Frequently Asked Questions

• Members
• Employers
• Providers

Member FAQ

How long does it take to receive my ID card?
Once your enrollment has been entered in to our system it takes an average of 7 to 10 business days to receive your ID card and plan information.

What if I lost my ID card or never received one?
You can contact our customer service department at 877.685.2432, or your benefit department to order a new or replacement ID card.

What if I have moved, can you send an ID card to my new address?
You do not need a new ID card if you change addresses. However it is important that you contact your benefit department or CHC customer service to update your new address. This will insure you receive any important information concerning your benefits.

To which address do I mail a claim?
Century Healthcare, LLC
P.O. Box 2256
Grapevine, TX 76099

Which providers accept my plan?
If you are in need of a participating provider, please refer to your ID card to determine the PPO network associated with your plan. The phone number for your PPO network is located on the back of your ID card. If you do not have your ID card available, contact customer service or your benefit department for your PPO network information. You can also visit our “Directory” page for a complete listing of important phone numbers and websites.

What does in-network mean?
In-network means the provider you have selected has contracted with your PPO network to offer services at a reduced rate. By using an In-network provider you are stretching your benefit dollars and reducing any out of pocket expense you may incur.

Do I need a referral to see a specialist?
No, however, you should verify that the specialist is in your PPO network and that the services are covered under your plan before making an appointment to receive care.

What do I need to do if I want to terminate/cancel my CHC benefit plan?
Please contact your employer’s Human Resources Department to terminate your CHC benefit plan.

Can I cancel my CHC benefit plan at any time?
Yes. However, you will want to contact your employer’s Human Resource Department to verify benefit plan cancellation guidelines.

Who do I contact if I have questions about my prescription coverage?
You should always discuss questions and concerns about prescriptions you may be taking with your physician. If you have questions about your prescription drug plan, the pharmacy company’s customer service line is listed on the back of your ID card. If you do not have your ID card, please contact CHC’s customer service or your benefit department for more information. You can also visit our “Directory” page for a complete listing of important phone numbers and websites.

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Employer FAQ

What is a limited benefit plan?
Limited benefit insurance plans focus on routine medical services including but not limited to inpatient and outpatient care, doctor office visits, lab, diagnostic tests, X-rays, surgery, anesthesiology, inpatient room and board and other hospital expenses, and prescription drug coverage. By offering “limited” benefits for these services, we are able to keep premiums affordable.

What are the benefits of offering a limited benefit plan?
Employees have access to care at an affordable price. The network discounts, copayments, and availability of network providers help manage out-of-pocket costs for those people in need of care.
Employers can help reduce the costs associated with employee turnover by offering a limited benefit medical plan to their employees that might otherwise be without healthcare coverage. Employers can contribute toward the cost of the plan, or offer on a voluntary (employee-funded) basis.

What types of plans are available?
CHC offers several customizable medical plans as well as a numerous supplemental products including vision, dental, short-term disability (STD), term life & accidental death along with nurse lines and employee assistance programs. Please contact your broker or CHC for a customized quote for your organization.

What type of employer can offer a limited benefit medical plan?
CHC limited benefit medical plans are available to employers with employees who are paid an hourly wage, work on a seasonal basis or must fulfill a waiting period for other company-sponsored benefits. We have a number of employers in nursing homes, retail, trucking, security firms, manufacturing and servicing companies.

How do I add or delete employees from my plan?
Please contact your CHC Account Representative for assistance.

As an employer, am I required to contribute toward the limited benefit medical plan premium?
No. CHC offers voluntary benefit plans (through payroll deduction, but 100% employee paid) as well as plans where the employer makes some level of contribution. We have found that employers that contribute toward the premium cost generally realize an increase in employee participation and retention. Typically, premiums are lower for groups who contribute to their employees’ medical premium.

Is everyone guaranteed coverage in the plan?
Yes. Eligible employees and their eligible dependents are automatically accepted for the CHC plan selected by the employer as long as they meet the eligibility guidelines set by the employer.

What happens after enrollment?
Following the process of enrolling a new group or adding members to an existing CHC limited benefit medical plan, ID cards and certificate booklets will be mailed to each enrolled employee.

Can employees’ coverage continue under COBRA?
Yes. CHC’s administrator will fully administer all aspects of COBRA continuation laws, including mailing COBRA notification correspondence to the employee’s home address of record. CHC’s plan administrator will also be responsible for collecting premium for COBRA continuation coverage. There is no extra charge for this service.

Can CHC members visit any doctor or hospital?
Yes. There is no restriction on which doctor or hospital a member may utilize, however, employees will receive an added value of having the PPO network discounts applied toward their charges, when they utilize in-network providers.

How do employees receive plan benefits when they go to a health or dental provider?
The provider will file a claim for their services and will be paid an amount equal to the employer’s plan benefits. If the provider’s charge exceeds the plan benefit, the provider will bill the employee directly for the balance of the charges.

Can employees visit any pharmacy?
Yes, discounts are determined by a set formulary of commonly used medications. Members can utilize any pharmacy to receive the discounted rate.

How does the prescription drug “copay” benefit work?
The prescription drug program provides benefits for both brand name and generic drugs. CHC members simply present their ID card at a participating pharmacy to receive their benefits. The benefit will automatically be applied against the discounted rate. If the plan benefit is less than the cost of the prescription, the employee must pay the difference.

How does the prescription drug “discount” benefit work?
The program provides benefits for both brand name and generic drugs. CHC members simply present their ID card to the pharmacy of their choice. The discounted rate is applied and the employee must pay in full at the time of purchase. Please note – this is not an insured product.

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Provider FAQ

If I have questions regarding my network participation, who do I contact?
Please contact the PPO network with which you are contracted relative to the CHC limited benefit medical plan.

Who do I contact to verify a member’s eligibility?
To verify a member’s eligibility, please contact CHC Customer Service at 877.685.2432, or at info@centuryhealthcare.com.

Does Century Healthcare accept electronic claims?
Yes, our electronic payor ID is 75261

Where do I mail my CHC member claims?
Mail: Century Healthcare, LLC, c/o Web TPA, P.O. Box 2256, Grapevine, TX 76099
Fax: Claims Department: 469-417-1960
Electronic claims: Payor ID: 75261

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