Proof of Coverage
What is required to be accepted?
- Name of Provider: We need to associate the document with the provider seeking benefits
- Effective Date of the Qualified Health Plan: This impacts the potential CCPU Reimbursement Fund benefit start date
- The Name/Type of Qualified Health Plan: This program has a specific set of plans that are eligible and we have to confirm the provider is enrolled in one
- Premium: We need to see the premium being paid for plans eligible for premium reimbursement
- Note: For CCA plans, we also need to see APTC applied in order to calculate provider premium eligible for reimbursement if on a family plan.
Acceptable Documentation Proof of Coverage (English/Spanish)
Reimbursement Receipts
What is required to be accepted?
- Name of Provider: We need to associate the document with the provider seeking reimbursement
- Date of Service/Goods Purchased: We must confirm payment is for services that were incurred in the current plan year and on or after the benefit effective date for the provider
- What the monies were paid towards: This program has a specific set of eligible expenses depending on the type of benefits you have. We have to have proof the provider paid for services/goods covered by their health insurance plan.
- Note: We NEVER need your medical diagnosis. We do need to see that charges were for an eligible expense: Covered Rx, Copay, Coinsurance, Deductible, etc.
- Amount: We need to see the amount needed for reimbursement
