Making a People Operations Wiki on Coda

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Making a People Operations Wiki on Coda

Making a People Operations Wiki on Coda

Benefits

Insurance General Info

If you don’t find the information you are looking for below, please

submit it here

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This communication is for informational purposes only. Plan documents and/or the insurance certificates shall govern in the event of a conflict.

At Coda we offer a full package of benefits that include medical, vision and dental and other benefits offered through our provider, SequoiaOne for our US-based employees.

Insurance Provider

Our health benefits are provided by SequoiaOne and you can check your account by login into SequoiaOne.

We also recommend you download the app so you can easily see your plans, deductibles, perks, digital insurance cards., etc on the go. Download the app Apple / Android.

Insurance Cards

You can access them on the SequoiaOne app

Some states don’t require for the cards to be mailed (CA is one of those). If you need physical versions of them, please request them through the App or email [contact info]. ALL cards are accessible digitally on the app.

Coverage

You have 30 days to make selections and your coverage will be retroactive to your starting date at Coda.

Coda covers 100% of insurance premiums for you and your dependents.

Open Enrollment is in June of each year. You’ll get a reminder email with the dates and you’ll get invited to an OE Session with Sequoia before the OE period begins.

Certain qualifying “Life Events” (e.g. marriage, birth, gain of other coverage) allow you to make changes off-cycle of open enrollment.

Sequoia open enrollment deck

Qualified Life Event

A qualified life event (QLE) is an event that may allow you to make certain changes to your health benefits outside of the regular open enrollment period. A QLE is a substantial change in your life that prompts you to re-evaluate your benefit selection. Examples include but not limited to getting married, the birth or adoption of a new baby, divorce, a move that brings you out of the medical network’s service area (i.e HMO NorCal to SoCal), or if one of your dependent experiences a loss in coverage. You must report your QLE within 30 days of the event to qualify for the open enrollment period.

How do I report a qualified life event and update my benefits?

Sign into the WorkLife portal

Click on "Benefits" > "Update Benefits (Life Event)"

Click "Report Life Event" and select your respective event and date of occurrence.

Click "Launch Benefit Enrollment"

Follow the prompts to make your election changes

Group Numbers

Medical Plan

Group Number

Network

There are no rows in this table

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Insurance Key Contacts

Insurance Key Contacts

Vendor

Phone Number

Website

SequoiaOne: Employee Advocate

Anthem

Kaiser

Guardian

VSP

There are no rows in this table

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Common Insurance Terms

Deductible: The set dollar amount you must pay toward covered benefits before the insurance carrier begins paying for covered medical expenses.

Copayment: A flat fee you must pay when a covered service is rendered.

Coinsurance: A percentage of the charges you must pay for a covered medical service after the deductible has been met.

Out-of-Pocket Max: The maximum amount you pay for covered services in a year (e.g. copays, deductibles). After you spend this amount your health plan pays 100% of the allowable charges for covered services.

In-Network: A hospital, doctor, medical group, and/or other healthcare provider contracted to provide services to a member for less than their usual fees.

Out-of-Network: A hospital, doctor, medical group, and/or other healthcare provider not contracted to provide services to a member for less than their usual fees. Balance billing may apply.

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Frequently Asked Questions

My dependent’s name changed. What do I need to do?

Log into the WorkLife portal

Click Myself > Dependents/Beneficiaries

Click the name of the Dependent

Enter the new information

Click Save when you're done

Updates in the Worklife portal feed over to the carriers on a weekly basis which means that the carriers of your benefits will be updated with the Dependent's name change within 2 weeks of them updating it on the WorkLife portal.

Once the carriers have reflected the change on their side, digital ID information should also update within the Sequoia mobile app to match. To request a hard-copy card ID, please reach out to [email].

I’m a recent hire. What if I don’t have my medical cards yet and I need to visit the doctor?

Kaiser — The Believe Me policy establishes a 90-day period during in which Kaiser will hold off on billing a patient for services, while they confirm you have active Kaiser coverage. Once Kaiser verifies there is active coverage, they will process the visit through insurance and collect any remaining balance if applicable. At the end of 90 days, Kaiser will bill a patient directly for any care that is not covered by a Kaiser Permanente plan and follow normal procedures for collection. How it works:

Call member services at 1-800-464-4000 and advise that you’d like to book an appointment or pick up a prescription using the Believe Me Policy while your enrollment is being processed. The Kaiser representative will book and flag the visit/account for follow-up.

Once an account has been flagged, it will be monitored periodically and checked against the membership system. After the insurance becomes active, the visit will be processed through insurance.

If an account is not linked to coverage after 90 days, it is sent to Patient Financial Services for appropriate billing and collection activities.

Anthem — Some providers will allow you to hold off on billing (simply ask!) In situations where a provider was unable/unwilling to bill your insurance, and that provider either sends you the bill directly or you make a full out of pocket payment at the point of service, you must notify your insurance company by submitting a claim for that date of service.

Online Submission:

www.anthem.com/ca⁠

(If this is your first time logging in, you will need to register first using your member ID

Hover over ‘My Plan’ and click on ‘Claims’

Scroll down to ‘Claims History’ and click ‘Submit a Claim’

Answer Yes or No to the question about a job-related injury.

Enter Date of Service (if multiple dates, use the first date on the itemized bill)

Enter state for location where service was performed

Attach copies of itemized bill by clicking ‘Attach Files'

The following information must be included on the itemized invoice:

Provider’s Name

Provider’s Address, including place of service code: (i.e. office = 11, hospital, etc.)

Provider's Tax ID, license and NPI numbers

Patient’s Name & DOB

Service(s) provided

Date of service

Amount charged for each service for each date of treatment (itemized invoice)

Diagnosis code

Procedure (also called CPT) code

Scroll down and click ‘Next’

Choose patient name from drop down and answer question about other coverage.

Fill in at least one phone number and email address.

Click ‘Certification’ box and click ‘Submit’

Note: It can take up to 30 days for the insurance company to review and process your claim. Once it has processed in their system, an Explanation of Benefits (EOB) will be provided to both you and your provider explaining applicable coverage by insurance.