Blue Cross benefits through UBCM

Sparwood had been experiencing significant issues with the management of our benefits through Blue Cross.
Firstly, we are finding the management of STD and LTD claims to be lacking. As the employer we are not receiving updates on the status of claims, employee return dates, claim extensions etc.
Secondly, we are experiencing significant billing issues, where a number of employee's coverage has been cancelled (incorrectly) backdated to 2014, and we received a huge credit on our account. The online system is showing these employees are covered, as should be, as no changes to their status was requested.
These matters have been raised with UBCM and Blue Cross, but I'm not receiving timely responses.
I'd like to hear if other municipalities are experiencing issues with Blue Cross too.

Comments

  • We are with a different carrier, but I wonder if some of your issues are related to the recent strike/lockout that Blue Cross was dealing with? Or are these issues more long term than that?

  • The billing issues occurred in November and January, so quite a significant time after the end of the strike. And I've been having issues with the management of STD and LTD claims since early 2016. So, no, I don't think these issues are related to the strike.

  • Hi Michele, We are with UBCM Blue Cross and are experiencing lack of communication as well. We have asked for some reports back in October and still have yet to receive anything. With regards to our employees, no employee has reported any claim issues nor have we noticed any incorrect adjustments to our account - the adjustments that were made in October and November went thru correctly.
    Karen

    Karen Sharp, Village of Radium Hot Springs

  • Stepping in a little late on this conversation, but we also had a lot of similar issues with the UBCM / PBC plan. In one case, they back dated premium credits for taxable benefits for two years prior and we had to go back and amend T-4's. In other cases, I had to remind them to provide waiver of premium for employees on LTD. Getting booklets for employees took months, our usage reports were poor at best. The list went on and on.

    We started working with a benefits consulting company in the fall of 2014, and switched to Sun Life in March 2015. The invoicing with Sun Life is very proactive, LTD department communicates with the billing department for waiver of premiums, etc. LTD case workers have been pretty good at communicating with our HR/payroll people. Reporting on usage stats is very good.

    I will say that Sun Life has been a lot tougher when adjudicating our claims. This has been an adjustment for staff, as typically most everything was paid as claimed by PBC. Our benefits consultant has gone to bat for our staff on a number of claim issues, and we've really appreciated their assistance.

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