Looking for Forms? The links below give you instant access to a host of forms for
many of your insurance needs. If you have any trouble finding the correct documents,
please contact customer service for additional assistance.
Q: What address should my premium payments be mailed
to?
If your 6 digit account number begins with a 1, 2, 4 or 6,
please mail your premium payment to:
Kelsey National Corporation
Premium Remittance
P.O. Box 39220
Los Angeles, CA 90039-0220
If your 6 digit account number begins with a 3, 7, 8 or 9,
please mail your premium payment to:
Kelsey National Corporation
Premium Remittance
P.O. Box 39220
Los Angeles, CA 90039-0220
Q: When are premium payments due?
Premiums statements are mailed on about the 5th of each month and due on the 15th
prior to the month of coverage. Premium should be paid within 10 days of the due
date. Our cut-off date for preparation of the next month's bill is around the
30th of each month (or prior working day if the 30th falls on a weekend or
holiday). Unless we receive payment, additions, terminations or changes prior to
that date, they won't appear on your statement until the second month following.
Q: What should I do if all insured persons in my
firm are not listed on my premium statement?
If your bill does not list someone, please write us a note on the bill or attach
a separate memo to the bill and forward with your payment. Please pay the amount
shown on the bill. We'll adjust the next bill accordingly.
Q: What should I do if I think something on my
premium statement is incorrect?
If you think your bill is incorrect, please write us a note on the bill or attach
a separate memo to the bill and forward with your payment. Please pay the amount
shown on the bill. We'll adjust the next bill accordingly.
Q: How do I enroll a new employee?
When hired, each individual must complete an Enrollment Form (and an evidence of
insurability form when necessary) and submit it to our office immediately. For
HMO Coverage, premium for the applicant should be submitted with the Enrollment
form. Please contact your Account Executive in our Customer Service Department
at (800) 366-5656 to get rates. Upon approval, your employee will be added to
the next month's billing statement and billed accordingly.
Q: When does a new employee's coverage become
effective?
Coverage for new employees is effective on the 1st day of the month following
completion of the Waiting Period, (provided the enrollment material is received
within the Waiting Period for all coverages selected).
Q: How does an employee add dependent family members
for coverage or change from individual to family coverage?
When an employee wishes to add dependent family members for coverage or change
from individual to family coverage, the employee should complete a new
Enrollment Form. Please refer to your Certificate of Insurance to verify when
additional dependents may be added.
Q: How does an employee add a new spouse for
coverage?
The Enrollment Form should be sent to KNC within 31 days of the marriage date, in
order for coverage to be effective as of the date of marriage. If you have HMO
coverage, the new spouse's choice of Primary Care Physician must be indicated on
the Enrollment Form. Be sure to indicate the date of marriage on the Enrollment
Form. If the Enrollment Form is not received within 31 days of the marriage date
penalties or limitations may apply. Call your Customer Service Representative
for details.
Q: How does an employee add coverage for a newborn
baby?
To provide continuous medical coverage for a new infant, the employee must
complete and submit an Enrollment Form to KNC within 31 days after the birth of
the child. Coverage for a newborn is not automatic. A newborn will be covered
for the first 31 days from the date of birth if enrollment materials are
received within 31 days. If enrollment materials are not received within 31
days, the newborn may not receive coverage. Call your Account Executive at (800)
366-5656 for details.
Q: How does an employee add coverage for an adopted
child?
An employee's family coverage may be extended to legally adopted children. A new
completed Enrollment Form and proof of adoption (copy of legal documentation)
should be sent to KNC within 31 days of the adoption. No coverage will begin
until all plan and enrollment requirements have been satisfied.
Q: How do I delete coverage for an employee who
wishes to discontinue it?
To delete or discontinue coverage for an employee or their dependents, complete
the Employee Data Change section at the bottom of your Premium Statement.
Q: How do I delete coverage for a terminated
employee?
To report a terminated employee or their dependents, complete the Employee Data
Change section at the bottom of your Premium Statement. Terminations must be
reported within 30 days of the employee's termination date. Retroactive
terminations are not accepted beyond 30 days. Please report terminations on the
Premium Statement immediately following the change...or better yet, FAX this
information as soon as it happens to your Account Executive at (310) 391-6534.
Q: When is termination effective?
Coverage shall terminate at midnight on the last day of the month in which the
loss of eligibility occurs. A premium payment is due for the entire month.
Q: Is there a way for terminated employees to
continue coverage?
When employment is terminated, the employee may be eligible for Medical or Dental
coverage under COBRA if your firm has 20 or more full-time employees. Please
refer to the section on COBRA Privilege in your Certificate of Insurance and
your Administrative Guidelines or consult your Legal Advisor. Feel free to call
your Account Executive for assistance. Also, terminated employees may be
eligible to enroll in a Conversion Plan. For more information, please refer to
the section on Conversion Privilege in your Certificate of Insurance.
Q: What should I do if a requested change does not
appear on my billing statement?
Sometimes a change is received after the billing cut-off. If a change does not
appear on your billing statement by the 2nd month, call your Account Executive
in our Customer Service Department immediately at (800) 366-5656. Our aim is to
provide the highest quality service by promptly responding to all requests we
receive.
If your specific question and answer is not listed, simply complete the Kelsey
National Q&A E-Mail Request. You will receive a prompt response from your
Account Executive by phone or fax.
P: (800) 366.5656 toll-free
P: (310) 390.1000 local area
FAX: (310) 390.3158
