Help Center

First, what type of plan are you on?

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Select your plan type to find the right provider search tool:

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Which plan type is the billing issue for?

1. 1Log in to your carrier portal (select your plan type above) and check your claims history. Compare the Explanation of Benefits (EOB) to the bill you received.
2. 2Verify that the provider billed the correct insurance. If you recently changed plans, the old information may have been used.
3. 3If the charge is incorrect, call the member services number on your ID card. Have your EOB and the bill ready when you call.

Still dealing with a billing issue? Submit a Ticket →

1. 1Adding or removing a dependent is a qualifying life event. You typically have 60 days from the event to make changes.
2. 2Qualifying events: marriage, divorce, birth/adoption, dependent turning 26, losing other coverage, or moving to a new area.
3. 3Call me at (941) 323-0041 -- I'll handle the paperwork and make sure your plan updates correctly. Don't try to do this through the carrier directly, let me coordinate it.

Need help with a dependent change? Submit a Ticket →

Log in to your carrier to review your Summary of Benefits and Coverage (SBC):

1. 1Your SBC lists everything: copays, deductibles, out-of-pocket maximums, and what services are covered. Find it in your carrier portal under "Plan Documents" or "Benefits."
2. 2For specific procedures, call your carrier's member services and ask for a pre-authorization or benefit verification before scheduling.
3. 3Preventive care is covered at 100% on ACA plans -- annual physicals, screenings, and immunizations. No copay required.

Still unsure about coverage? Submit a Ticket →

1. 1Review the Explanation of Benefits (EOB) carefully. It includes a denial reason code and explanation of why the claim was rejected.
2. 2Common denial reasons: out-of-network provider, no pre-authorization, coding errors, or non-covered service. Verify the reason before taking next steps.
3. 3You always have the right to appeal. Call me at (941) 323-0041 and I'll help navigate the appeals process with your carrier.

Need help with a denied claim? Submit a Ticket →

1. 1Plan changes are typically only allowed during Open Enrollment (November through January) unless you have a qualifying life event.
2. 2Qualifying life events include: marriage, divorce, having a baby, losing other coverage, moving to a new area, or changes in income.
3. 3Call me at (941) 323-0041 to discuss your options. I'll compare plans across all carriers to find the best fit for your updated needs.

Want to explore plan changes? Submit a Ticket →

1. 1Check the Client Resources page for guides, tools, and carrier links that might help.
2. 2Call me directly at (941) 323-0041 for urgent matters.
3. 3Submit a ticket below with details and I'll look into it for you.

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