Frequently Asked Questions

Please send an email to your ORAU Program Point-of-Contact (POC) and the ORISE Benefits Administrator (BA) at HRHealthInsurance@orau.org as soon as possible to request terminating coverage. Our insurance can only be termed on the last day of the month the coverage is termed. Example: 01/31; 02/28; 03/31, etc.

• ORISE programs require that non-employee participants have health insurance throughout their appointment.

  • Non-employee participants could be asked to proof of outside coverage to their ORAU Program POC to terminate their insurance through ORAU unless their appointment is ending.

Once a non-employee participant enrolls in the ORAU insurance plan, there is a 30 day grace period from the effective date of the insurance plan to pick up outside coverage.

If they go past the 30 day grace period, they are locked into our policy for 90 days from their insurance effective date.

• The only exceptions to this rule would be if the appointment ended before the 90 days, or the non-employee participant has a qualifying life event. Please reach out to the ORISE BA at HRHealthInsurance@orau.org, with any questions.

If a non-employee participant enrolls in ORAU insurance coverage, they must pay a minimum of one month’s premium, unless they cancel within one to two days of enrollment.

• ORISE programs require that non-employee participants have health insurance throughout their appointment.

• If you term ORAU health insurance, you must have outside health coverage and there can be no gaps in your coverage.

  • For example: If the ORAU insurance coverage ends July 31 ^st, then your outside coverage can begin no later than August 1 ^st.

If a non-employee participant has outside coverage, they have one to two days from the day they received their official insurance welcome email to inform their ORAU Program POC and the ORISE BA that they would like ORAU to void the coverage at no cost.

To add an insurance eligible dependent to their plan, the non-employee participant must reach out to their ORAU Program POC and the ORISE BA.

• The definition of what is considered an eligible dependent is explained in #16 below.

A non-employee participant will need to communicate their situation with their ORAU Program POC. Their ORAU Program POC will notify the ORISE BA and payroll immediately.

• The ORAU Program POC will instruct the non-employee participant on how to pay their premium while on leave from the program.

• The insurance premiums must remain current while the non-employee participant is on a LOA.

  • LOA’s due to immigration issues may be eligible for a premium hold.

    • Please contact your ORAU Program POC and ORISE BA.

  • Arrangements regarding insurance coverage must be made prior to the non-employee participant going on a LOA to ensure the insurance requirement is met.

Premiums will not be refunded to the non-employee participant if the reason for the over-payment is due to the non-employee participant’s error.

• Please reach out to your ORAU Program POC with any questions.

It is the non-employee participants responsibility to keep their ORAU Program POC, and Zintellect up to date on anything that will affect their insurance coverage, or appointment in any way.

• If a non-employee participant fails to notify their ORAU Program POC, and officially update their insurance information in Zintellect, they will not be given any refunds, and we will not backdate the insurance term date to when their new coverage started.

  • Their insurance will be termed on the last day of the month they let us know of their outside coverage and completed the health insurance card in Zintellect.

• It is the non-employee participant’s responsibility to make sure they complete these steps.

  • If you filled out insurance information at any time in Zintellect, then you have to unenroll in Zintellect for it be official.

No.

If a non-employee participant starts insurance coverage from the 1 ^st through the 15 ^th of the month, they will pay a premium in that month.

• If insurance coverage starts the 16 ^th of the month or later, the first premium will be deducted the following month.

  • If the non-employee participant signs up for coverage the 16 ^th of the month or later, and then terms coverage at the end of that same month, they will owe that month’s insurance premium in accordance with #3 above.

Coverage for the non-employee participants is always termed at the end of the month in which they end their appointment or request their coverage to end as they have procured outside coverage.

• If a non-employee participant’s appointment is scheduled to term within the first 10 days of a month, two premiums may be taken in the last full month of participation to cover the cost of insurance coverage for that current month and the next month in which the participant terms.

Payroll will normally take the final premium in the month the coverage ends.

• If the non-employee participant leaves the program before enough stipend is earned to pay the premium, Payroll will deduct the premium first, which may result in a zero stipend check.

If the eligible dependent is added from the 1st through the 15th of the month, they will pay a premium in that month.

• If coverage starts the 16th of the month or later, the first premium will be deducted the following month.

• If an eligible dependent is signed up for coverage, the non-employee participant will owe at least one month’s premium in accordance with #3 above.

In most cases, you should expect to receive your benefits welcome email within a week of your coverage starting.

• In cases of high enrollment rates, there may be a slight delay.

  • If for any reason you have a need for the plan information and you have not received it, please email the ORISE BA at HRHealthInsurance@orau.org, and they will assist you.

  • The benefits welcome email will contain job aids for how to register your account/s online, download temporary insurance cards, download the apps, etc.

• Cards should arrive at the address listed on the application within 15 business days.

  • Make sure that the address in Zintellect is where you want your health insurance cards, medical correspondence, and health insurance tax information to go to.

  • If you move at any time, you must update your mailing address in Zintellect. This will update your information with the providers as well.

Log in to Zintellect and verify all the information is correct there.

• If it is correct, contact your ORAU Program POC and the ORISE BA at HRHealthinsurance@orau.org and they will assist you in updating your information with the providers.

• If it is not correct, update your information, and also send an email to your ORAU Program POC and ORISE BA, to let them know.

If you forget your password to the BCBST website, click on the Forgot / Reset Password button. Click that you are a member and enter your User ID and click continue. Answer the security questions that you created when you initially setup your account. It will then prompt you to enter a new password and confirm your new password.

• If you forget your User ID, click on the Forgot / Reset Password button. On the bottom it will say Forgot Your Member User ID? Click retrieve my Member User ID. You will need the subscriber ID, group number, date of birth, and zip code. You should be able to find the subscriber ID and group number on your insurance card.

• If these steps do not work, please contact BCBST Member Services directly at 1-800-565-9140.

Dependent is defined as your legal spouse and/or child to age of 26 including:

• Your children related by blood or marriage.

• A child 26 years of age or older who is disabled and dependent upon you for care.

• Children you have legally adopted.

• Children whom you have legal custody of.

• Children for whom you are required to provide coverage as part of a divorce decree.

Note: No child can be a dependent of more than one participant.

Legal spouse is defined as the person you are legally married to.

• Common law marriages are only recognized in the following places:

  • Colorado, Iowa, Kansas, Montana, Oklahoma, Rhode Island, South Carolina, Texas, Utah, and Washington D.C.

  • Common law marriage will only be recognized if the participant is living in a state where Common law marriage is legally recognized.

  • You will be required to fill out, sign and have notarized an Affidavit of Common Law Marriage.

• Domestic partnership is not a legal marriage.

  • Self-insured and self-funded plans, like the one ORAU/ORISE offers, are not subject to state laws that require companies to offer health insurance to domestic partners because federal law under ERISA preempts state law where it relates to ERISA benefit plans.

If you reside outside of the state of Tennessee, please use BlueCard PPO (Outside of Tennessee) as your network when searching for in-network providers.

• This includes doctors, pharmacies, hospitals, etc.
• BCBS link to Find Care. 

No.

• Non-employee participants must be currently enrolled in medical coverage or applying for new medical coverage to enroll in dental and vision.

Dental and vision must be taken as a package deal.

• You cannot have one without the other.

No.

• Medical, dental, and vision coverage must all be enrolled at the same coverage tier.
  • For example: If you currently have family coverage for medical and want to enroll in dental and vision, you must enroll in family coverage for those benefits well.
• ORAU’s plans offer individual, member +1, and family tiers for coverage options.

Yes.

• Please see the second and third guideline in the medical portion above.

No.

• You are not required to have dental and vision coverage for your appointment.
• Only medical insurance is required.