Common Questions

Common Questions

1. Who do I call when I have questions regarding my benefits?
Administrative Employer Driven Solutions, and each TPA has it's own dedicated Customer Service Department who is trained to handle your questions.  Simply dial:

(888) 886-7973 for BEN-E-LECT
(877) 646-9315 for E.D.I.S.

2. What happens when I go to the doctor?
If you have a standard HRA plan, your doctor will copy both your insurance carrier card and your TPA card and will charge you a copay. If your doctor has questions regarding the plan, please have them contact our Customer Service Department.

Our EDHP Excess Loss Plan only has one ID card that you will show your doctor, then pay your copay.

3. What happens when I go to the pharmacy?
You will simply pay your copay as listed on your TPA ID card. If the pharmacist has any questions they can contact our Customer Service Department.

4. What happens when I get a doctors bill?
Some doctors bill very quickly after your visit. If you receive your doctors billing statement within 30 days after your visit, please disregard it as it may not be a bill. You will receive your carrier Explanation of Benefits soon after. This is what your physician will be paid from.

5. Who do I call to check status on my claim?

Customer Service Department.

(888) 886-7973 for BEN-E-LECT
(877) 646-9315 for E.D.I.S.

You can also check status on your web portal by visiting yourbenportal.com

6. Why did my Employer select this plan?
Your employer has seen the cost of your group medical plan increase by double digits for the past 20 years. Instead of lowering your benefits and increasing your contributions, your employer has decided on this plan. It gives your employer the premium stability it needs from the High Deductible Plan, and the benefits you want from the TPA Plan.

7. Who pays my claims and how do I know they have been paid?
Each TPA has a specially trained claims staff in house with Administrative Employer Driven Solutions to process all your medical, dental and vision claims. Once your claim has been processed, you will receive an Explanation of Benefits from the Claims Department.  The Explanation of Benefits are Episodic EOBs, which means you will get one EOB outlining services over a period of 10 days.  The alternative would be receiving multiple EOB's day after day.  This is particularly helpful when you have a major episode, are hospitalized, etc.

8. What is the phone number for Customer Service?
(888) 886-7973 for BEN-E-LECT
(877) 646-9315 for E.D.I.S.