1.  When does open enrollment take place at my school?

Answer:  The open enrollment meeting will be scheduled with your school's human resources or administration office and those meetings are typically held right before school starts.

2.  I would like to obtain an application for a scholarship and/or reading grant.  How do I obtain an application?

Answer:  Contact your school's human resource or administration office for an application.

3.  Who is eligible for a scholarship and/or reading grant?

Answer:  A current or former student of the participating schools in Native American Schools Health & Welfare Trust.

4.  When are the scholarship and reading grant applications due?

Answer:  September meeting of the Native American Schools Health & Welfare Trust.

5.  When are the scholarship and read grants awarded?

Answer:  The checks are mailed after the scholarships are approved by the trust at the September meeting.

1.  Where can I obtain a copy of my Schedule of Benefits?

Answer:  Contact your human resources or administration office.  It will show your school's medical plan coverage, dental plan coverage, prescription drug plan coverage, mental health plan coverage, vision plan coverage, if any, and medicine man coverage, if any.

2.  How to I obtain a list of preferred providers for my location?

Answer:  You can click on this link to be taken to the First Health Network or go to www.CURE-Inc.com and select the related links tab and then the First Health Network link.

3.  Which company handles my health claims?

Answer:  Summit Administration Services.

4.  How long does it take for Summit Administration Services to process an new application for coverage?

Answer:  It takes 48 hours to process an enrollment application.  Applications should be filled out thoroughly as missing information can cause processing delays.  Until the missing information is collection, ID cards are held and claims are suspended.

5.  Do I have to go to Indian Health Services first?

Answer:  No.  You have the choice of using Indian Health Services and/or the medical plan (“medical plan”) your employer provides to its employees.  Indian Health Services and the medical plan will coordinate benefits.

6.  How does Coordination of Benefits work?

Answer:  Payment for health services may be coordinated when a person is covered under more than one group medical plan (including Indian Health Services) to avoid duplication of benefits.  The primary coverage is the plan that pays any eligible expenses without consideration of any other coverage.  The secondary carrier is the plan that has the responsibility for payment of a portion of all or any remaining eligible charges not covered by the primary coverage.  You do not have the ability to determine which carrier is primary.  This is governed by the rules set forth in the summary plan description documents.

7.  I have two plans.  Why doesn't Coordination of Benefits result in my claims being paid in full?

Answer:  Your secondary carrier may not have adopted coordination of benefits provisions that cover the remaining amount in full.  Please consult your summary plan description documents for the details of coordination of benefits for more information.

8.  Where do I get a new or replacement Insurance Card?

Answer:  Check with your School’s Human Resources or Administration Office.  New cards were issued on July 1, 2010.  If they cannot provide you with one, then call Summit Administration Services at 1-888-690-2020.

9.  I have a question about how a claim was processed.  Who should I call?

Answer:  Call Summit Administration Services directly at 1-888-690-2020.

10.  When should I call Summit Administration Services?

Answer:  You should contact Summit Administration Services any time you have questions on how your plan works or inquiries on claim payments.

11.  What is an EOB?

Answer:  An EOB is an Explanation of Benefits statement detailing your health care benefits activity.  Whenever you or a covered family member receives medical services, you will receive and EOB.  The EOB will include information about services provided including the facility, the date(s), the amounts billed and paid, if any, and other details regarding the medical services you received.

12.  My spouse has lost his/her coverage and would like to apply for mine.  What type of documentation do we need from his previous insurance carrier?

Answer:  Individuals applying for coverage must provide a Certificate of Coverage to avoid waiting periods for pre-existing conditions.  If your spouse lost coverage involuntarily, get a Certificate of Coverage from the prior pan and attach it to the new application.

13.  Will my medical plan cover any services provided by Bishop Optical in Gallup, New Mexico?

Answer:  You will be responsible for full payment to Bishop Optical.  The employee health plan shall reimburse the employee for expenses incurred at Bishop Optical subject to the following:

           a: The employee must submit an itemized invoice to Summit Administration Services; and

          b: The Plan shall only reimburse to the employee amounts that are customary and reasonable  charges for the service rendered.

Any other vision care provider shall be a covered provider under the School’s employee health plan.  If the employee or the covered family member uses another vision provider, Summit Administration Services shall make applicable benefits payment to any other vision provider.

1.  What is the name of the company who handles my Prescription Drug coverage?

Answer:  In 2010, the prescription drug coverage company changed to Partners RX.

2.  I have question about how a prescription claim was processed.  Who should I call?

Answer:  Call Partners RX directly at 1-800-711-4550.

3.  Where do I get a new or replacement Prescription Drug Card?

Answer:  Check with your School’s Human Resources or Administration Office.  If they cannot provide you with one, then call Partners RX directly at 1-800-711-4550.

1.  Which company handles my Short & Long Term Disability benefits?

Answer:  Lincoln Financial Group.

2.  I have question about how a disability claim was processed.  Who should I call?

Answer:  Contact Lincoln Financial Group directly at 402-361-2832.

1.  Which company handles my Life Insurance benefits?

Answer:  Lincoln Financial Group.

2.  I have question about how a life insurance claim was processed.  Who should I call?

Answer:  Contact Lincoln Financial Group directly at 402-361-2832.

3.  If I need assistance with filing a Life Insurance, Short Term Disability Insurance or Long Term Disability Insurance claim who do I contact?

Answer:  You can contact Lincoln Financial Group at 402-361-2832 or CURE Inc. at 505-873-8972 our staff will help you fill out your claim form.