Monterey County Schools Insurance Group MCSIG

Frequently Asked Questions

Do I have coverage out of the country?

Yes, don’t forget to take your MCSIG/Anthem Blue Cross ID card along with you. The card identifies you as a participant in the BlueCard network. If you need help, call the BlueCard Provider Access number listed on the back of your card. You will be directed to the nearest network provider in the area in which you are traveling.

 

I’m not sure what plans I have, how do I find out?

Contact your individual Districts’ Benefit Representative or call MCSIG Customer Service at 831-755-8055 or 1-800-287-1442.

 

Do I have a deductible?

Yes, but because MCSIG has several plans, call Customer Service to find out the exact amount you are responsible for.

 

What is the difference between a deductible and coinsurance?

Deductible is what the patients pay before the plan pays on the benefit. Coinsurance is the difference between what percent the plan pays and amount owed. Coinsurance is the patient responsibility.

 

How does coordination of benefits work?

If you have more than one insurance the amount left over from the primary that is patient responsibility is then sent to secondary for consideration of additional payment per contract benefits.

 

Who do I call to change my address?

Contact your district representative for a Change Form. It must be signed and returned to your district for processing.

 

Do we cover immunizations?

Yes and there is no office visit co-pay for immunizations or wellness exams such as physical exams, well-child or well woman care on any of MCSIG PPO plans.

 

How does the RX by mail order work?

MCSIG provides Express-Scripts.

 

How do I access the Anthem Blue Cross web site?

The MCSIG web site (www.mcsig.com) has a link to www.anthem.com

 

My dependent is away to college, can he/she have their own medical insurance card?

Yes, simply call the MCSIG Customer Service at 831- 755-8055 or 800-287-1442.

 

Can I access my medical claim on-line?

Yes, you can access your claims, explanation of benefits (EOB) and other medical information by logging into www.anthem.com and clicking on Access to Members Services then follow the directions.

 

Do I have mental health coverage?

Yes, your mental health/employee assistance plan (EAP) is administered by MHN. If you need assistance, you can call and speak to an EAP counselor 24 hours a day/7 days a week, including holidays at 1-800-327-8399. This is a strictly confidential service.

 

Are legal guardians allowed to enroll the child/ren under my plan?

Yes, legal guardians’ related children under the age of 18 are covered under MCSIG plans, subject to a waiting period and evidence of insurability and copy of legal guardianship papers.

 

Can I add my domestic partner to my plan?

Yes, same sex domestic partners over age 18 and opposite sex domestic partners age 62 and over. Partners must be registered with the Secretary of State.

 

I just got married, when can I cover my spouse?

You can add your spouse and step-children within 30 days of marriage and provide a copy of the state issued marriage license within 90 days. Contact your district representative to add your new dependents.

 

I just had a baby, when can I cover him/her?

Newborns need to be added within 30 days of birth, with a copy of their state issued birth certificate within 90 days. Contact your district benefit representative to add your newborn.

 

I am thinking about retiring - how will this affect my benefits?

Please read the "Important Information for Retirees"

 

My insurance took effect on the 1st of the month, but when I went to the doctor, I had no coverage?

Your coverage is effective on the 1st of the month; however, you will not show up on the computer system until the 25th of the month due to processing. In the meantime, your doctor’s office may verify eligibility by calling MCSIG Customer Service at 831-755-8055 or 800-287-1442.

 

How can I access network provider listings?

To access the provider directory on the web, log on to www.mcsig.com and click on the link for provider listings. If you do not have access to the internet, call MCSIG Customer Service at 831-755-8055 or 800-287-1442.

 

What is COBRA?

This is a Federal law that provides a right for continuation of coverage for MCSIG termed members and qualified dependents. Termed members are those who lost coverage with MCSIG due to leaving a district, death, a divorce, etc. For more information, contact your district representative.

 

What is a Healthy Weight Incentive Program?

This is a reimbursement program for MCSIG members who have successfully completed or are currently enrolled in Weight Watchers. For more information contact MCSIG at 831-755-0161. 24. Do you offer discounts to health clubs? Yes, as a MCSIG member, you can receive a discounted rate at a number of fitness clubs throughout Monterey County area. For more information contact MCSIG at 831-755-0161.

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