Online Account Management Broker s User Guide

Transcription

1 Online Account Management Broker s User Guide

2 TABLE OF CONTENTS BROKER SINGLE SIGN-ON ACTIVATION BROKER SINGLE SIGN-ON REQUEST FORM BROKER NOTIFICATION OF ACCESS TO ONLINE ACCOUNT MANAGEMENT BROKER NUMBER LOGGING IN AS A BROKER WHERE DO I GO TO ACCESS ONLINE ACCOUNT MANAGEMENT? LOGGING IN BROKERS - ACCESSING EMPLOYER GROUPS INFORMATION HOW TO ACCESS THE EMPLOYER GROUPS ACCOUNT? BROKERS UPDATING YOUR PROFILE HOW DO I UPDATE MY PROFILE? EMPLOYER GROUPS - GRANTING ACCESS TO BROKERS HOW DO EMPLOYER GROUPS GRANT ACCESS? TECHNICAL ASSISTANCE WHO DO I CALL IF I NEED TECHNICAL ASSISTANCE? APPENDIX A - ELECTRONIC COMMERCE AGREEMENT APPENDIX B - SINGLE SIGN-ON REQUEST FORM APPENDIX C - BROKER WELCOME LETTER

3 Broker Single Sign-On Activation Broker Single Sign-On Request Form Brokers wishing to have a single sign-on to their group accounts through Online Account Management should log into their health plan s website on the employer or broker home page and download the Broker Sign-On Request form. The Brokers must also read the Electronic Commerce Agreement prior to signing up for Online Account Management. (See Appendix B to review the Electronic Commerce Agreement.) Once they have filled out the form completely, they will need to fax the form to Group Administration Employer WEB Support Team at (866) (See Appendix A for sample form.) The Group Administration Employer WEB Support Team will conduct the necessary research to ensure that the broker requesting an account is eligible to have an Online Account Management account. Broker Notification of Access to Online Account Management Once the account has been created by the Group Administration WEB Support Team, a secure will be created and sent to the broker using the address supplied on the Sign-On request form. (Sample Letter - Appendix C) This will contain a letter to the broker and will include the brokers Login ID and Password needed to log into the Online Account Management for the first time. Broker Number In addition to the Login ID and Password, the broker will be given a unique broker number. The broker number is included in the e- mail notification sent to the employer with the Login ID and Password. This number will be required to obtain access to their employer group s accounts. This guide will cover how an employer allows access to the broker using the broker number. Logging in as a Broker Where do I go to access Online Account Management? Accessing Online Account Management is the same for Brokers as it is for Employers. The brokers need to log onto the health plan website that they requested their access for in the single sign-on request form. Once they are on that site, they need to enter the Employer Channel and click the Login button located in the left hand navigation box. (See screen shot below)

4 Logging In Once the broker clicks the Login button in the left navigation bar, they will be presented with the Login ID and Password boxes. (See screen shot below) Their login ID and initial password were included in the letter set via secure from the Group Administration WEB Support Team. The first time the broker logs into Online Account Management, they will be prompted to change their password and place a check mark in the agreement terms and click the submit button.

5 Brokers - Accessing Employer Groups Information How to access the Employer Groups account? Once the broker has logged in, they will be presented with the Broker Group List screen below. From this screen they can chose the employer group that they wish to access from the drop down and click submit to enter the account. Note the employer group must first grant access to the broker before the group will show on the brokers list. See the Employer Groups Granting Access to Brokers section of this user guide for instructions on adding a broker. Once they have selected and account and hit submit,, the screen will appear depending on the access that has been granted by the employer group. In the screen shot below, the broker has full access. Once the broker has finished in the employer s account, they simply need to click the Logout button at the top of the screen to return to the Broker Group List screen shown above.

6 Brokers Updating Your Profile How do I update my profile? Brokers can update there profile at anytime by clicking on the profile tab on the Broker Group List screen. Brokers have the ability to update their Agency Name, Phone number, address, Password and Secret Question.

7 Employer Groups - Granting Access to Brokers How do Employer Groups grant access? As mentioned earlier in this document, the broker was given a broker number at the same time they were sent their Login ID and Password. The broker number is what the Employer Group will use to set the broker up with access to their Online Account Management account. The employer must log into their Online Account Management account and access the Manage tab across the top of the screen. Once they are in the Manage tab, they will see the section called Manage Broker. (See screen shot below) Once the employer has entered the Manage Broker section of the Manage tab, they need to click on Add a Broker. Add a broker will bring up a screen where the broker number will be required to advance to the next screen. The broker must communicate their broker number to the employer group to gain access. The employer enters the broker number on this screen and clicks Search for broker to continue.

8 Once the system finds the broker number just entered, the employer will be presented with the screen below. On this screen, the employer has the ability to limit the access that the broker is granted to their account or grant them access to all areas. Once they fill out what they want the broker to access, they need to click the submit button at the bottom of the screen. They will then be presented with the screen below which states that they have granted access to the broker.

9 Technical Assistance Who do I call if I need technical assistance? Brokers can call the Group Administration CARE Team for technical help. The CARE Team numbers are as follows: HealthAmerica/HealthAssurance Carelink Georgia Group Health Plan Delaware Southern Health Services Tennessee Nebraska Iowa Altius Louisiana WellPath/North Carolina Kansas Personal Care

10 Appendix A - Electronic Commerce Agreement Electronic Commerce Agreement This Electronic Commerce Agreement (hereinafter Agreement ) is made by and between the health plan(s) identified on the Employer Web Account Request Form (hereinafter the Plan ), and the employer group listed on the Employer Web Account Request Form (hereinafter Group ). WHEREAS, the Plan provides health care benefits to Group s employees and their dependents; and WHEREAS, the Plan and Group desire to facilitate the transaction of business via an interactive Internet process provided by the Plan for access by the Group to certain Plan records for the purpose of viewing the Group s billing and eligibility related information, conducting billing related transactions and performing certain transactions on behalf of its employees and/or members; and WHEREAS, such services are all integral parts of the administration of insurance benefits provided by the Plan. NOW THEREFORE, in consideration of the mutual promises and covenants contained herein and other good and valuable consideration, the receipt of which is hereby acknowledged, the Parties hereto agree as follows: I. DEFINITIONS 1.1 Electronic Signature. Electronic Signature means a substitute for a written signature that is transmitted via electronic medium. For the purpose of this Agreement, the Electronic Signature is comprised of a LoginID and an Activation Password/Password. 1.2 Employer Admin. Employer Admin means a person who is employed by the Group and who is granted access to set up Group Users for the Group. 1.3 Group User. Group User means an entity or individual that the Group or Employer Admin. grants access to the Group s Online Account Management account in accordance with the terms and conditions of this Agreement. Such users may include employees, brokers or other agents of the Group. 1.4 Online Account Management. Online Account Management means an interactive Internet process provided by the Plan to send certain electronic mail notices and invoices to Group and for access by Group to certain Plan records for the purpose of viewing and changing the Group s premium billing and eligibility related information, conducting premium billing related transactions including, but not limited to, payment of premiums online, and such other transactions listed on the website, which list may be revised by the Plan from time to time, in its sole discretion. Such list may include: Review Group Demographics; View Roster; Download Roster, View/Print Account and Invoice Summary, View/Print/Download Invoice Detail, View Payment History/Current Balance; View Member Eligibility; Request ID Card; Request Certificate of Creditable Coverage; View Member Demographics; Submit a Question (specific to member); View Current ID Card; Review Service Requests; Ask a General Question; Request Literature. Online Account Management shall not include any activities that would enable the Group to review any protected health information of an employee or dependent as such term is defined in 45 C.F.R , as amended from time to time, or any medical or health information protected under state law. II. TERM AND TERMINATION 2.1 Term. This Agreement shall become effective upon Group s execution of the Employer Web Account Request Form and the Plan s acceptance and approval of the Request Form and this Agreement and, unless otherwise terminated as provided in Section 2.2, shall terminate automatically upon the termination or expiration of the agreement for health care benefits between Plan and Group. Approval of this Agreement by the Plan shall be signified by the issuance of a LoginID and Activation Password to the Employer Admin named on the form. 2.2 Termination and Suspension.

11 2.2.1 This Agreement may be terminated by either party with or without cause upon thirty (30) days written notice Plan may terminate this Agreement upon fifteen (15) days prior written notice to Group in the event of a material breach of the terms and conditions hereunder by Group (or by Group s agent, employee, or contractor) or a Group User; provided, however, that Group shall be allowed fifteen (15) days after receiving such notice to cure such breach. In the event that the alleged material breach is cured within such fifteen (15) days to the Plan s satisfaction, which shall not be unreasonably withheld, the Agreement shall continue in full force. In the event that said breach is not cured within such fifteen (15) day period, Plan shall give Group notice of the immediate termination of the Agreement Plan may terminate this Agreement immediately for cause in the event of Group s (or Group s agent, employee or contractors) or Group User s fraud, abuse, unauthorized transaction, unauthorized transfer or disclosure of information, or use of password and LoginId, access or disclosure of data, and/or failure to protect proprietary or confidential information Plan may suspend this Agreement and Group s access to Online Account Management if Group s accounts are inactive for a period of time that may suggest changes at the Employer Admin or Group User level for which Plan has not received notice. Plan shall provide Group with notice of such suspension within ten (10) days of such suspension and the opportunity to provide evidence of the continued protection of passwords and LoginIds by Group. If Group responds within a ten (10) day period of receipt of such notice, Group and Plan may determine whether to terminate the Agreement or to resume access to Online Account Management. If Group fails to respond within such ten (10) day period, Plan may terminate this Agreement In the event of suspected fraud or unauthorized use, which may be indicated by an unusually large volume of transactions, Plan may suspend Group s access to Online Account Management. Plan shall provide written notice to Group of such suspension and the concerns which gave rise to the suspension and shall provide Group with the opportunity to investigate any matter. If such matter is not explained or corrected to Plan s satisfaction, Plan may terminate this Agreement. III. THE PLAN S OBLIGATIONS 3.1 Access to Online Account Management. The Plan shall, subject to the terms of this Agreement, make available to the Employer Admin and Group Users, through Online Account Management, services and information for which access is authorized. Group acknowledges that this Agreement obligates the Plan only to provide access to Online Account Management of the Group s data. Group also understands and agrees that access may be prevented from time to time for system maintenance, updates or as a result of acts of God or other causes beyond Plan s control. Group acknowledges that Plan shall have no liability for Group s failure to access Online Account Management for any reason. 3.2 Passwords. The Plan shall provide Group access to Online Account Management via a LoginID and Activation Password provided to the Employer Admin designated on the Employer Account Form. The Plan shall provide access to the Employer Admin to create Group Users. 3.3 Title to Passwords. The Plan shall retain title to all Activation Passwords that Employer Admin is granted or which Employer Admin or Group Users create as a result of access granted them. 3.4 Status of Information. The Plan shall enable Group to view Plan s membership records with respect to Group s account. The Parties understand that this information is only as current as information provided by Group and processed by Plan and that such information is subject to change due to group coverage alterations, cancellations, or deletion of members. IV. GROUP OBLIGATIONS 4.1 Authorized Transactions Group represents and warrants that it will not engage in any transaction on behalf of a member unless it has received specific written authorization from the member or his or her legal representative to engage in such transaction. Group assumes all financial liability for any changes made in Online Account Management by Employer Admin, Group Users or any third party, whether authorized or unauthorized.

12 4.1.2 Group will designate an Employer Admin who shall be responsible for establishing Group User accounts for the Group. If the Group determine to permit its broker to have access to the Online Account Management, the Employer Admin shall establish such account using the Broker identication number provided by Plan to broker. Group acknowledges that it is solely responsible for the actions of all Group Users including any Group User that is the Group s broker. 4.2 Maintenance of Security. Group agrees that responsibility for the maintenance and security of the Employer Admin and Group User accounts are the sole responsibility of the Group. Group shall maintain adequate security procedures to prevent unauthorized access to electronic services and data and shall immediately notify the Plan of any unauthorized attempts to access and/or tamper with electronic data. Group further understands and agrees that security access codes, LoginIDs and/or Activation Passwords/Passwords shall not be disclosed to any third party or unauthorized employee of the Group in any manner. Group acknowledges the Plan may change such codes at any time without notice. Group assumes all liability for any damage, whether direct or indirect, to the electronic data or to the Plan s systems caused by unauthorized use of such systems by Employer Admin, Group Users or any third party. Group shall provide Plan with the names, addresses and phone numbers of all Group Users, upon Plan s request. 4.3 Electronic Signature. Group understands that LoginIDs and Activation Passwords/Passwords constitute an Electronic Signature for purposes of Online Account Management. Group understands that Employer Admin and Group Users are responsible for securing their Electronic Signatures so that the Electronic Signatures are never compromised, released or discovered by any person who does not have authorization to engage in a transaction pursuant to this Agreement. If a breach of this provision occurs, Group must notify the Plan immediately by telephone to the Plan s Net Support Team at Privacy of Information. Group shall now and in the future comply with all laws, state and federal, dealing with employee and/or member records and personal privacy information. Group will maintain the confidentiality of such records and information for the benefit of the employee and/or member as is required by law. 4.5 Confidentiality of Information. Group shall maintain the confidentiality of all information that it receives in connection with Online Account Management and all other information that it knows or should know is confidential and proprietary information of Plan. Group will immediately notify the Plan of any unauthorized disclosure of the Plan s or Group s proprietary information and/or confidential information that comes to its attention and will cooperate with the Plan in the event of any litigation concerning unauthorized use, transfer or disclosure of such information. 4.6 Termination of Employer Admin. If the Employer Admin resigns or is terminated from his or her employment, or Group decides to change the Employer Admin, Group must notify the Plan within the later of (i) 24 hours after notice of termination or change is provided to or by the Employer Admin or (ii) five (5) days in advance of the effective date of termination of the employment of the Employer Admin. In connection with such notice, Group shall provide information on a replacement for the Employer Admin using the Employer Account Form. In the event no replacement information is provided, Group understands that its account will be deactivated until such time as replacement information is provided to the Plan. Group is responsible for any breaches of the security of that Employer Admin s Electronic Signature until Group has been notified by the Plan that the Electronic Signature has been deactivated. 4.7 Termination of Group User. If a Group User resigns, is terminated from his or her employment, or otherwise severs its relationship with Group, or Group decides for any reason to terminate Group User s access to Online Account Management, Group is solely responsible for deactivating his/her account within 24 hours of when the decision to terminate the Group User is made or when the Group User discloses his or her initial intent to resign. Group is responsible for any breaches of the security of that Group User s Electronic Signature until Group has deactivated the account. 4.8 Costs. Group shall assume all costs associated with its establishment and operation of Online Account Management including, but not limited to, the costs of personal computers (PCs) terminals, connections, modems, and Internet service providers and browsers. 4.9 Document Retention. Group shall maintain, in accordance with its own document retention policy, true copies of any source documents from which it produces electronic data. The Plan reserves the right to audit, at any time, source documents relative to the Plan s reconciliation process and/or require Group to produce source documents that result in the electronic change, addition or deletion.

13 4.10 Billing Statement. Group acknowledges and understands that any changes, additions, or deletions to enrollment data affect invoice, statement and current balance amounts. Group understands and agrees that it remains obligated to pay the amount that is due based on actual enrollment regardless of what is initially billed Indemnification. Group shall indemnify, defend and hold the Plan, its officers, directors, employees and agents harmless for any loss or damages including, without limitation all costs and attorneys fees arising from any act or omission of Group, its employees Employer Admin, Group Users or agents, including but not limited to, unauthorized disclosure of LoginID, Activation Passwords, Passwords, and other security access codes, its failure to prevent access or use of the system by any third party or unauthorized employee and from any unauthorized transactions. Group shall indemnify the Plan against any and all damages, costs and reasonable attorney s fees which may result from Group s, Group User s or Employer Admin s disclosure of the Plan s or Group s proprietary and confidential information in violation of this Agreement Survival. The terms of this section shall survive the termination of this Agreement. V. MISCELLANEOUS 5.1 Amendment. This Agreement may only be amended with the mutual written consent of the parties; provided Plan may amend this Agreement to the extent necessary to comply with applicable Federal or State law, regulatory requirements, accreditation standards or licensing guidelines or rules. Plan shall give advance notice to Group of such amendment and the effective date of the amendment. Group may terminate the Agreement if it objects to the amendment. 5.2 Assignment/Subcontracting. Neither party shall have the right to assign any of its rights or obligations hereunder without the prior written consent of the other party; provided, however, that nothing herein shall prevent the assignment by Plan of its rights, duties and obligations under this Agreement to any entity that controls, is controlled by, or is under common control with Plan. 5.3 Notices. Except as set forth herein, all notices required or permitted to be given hereunder, shall be in writing and shall be sent by mail, certified or registered, return receipt requested, postage prepaid, or by to the parties hereto at their respective addresses set forth on the Employee Account Form. Except as set forth herein, if mailed in accordance with the provisions of this paragraph, such notice shall be deemed to be received three (3) business days after mailing. 5.4 Waiver of Breach. The waiver of or failure to enforce, by either party, or a breach or violation of any provision of this Agreement shall not operate as, nor be construed to be, a waiver of any subsequent breach thereof. Any specific waiver by either party of any of the terms of this Agreement shall be considered a one-time event and shall not constitute a continuing waiver. 5.5 Severability. If, for any reason, any provision of this Agreement is determined by law, act, decision, or regulation of a duly constituted body or authority, to be invalid, such determination shall not nullify any of the other terms and provisions of this Agreement and, unless otherwise agreed to in writing by the parties, then, the said provision or provisions shall be deemed automatically amended as may be necessary to conform this entire Agreement with such applicable law, act, decision, rule or regulation. 5.6 No Third Party Beneficiary. This Agreement is entered into by and between Group and Plan. There is no intent by either party to create or establish third party beneficiary status or rights or their equivalent in any person, including without limitation, Members and no such third party shall have any right to enforce any right or enjoy any benefit created or established under this Agreement. 5.7 Entire Agreement. This Agreement shall constitute the entire agreement relating to the subject matter hereof between the parties hereto, and supersedes all other agreements, written or otherwise.

14 Appendix B - Single Sign-On Request Form Coventry Health Care, Inc. Single Sign-on Broker Setup Form The purpose of this form is to establish a Broker Account which will provide you with single sign-on access to all of your employer accounts. Please note that each of your employer groups is responsible for granting (and terminating) your access to their Online Account Management accounts. Once an employer has established your access, the employer account can be accessed through your single sign-on account. Please complete the following information: Broker Name: Broker Agency Name: Check box(es) below for each Coventry health plan for which the broker contracts with employer group Altius Carelink CHC of DE CHC of GA Southern Health CHC of IA CHC of LA CHC of KS CHC of NE Personal Care CHC of OK GHP WellPath CHC of TN Health America/Health Assurance Broker Information You are responsible for following all stipulations is accordance with the Electronic Commerce Agreement signed by the employer group. The Employer Administrator of your employer group is responsible to provide you with access to their Online Account Management account. Once your registration has been completed, a broker access ID will be assigned to you. You must provide that ID number to the employer group. Please provide the following information to register: Name(First, MI, Last): Title: Work Address: City / State / Zip: Work Phone Number: Address: ***Login information will be sent via Secure from EmployerNetSupport@cvty.com, to the address listed above. You may need to adjust your spam filter to accept s from this address.*** Request and Agreement: I am hereby requesting the establishment of Broker Single Sign-on Access. Please establish a Broker Sign-on Account pursuant to the information I have provided above. I understand and agree that Coventry Health Care, Inc. must be notified promptly of any changes to my Broker information. By signing below, Broker acknowledges and agrees that Broker has read the Electronic Commerce Agreement and agrees to the terms and conditions therein. For purposes of this Agreement, a signature sent by facsimile transmission shall have the full force and legal effect of an original signature. This form must be signed by the licensed agent/broker requesting access Signed: Print Name: Title: Date: Fax To Coventry Online Account Management Coventry Health Care, Inc. Online Account Management PO Box Harrisburg, PA

15 Appendix C - Broker Welcome Letter Thank you for your recent request for broker access to Online Account Management! We re pleased to provide you with your Broker Number, Login ID and Password so that you can begin to use the site. Here s how: Broker Number Your Broker Number will be used by the Employer Administrator for each of your groups to grant you access to their Online Account Management account. YOUR BROKER NUMBER: What does the Employer Administrator need to do? Provide your Broker Number to the Employer Administrator for each of your groups. The Employer Administrator will use the Broker Number to grant you access to their account by going to the Manage/Broker tab within their Online Account Management account. From the Manage Broker screen, the Employer Administrator will click on the Manage Broker tab and follow the steps until the broker has been granted permissions to access their Online Account Management account. Login Information Your Login ID and password were customized just for you as a broker. YOUR LOGIN ID: ACTIVATION PASSWORD: To login go to and click on the LOGIN link located on the Employer Channel of the website. Enter your Login ID and Password in the boxes that appear in the center of your screen. You will be prompted to create your own personal Password at the time of your initial login. Once logged in, you can choose which group s Online Account Management account that you would like to enter by choosing it from the Broker Group drop down list. All groups that you have permission to access will appear in the drop down list selection. Support Our CARE Team is available at during our regular business hours to assist you with any technical questions regarding the site. Welcome to Online Account Management!