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FAQ

Will I receive different ID cards/numbers under my COBRA Plan?

If you are a member electing COBRA you will not see a change to your ID numbers. If you are a dependent electing COBRA on your own you will receive new ID cards and will need to update this information with your providers.

Should I tell my doctors that I am now on COBRA?

Your doctors will not see a change in your coverage; you do not have to tell them that you are on COBRA.

Do I need to send payment with my election form?

No, your first payment is due no later than 45 days after the post-mark on your election form. Once we receive your election form we will send you a packet which will tell you when your first payment is due.

Will I receive a monthly COBRA bill?

No, we do not bill for COBRA. You will receive payment slips once you have elected and activated your COBRA account. You are responsible for making sure that your COBRA payment is received on time.

Can I make my COBRA payment over the phone with a credit card?

No. Payments must be check or money order made payable to Allegiant Care; PO BOX 4604; Manchester, NH 03108.

I thought I had a grace period; why was my coverage terminated?

If you do not make your payment prior to the start of the coverage month your coverage will be terminated until payment is received.  A 30-day grace period allows your coverage to be reinstated retroactively to the first of the coverage month provided payment is post-marked no later than 30 days after the start of the coverage month.

When does my payment need to be received in order to avoid a break in my coverage?

Eligibility files are run electronically on a weekly basis. Payment for the following month should be received by the 23rd in order to avoid a break in coverage.

COBRA is so expensive; is there assistance available for paying the monthly COBRA premium?

COBRA is very expensive and typically a last resort for many. You should check with your State in regards to what might be available to you for premium assistance or State health coverage. www.healthcare.gov is a resource available to assist you in finding individual policies in your State.

I’m becoming eligible for Medicare; is my spouse able to remain on COBRA once I enroll in Medicare?

Yes, your eligibility for Medicare serves as a second qualifying event for your spouse. S/he will be eligible to remain on COBRA for a total of 36 months (less what has been used while covered under your COBRA policy). For example: if you and your spouse have been on COBRA for 9 months, when you become eligible for Medicare your spouse will be eligible for 27 remaining months of COBRA on his/her own.

How do I cancel my COBRA coverage?

You may simply stop paying your COBRA premium and your policy will term naturally.

Where can I find the Health Club Reimbursement form?

A Health Club Reimbursement Form  was included in your SPD binder or you can find it under the “Forms” tab on the website. You can also contact Ann Simpson at Allegiant Care by calling (603) 669-4771 or 1-800-258-9732 Ext. 229.

How do I know if I have Health Club Reimbursement?

If your plan includes the Health Club Reimbursement benefit, you will see details in the “Supplemental Benefits” section of your SPD binder or you may call Allegiant Care at (603) 669-4771 or 1-800-258-9732.

Who is eligible for the Health Club Reimbursement?

The member and covered spouse are eligible to receive Health Club Reimbursement. Children and adult dependents are not eligible for this benefit.

How does the Health Club Reimbursement work?

The benefit is based on attending a gym an average of three times per week for a period of six months. The reimbursement is for $100.00 per individual after the completion of each six-month period. The entire six-month period must be while the member and/or spouse are enrolled in an Allegiant Care plan which covers the Health Club benefit.

At the end of the six-month period, complete the Health Club Reimbursement Form that was included in your SPD binder or you can find it under the “Forms” tab on the website.  The form must be completed in full, including dates of the six month period, a signature of a supervisor at the club, your signature and a print-out of your attendance.

What if I missed going to the gym due to illness or vacation during the six month period?

The benefit is based on an average. This is why it’s important to include a print-out of the attendance. Most members will still receive their Health Club Reimbursement, even if they missed a couple of weeks of going to the gym.

Who do I contact if I have any questions regarding Health Club Reimbursement?

You may contact Ann Simpson at Allegiant Care by calling (603) 669-4771 or 1-800-258-9732 Ext. 229.

How do I obtain a replacement CIGNA Medical Card?

Login to www.MyCigna.com or call Cigna at 1-800-244-6224.

How do I inquire about the status of my medical claim?

Call Cigna at 1-800-244-6224. Have your card ready to provide your CIGNA ID, and know the date of service about which you are calling.

Do I need a referral to see a specialist such as a dermatologist or a chiropractor?

Under the CIGNA Open Access plan you do not need a referral. Keep in mind that sometimes having a referral from your PCP can help you to get an appointment with a specialist in a more timely manner. You will need to use an In-Network specialist in order to avoid being charged for deducible and coinsurance.

I received an Explanation of Benefits that I believe is incorrect. What should I do?

You may contact CIGNA by calling the Member Services Number on the back of your medical card. A customer representative will review the EOB (Explanation of Benefits) and advise you as to how and why the charges were processed. In some cases, the medical provider (doctor’s office) may have to be contacted to review the claim that was submitted to the insurance company.

Will I be charged a copay for my child’s well-visit?

Copays vary depending on the type of plan you have. Please refer to the medical section of your SPD binder or call Allegiant Care at (603) 669-4771 or 1-800-258-9732 if you have specific questions about your plan.

What if I need a CAT scan, MRI (or other imaging services)?

All scans/imaging must have pre-certification through CIGNA prior to the date of service. In order to receive the maximum benefit you should use a in-network imaging facility.

Where should I go for minor injuries such as sprains or those requiring stitches?

You should use an In-Network Urgent Care facility for non-life threatening illness or injury as the copay is less than had you gone to the emergency room for treatment. Visit www.cigna.com to locate In-Network Urgent Care facility in your area.

Why is Cigna telling me that I don’t have a vision/dental/prescription benefit?

You only have your medical coverage through Cigna. If you have a separate vision benefit it is through Davis Vision. If you have a separate dental benefit it is through Allegiant Care (unless otherwise specified). Prescription coverage is through Medco/Express Scripts.

I have cataracts; do I have coverage for treatment under the Retiree Plan even though I do have a vision benefit?

Vision services for medical conditions such as cataracts or diabetes will be billed under your medical benefit.

Do you offer separate Dental and/or Vision Plans for members on the Retiree Plan?

Allegiant Care does not offer a separate policy for dental or vision at this time.

I have been approved for Social Security Disability and will become eligible for Medicare prior to turning 65. Do I have to notify Allegiant Care if I enroll in Medicare?

Yes, you must notify Allegiant Care immediately upon receipt of your Medicare cards and provide us with the effective date to ensure the proper processing of any claims.

What happens when I turn 65 years old in six months?

Approximately 3 months prior to your 65th birthday you will receive a packet outlining your options when you turn 65.

I received a packet with post-65 election options. If I don’t elect post-65 coverage, will my spouse be eligible to remain on the Plan?

Your spouse may continue on the Retiree coverage (subject to current eligibility rules) even if you do not elect any post-65 coverage with Allegiant Care.

I’m going to be 65 y/o; however, I intend to work for at least another year; do I have to enroll in Medicare?

You may enroll in Medicare Part A; however, you should defer your enrollment into Medicare Part B until you stop working. When you receive your Medicare cards you should contact the toll free number on the back and let them know that you are covered under an active group plan and will not be enrolling in Medicare Part B at this time.

My spouse is going to be 65 y/o and is covered under my Plan. If I intend to work for at least another year, does s/he have to enroll in the Medicare?

S/he may enroll in Medicare Part A; however, s/he should defer enrollment into Medicare Part B until your group coverage ends. Once s/he receives his/her Medicare cards s/he should call the toll free number on the back and advise them that she is covered under an active group Plan and will not be enrolling in Medicare Part B at this time.

How do I confirm eligibility for Dental benefits for myself or my dependent(s)?

Call the Allegiant Care Dental department at (603) 669-4771 or 1-800-258-9732, select option 2.

How do I find a dentist covered under my plan?

You may see any licensed dentist in your area. Allegiant Care does not have a participating provider network for dental benefits. Please consult the Dental Fee Schedule for the maximum amounts paid for each service.

Is the Allegiant Care dental plan an HMO or PPO plan?

Neither. There is no network of dental providers; our members may go to any license dentist of their choice.

What is the breakdown of dental benefits?

All the benefits are paid according to the Allegiant Care Dental Fee Schedule. The fee schedule is the same for all four Allegiant Care dental plans. The member is responsible for any difference between the amount charged by the provider and the amount paid by Allegiant Care.

NOTE: Plan deductibles, calendar year maximums, and orthodontic maximums vary by plan.

Does Allegiant Care accept dental claims electronically?

Yes. To make an electronic claim submission use: Payer ID Number: 38238 and Group Number: R40.

Where do I mail dental claims?

The mailing address is: Attn: Dental Department, Allegiant Care, PO Box 4604, Manchester, NH 03108.

How do I obtain a replacement Dental ID card?

Call the Allegiant Care Dental department at (603) 669-4771 or 1-800-258-9732, select option 2.

Where can I find a copy of the Allegiant Care Dental Fee Schedule?

Dental Fee Schedule Form  It can also be found under “Forms” on the Allegiant Care website.

How often am I eligible for cleanings, x-rays, fluoride treatments, etc?

Dental Breakdown of Frequency Benefits Form  It can also be found under “Forms” on the Allegiant Care website.

How do I know if I have the Health Education reimbursement?

If you have CIGNA medical coverage through Allegiant Care, then you have access to the Health Education Reimbursement.

What is the Health Education Reimbursement?

If you or a covered family member (including children) attends an approved Health Education class, you the covered family member can be reimbursed up to $100 per completed course with a limitation of 2 courses per year per individual. Reimbursement will go to the member if the claim is for a child under the age of 18, or if there is a note requesting that it should be paid to the member, not the child.

NOTE: You must attend at least 75% of the classes and successfully complete all class requirements to receive reimbursement.

Which courses are eligible for reimbursement?

There are over twenty Health Education courses eligible for reimbursement including: Cancer/Diabetes Education, CPR, Childbirth classes, Yoga, Babysitting, Weight Watchers®, Smoking Cessation and Nutrition to name a few. The complete list can be found on the Health Education Reimbursement Form.

Is Weight Watchers eligible for reimbursement

Yes. Just save your receipts until you have reached a $100.00, and mail them in with the completed Health Education Reimbursement Form to Allegiant Care; Attn: Health Promotion Department; P.O. Box 4604; Manchester, NH 03108

Where can I find the Health Education Reimbursement Form?

You can find the Health Education Reimbursement Form under the “Forms” tab of the website website or you may call Allegiant Care at (603) 669-4771 or 1-800-258-9732 Ext. 229 and request the form.

NOTE: The form cannot be completed online. You must print the form, and mail it to Allegiant Care; Attn: Health Promotion Department; P.O. Box 4604; Manchester, NH 03108.

Who do I contact if I have any questions regarding Health Education Reimbursement?

You would contact Ann Simpson at Allegiant Care by calling (603) 669-4771 or 1-800-258-9732, extension 229.

I wish to change my primary care physician? What do I need to do?

You may change your primary care physician by calling the number on the back of your medical card or going logging into your account at www.mycigna.com.

Who should I notify of an address change?

You should always notify Allegiant Care of an address change. You may call Allegiant Care at (603) 669-4771 or 1-800-258-9732 or you may send notification through the Member Information Page under “My Benefits” on the Allegiant Care website.  You must also notify your employer of the change.

I set up a forwarding order with my new address through the post office. Do I need to notify Allegiant Care of the change?

You should always notify Allegiant Care of an address change as soon as possible.

Where can I find the Short-Term Disability Forms?

You can find applications packets for Medical Short-Term Disability and/or the Mental Health & Substance Abuse Short-Term Disability under the “Forms” tab on the Allegiant Care website or you may call Allegiant Care at (603) 669-4771 or 1-800-258-9732 Ext. 211 and request the form.

NOTE: The form cannot be completed online. You must print the form, and mail it to Allegiant Care; Attn: Elaine Bunie; P.O. Box 4604; Manchester, NH 03108.

Do I need to be receiving medical attention from a doctor in order to claim Short-Term Disability?

Yes. With Short Term Disability you must be receiving medical attention by an MD. The doctor must complete an initial medical report and provide updates when requested in order for you to continue to receive the benefit while you are out of work.

If I was injured at work, can I collect Short-Term Disability through Allegiant Care?

No, you must contact your employer to file a Workers Compensation claim.

What is the difference between FMLA & Short-Term Disability?

A FMLA (Family Medical Leave Act), if approved, helps maintain your job position and contributions will be sent from your employer to Allegiant Care for Health & Welfare benefits in order to stay eligible. Short-Term Disability is for Wage Replacement while out on a Medical Leave.

How do I apply for FMLA and Short-Term Disability?

Apply for FMLA with your Human Resource Department and Short-Term Disability with Allegiant Care.

You can find applications packets for Medical Short-Term Disability and/or the Mental Health & Substance Abuse Short-Term Disability under the “Forms” tab on the Allegiant Care website or you may call Allegiant Care at (603) 669-4771 or 1-800-258-9732 Ext. 211 and request the form.

NOTE: The form cannot be completed online. You must print the form, and mail it to Allegiant Care; Attn: Elaine Bunie; P.O. Box 4604; Manchester, NH 03108.

When does Short-Term Disability begin paying towards wage loss?

The weekly benefit is payable after the first week has been withheld (seven calendar days from the date medical care was sought).  Payment on an approved short-term disability claim will begin on day 8.  The weekly benefit is payable for a maximum period of 26 weeks for all members.

Does Allegiant Care send out W-2 forms at the end of the year?

No. Weekly reports are sent to your employer and your employer will include these amounts on the W-2 they issue to you.

Can I submit a claim for Short-Term Disability for a previous year?

No. We allow claims to be processed within a maximum of 60 days from the date of illness or injury for which you first sought medical attention.

I am legally separated; do I need to notify Allegiant Care?

Yes, you will need to update the address and phone number for yourself and your spouse (if known) as well as any children on your plan.

I am in the process of a divorce, but it is not final; do I need to notify Allegiant Care?

Yes. You will need to update the address and phone number for yourself and your spouse (if known) as well as any children on your plan. You will need to send in a copy of your finalized Divorce Decree as soon as it is available to you. You may fax it to 603-666-4477 or mail a photocopy to Allegiant Care; PO BOX 4604; Manchester, NH 03108.

I am recently divorced, what do I need to do next?

Contact Allegiant Care at 1-800-258-9732 and update the address and phone number for yourself and your spouse (if known) as well as any children on your plan. You will need to send in a copy of your Divorce Decree as soon as possible. You may fax it to 603-666-4477 or mail a photocopy to Allegiant Care; PO BOX 4604; Manchester, NH 03108.

NOTE: If a member does not notify us of the divorce and claims are incurred, the member will be responsible to reimburse Allegiant Care for any claims paid after the divorce.

My ex-spouse does not have a health plan for my step-child. Am I able to continue covering the step-child after the divorce?

No, Allegiant Care does not cover stepchildren after a divorce. If a member does not notify us of the divorce and claims are incurred, the member will be responsible to reimburse Allegiant Care for any claims paid after the divorce.

Will my ex-spouse be able to remain covered on my Plan after the divorce?

If you Plan covers ex-spouses, s/he may be covered only if there is language in the Divorce Decree stating that you must provide coverage.  (You will need to confirm with your employer whether or not they will cover an ex-spouse.)

How long is my ex-spouse able to remain covered after my divorce?

If you Plan covers ex-spouses, s/he may remain covered until one of you remarries, until s/he becomes eligible for Medicare, until s/he becomes eligible under another group plan, or in accordance with any state laws or statutes named within the Divorce Decree.

Will my child(ren) be able to remain covered on my Plan after the divorce?

Your natural and/or adopted children may remain covered after a divorce.  You will be asked to provide an updated Coordination of Benefits  so that we are able to determine if Allegiant Care coverage will be primary or secondary.  Step-children are not eligible for coverage after a divorce.

Why does Allegiant Care need a copy of the Divorce Decree?

We must have an official document to indicate a divorce has occurred and whether or not a member is responsible to provide coverage for the ex-spouse and/or provisions for children covered under the Plan.

What happens if I do not provide a Divorce Decree and my ex-spouse and/or step-child(ren) continue using my Plan benefits?

We allow a 60-day grace period to send appropriate documentation. If you do not notify Allegiant Care of the divorce in the required time frame and claims are paid for an ineligible ex-spouse or ineligible step-child, you will be required to reimburse the cost of those claims. Furthermore, Allegiant Care may retract any outstanding claims and seek restitution, including legal expenses needed to obtain repayment.

What coverage is available for my ex-spouse and/or step-child(ren) if I am not required to provide insurance under the Divorce Decree?

An ex-spouse may elect to be covered through COBRA at their expense. It is the member’s responsibility to provide contact information for the ex-spouse.

My ex-spouse is currently employed and obtaining insurance through his/her employer. Is s/he still eligible for coverage under my Plan?

If the ex-spouse has other coverage or becomes eligible for other coverage s/he is not eligible to be covered by Allegiant Care.

What happens if my ex-spouse becomes eligible for Medicare?

If the ex-spouse has Medicare or becomes eligible for Medicare, s/he is not eligible to be covered by Allegiant Care.

I am not required to cover my ex-spouse and/or step-child(ren) after the divorce. Who do I contact for COBRA information?

You should contact the Allegiant Care at 1-800-258-9732 as soon as your divorce becomes final so that we can update our records and mail a COBRA package to the member loosing coverage. Please review the COBRA Continuation Coverage document for more information regarding COBRA.

How do I know if I have the Hearing Aid Reimbursement?

If you have medical coverage through Allegiant Care, then you have access to Hearing Aid reimbursement. The benefit covers the member and eligible dependents over the age of 19. You may find more details in the “Supplemental Benefits” section of your SPD binder.

How do I go about getting a hearing aid or hearing aid molds for my child under the age of 19?

The child’s medical provider must contact CIGNA with the procedure and diagnosis codes to verify coverage for those codes. If the charges are approved, the medical provider will submit their claims to CIGNA as Durable Medical Equipment. The member will be responsible for any applicable copays or coinsurance, dependent upon the facility used for evaluation.

What is the Hearing Aid Reimbursement?

You will be reimbursed 75% of the total cost up to $1500.00 for testing and/or hearing aids. The benefit is payable once every five (5) years.

Can I use any hearing aid facility or provider?

The Hearing Aid reimbursement is 75% of the total charge, up to $1,500.00 no matter where you choose to go for treatment. You may also choose to go to an Epic Hearing Healthcare provider. Their hearing aid prices are discounted before you purchase them, eliminating the need to submit for reimbursement. Contact Epic Hearing directly at 1-866-956-5400 for names of specific network providers in your area.

How do I submit for Hearing Aid Reimbursement?

After paying the provider in full, you should submit a copy of the itemized, paid receipt to Allegiant Care for reimbursement. Attn: Hearing Department; Northern New England Benefit Trust; PO Box 4604; Manchester, NH 03108.

What is a pay-in?

A member receives a Pay-in when they do not meet the minimum required monthly hours to maintain their coverage. The Pay-in amount is calculated by multiplying the number of hours the member is short for the month by the employer’s current hourly rate.

What forms of payment do you accept?

At this time, we are only able to accept check or money order mailed to Northern New England Benefit Trust; Attn: Pay-In; PO Box 4604; Manchester, NH 03108. Cash and charge cards are not accepted.

I wish to dispute my hours worked/remitted, who should I contact?

Any disputes must go through your employer. We are only able to confirm what hours were remitting by your employer each month.

When will I become eligible again if I do not pay my Pay-In?

If you choose not to pay in, your coverage will terminate on the date indicated on your Pay-in Notice. The only way you can be reinstated once your coverage terminates (and the due date for the Pay-in option has passed) is by meeting the reinstatement requirements (see your Plan’s eligibility rules for reinstatement requirements ).

NOTE: there is no Pay-in option for reinstating your coverage once you allow your coverage to terminate, so it is possible that you could remain ineligible for an indefinite period of time if you continually work fewer than the minimum required hours to reinstate.

How many hours per month must I work to maintain my coverage?

The minimum work hours required to become eligible for benefits is determined by your employer and is listed on your Pay-in Notice.

Why am I receiving COBRA information with my Pay-in Notice?

By law we must include COBRA information with your Pay-in Notice. For some members who are not returning to work, this may be a more financially suitable option as it is tiered (based on the number of dependents). You may contact Jacky at Allegiant Care (1-800-258-9732 Ext. 235) if you would like to discuss these options further.

When is the Pay-in due?

Pay-in due dates are firm and the envelope must be post-marked by the Post Office no later than the due date to be considered on time. Always refer to the Pay-in Notice for the proper due date.

I mailed my Pay-in on the due date; why did my coverage terminate?

Coverage will term if payment was not received by the due date. However, if your payment arrives with a postmark on or before the due date, your coverage will be reinstated retroactively. Please allow 5 to 7 business days to process your payment.

Why am I receiving a pay-in now when I was out 3 months ago?

Hours worked this month provide eligibility for insurance coverage in three months. For example: June work hours will determine eligibility for coverage in the month of September. The pay-in is applicable to the employment period and coverage month listed.

How do I know if I have a Vision benefit?

Your SPD binder outlines which benefits your Plan includes, or you may call Allegiant Care at (603) 669-4771 or 1-800-258-9732.

Can I go to any Vision Care provider for my examination, glasses or contact lenses?

In order to receive the maximum Vision benefit, you should use a Davis Vision Provider as well as Davis Vision selected frames or contact lenses. If you are not sure whether your provider is a Davis Vision Provider, contact Davis Vision directly at (800) 999-5431 or log on to their website at  www.davisvision.com.

How do I find a Davis Vision Provider?

If your plan includes the Davis Vision benefit, a provider directory was included in your SPD binder. You may also visit their website:www.davisvision.com. Once you set up an account login, you will be able to search for providers in your area.

What if I choose a non-participating provider?

The non-participating provider benefit is $45.00 toward the exam and $55.00 towards glasses or contact lenses. You would need to submit the Out-of-Network form directly to Davis Vision for reimbursement. The form can be found on the Davis Vision website:  www.davisvision.com. Once you set up an account login, you will be able download and print the form.

How often am I eligible for reimbursement for my eye exam, glasses or contact lenses?

For member/spouse and adult dependents age 19 and over, the benefit may be used once every 24 months. For children age 18 and under, the benefit may be used once every 12 months.

Must I select my glasses or contact lenses on the day of my examination?

Yes. In order to be considered under your Vision benefit, the glasses or contact lenses must be chosen on the same day of the eye exam.

I forgot when I last had my eyes examined. How can I find out when I am eligible for new glasses or contact lenses?

Contact Davis Vision directly to find out when you will be eligible to receive your vision benefit again. You can either call Davis Vision at (800) 999-5431 or log on to their website at www.davisvision.com.

I have diabetes (or other medical condition) and my PCP recommends having my eyes examined every year. Does Davis Vision cover this?

Davis Vision only covers the examination for glasses or contacts once every 24 months. You are responsible for any routine vision care necessary within the 24months. If you need to have a medical examination (i.e., glaucoma, cataracts, injury to the eye, etc.) prior to Davis Vision eligibility, you may visit a CIGNA Network ophthalmologist; however, only the medical part of the examination will be covered. If they do an evaluation for an eyeglass or contact lens prescription during the exam, that part of the visit will not be covered nor will new glasses or contacts be covered at that time.

What identification number do I use when I login or call Davis Vision?

You may use your Allegiant Care Family ID number or your social security number. Your Allegiant Care Family ID number can be found on your dental card and Davis Vision card.

What is a Qualifying Event?

Qualifying Event can be any of the following:

  • Change in legal marital status, including marriage, death of a spouse, divorce, legal separation and annulment.
  • A change in the number of dependents, including birth, death, adoption and placement for adoption.
  • A change in employment status of the member’s dependent spouse and/or adult dependent, including termination or commencement of employment, a strike or lockout, a commencement of or return from an unpaid leave of absence, a change in work site, or a change in employment status which results in a change in benefits s/he receives or is eligible to receive.
  • A change in the employment status of the member’s adult dependent child that results in loss of access to employment-based group insurance.
  • A dependent’s loss of eligible status.
  • A change in the place of a dependent’s residence making the current Plan unavailable.
  • Open enrollment under the Plan available through the dependent spouse’s employer.
  • Judgments, decrees or orders.
  • Significant cost or coverage changes under the member’s Plan.
  • Entitlement to Medicare or Medicaid.

I am getting married or recently married; can I add my new spouse’s child(ren) to my Plan?

Step-children can be added to your policy as long as Allegiant Care receives all the required documentation.  You should download and complete the Enrollment Change Form and forward to Allegiant Care with all required documentation within 30 days of the Qualifying Event. Dependents will not be added unless all required documentation is received.   If you have questions about completing the form, please contact Allegiant Care at 1-800-248-9732.

My spouse or child lost their current insurance coverage, how do I add them to my Plan?

You should download and complete the Enrollment Change Form and forward to Allegiant Care with all required documentation within 30 days of the Qualifying Event. Dependents will not be added unless all required documentation is received. If you have questions about completing the form, please contact Allegiant Care at 1-800-248-9732.

My spouse or dependent gained other insurance, how do I cancel their coverage on my Plan?

You should notify Allegiant Care within 30 days of the Qualifying Event using the Dependent Termination Form.  If you have questions about completing the form, please contact Allegiant Care at 1-800-248-9732.

Can I cover a non-dependent (i.e., grandchild, sibling, niece, nephew, elderly parent, etc.) who lives with me?

No. Your Plan with Allegiant Care does not cover extended family. However, a dependent would be covered if you are able to provide court documentation indicating that you and/or your spouse are the appointed legal guardian(s) in the relationship.

Can I cover my elderly parent on my Plan?

No. Your Plan with Allegiant Care does not cover extended family.

Can I cover my significant other (girlfriend, boyfriend, fiancé, etc.) on my Plan?

No. Your Plan with Allegiant Care does not cover significant others.

What do I do if someone in my family has other dental, vision, prescription, or medical coverage but does not want to cancel either Plan?

You should download and complete the Coordination of Benefits Form.  If you have any additional questions regarding this form, please contact Allegiant Care at 1-800-258-9732.

I’m going to be 65 y/o; however, I intend to work for at least another year; do I have to enroll in Medicare?

You may enroll in Medicare Part A; however, you should defer your enrollment into Medicare Part B until you stop working. When you receive your Medicare cards you should contact the toll free number on the back and let them know that you are covered under an active group plan and will not be enrolling in Medicare Part B at this time.

At what age does my dependent child age-out of the Medical coverage of my Plan?

Under current laws, a dependent may remain covered under your Plan until the end of the month in which s/he turns 26.

How do I inquire about the status of my eligibility?

Please contact Allegiant Care at 1-800-258-9732.

How do I add or remove dependents from my Plan?

You can add or remove qualified dependents from your Plan any time there is a Qualifying Event (i.e., birth, death, marriage, divorce, gain or loss of other coverage) or during an annual Open Enrollment period (if applicable).

To add a dependent, please complete the Enrollment and Change Form.  You must return all required documents before your dependent(s) can be added.  You should also notify your employer of any changes.  If you have questions about completing the form, you may contact Allegiant Care at 1-800-248-9732.

How do I add my new spouse or newborn child to my Plan?

You must notify Allegiant Care within 30 days of the Qualifying Event.  Please complete the Enrollment and Change Form.  You must return all required documents before your dependent(s) can be added.  You should also notify your employer of any changes. If you have questions about completing the form, please contact Allegiant Care at 1-800-248-9732.

Who do I contact if I have any questions regarding Massage Reimbursement?

You may contact Marcia Frappier at Allegiant Care: (603) 669-4771 or 1-800-258-9732 extension 221

How do I know if I have Massage Reimbursement?

If your plan includes the benefit, you will see details in the “Supplemental Benefits” section of your SPD binder or you may call Allegiant Care at (603) 669-4771 or 1-800-258-9732.

Who is eligible for the massage therapy benefit?

The member and covered spouse are eligible for Massage Reimbursement. Children and adult dependents are not eligible for this benefit.

Which Massage therapists providers can I use?

You can go to any licensed massage therapist that you choose.

Where can I find the Massage Reimbursement form?

Massage Reimbursement Form  It is also found under “Forms” on the Allegiant Care website; or you may call Allegiant Care at (603) 669-4771 or 1-800-258-9732, extension 221 and request the form

NOTE: The form cannot be completed online. You must print the form, and mail it to: Attn: Massage Department, Northern New England Benefit Trust, PO Box 4604, Manchester, NH 03108.

How do I submit for Massage Reimbursement?

You will need to submit a completed Massage Reimbursement Form to: Allegiant Care, Attn: Massage Department, Allegiant Care, PO Box 4604, Manchester, NH 03108. The massage therapist will need to complete and sign the bottom section of the form. Up to five sessions will fit on one form.

What is the Massage Reimbursement?

The Massage Reimbursement is $30.00 for each visit. The maximum amount of reimbursement per calendar year is $1000.00 per covered member or spouse.

Who do I contact if I have any questions regarding Prescriptions?

Allegiant Rx at 1-866-888-0103

Which card do I use to fill a prescription?

You should present your Medco/Express Scripts card that carries the Allegiant Rx logo to the pharmacy to fill a prescription. If you do not have a card or are unsure if you have the correct card, please call Allegiant Rx at (866) 888 0103.

How do I obtain a replacement prescription card?

Login to www.AllegiantRx.com  or call Allegiant Rx at 1-866-888-0103.

Why does the local pharmacy only dispense a 30-day supply of my maintenance medication?

Your plan benefits limit you to a 30 day supply or a quantity of 100 doses, which ever is less, at your retail pharmacy. However, for greater benefit to you, a 90 day supply is available by mail order for all of your maintenance medications.

NOTE: If you are an Anheuser Busch member, you can fill your maintenance medications 3 times at the retail pharmacy. After 3 fills, you must fill your 90 day supply prescription at mail order in order to avoid paying the entire cost of your prescription at retail.

How do I use the mail order pharmacy for my prescriptions?

You can log in to www.myallegiantrx.com utilizing your Allegiant Rx ID # to create a user logon to register for mail order, add billing, verify shipping information. Your physician can fax your 90 day prescription to (800) 837-0959 or your physician can call in your prescription to (888) 327-9791. You may also call Allegiant Rx at (866) 888-0103 for more information.

Is the flu shot covered at a local pharmacy?

Yes. If you are a Northern New England Retiree, you must contact Allegiant Rx at 1-866-888-0103 before filling your prescription at your retail pharmacy. Copay will depend on if member is in a grandfathered or non grandfathered plan.

Is the Shingles vaccine covered at a local pharmacy?

Yes. If you are a Northern New England Retiree, you must contact Allegiant Rx at 1-866-888-0103 before filling your prescription at your retail pharmacy. Copay will depend on if member is in a grandfathered or non grandfathered plan.

I have Diabetes. Are my test strips/lancets covered through my prescription benefit?

Yes. Test strips and lancets are covered through mail order only. If you purchase them at a retail pharmacy, you are responsible for the entire cost. Check with your physician to see if they have any samples you can use until your mail order prescription arrives.

Contact Us

Toll Free: 800.258.9732
Local: 603.669.4771
Fax: 603.666.4477

Allegiant Care
51 Goffstown Road
P.O. Box 4604
Manchester, NH 03108

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Allegiant Care News

27
03/27/17

A New Name