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Frequently Asked Questions

Frequently Asked Questions

  1. How do I order a new medical card?
  2. I have an appointment with LabCorp and they are asking for my credit card information. Is this correct?
  3. Can I remove my spouse from my medical coverage outside of the annual Open Enrollment?
  4. My dependent (spouse or child) lost alternative coverage. How do I add them to my School District of Philadelphia coverage?
  5. I'm insulin dependent. How do I go about getting my prescriptions and supplies?
  6. How do I submit for Vision reimbursement?
  7. What is my Vision benefit?
  8. How do I update my Primary Care Provider ?
  9. What is the difference between Keystone HMO, Personal Choice 20/30/70%, and Modified Personal Choice 320?
  10. I have Keystone HMO, how do I change to Personal Choice?
  11. Can I get a Shingles shot?
  12. How do I get an injectable drug filled?
  13. How do I change the beneficiary of my SDP Life insurance?
  14. How can I add my grandchild to my coverage?
  15. How long may my children remain on my Medical coverage?
  16. How do I cancel my wage continuation?
  17. How do I apply for PSERS Premium Assistance?
  18. Am I eligible to continue my coverage until age 65?
  19. How do I change my Name?
  20. How do I change my address?
  21. How do I add my Spouse to my coverage?
  22. How do I add my newborn to my coverage?
  23. Where do I make my COBRA payment?
  1. How do I order a new medical card?

    To order a new medical card, please call 1-800-ASK-BLUE or register an account at https://www.ibx.com/login.

  2. I have an appointment with LabCorp and they are asking for my credit card information. Is this correct?

    LabCorp reserves the right as a provider to request credit card information before your scheduled services. If you are enrolled in a Personal Choice plan, you can use an in-network laboratory services provider of your choosing. Please contact 1-800-ASK-BLUE to find another provider.

    If you are a Keystone member, you must use the laboratory services your primary care physician refers you to.

    Please see here and here for Labcorps credit card policies. 

  3. Can I remove my spouse from my medical coverage outside of the annual Open Enrollment?

    The removal of dependent spouse outside of the annual Open Enrollment in May can be done for the following reasons:

    • Enrolled in alternative coverage
    • Eligible for Medicare
    • Legal Separation (not recognized by all states, including Pennsylvania)
    • Divorce
    • Death of a spouse 

    Within 30 days of the date of your notice of any of the above qualifying events, complete and submit:

    1.  An Enrollment Application

    • Complete Sections 1 and 2 (leave 3 and 4 blank)
    • Sign and date Section 5      

    2. Proof of the qualifying event (i.e. divorce decree, Medicare eligibility letter, etc.)


    If all required documents are submitted within 30 days, coverage for the dependent spouse will terminate the first day of the following month. For example, if a divorce is effective December 12, termination of coverage will be effective January 1.

  4. My dependent (spouse or child) lost alternative coverage. How do I add them to my School District of Philadelphia coverage?

    Within 30 days of an eligible dependent’s loss of coverage, you will need to complete and submit:

    • Medical Insurance Application
    • Proof of loss of coverage
    • Depependent eligibility documentation (e.g. Marriage License or Birth Certificate)

    See below for instructions.

    Medical Coverage:

    Medical Insurance Application

    • Complete section 1 
    • Complete section 2, checking off "Qualifying Life Event" under Application Type, and "Add spouse/dependents" under Request Type.
    • Complete section 3 selecting the coverage in which you are currently enrolled.
    • Complete section 4 listing just the dependent(s) you are adding. 
    • Sign and Date section 5

    Please fax, email, bring in (please see Office Hours before visiting Employee Benefits), or mail all the required documents listed above.  Please call (215) 400-4630 to confirm receipt.

     

    Prescription, Vision and Dental Coverage:

    Employees who are Non Represented, CASA, and SPAP - your dependent will be added to these coverages provided you have completed the paperwork for medical coverage above.

    If your position is represented by PFT, Local 634 or District 1201 - please contact your Union's Health & Welfare Office to add your dependent to your Prescription, Vision, and Dental coverage.

  5. I'm insulin dependent. How do I go about getting my prescriptions and supplies?

    Typically insulin is dispensed at your pharmacy.  Other supplies may be covered by your medical insurance.  Please visit our Diabetic Supplies page.

  6. How do I submit for Vision reimbursement?

    Eligible participants (see What is my Vision benefit? above) should complete and mail Direct Reimbursement Claim Form with receipts attached to:

    Vision Care Processing Unit

    P. O. Box 1525

    Latham, NY 12110

    To obtain a claim form, please visit www.ibx.com and click on 'Forms'. The IBC Vision Direct Reimbursement Claim Form is located on this Forms page under the Claims section.

  7. What is my Vision benefit?

    All Keystone members, with a referral from their PCP, may visit the eye doctor.  Specialist co-pay applies. 

    Personal Choice members with a combined Medical and Prescription ID card (CASA, SPAP and non rep employees) are eligible for an Eye exam, including refraction and glaucoma screening, and dilation, as professionally indicated with no copay at participating providers.  No referral needed.

    Those eligible for the vision exam as noted above, also have a Biennial Benefit (every other year) for Eyeglasses reimbursement.  Using a Davis Vision Network will maximize the eyeglasses benefit.  A reimbursement of up to $100 is available for contact lenses and glasses from a non-network provider. 

    You can check your eligibly for this reimbursement from the IBXpress.com portal by clicking the “manage your  vision benefits” link or by contacting Davis Vision at the number on the reverse of your insurance ID Card.

    Personal Choice members with a union Express Scripts card, should contact their Health and Welfare fund for exam and glasses reimbursement information. 

  8. How do I update my Primary Care Provider ?

    You can update your Primary Care Provider (PCP)  by contacting Independence Blue Cross at 1-800-ASK- BLUE  (1-800-275-2583) or online by logging into your IBC account at www.ibxpress.com

     

  9. What is the difference between Keystone HMO, Personal Choice 20/30/70%, and Modified Personal Choice 320?
    Our Keystone HMO and Personal Choice plans cover basically the same services, with the exception of infertility which is only covered through Personal Choice.   The difference in the plans is how and where you access services and your co pays and co-insurance. Below are the general differences between our Keystone and Personal Choice plans:

    For In-network providers, Keystone offers Co-pays of $15 for primary care providers and $25 for specialists, Personal Choice co-pays are $20 for primary care providers and $30 for specialists.  

    Keystone HMO requires a referral from your primary care physician for all specialty care. For Keystone, you must use network providers and some services are capitated, meaning you must use specific therapy centers, labs or other facilities, etc. There is no out of network benefit for Keystone.  You are responsible for any out-of network charges and non emergency services provided without a referral.

    Personal Choice 20/30/70% services provided by an out-of-network provider or facility are covered at 70% of the reasonable and customary amount after a $500 individual or $1,000 family deductible is met.  Your co-insurance is 30%.  If the providers' charges are greater than the reasonable and customary amount, they may balance bill you for any remaining amounts.

    Modified Personal Choice services provided by an out-of-network provider or facility are covered at 70% of the reasonable and customary amount after a $750 individual or $2,250 family deductible is met.  Your co-insurance is 30%.  If the providers' charges are greater than the reasonable and customary amount, they may balance bill you for any remaining amounts. This plan is only offered to Non-represented and CASA union employees.

  10. I have Keystone HMO, how do I change to Personal Choice?

    Eligible PFT, CASA, SPAP and Non Represented employees who have completed 4 years of service as specified in the applicable collective bargaining agreement, may complete and submit an enrollment form to the Employee Benefits office.  Employee’ signature is required.  Applications received by the 15th of the month will be processed for the first of next month.  Later applications will be processed for the first of the following month.  Applicable premium contributions will be deducted from bi-weekly pay. 

     

  11. Can I get a Shingles shot?

    The shingles shot is covered for subscribers 60 and above.  Member can have shingles done at doctor’s office and billed to insurance. If doctor does not stock vaccine, it should be requested thru direct ship for member.

  12. How do I get an injectable drug filled?
    Employees with a combined Medical and RX card from Independence Blue Cross, can visit their pharmacy or use FutureScripts mail order service.  Member Services can be reached at (888) 678-7012 for assistance. 

    Employees with Optum Rx who need injectable prescription OTHER than insulin, need to have the prescription filled by IBC Direct Ship. 

    Employees can give their provider the “generic direct ship form” or have the PROVIDERS contact direct ship at 267-402-1711 or 888-678-7012.  The provider faxes the completed form to 215-761-9165. Direct ship reviews and approves or denies request – the doctor is faxed back the decision.

    Employees may contact Direct Ship at 1-800-275-2583 or call Employee Benefits 215-400-4630 if further assistance is needed.

  13. How do I change the beneficiary of my SDP Life insurance?
    To update the beneficiary of your
    SDP Basic $2,000, $25,000 or $45,000 or retiree $2,000 policy, you must
    complete and return the “Designation of Beneficiary” form on the forms section
    of the benefits website.  Submission of
    this form will replace your current beneficiaries.  If no beneficiary has been designated for a
    policy, proceeds will be disbursed to your estate.  You must contact PSERS directly to update
    beneficiary information for your pension.

  14. How can I add my grandchild to my coverage?
    You can add a grandchild to your medical coverage only if you have legal custody.  You must provide custody papers within 30 days of the court order and complete an enrollment application. Otherwise your grandchild can only be added during our annual open enrollment in May, which is effective July 1.

    However, if a dependent currently enrolled on your coverage, gives birth, that grandchild is covered as specified by PA ACT81 , which states:

    “The newborn child(ren) of you or your Dependent shall be entitled to the benefits provided by the Plan from the date of birth. To add a newborn to your coverage, you must notify the group within 30 days of the birth”  

  15. How long may my children remain on my Medical coverage?

    Once enrolled, your eligible children remain on your district paid benefits until the end of the month they turn 26.  They can be removed from your coverage during our annual open enrollment in May, effective July 1, or during the year if they experience a qualifying event, new coverage from another source, they get married, etc.  

    Foster children and children added by court custody documents are covered until age 18 or additional eligibility is provided. 

    You will receive enrollment materials for self-pay benefits from our Third Party Administrator, AmeriHealth, for continuation of coverage when dependent’s coverage expires. 

  16. How do I cancel my wage continuation?

    PFT, SPAP and 1201 members are permitted to cancel participation in the Wage Continuation program at any time. To cancel coverage, complete the form “Wage Continuation Cancellation Form” on the forms section of the benefits website.   The form can be mailed or faxed 215-400-4631 to the Employee Benefits office. 

    Payments prior to this request are non-refundable except for the first 2 charges for new employees. Based on the receipt date of the form, there may be up to two additional deductions before the Wage Continuation is cancelled. 

    CASA, Non-represented and 634 employees are only permitted to cancel participation during the annual Open Enrollment held in May for a July 1 effective date. 


  17. How do I apply for PSERS Premium Assistance?

    Retirees enrolling in the District sponsored Keystone or Personal Choice retiree coverage and also meeting PSERS Premium Assistance eligibility guidelines should obtain a Premium Assistance Election Form.  These are typically generated once you have completed your retirement with PSERS.  You can obtain copies by calling 1-866-483-5509.   The retiree should sign and date Section D and submit the original two-sided form to the Employee Benefits Office.  The Plan and Employer Information sections (Parts B and C) will be completed when proof of payment is received from AmeriHealth Administrators, the company that handles enrollment and payments for retiree/COBRA coverage.  The Employee Benefits Office will then forward the completed original to PSERS and a copy will be sent to the retiree. 

     

  18. Am I eligible to continue my coverage until age 65?

    Retirees and their spouses who meet at least one of these conditions are eligible to continue their self-paid coverage’s through the SDP until they are eligible for Medicare, typically age 65.

    • took superannuation retirement on or after age 62,
    • retired with 30 or more years of service, OR
    • were receiving PSERS disability benefits.

    Years of service are based on their PSERS service credit. If you believe you are eligible and this is not reflected in your continuation account, Contact the benefits department to review your status.

  19. How do I change my Name?

    Complete the Employee Change of Name/ Birthdate form available on the Retirement department website and provide the request documentation (marriage certificate, photocopy of Driver’s License or Birth Certificate, etc.)

    http://webgui.phila.k12.pa.us/offices/r/retirement/forms

  20. How do I change my address?

    Address changes must be submitted to the Payroll office via an "Employee Change of Residential Address", which is available on their website.

    The form must be accompanied by a copy of the employee's School District photo ID, or other governmentally issued photo ID. It may be mailed or fax directly to the Payroll Department at (215) 400-4491.

    This form will change your address for the School District System, Medical Insurance (if applicable), and the PSERS penion plan.

    You must also ensure that you inform your Union of the changes.

     

  21. How do I add my Spouse to my coverage?
    How do I add my Spouse to my coverage?

     

    Within 30 days of the marriage complete the enrollment application and return to our office with a copy of the marriage certificate.

    This application is used for all Medical plans.

    • Fax application and a copy of marriage certificate (and Birth Certificates, if applicable) to the Benefits Office at (215) 400-4631 or emailed to benefits@philasd.org.  Call (215) 400-4630 to confirm receipt of the application and marriage certificate.



    Prescription, Vision and Dental Coverage:

    • Employees who are Non Represented, CASA, and SPAP - your spouse will be added to these coverage provided you have completed the paperwork for medical coverage above.
    • If your position is represented by PFT, Local 634 or District 1201 - please contact your Union's Health & Welfare Office to add your spouse to these coverages.
  22. How do I add my newborn to my coverage?

    How do I add my newborn to my coverage?


    Within 30 days of the birth complete the enrollment application and return to our office with a copy of the hospital birth record.

    • This application is for all SDP provided insurance plans
    • Complete all sections in entirety.
    • Fax application and a copy of hospital birth record to the Benefits Office at (215) 400-4631 or email to benefits@philasd.org.  Call (215) 400-4630 to confirm receipt of the application and hospital records.
    Within 60 days from date of birth - Fax a copy of the child's birth certificate and Social Security Number Office at (215) 400-4631 or email to benefits@philasd.org. Call (215) 400-4630 to confirm receipt of the application and hospital records.


    Prescription, Vision and Dental Coverage:
    • Employees who are Non Represented, CASA, and SPAP - your newborn will be added to these coverage provided you have completed the paperwork for medical coverage above.
    • If your position is represented by PFT, Local 634 or District 1201 - please contact your Union's Health & Welfare Office to add your newborn to these coverages.
  23. Where do I make my COBRA payment?

    AmeriHealth Administrators, an independent company, will bill you and collect premiums for your COBRA-related health insurance.Once you have elected to enroll in COBRA coverage, you will receive monthly premium payment coupons from AmeriHealth Administrators(AHA). All election materials and payments are made directly to AHA.

    You may contact AmeriHealth Administrators at (888) 547-5090 about your monthly premium payment coupons. You may also email  the Benefits Outsourcing Department at BenefitsOutsourcing@ahatpa.com.