Online Benefits Management

Avesis Advantage Vision Care Online Benefits Management Complete Instructions for e-billing & Group Maintenance

Benefits Manager, Thank you for your interest in the Avesis Online Benefits Management System. You have the option of choosing a system that makes the process of managing your group s vision benefit convenient and simple. You will no longer be required to maintain paper records or rely on others to update the status of your group enrollment and changes. Avesis gives you the power to control your plan when it is convenient for you. Add new members, change dependent status, print invoices and more all online. This system not only saves you valuable time, but it also gives you the power to recalculate your monthly invoice each and every time you make a cost-reflecting change. About this Guide The Avesis Online Benefits Management system will be described in detail within this guide. You will learn how easy it is to: sign-up begin enrollment of new members receive your monthly invoices electronically manage the changes of your group s vision plan recalculate and print your most up-to-date invoice This guide should provide you with the necessary information that will enable you to begin managing your group online. However, if questions do arise, you should direct them to your group s Account Representative. Sincerely, Avesis Questions? Call the Avesis Online Billing Department: 1.800.522.0258 3

Contents The Avesis Website Introducing the Avesis Website 8 Online Member Enrollment How Online Member Enrollment Works 15 Introduction to Online Member Enrollment 15 e-billing Why Online Benefits Management? 18 The e-billing Process in a Nutshell 19 Signing-up for Online Billing 20 Activation e-mail 22 e-bill Notification 23 e-billing Login 24 Login Terms 25 e-bill 26 Electronic Billing and Eligibility Page 27 Viewing & Confirming Your Bill 28 Sending Payment 31 Sub-Groups About Sub-Groups 34 Group Maintenance Group Maintenance Overview 38 Important Notes about Billing Accuracy 41 Add A New Member 42 Edit An Existing Member/Dependent 45 Terminate An Existing Member/Dependent 49 Reinstate A Terminated Member 52 Add A New Dependent 54 Edit Group Contact Information 58 List All Members 60 Download A Vision Claim Form 61 COBRA 62 Questions? Call the Avesis Online Billing Department: 1.800.522.0258 5

The Avesis Website Introducing the Avesis Website

The Avesis Website Introducing the Avesis Website In order to access Online Benefits Management, it is necessary to become familiar with the avesis.com website. A screenshot of the avesis.com homepage is displayed below. This initial page will allow visitors to choose their area of interest Vision or Dental. The Avesis website contains a section for the use of Benefits Managers and Plan Administrators. Here you will be able to sign-up for Online Benefits Management if you are a new member, or login into your account if you are a returning user. 8 www.avesis.com

In order to access the Benefits Manager s portion of the site, you will need to click the For Vision area, circled below. The following page appears. If you place your cursor on Benefits Managers in the toolbar, you will find a drop-down menu with some of your Benefits Manager tools. Questions? Call the Avesis Online Billing Department: 1.800.522.0258 9

The Avesis Website Introducing the Avesis Website (continued) From this drop-down menu, you can select provider search, online billing sign-up, online billing login, forms, benefits managers FAQ, or contact Avesis. These options are discussed below. Members Providers Brokers Benefits Managers Provider Search Online Billing Sign-up Online Billing Login Forms Benefits Managers FAQ Contact Avesis Provider Search This feature allows you to locate a provider using a number of different search criteria. Online Billing Sign-up This feature allows you to sign-up for e-billing quickly and easily, see page 20. Online Billing Login Once you are signed-up for online billing and have received your user name and password by e-mail, you can use this option to log into your account. Forms Choose this option to download a vision claim form. Benefits Managers FAQ Question? Try looking at the Frequently Asked Questions page to find your answer. Contact Avesis This page contains address, phone number, hours of operation, and an e-mail message option. 10 www.avesis.com

If you click Benefits Managers on the toolbar instead of utilizing the drop-down menu options, the Benefits Manager s page will appear. Once you login, you can access all the e-billing and group maintenance options. Benefits Manager s Page Notice: There is an online demo to supplement this guide. It s a quick way to find the information you re looking for without paging through this guide. Questions? Call the Avesis Online Billing Department: 1.800.522.0258 11

Online Member Enrollment Introduction to Online Member Enrollment How Online Member Enrollment Works

Online Member Enrollment Introduction to Online Member Enrollment Online member enrollment is an option for new groups who wish to use the convenience of the internet to allow members to enter enrollment information on their own. There are no paper forms to fill out and mail in, which saves time and increases accuracy. How Online Member Enrollment Works The administrator must sign-up the group for online enrollment at www.avesis.com. Then, call an Avesis Implementation Specialist to assist you in setting up the online environment. Once set-up, Avesis will send the Benefits Manager a link to access a data entry page for entering member and dependent information. This link will remain active for a specific period of time, which usually coincides with your open enrollment period. Once each member enrolls, his or her eligibility information (including dependent information) is automatically entered into the Avesis eligibility database. To ensure the accuracy of this information, a summary report is e-mailed to the Benefits Manager detailing every record entered. To take advantage of this time-saving feature, please contact an Implementation Specialist at 1.800.522.0258 ext. 233. Questions? Call the Avesis Online Billing Department: 1.800.522.0258 15

e-billing Why Online Benefits Management? The e-billing Process in a Nutshell Signing-up for Online Billing Activation e-mail e-bill Notification e-billing Login Login Terms e-bill Electronic Billing and Eligibility Page Viewing & Confirming Your Bill Sending Payment

e-billing Why Online Benefits Management? One of the key advantages of signing-up for Avesis Online Benefits Management is the ability to receive and completely manage your vision plan billing online. This process is described by Avesis as e-billing. With e-billing, you will never miss a payment, wait for change forms, or have any question as to the amount due to Avesis. Additionally, Benefits Managers can login and review current billing information at any time. The Advantages of Online Benefits Management Make eligibility changes effective instantly No more paper bills, change forms, or enrollment forms Change member information without picking up the phone, sending e-mails, or faxing e-billing is available 24/7 18 www.avesis.com

The e-billing Process in a Nutshell 1Receive e-mail Notification and Login When payment is due, the benefits manager receives an e-mail providing a link to a webpage that contains billing information. 2View Current Bill The Benefits Manager then looks over the bill to verify the charges are accurate. 3Make Changes, if Necessary } Group Maintenance: (pages 38-60) Add a Member Edit an Existing Member/Dependent Terminate A Member Reinstate a Terminated Member Add A New Dependent Edit Group Contact Information 4Confirm Bill This requires the Benefits Manager s initials to confirm that the bill has been verified. 5Print Payment Voucher & Send Payment Print the payment voucher and mail it to Avesis along with your payment. Questions? Call the Avesis Online Billing Department: 1.800.522.0258 19

e-billing Signing-up for Online Billing If you have elected to utilize our online member enrollment option, you are already signed-up for e-billing. If you did not select online member enrollment, you must sign-up for e-billing. STEP 1: Rollover Benefits Managers on the toolbar and click on Online Billing Sign-up in the drop-down menu that appears. STEP 2: Populate all fields Members Providers Brokers Benefits Managers Benefits Managers Provider Search Online Billing Sign-up Online Billing Login Forms Benefits Managers FAQ Contact Avesis 20 www.avesis.com

Group Sign Up You have reached this page because you are an existing Avesis group that would like to begin managing its billing and eligibility online. If this is correct, please fill out the form below. Then, click Submit. This system allows you to view, modify, print and verify your monthly invoices online. (Online payment coming soon!) In addition, your group will maintain all of its own eligibility online in a secure, 100% real-time environment. What Avesis Group are you with? Carrier/Group Number: Company Name: Telephone: Who will be administering these online services for your company? * First Name: Last Name: User Name (to log in): E-Mail: Confirm E-Mail: What month would you like to begin utilizing Avesis online services? (The first month you would like to verify an invoice online) (All fields required) SUBMIT STEP 3: Click SUBMIT to complete e-billing sign-up Note: If the administrator name entered does not match that of the billing administrator on file, Avesis must validate this request for security purposes, possibly delaying access to these online services. Questions? Call the Avesis Online Billing Department: 1.800.522.0258 21

e-billing Activation e-mail Within five business days of signing up, you will receive an e-mail that will introduce you to e-billing and go over important details about the activation of the account, including your user name and password. 22 www.avesis.com

e-bill Notification Now that your online account has been activated, you will no longer receive paper bills by mail. Each month, on or around the 15th, you will receive an e-mail informing you that your most recent bill is ready for review. Tip: Once you click on the link in the body of the e-mail, save the site to your favorites. This allows you to quickly access your account at any time. Questions? Call the Avesis Online Billing Department: 1.800.522.0258 23

e-billing e-billing Login When you click on the link provided in your e-bill notification, you will be brought to a login page. Simply, populate the fields and click Go. E-Eligibility and E-Billing Login Carrier Number User Name Password Forgot it? Go New User? 24 www.avesis.com

Login Terms Carrier Number This is a 5-digit number assigned to you by your Avesis Implementation Specialist during the group set-up process. User Name The user name is your identification for the e-billing system. It must be at least 5 characters. Password Your password must be at least 5 characters and cannot be the same as your user name. Forgot it? If you forget your password, click here. Fill in both required fields, and Avesis will e-mail you your password. New User? Clicking New User? is another way of getting to the group sign-up page discussed on page 20. If you are a first-time user, your password will be disclosed to you by Avesis in the e-mail about your account activation (see page 22). Upon login, you will be prompted to change your password. There is only one user name and password per group, unless your organization elects to have subgroups. For information about sub-groups, see page 34-35. Questions? Call the Avesis Online Billing Department: 1.800.522.0258 25

e-billing e-bill If you are logging onto your account via the link within your monthly e-mail notification, the first screen that will be displayed upon login is your current e-bill. CURRENT BILL FOR JANUARY 2006 Is The Billing Invoice Below Correct? CLICK YES OR NO AT THE BOTTOM OF THIS PAGE Company Name ATTN: Contact Person 2000 Main Street Baltimore, MD 21201 Group #: 123-02 Coverage: January 2006 Due Date: 1/1/2006 Rates: Employee Only-(EE) Employee + Family-(FAM) $10.95 $20.95 Printer Friendly Version ( PRINTABLE COPY ) MEMBER # COVERAGE 956555656V,FAM 121212121V,FAM 652146868V,EE 501869589V,FAM 542114444V,EE MEMBER NAME Member Name Member Name Member Name Member Name Member Name EFFECTIVE 1/1/2006 1/1/2006 1/1/2006 1/1/2006 1/1/2006 AMOUNT $20.95 $20.95 $10.95 $20.95 $10.95 ***Invoice Summary*** Employee Only [2] Employee + Family [3] Current Month Due $21.90 $62.85 $84.75 Is The Billing Invoice Above Correct? YES. This information is correct. The Amount Due will be submitted to Avesis. NO. The information is not correct and I d like to make changes. e-bill 26 www.avesis.com

Electronic Billing and Eligibility Page If you are logging into the Online Benefits Management system directly, and there is no current bill to review, the Electronic Billing and Eligibility page will appear. Electronic Billing and Eligibility Company Name, 123-02 There are no current bills to review. You may make any necessary changes by selecting from the menu below. Add A New Member Edit An Existing Member/Dependent Terminate An Existing Member/Dependent Reinstate A Terminated Member Add A New Dependent Edit Group Contact Information Summary Of This Session List All Members Electronic Billing and Eligibility Page The Electronic Billing and Eligibility menu displays all the management options for editing and maintaining member and group information. Questions? Call the Avesis Online Billing Department: 1.800.522.0258 27

e-billing Viewing & Confirming Your Bill If you have not confirmed a previous bill(s), the most recent bill without confirmation will be displayed after logging in. You must first confirm that bill. Then, to proceed with additional bills, you will need to log off and back on in order for the database to regenerate the most recent bill. STEP 1: View e-bill and make sure the contents are correct STEP 2: If the current bill is accurate and does not require changes, click YES. This information is correct. The Amount Due will be submitted to Avesis. This item appears in green, at the bottom of the e-bill. If the bill is not accurate and requires changes, click NO. The information is not correct and I d like to make changes. This item appears in red, at the bottom of the page. Instructions for making changes follow on pages 38-60, Group Maintenance. 28 www.avesis.com

CURRENT BILL FOR JANUARY 2006 Is The Billing Invoice Below Correct? CLICK YES OR NO AT THE BOTTOM OF THIS PAGE Company Name ATTN: Contact Person 2000 Main Street Baltimore, MD 21201 Group #: 123-02 Coverage: January 2006 Due Date: 1/1/2006 Rates: Employee Only-(EE) Employee + Family-(FAM) $10.95 $20.95 Printer Friendly Version ( PRINTABLE COPY ) MEMBER # COVERAGE 956555656V,FAM 121212121V,FAM 652146868V,EE 501869589V,FAM 542114444V,EE MEMBER NAME Member Name Member Name Member Name Member Name Member Name EFFECTIVE 1/1/2006 1/1/2006 1/1/2006 1/1/2006 1/1/2006 AMOUNT $20.95 $20.95 $10.95 $20.95 $10.95 ***Invoice Summary*** Employee Only [2] Employee + Family [3] Current Month Due $21.90 $62.85 $84.75 Is The Billing Invoice Above Correct? YES. This information is correct. The Amount Due will be submitted to Avesis. NO. The information is not correct and I d like to make changes. e-bill Questions? Call the Avesis Online Billing Department: 1.800.522.0258 29

e-billing Viewing & Confirming Your Bill (continued) The following confirmation page is displayed when you select, YES. This information is correct. The Amount Due will be submitted to Avesis in green at the bottom of the e-bill. YOU HAVE INDICATED THAT NEXT MONTH S BILLING INVOICE FOR COMPANY NAME IS CORRECT. THE CURRENT PREMIUM DUE IS $84.75 Please enter your initials below then click Confirm to finalize [Month] s bill. A printable payment voucher will be displayed on the following page, please include a copy of this voucher with [Month] s payment. (NOTE: IF THE PREMIUM DUE DISPLAYED ABOVE IS INCORRECT, OR YOU DO NOT WISH TO FINALIZE [MONTH] S BILL AT THIS TIME, CLICK CANCEL. NO FURTHER CHANGES CAN BE MADE TO [MONTH] S BILL ONCE IT IS CONFIRMED.) Initials: Confirm Cancel STEP 3: Enter your initials in the field provided. Confirmation Page STEP 4: Click Confirm Once you click Confirm, you cannot make any additional changes until the next month s bill. Please, make certain that all information has been correctly edited before selecting confirm. 30 www.avesis.com

Sending Payment STEP 1: Print your payment voucher (example below) by clicking the Printer icon. The icon appears on the top and then again on the bottom of your payment voucher. After you click Print, a page will appear letting you know the bill confirmation was successful. The page will also provide instructions if you experience trouble printing your payment voucher. Avesis Incorporated NOVEMBER 2005 PAYMENT VOUCHER PLESE PRINT THIS BILLING PAYMENT VOUCHER BY CLCIKING PRINT. PLEASE REMIT PAYMENT TO: Print AVESIS INCORPORATED P.O. BOX 52718 PHOENIX, AZ 85072 AVESIS ADDRESS ABOVE WILL SHOW THROUGH A STANDARD WINDOW ENVELOPE. COMPANY NAME 123-02 NOVEMBER 2005 AMOUNT DUE: $84.75 DUE DATE: 10/1/2005 Print PLEASE PRINT THIS BILLING PAYMENT VOUCHER BY CLICKING PRINT, AND INCLUDE A COPY WITH YOUR PAYMENT. STEP 2: Payment Voucher Mail voucher to Avesis with the required payment amount. Any additional changes to member information should be made on the next monthly billing. Retroactive adjustments will be calculated at that time. Questions? Call the Avesis Online Billing Department: 1.800.522.0258 31

Sub-Groups About Sub-Groups

Sub-Groups About Sub-Groups Sub-Groups are important for companies with a large number of members. Having sub-groups allows there to be separate billing for different locations and it allows for multiple benefits managers to maintain the groups eligibility updates. If your organization has been implemented with sub-groups, there are two subtle differences in your benefits management. Once you login, you will see the sub-group selection page (shown below), where you will have to select the sub-group that you would like to view or modify. Sub-Groups can be named by location, store number, or whichever naming method the organization prefers. 34 www.avesis.com

After selecting one sub-group, you now have the ability to view and confirm the current bill, view member information, or modify member information within that sub-group. Sub-Group Electronic Billing and Eligibility Page To return to the sub-group selection page, click DISPLAY SUB- GROUPS (circled above). Then, select the sub-group you would like to view or modify next. Questions? Call the Avesis Online Billing Department: 1.800.522.0258 35

Group Maintenance Group Maintenance Overview Important Notes about Billing Accuracy Add A New Member Edit An Existing Member/Dependent Terminate An Existing Member/Dependent Reinstate A Terminated Member Add A New Dependent Edit Group Contact Information List All Members Download A Vision Claim Form COBRA

Group Maintenance Group Maintenance Overview Group Maintenance is required in order to update a bill that is inaccurate when member or group information has changed. Editing options are displayed on the Electronic Billing and Eligibility page. Carrying out any of the change options listed on this menu will change the amount due to Avesis on your bill. The process of making an edit to member or group information, and updating a bill is summarized below: STEP 1: After you have clicked on the e-mail notification link to view your bill and you have identified an error, click NO. The information is not correct and I d like to make changes. This item appears in red, at the bottom of the e-bill. STEP 2: Select the category of information you would like to modify from the Electronic Billing and Eligibility page that appears. Add A New Member Edit An Existing Member/Dependent Terminate An Existing Member/Dependent Reinstate A Terminated Member Add A New Dependent Edit Group Contact Information Summary Of This Session List All Members Electronic Billing and Eligibility Menu 38 www.avesis.com

STEP 3: Edit the information that requires modification. Steps for each editing category are on the following group maintenance pages. STEP 4: When you have finished editing information, click Summary of Session on the Electronic Billing and Eligibility menu. ber Member/Dependent xisting Member/Dependent minated Member Add A New Dependent Edit Group Contact Information Summary Of This Session List All Members Clicking "Summary Of This Session" allows you to view all the actions you took during the session. A sample summary is shown on the following page. Questions? Call the Avesis Online Billing Department: 1.800.522.0258 39

Group Maintenance Group Maintenance Overview (continued) Newly Added Members - Test Member Edited Members - Test Member Terminated Members - Test Member, Jr. Reinstated - Another Member What Would You Like To Do Next? You may make any necessary changes by selecting from the menu below. Add A New Member Edit An Existing Member/Dependent Terminate An Existing Member/Dependent Reinstate A Terminated Member Add A New Dependent Edit Group Contact Information Summary Of This Session Update [Month] s Bill Summary of Session Page STEP 5: Then click, Update [Month] s Bill on the Summary of Session Page STEP 6: View bill and confirm its accuracy STEP 7: Print payment voucher and send to Avesis with payment 40 www.avesis.com

Important Notes about Billing Accuracy In order for the billing amount to be accurate, it s imperative that the coverage codes be correct for each individual in your group. The premium due is calculated from these coverage codes. When you terminate a dependent, the cardholder s coverage does not automatically go back to EE. You must manually change the coverage code of the cardholder back to EE. If this process is not carried out, the bill will reflect a higher charge due to the cardholder s coverage code remaining DEP. Coverage codes are described below. Always keep them in-mind when making changes to member and dependent coverage. Coverage Code Shorthand EE Employee only DEP Employee plus one dependent CHD Employee plus children FAM Employee plus family TIER 1 TIER 2 TIER 3 TIER 4 Also, it is very important that the entire billing amount that is confirmed be the exact payment amount that is actually submitted. Do not over or underpay a bill to account for changes not calculated on the confirmed bill. Any additional changes to member information should be made on the next monthly billing. Retroactive adjustments will be calculated at that time. Questions? Call the Avesis Online Billing Department: 1.800.522.0258 41

Group Maintenance Add A New Member As new employees are hired or open enrollment attracts new vision members, it will be necessary to add new members to the Avesis eligibility database. This is the first option listed on the Electronic Billing and Eligibility menu. The steps for adding a new member follow: STEP 1: Login STEP 2: Click "Add A New Member" Add A New Member Edit An Existing Member/Dependent Terminate An Existing Member/Dependent Reinstate A Terminated Member Add A New Depende Edit Group Contact In Summary Of This Se List All Members Electronic Billing and Eligibility Menu 42 www.avesis.com

STEP 3: After clicking the Add A New Member link, a data entry page will appear. Populate all required fields (denoted by a red asterisk). * First Name: M. I.: * Last Name: SSN: * Birth Day: * * Effective Date: * Address: Addr 2: * Zip: * Coverage: E-Mail Address: Home Phone: Work Phone: * Sex: M Month Day Year November 1 2005 EE- Employee Only Check If COBRA Member Add A Member Data Entry Page If the coverage code is anything other than EE, you will be asked Would You Like To Add This Member s Dependent(s) Now? If no, continue onto step 4 on the next page. If yes, go to step 3 of Add A New Dependent (page 54). Questions? Call the Avesis Online Billing Department: 1.800.522.0258 43

Group Maintenance Add A New Member (continued) STEP 4: Click STEP 5: ADD to continue the process of adding a member. You will be prompted, "Is the information displayed below correct?" If yes, click the "YES" button and the information will be added to the system. If the information displayed is not correct, click the No button and you will return to the data entry page. Is the Information Displayed Below Correct? Name : TEST MEMBER Address : 2000 MAIN ROAD ROSELAND, PA 30001 Sex : M Birth Date : 12/3/1969 Effective Date : 11/1/2005 Coverage : EE Is This Correct? Yes No 44 www.avesis.com

Edit An Existing Member/Dependent Editing a member or dependent is required when some aspect of that member s information has changed. For example, the member s address may have changed, the member may have had a name change, they may have elected to change their coverage; or perhaps you have just recognized an error, and wish to correct it. The steps for editing an existing member or dependent are as follows: STEP 1: Login STEP 2: Click "Edit An Existing Member/Dependent" Add A New Member Edit An Existing Member/Dependent Terminate An Existing Member/Dependent Reinstate A Terminated Member Add A New Depende Edit Group Contact In Summary Of This Se List All Members Electronic Billing and Eligibility Menu Questions? Call the Avesis Online Billing Department: 1.800.522.0258 45

Group Maintenance Edit An Existing Member/Dependent (continued) STEP 3: There are several different criteria you can use to search for the member you would like to edit. You can use any one or a combination of these search criteria: cardholder s first name, cardholder s last name, cardholder s member number, dependent s first name, dependent s last name, dependent s member number. Last Name : First Name : Member Number : STEP 4: Click Search to locate the member you wish to edit. STEP 5: Select the member or dependent s name (shown in blue and underlined) from the list whose information you wish to modify. Depending on the search criteria, multiple names may appear on the list. Member Member # Coverage Status Effective Date Member, Test 7074862X-01 EE ACTV 11/1/2005 Note: The pencil next to the member s name will pivot when it s rolled over to help you visually clarify which member you are selecting. 46 www.avesis.com

STEP 6: Edit the data that requires modification. * First Name: M. I.: * Last Name: SSN: * Birth Day: * * Effective Date: * Address: Addr 2: * Zip: * Coverage: E-Mail Address: Home Phone: Work Phone: Test * Sex: M Member February 2 1954 November 1 2005 2000 Main Street 21110 DEP- Employee + Dependent Check If COBRA Member Edit A Member Data Entry Page Questions? Call the Avesis Online Billing Department: 1.800.522.0258 47

Group Maintenance Edit An Existing Member/Dependent (continued) STEP 7: Click STEP 8: EDIT to continue the editing process. You will be prompted, "Is the information displayed below correct?" If yes, click the "YES" button and the information will be added to the system. If the information displayed is not correct, click the No button and you will return to the data entry page. Is the Information Displayed Below Correct? Name : TEST MEMBER Address : 2000 MAIN ROAD ROSELAND, PA 30001 Sex : M Birth Date : 12/3/1969 Effective Date : 11/1/2005 Coverage : EE Is This Correct? Yes No 48 www.avesis.com

Terminate An Existing Member/Dependent When a member s employment is terminated or the member has decided to no longer participate in the vision plan, you can remove him/her from the Avesis eligibility database. Termination of a cardholder will automatically terminate dependents attached to that cardholder. A member can also elect to no longer cover dependents, but keep individual coverage. The steps for terminating a member or dependent follow: STEP 1: Login STEP 2: Click "Terminate An Existing Member/Dependent Add A New Member Edit An Existing Member/Dependent Terminate An Existing Member/Dependent Reinstate A Terminated Member Add A New Depende Edit Group Contact In Summary Of This Se List All Members Electronic Billing and Eligibility Menu Questions? Call the Avesis Online Billing Department: 1.800.522.0258 49

Group Maintenance Terminate An Existing Member/Dependent (continued) STEP 3: There are several different criteria you can use to search for the member you would like to terminate. You can use any one or a combination of these search criteria: cardholder s first name, cardholder s last name, cardholder s member number, dependent s first name, dependent s last name, dependent s member number. Last Name : First Name : Member Number : STEP 4: Click Search to locate the member you wish to terminate. STEP 5: Select the member or dependent s name from the list who you would like to terminate. Multiple names may appear on the list. Member Member # Coverage Status Effective Date Member, Test 7074862X-01 EE ACTV 11/1/2005 50 www.avesis.com

STEP 6: Use the drop-down menus to enter a termination date. SELECT A TERMINATION DATE, THEN CLICK TERM. MONTH: November DAY: 1 YEAR: 2005 STEP 7: Click TERM to complete the termination process. IMPORTANT: If you are terminating a dependent s coverage, you must manually change the coverage code of the cardholder back to EE. The cardholder s coverage does not automatically go back to EE. If this process is not carried out, the bill will reflect a higher charge due to the cardholder s coverage code remaining DEP. Questions? Call the Avesis Online Billing Department: 1.800.522.0258 51

Group Maintenance Reinstate A Terminated Member If a former employee is re-hired or a former member wishes to participate in the vision benefit again, it may be necessary to reinstate the member s status in the Avesis eligibility database. The process of reinstating a terminated member is explained in the following steps: STEP 1: Login STEP 2: Click "Reinstate A Terminated Member." Add A New Member Edit An Existing Member/Dependent Terminate An Existing Member/Dependent Reinstate A Terminated Member Add A New Depende Edit Group Contact In Summary Of This Se List All Members STEP 3: Electronic Billing and Eligibility Menu There are a few different criteria you can use to search for the member you would like to reinstate: member s first name, member s last name, or member number. You can use any one or a combination of these search criteria. Last Name : First Name : Member Number : 52 www.avesis.com

STEP 4: Click Search to locate the member you wish to reinstate. STEP 5: Select the former member's name from the list who you would like to reinstate. Multiple names may appear on the list depending on your search criteria. Member Member # Coverage Status Effective Date Member, Test 333333222V-01 EE TERM 10/17/2005 STEP 6: Use the drop-down menus to enter the new effective date to reinstate. This date must be later than the termination date. ENTER NEW EFFECTIVE DATE TO REINSTATE: November DAY: 1 YEAR: 2005 STEP 7: Click Reinstate to enact the effective date of reinstatement. Questions? Call the Avesis Online Billing Department: 1.800.522.0258 53

Group Maintenance Add A New Dependent Adding a new dependent allows you to attach a dependent to a cardholder already entered into the Avesis eligibility database. You must change the cardholder s coverage code before you are able to add the dependent. The steps for adding a new dependent are described below: STEP 1: Login STEP 2: Click "Add A New Dependent" ber Member/Dependent xisting Member/Dependent minated Member Add A New Dependent Edit Group Contact Information Summary Of This Session List All Members Electronic Billing and Eligibility Menu STEP 3: Enter the cardholder's name or member number to whom you wish to add the new dependent. Last Name : First Name : Member Number : 54 www.avesis.com

STEP 4: Click Search to locate the cardholder. STEP 5: Select the cardholder's name from the list. Member Member # Coverage Status Effective Date Member, Test 7074862X-01 EE ACTV 11/1/2005 STEP 6: Populate all required fields * First Name: M. I.: * Last Name: * Sex: M * Birth Day: Month * * Effective Date: November * Address: Addr 2: * Zip: E-Mail Address: Home Phone: Work Phone: Day 1 Year 2005 Add A New Dependent Data Entry Page Questions? Call the Avesis Online Billing Department: 1.800.522.0258 55

Group Maintenance Add A New Dependent (continued) STEP 7: Click STEP 8: ADD to continue the process of adding a new dependent. You will be prompted, "Is the information displayed below correct?" If yes, click the "YES" button and the information will be added to the system If the information displayed is not correct, click the No button and you will return to the data entry page. Is the Information Displayed Below Correct? Name : DEPENDENT MEMBER Address : 2000 MAIN STREET TOWN, MD 21110 Sex : F Birth Date : 5/22/1960 Effective Date : 11/1/2005 Coverage : DEP Is This Correct? Yes No 56 www.avesis.com

STEP 9: If there are no more dependents to add under this cardholder, click "CLICK HERE IF ALL FAMILY MEMBERS HAVE BEEN ADDED." You will be brought back to the Electronic Billing and Eligibility page. Name Member # Birth Date 1. TEST MEMBER 7000698X-01 6/18/1955 CLICK HERE IF ALL FAMILY MEMBERS HAVE BEEN ADDED OR... ADD DEPENDENT NOTE : This information will be entered into our system EXACTLY as typed below. For example, please type John Smith in place of john smith or JOHN SMITH. * First Name: M. I.: * Last Name: * Sex: M * Birth Day: Month * * Effective Date: November * Address: Addr 2: * Zip: E-Mail Address: Home Phone: Work Phone: Day 1 Year 2005 Questions? Call the Avesis Online Billing Department: 1.800.522.0258 57

Group Maintenance Edit Group Contact Information Company contact information may have to be updated in the event of a move or a new company contact has been established. The steps for editing group contact information follow: STEP 1: Login STEP 2: Click "Edit Group Contact Information" ber Member/Dependent xisting Member/Dependent minated Member Add A New Dependent Edit Group Contact Information Summary Of This Session List All Members STEP 3: Electronic Billing and Eligibility Menu Make the desired changes to the proper fields. * Company Name : * Contact Person : * E-Mail : Phone # : Fax # : * Address : (Address 2) : *City, State, Zip :, 58 www.avesis.com

STEP 4: Click Update to continue. STEP 5: You will be prompted, "Is the information displayed below correct?" If yes, click the "YES" button and the information will be modified in the system. If the information displayed is not correct, click the No button and you will return to the data entry page. Is the Information Displayed Below Correct? Company Name : Contact : E-Mail : Phone # : Fax # : Address : City, State, Zip : Company Name Company Contact contact@company.com (800) 555-5555 (800) 555-4444 2000 Main Street Baltimore, MD 21201 Yes No Note: Please, keep the company contact information current to prevent any administrative problems. Questions? Call the Avesis Online Billing Department: 1.800.522.0258 59

Group Maintenance List All Members Clicking "List All Members" allows you to view all the current members and dependents. A New Member An Existing Member/Dependent minate An Existing Member/Dependent nstate A Terminated Member Add A New Dependent Edit Group Contact Informat Summary Of This Session List All Members Add A New Member Edit An Existing Member/Dependent Terminate An Existing Member/Dependent Reinstate A Terminated Member Add A New Dependent Edit Group Contact Information Summary Of This Session (# 61556) List All Members Name Member # Effective Date Coverage EDIT TERM Member Name 333333222V-01 11/1/2004 EE EDIT TERM Member Name 6392027X-01 4/1/2005 FAM EDIT TERM Member Name 6392027X-02 4/1/2005 FAM EDIT TERM Member Name 7054936X-01 11/1/2005 DEP EDIT TERM Member Name 7075698X-01 11/1/2005 EE EDIT TERM Member Name 552444888V-01 8/1/2004 FAM EDIT TERM Member Name 333444888V-02 8/1/2004 FAM EDIT TERM Member Name 333444888V-03 8/1/2004 FAM EDIT TERM Member Name 444555111V-01 8/1/2004 EE Note: You can also edit and terminate members from this list by clicking "EDIT" or "TERM" left of the name. 60 www.avesis.com

Download A Vision Claim Form Filing a claim form is necessary if members receive vision care from a provider not participating in the Avesis network. The member is responsible for payment of services to the non-avesis provider in full at the time of the visit. Afterwards, you must fill out an Out-of-Network vision claim form, and mail it to the Avesis claims department along with a receipt from the provider. Mail to: Avesis Vision Claims Department P.O. Box 7777 Phoenix, AZ 85011-7777 The steps for downloading a vision claim form follow: STEP 1: Rollover Benefits Managers on the toolbar and click on Forms in the drop-down menu that appears. STEP 2: Click Get Form Members Providers Brokers Benefits Managers Benefits Managers Provider Search Online Billing Sign-up Online Billing Login Forms Benefits Managers FAQ Contact Avesis A Vision Benefits Claim Form in PDF format will appear for you to download for later use, or print directly from the website. Questions? Call the Avesis Online Billing Department: 1.800.522.0258 61

Group Maintenance COBRA To enter a member into the database as a COBRA member, you can use the Edit An Existing Member option (page 45). Simply check the COBRA box, circled below, to show a member has elected COBRA. * First Name: M. I.: * Last Name: SSN: * Birth Day: * * Effective Date: * Address: Addr 2: * Zip: * Coverage: E-Mail Address: Home Phone: Work Phone: Test * Sex: M Member February 2 1954 November 1 2005 2000 Main Street 21110 DEP- Employee + Dependent Check If COBRA Member Edit A Member Data Entry Page If the member has already been terminated, you must first reinstate the member by using the Reinstate A Terminated Member option (page 52). Then, you must use the Edit An Existing Member option in order to check the COBRA box. 62 www.avesis.com

Contact Here at Avesis, we are constantly striving to exceed your expectations. To ensure that we are achieving this goal, please feel free to call us to discuss any questions or concerns you may have regarding online benefits management. Avesis 3030 North Central Avenue Suite 300 Phoenix, AZ 85012 Telephone: 1.800.522.0258 Fax: 602.240.9100 Hours: 8am to 5pm (MST) Questions? Call the Avesis Online Billing Department: 1.800.522.0258 63