CBIA Health Connections Administration Manual

Welcome to the CBIA Health Connections Administration Manual site. The manual has been arranged in sections for your convenience. Just click on the appropriate heading and you'll be linked directly to it. Each section has been saved in pdf format for easy download. You can also download the entire manual by clicking here.

Section I - About CBIA (pdf)

Section II -How to Administer Your Plan (pdf)

• Section A: Adding Employee/Dependent Coverages
  How to Add an Employee With or Without Dependents
  How to Add a Dependent
  
• Section B: Canceling Employee/Dependent Coverages Canceling Coverage for Individual Employees and
  Dependents
  
• Section C: Submitting Adjustments
  Where to Submit Your Adjustments
  Employee Change of Address
  Primary Care Physician (PCP) Changes
  
• Section D: Qualifying Events
  Changes that May Affect Coverage
  Adoption or Placement for Adoption
  Birth of a Child
  Change from Part-time to Full-time Status
  Court-Ordered Dependent
  Death
  Divorce
  Exhaustion of Continuation — Eligibility
  Legal Guardianship
  Loss of Coverage
  Loss of Dependent/Student Status
  Marriage
  New Stepchildren
  Reaching Age 65
  Reduction in Hours
  Retirement
  
• Section E: Life Insurance
  Life Insurance
  Life Insurance Increases (salary based plans)
  Age Reduction Rule
  Retiree Coverages
  How to file a Life Claim
  Waiver of Premium (totally disabled)
  
• Section F: Medicare
  Medicare Overview
  TEFRA/DEFRA Chart (available as separate pdf as well)
  
• Section G: Changing/Canceling Your Coverages
  Adding or Changing Ancillary Coverages
  Case Address/Area Changes
  Administrative Changes
  Employer’s Request for Cancellation
  
• Section H: Billing and Premium Payment
  About Your Bill
  How to Interpret Your Bill
  —Case Number
  —Bill Date
  —Amount Due
  —Due Date
  —Detail
  —Summary
  —Adjustment Premium
  —Current Premium
  —Total Premium
  —Previous Balance
  —Payments Received
  —Outstanding Balance
  —Adjustments
  —Case Adjustment
  —Total Amount Due
  Premium Payments
  Direct Debit
  Notices and Late Fees
  Cancellation: Nonpayment of Premium
  Cancellation: Nonpayment of CBIA Dues
  Reinstatement
  Collection
  Example of Monthly Cycle
  
• Section I: Definitions
  Ancillary Lines of Coverage
  Cancellation of Coverages
  Certification
  COBRA
  Connecticut Small Employer
  Continuation-of-Coverage
  Contributory
  Conversion (To an Individual Policy)
  —Medical
  —Life
  Covered Employee
  Disabled Employee
  Eligible Employee
  Eligible Dependent
  Eligible Group (Case or Account)
  Eligibility Period
  Evidence of Insurability
  Extension of Benefits
  Full-time Student
  Handicapped or Disabled Dependents
  Health Maintenance Organization (HMO)
  Late Applicant — Medical, Dental, Life, Long-term and Short-term Disability
  Medicare
  Noncontributory
  Open Access
  Open Enrollment
  Point-of-Service (POS) Plan
  Premium Waiver
  Primary Care Provider (PCP)
  Probationary Period
  Qualifying Event
  Recertification
  Rehire
  Renewal
  Termination of Employment

Section III — State and Federal Laws & Regulations

• State and Federal Continuation Laws
  Who is Eligible for Continuation Benefits
  COBRA Chart (available as separate pdf as well)
  HIPAA: Health Insurance Portability and
  Accountability Act of 1996
  —Special Enrollments
  Family and Medical Leave Act (FMLA): What You Should Know
  —Companies Affected
  —Employees Eligible for FMLA Leave
  —Acceptable Reasons for Taking FMLA Leave
  —Notification and Certification
  —Job and Benefits Protection
  —Group Health Insurance Premium Payments During FMLA Leave