the top Tabs to Employer Details gt Contact Us Billing Forms Reports and Profile are embedded at the top EmployerAccess PACARE Welcome UPI Administrator SV Provider Finder Help Log out Membership 2275752872 Forms Reports Profile gm They give you quick access to any of these screens Group Name ABCCO EmployerAccess f j US ON Overview Xi GA 2 Number o EmployerAccess Overview Welcome to EmployerAccess our i4 o stale eae Daneta menyene displays all your pending activity ens To access your pending activity click View All on the right Resume or x b Subscriber Name Type uer bod Tod iran delete pen li g activity using the 123456789 JOHN SMITH Dee JSMITH123 e hyperli l to the right of the 123456789 JOHN SMITH eee JSMITH123 ifi Pen All l t 1
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