What to do when your plans start

What to do when your Plans Start 

With most of your plans beginning or restarting in January, here are some quick tips to get started.   

Aflac  

You don’t have to do anything to set up Aflac. Once the plan starts, that’s it! It is, however, important to know when and how to file a claim.   

You’re able to file a claim for a qualifying event as long as it happened while you were covered by Aflac. Anytime you go to the doctor/hospital, be sure to check your Aflac brochure to see if you experienced any qualifying events.  

In order to file a claim, make an account on MyAflac.Aflac.com using your certification number. If you don’t remember that, you can email [email protected] or call 888-315-8027. Once you have made an account, you can click “file a claim” and then follow the steps provided. If you need more help filing a claim contact us or check out our guide linked here.  

Aura 

Once you’re enrolled with Aura, you’ll receive an email from Aura asking you to set up your account. You’ll need to go in, make an account, and start filling in your information. The more information you give it, the more coverage you’ll have!   

Best Health  

Once you’re signed up for Best Health, you’re in! There’s nothing else to do. You can access the site by heading to https://sdpeba.sharp.wellness.us-1.healtheintent.com/onboarding and logging in.   

If you’re having trouble, you can contact us by emailing [email protected] or by calling 888-315-8027 and we’ll help get you set up!    

MetLife Dental  

There are two dental plans: HMO and PPO. Depending on which plan you’re enrolled in there are some differences in how to get started.     

If you have the HMO plan, you’ll need to select a dentist ahead of time. You can do so while you’re enrolling, but if you didn’t, you can make those changes on MetLife’s website or by calling us at 888-315-8027 (you can also email [email protected]). We recommend you contact us because our wait times are a lot lower than MetLife’s and also because we can make the change to your account immediately, whereas MetLife’s changes might take up to a month. If you choose to use their website to find a provider, SDPEBA’s HMO plan is under the “MET100” network.      

If you’re new to the plan, you’ll also receive an ID card with the HMO plan. This card should be sent out within 10 days of your enrollment, if you don’t receive one within 14 days, call us! We’ll get that squared away.    

With the PPO plan you don’t get an ID card. You can grab one from MetLife’s website, but it’s not necessary. We recommend you head to MetLife’s website and find a dentist through their service to make sure you’re in-network. SDPEBA’s PPO plan is in the PDP Plus network. 

Note: If you are a member of Local 127 and have their version of MetLife Dental you will need to go through them.      

MetLife Legal  

Once you signed up for MetLife Legal you can start receiving covered legal services through MetLife’s site. You don’t need an ID card; you just need to call 800-821-6400 or go to https://legalplans.com and you’ll be able to get set up with a referral number.     

If you signed up for the MetLife Legal + Parents plan, you’ll need to get them added as well. This will happen when you enroll with us.   

We highly recommend you call the MetLife service team for advisement on what’s covered and do your research when choosing your lawyer!  

Pet Insurance  

There isn’t much extra you need to do for pet insurance. Since you can technically enroll in the plan year-round, your start date might not be January 1st. Much like Aflac, this is a claims based service, so you just need to contact Nationwide after you go to the vet. There are a couple of ways to submit a claim, check out their site here: https://www.petinsurance.com/submit-claim/.   

Purchasing Power  

Once you’re signed up for Purchasing Power, you’re in! There’s nothing else to do. You can access the site by heading to https://www.purchasingpower.com/?domain=sdpeba and logging in.  

If you’re having trouble, you can contact us by emailing [email protected] or by calling 888-315-8027 and we’ll help get you set up!   

Sharp Healthcare  

When it comes to Sharp Health insurance you could have 1 of 4 plans. There’s the Classic, Saver, Select, and our retiree plans. If you’re new to the plan, you’ll get an ID card in the mail within 10 days of your plan being entered into the system. If you don’t receive your ID card within 2 weeks of your plan starting, contact Sharp’s dedicated SDPEBA team by calling 888-840-4747 (for active employees) or 888-562-8853 (for Sharp Medicare).     

Once you have your ID card, you’re basically good to go! But we do recommend you make an account online. https://account.sharp.com/.    

Once you make an account, you’ll be able to see where your doctor, urgent care, and emergency care center are, and you can read more about your benefits. If you’d like to make any changes to your doctor, you can do so online or by calling the SDPEBA Sharp Team which again is 888-840-4747 (for active employees) or 888-562-8853 (for Sharp Medicare). We can help you out as well of course! But these hotlines are actual Sharp employees who know your benefits in and out, so we recommend you start by reaching out to them. If you have any billing or cost questions though, then you should call us first! 888-315-8027.   

If you need help finding a provider, we have an article to help with that! Click here.   

Unum  

There isn’t much to do for Unum until you come to actually need long term care. If you are qualified to receive long-term care (you’ll need a doctor to sign off on this), you’ll have a 90-day elimination period. Once that period is over you can call 800-227-4165 to start receiving payouts.   

If you have questions or are having trouble, contact us and we’ll help you: [email protected] or call 888-315-8027.   

We put together an article on Unum that has a lot of useful information, check it out by clicking here.  

VSP  

Whether you just got VSP through SDPEBA or you’ve had it for a while, the most important thing is to use your plan!    

You can get an eye exam and two pairs of glasses every year. So be sure to book that optometrist appointment early so that way you’re not leaving any money on the table (reminder, with SDPEBA’s VSP plan you can get 2 pairs of glasses, if you have your plan through the city, you can only get one pair every 2 years).