Frequently Asked Questions

Newly eligible employees have 30 days from their date of eligibility to enroll in an OGB health plan. If the employee misses the 30 day deadline, he or she can enroll during the next annual enrollment period, Zusually held in October for the next plan year, or upon an OGB Plan Recognized Qualified Life Event.

The surviving legal spouse and/or legal dependent of an employee or retiree may continue coverage unless or until the surviving legal spouse and/or legal dependent is or becomes eligible for coverage in a group health plan other than Medicare.

Yes, you may drop your coverage during annual enrollment or upon an OGB Plan Recognized Qualified Life Event. Retirees should note that if coverage is dropped, they may not be able to enroll again.

A copay is a flat fee for a specific service. Coinsurance, however, is a percentage of the contractually allowed cost of a specific service.

For health insurance ID cards, contact the insurance carrier of your health plan.

The Health Reimbursement Arrangement (HRA) is handled by Blue Cross and Blue Shield of Louisiana (BCBS) on behalf of the employee. BCBS uses the HRA account to pay the provider (doctor or hospital) when a medical claim is submitted. The HRA is only for eligible medical expenses and does not include prescription drugs.

The HRA is funded by the employer. When eligible medical expenses occur and qualify for reimbursement, BCBS claims administration applies HRA funds from the member’s HRA account.

HRAs are not portable. If you get a new job with a non-OGB participating employer, you will not be able to take your HRA account with you or use the funds still in it.

No. Only eligible medical services may be reimbursed by HRA funds. Pharmacy charges are not covered by the HRA.

You may contact Blue Cross and Blue Shield of Louisiana at 1-800-392-4089 with questions about your HRA funds.

Yes. If you are an active full-time employee, a General-Purpose FSA or Limited-Purpose FSA may be used with an HRA.

The HRA pays for 100% of covered out-of-pocket medical expenses until the HRA is exhausted. Blue Cross and Blue Shield of Louisiana’s Explanation of Benefits (EOB) will indicate the funds available for reimbursement. After the HRA is exhausted, you will pay the full contracted amount for that service until you meet the remaining balance of your deductible and/or any coinsurance amount.

Yes. Unused HRA funds will roll over year after year. You will not lose your money if you do not spend it within the current year.

No. There is no maximum on the amount you can roll over in the Health Savings Account (HSA) each year.

No. The Pelican HSA plan is only available to active employees who have not enrolled in a Medicare plan (i.e., Medicare Part A or Medicare Part B).

If you get a new job with a non-OGB participating employer, you can still use your HSA. It is yours to keep and the funds in it will remain available for your use.

You will receive a debit card that can be used to pay for eligible expenses. You may also order checks from HealthEquity after your account has been set up successfully.

Yes. You must complete and return the HSA Signature Card and beneficiary election form enclosed in your welcome letter. Review the information, make any necessary additions or corrections, sign where indicated, and return the form to HealthEquity, the custodian of your HSA, in the provided envelope within ten business days of receiving it.

Agencies contribute $200 initially to employees’ HSAs at the beginning of each plan year. They will also match employees’ tax-free contributions dollar-for-dollar up to an additional $575 through payroll deduction each plan year. Employees must have the Pelican HSA775 in order to receive the initial deposit and matching contributions.

An employee who is age 55 or older may contribute an additional $1,000 each year to their HSA as a catch-up contribution, subject to IRS limits.

The HSA deduction schedule is based on your payroll schedule (for example, monthly or bi-weekly).

No. You own the money in your HSA. Your employer cannot control how you use the funds.

Yes. HSA funds can be used for you, your spouse, or eligible dependents (as identified on your federal tax return) even if they are not covered by the Pelican HSA775 plan.

HSA enrollees that are over 65 should stop contributing to their health saving account at least 6 months prior to retirement to avoid IRS tax penalties.

Two important concepts for FSAs are the Grace Period and the Run-Out Period.

The Grace Period lasts until March 15 following the Flex plan year and allows you to use the previous year’s flexible spending funds to pay for eligible expenses incurred during that period. If you still haven’t used the money in your account by the end of the Grace Period, you will forfeit the remaining balance.

The Run-Out Period lasts until April 30 for submitting claims. You must submit all claims by April 30 in order to be reimbursed from your previous year’s funds.

The FSA MasterCard debit card will auto-substantiate at IIAS-compliant stores and for insurance-specific copays. You also have the option to submit your claims manually.

You will receive a payment card from TASC (a silver MasterCard). You will need to register your payment card. If you are not already a registered user, you will need your payment card number to register and sign in for the first time at https://uba.tasconline.com/login. If you enrolled in a Dependent Care FSA (DCFSA), you will not be issued a payment card for that account.

To access your account, you may download the TASC Mobile App or register online at https://uba.tasconline.com/signup.

The first time you access Universal Benefit Account, you need to sign up. On the Sign In page, below the Email field, find the First Time here? prompt and click Sign up to establish access. If you already have a Universal Benefit Account, simply sign in with your existing username and password.

Once you are signed in, you will be able to:

• View account balances and transaction information
• Link your personal bank account directly to your account for faster reimbursements
• Set your personal communication preferences for alerts and notices

For further assistance with registering your information, contact TASC Customer Care at 1-800-422-4661.

Yes. Out-of-pocket medical expenses for your spouse and dependents can be reimbursed through the General-Purpose FSA (GPFSA), as long as they are your tax dependents and you are enrolled in a GPFSA.

Yes. You and your spouse may each have a General-Purpose FSA (GPFSA). However, you both cannot be reimbursed for the same receipts.

Please contact OGB Customer Service with the following information:

• Your name
• Your date of birth
• How you completed your wellness visit requirement (for example, attending an Ochsner Health on-site clinic or visiting your doctor, having them complete the Primary Care Provider form, and sending it to Ochsner Health)
• The date you completed the wellness visit requirement

OGB will work with Ochsner Health and Blue Cross to research your eligibility for the wellness credit.

Only the primary plan member is eligible to participate in the Live Better Louisiana program.

The primary plan member can receive a wellness credit (through their payroll system) by participating in the Live Better Louisiana program. This is a simple one-step process.

You must receive a preventive health screening or have your doctor complete a Primary Care Provider (PCP) form after your annual wellness visit. OGB provides clinics across the state that screen for cholesterol, glucose levels, and liver function. You will leave the clinic with a personalized health plan and, if necessary, referrals to appropriate specialists, primary care physicians, or disease management programs.

This process must be completed each year to continue receiving the wellness credit.

OGB is currently working on the clinic schedule for the plan year. Please check the Ochsner Health wellness resources for the most up-to-date list of scheduled clinics, or contact Ochsner Health at [email protected] or 1-866-495-6235.

Members who participate in the Live Better Louisiana program will receive a $120 annual ($10 monthly) premium credit on their BCBSLA health coverage.

Yes. There is a form you can bring to your physician to document that you had your annual physical. The Primary Care Physician (PCP) form can be found on the OGB website under Resources > Forms > Live Better Louisiana.

Yes. Blue Cross members can sign up for Blue365, which offers exclusive health and wellness deals to help keep you healthy and happy year-round.

With categories like fitness, apparel, healthy eating, alternative medicine, healthy living, weight management, experiences, personal care, financial care, and wellness, you are sure to find something that enhances your well-being.

No. There is no time limit on filing life insurance claims with Prudential.

Supplemental life insurance can be canceled during the annual enrollment period or if you experience a plan-recognized Qualified Life Event (QLE).

Yes. Evidence of Insurability (EOI) must be submitted before the November 15th deadline.

Life insurance premiums are based on your age as of December 31. If you move into a new age bracket, your premium will be adjusted in January of the following year.

No. EOI is not required to decrease life coverage. However, if a member decides to increase coverage, EOI will need to be completed.

Yes. Life insurance coverage will be automatically reduced by 25% on January 1 following your 65th birthday and again on January 1 following your 70th birthday. The premium will also be reduced.

Yes. When your employment terminates, you may convert your group term life coverage to an individual term life insurance contract policy, subject to the plan’s conversion rules.

Yes. A terminally ill employee whose life expectancy is six months or less may apply for an accelerated payment of death benefits. Proof of terminal illness must be received by Prudential within six months or less of the certified life expectancy.

Yes. You may continue your life insurance coverage after retirement, subject to the plan’s provisions.

Yes. You may add your spouse and dependent children up to age 26. Plan members who wish to add dependent life coverage for a spouse must provide Evidence of Insurability (EOI). Eligible dependent children may be added without providing EOI.

No. The employee pays 100% of dependent life premiums for spouses and eligible dependents.

Active employees should contact their agency’s Human Resources Department for assistance with life insurance questions.

Active employees should check with their Human Resources Department. Retirees may contact OGB or send a letter to OGB requesting the amount. Make sure to sign and date the information.

No. While you are actively employed, you are not required to enroll in Medicare Part B. You may enroll in Medicare Part A only and then enroll in Medicare Part B upon retirement.

OGB becomes the secondary plan for a retiree who has both Medicare Part A and Part B. When this occurs, the retiree’s monthly premium decreases. The premium reduction only applies to retirees who have both Medicare Part A and Part B.

If you are enrolled in Medicare Part A and/or Part B and in a Blue Cross health plan, SilverScript will become your pharmacy provider. SilverScript will provide you with a new prescription card. You should not enroll in a separate Medicare Part D plan.

The most common parts of Medicare include:

• Medicare Part A – Covers hospitalization and is usually paid for in full at age 65.
• Medicare Part B – Covers physician visits and other outpatient services and requires a monthly premium to keep in force.
• Medicare Part C – Privately offered plans that serve as an option to regular Medicare and are commonly referred to as Medicare Advantage.
• Medicare Part D – Provides prescription drug coverage.

No. Retirees are not eligible to participate in the Pelican HSA plan.

Yes. If you are eligible for Medicare Parts A and B, you are required by OGB rules to enroll in both. Failure to do so may result in a reduction or loss of claim benefits.

Yes. You will pay your OGB health plan premium and the Medicare Part B premium. However, once you sign up for Medicare Parts A and B, your OGB premiums are reduced. Refer to the OGB Premium Rates page for more information.

Medicare Advantage plans can vary in deductibles, copayments, prescription drug coverage, provider networks, and the geographic area covered. OGB encourages you to research your options and select a plan that best suits your needs.

Initial Enrollment Period: The 7-month period that begins 3 months before the month you turn 65 and ends 3 months after the month you turn 65. If your birthday is on the first of the month your 7-month period starts 4 months before the month you turn 65 and ends 2 months after the month you turn 65.

Special Enrollment Period: After your Initial Enrollment Period is over, you may have a chance to sign up for Medicare during a Special Enrollment Period. For example, if you didn’t sign up for Part A and/or Part B when you were first eligible because you have group health plan coverage based on current employment, you can sign up for Part A and/or Part B:

• Any time you’re still covered by the group health plan
• During the 8-month period that begins the month after the employment ends. (HR will need to complete form CMS-L564: Request for Employment Information in order for the newly retired person to get the 8-month Special Enrollment Period)
• HSA enrollees should note that when applying for Part A anytime after you’re first eligible for Medicare, your Part A coverage will go back (retroactively) 6 months from when you signed up. HSA enrollees that are over 65 should stop contributing to their health saving account at least 6 months prior to retirement to avoid IRS tax penalties.
• Part B coverage generally starts the first day of the month after you sign up. You can request to delay your Part B start date up to 3 months.

General Enrollment Period: You can sign up for Part B during the General Enrollment Period (January 1-March 31 each year) if you missed your Initial Enrollment Period and don’t qualify for a Special Enrollment Period. You may have to pay a higher Part B premium for late enrollment.

HSA enrollees that are over 65 should stop contributing to their health saving account at least 6 months prior to retirement to avoid IRS tax penalties.

You and your covered dependents may be eligible for COBRA continuation coverage if you lose health insurance because of one of the following qualifying events:

• Termination of employment (other than for gross misconduct)
• Reduction in work hours
• Divorce or legal separation
• A dependent child losing eligibility
• The death of the covered employee
• The employee becoming entitled to Medicare

You may continue the same medical, dental, vision, and other group health plan coverage you had before the qualifying event. If the employer changes their plans, your COBRA coverage may change in the same way.

COBRA coverage typically lasts:

• 18 months for job loss or reduction in hours
• 36 months for divorce, legal separation, death of the employee, or loss of dependent status

Extensions may be available under specific circumstances as defined by federal law.

Under COBRA, you generally pay the full cost of the coverage—the amount previously paid by you and your employer—plus a small administrative fee of up to 2%.

If you experience a qualifying event, you will receive a COBRA Election Notice explaining your rights, costs, deadlines, and how to enroll in continuation coverage.

You usually have 60 days from the date you receive the COBRA Election Notice or the date your coverage ends—whichever is later—to elect COBRA coverage.

If you elect COBRA and pay the required premiums within the applicable deadlines, coverage is retroactive to the date your original health coverage ended, so there is no gap in coverage.

Yes. You may end COBRA coverage at any time. You may also switch to other coverage options, such as:

• A spouse’s employer-sponsored plan (if eligible)
• Coverage through the Health Insurance Marketplace/Exchange
• Medicaid (if eligible)

No. COBRA only applies to employer-sponsored group health plans—such as medical, dental, vision, and in some cases FSAs—not life insurance or disability insurance.

You may contact any of the following with questions about COBRA:

• Your agency’s HR/Benefits team
• The plan administrator listed in your COBRA notice
• The U.S. Department of Labor for questions about your COBRA rights

Not exactly. Some states offer additional continuation rights (often called “mini-COBRA”). If applicable, your COBRA notice will explain any state-specific continuation options.

Receiving an initial COBRA notice does not mean you have been terminated. Initial notices are sent automatically to all newly enrolled employees so that you are aware of your rights and options in case you ever lose your health insurance coverage in the future.