Coffeepot Chatter: Forms, Forms, Forms

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Monday, June 16, 2014

Harry:  You seem grumpy today, Tom.

Tom:  I got another coordination of benefits questionnaire from the medical plan yesterday.  It seems like I just did one a couple of weeks ago.

Maria:  Yeah, why do they send those things out so often?

Tom:  This one said it was from Lehigh—something about making sure the right medical plan pays first if anyone in the family’s covered by more than one plan.

Maria:  Then what was the earlier one about?

Tom:  The first one was to see if my 25 year old son had any medical coverage of his own; but he lost that when his job ended more than a year ago.

Harry:  Yes, I got one when my wife hurt her ankle while running.

Maria:  You’d think the plan would keep up with that stuff better.

Harry:  Maybe that’s why they send out the forms when they do, because there’s no other way for them to know if anything about your medical coverage has changed.

Email has greatly reduced the number of letters we get in our mailboxes, but sometimes it seems that what remains is 75 percent junk mail and 25 percent insurance forms. 

But Harry is right. You receive multiple coordination of benefits forms from Capital Blue Cross (CBC) during the year because things change. The only way to ensure that your medical benefits are in line with your situation is to ask you. That’s also why your doctor asks you for your insurance card and if your personal information is up to date every time you visit.

We hope that relieves a little of your frustration at receiving multiple forms. But we also want to help you understand the difference between the two types of coordination of benefits forms you may receive.


Type One: The Annual Questionnaire

We have written in the past about this questionnaire. You only receive this form once a year. Its purpose is to determine whether other medical coverage exists that should pay charges before your Lehigh CBC coverage for any members of your family. By answering the questions on this form, CBC can determine whether you have a spouse or partner whose medical plan is the appropriate primary medical plan for your dependents.

This year’s edition (shown at right) was mailed to 1,551 employees in early May. If you received it, you must return it to Capital Blue Cross in order to prevent delays in the payment of your medical benefits claims. 


Type Two: The Periodic CBC Form

The second type of Coordination of Benefits form is triggered by specific claims. Depending on what happens to you and your dependents in a given year, you could potentially receive this form on multiple occasions. 

This form is used to determine whether:

  • Some other source—like homeowner’s, auto, or business insurance—should be paying to treat an injury
  • There’s been a change in medical plan coverage for an individual member of your family
  • Worker’s compensation coverage should be paying work-related treatment costs.

Regardless of the reason you receive a coordination of benefits form, it’s vital that you fill it out and return it to CBC. Doing so keeps your medical claims moving forward smoothly and ensures the responsible use of Lehigh’s benefits budget.