Frequently Asked Questions

There are always exceptions, so please contact the Benefits Office for information regarding your specific situation at (805) 546-3161 or send an email to moncia_banta@cuesta.edu

Q: Why didn't the insurance pay for my service?

  • To get the most benefit from your plan you must go to a participating provider and present your ID card when you receive services.
  • Most plans have a deductible that you as an individual or a family must meet before certain services are covered.
  • Check your Evidence of Coverage/Plan Summary Description booklet to see if the service you received is covered under your plan. 
  • Sometimes the insurance company needs more information from you or your doctor to process the claim. See below.

Q: I have a claim problem. What do I do?

  • You should contact customer service for the insurance company in question.  Have your Explanation of Benefits/Member Statement from the insurance company, your ID card and the doctor's bill in hand when you call.
  • Ask why they denied payment on your claim.
  • Follow the instructions of the customer service person to get the claim resolved.

Q: When can I add my dependent?

  • You can add a spouse, domestic partner or child at Open Enrollment.
  • Outside of Open Enrollment, you can add dependents when you acquire them (marriage, establishment of domestic partnership, birth of a child, court ordered coverage).
  • You can add dependents if they experience a loss of health converge under another group plan. Documentation is required. Call the insurance office for more details.
  • The Insurance Office must be notified within 30 days of the event for your dependent to be added outside of Open Enrollment.

Q: What happens if I get separated or divorced?

  • Your spouse may stay on your plan if you become legally separated.  In California you are still married even if you are separated.
  • If you file for divorce, your spouse will no longer be eligible to continue on your insurance plan as of the date of the final dissolution of marriage.
  • You MUST inform the office within 30 days of your divorce becoming final.
  • Your former spouse will be offered COBRA continuation.

Q: How long can I keep my child on my insurance?

  • Dependent children (including step-children and adopted children) may stay on your plan until their 26th birthday.
  • After age 26 your child is not eligible unless he/she is disabled.

Q: When is Open Enrollment?

  • Open Enrollment for SISC Blue Cross (faculty medical) happens in August for the new plan year starting on October 1.
  • Open Enrollment for MCSIG/Anthem Blue Cross, Delta Dental, VSP Vision and American Fidelity happens in November/December for coverage beginning on January 1.

Q: How do I get a new ID card?

  • You may request a replacement MCSIG/Anthem Blue Cross card by calling customer service or by requesting one through the company's website. Phone number and websites are listed on the Insurance Benefits Home Page.
  • If you need a new SISC/Blue Cross card contact the Insurance Benefits Office for assistance.
  • Delta Dental ID cards is not required to receive services.  You simply give them your name and the subscriber's (employee) Social Security number. 
  • VSP Vision does not print ID cards. Similar to the dental plan, all you need is your group number #30071230 and SSN to access benefits.

Q: How do I know if my doctor is a Participating Provider/Preferred Provider?

  • Each of the medical, dental and vision plan websites allow you to search for a provider in their network. See the Benefits Home Page for websites.
  • Call Customer Service to see if your doctor is a provider.

Q:  How do I change my TSA (403b) or 457 contribution?

  • 403(b)/457 contribution changes must go through Envoy Plan Services. Forms are available online at www.envoyplanservices.com.  

Q: How do I get information about Medicare?

  • Please visit Medicare online for more information. Please click for the Medicare and You Handbook.