Employee Q & A Archive

  • Benefits Q&A Issue 2 - 2015 +

    Q: May I use the WageWorks Healthcare Card to pay for Lasik procedure? Does Superior Vision cover this procedure?
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  • Benefits Q&A Issue 3 - 2015 +

    Q: If I am age 65 or approaching age 65 and eligible for Medicare but am still employed with the
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  • Benefits Q&A Issue 1 - 2016 +

    Q: I am a deferred retiree. Do I qualify for retiree benefits?
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  • Benefits Q&A Issue 2 - 2016 +

    Q: Do I need to add my newborn as a dependent, or will she be added automatically?
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  • Benefits Q&A Issue 1 - 2017 +

    Q: My 15-year-old daughter and 21-year-old son live with their mother in another state. Are my children still eligible for
    Read More
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Tuesday, 11 April 2017 15:25

Benefits Q&A Issue 1 - 2017

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Q: My 15-year-old daughter and 21-year-old son live with their mother in another state. Are my children still eligible for medical and dental coverage under my City of Houston-sponsored plan?

A: Your natural or adopted children are eligible for coverage up to age 26, whether or not they live with you. (Adult children are eligible to remain covered regardless of marital status and accessibility to other coverage). Since your children live out of state, the level of health coverage depends on the plan in which you are enrolled.

For example, if you are enrolled in the Limited plan, your health coverage is limited to the following core service area: Harris, Montgomery, Galveston, Brazoria, Fort Bend, Austin, Waller, Grimes, San Jacinto, Liberty, Walker and Chambers counties.

Call one of the Cigna on-sites to see if your zip code is included the City of Houston-approved extended zip code list. Outside the service area, you are covered only for emergency and urgent care. Call Cigna to find out information about its Guest Privileges Program at 800-997-1406.

If you are covered with the Open Access Plan or Consumer Driven Health Plan, coverage is the same as though your children were with you in Houston. Guest Privileges Program does not apply to these plans since both are nationwide.

Be sure to verify that providers used are participating Cigna Care Providers. For a list of participating providers, call 800-997-1406 or log on to www.cigna.com. OAP does not have out-of-network benefits. CDHP has in-network and out-of-network benefits. Dental is administered with Delta.

You are limited to coverage in Houston and a few surrounding counties if you are covered with the DHMO plan. Emergency coverage is available if the member is more than 35 miles away from the service area; emergency coverage extends to stabilizing the patient, but further treatment must be obtained by the member’s primary dentist in the service area.

For more information about emergency services, call 844-282-7637 (DHMO) or 855-242-1549 (DPO). The DPPO is a nationwide plan so your children will have the same level of coverage as if they were in Houston.

Read 347 times Last modified on Tuesday, 11 April 2017 15:43