FAQ

FREQUENTLY ASKED QUESTIONS

Please reach us at member.services@exemplarhba.com or call us directly at 1-855-826-EHBA if you cannot find an answer to your question.

A TPA is a company that your employer hires to handle the many tasks associated with managing your health benefit plan. For example, EHBA handles general enrollment tasks when new plan members sign up to receive health benefits. We also process your health claims, making sure they are handled quickly and accurately.  EHBA even has medical professionals on staff who can help coordinate your care if you are in the hospital or are dealing with a chronic health condition.

With a level-funded plan, an employer pays a health carrier the same monthly amount to cover the estimated cost for expected claims, the premium for stop-loss insurance that covers health care costs over a set dollar amount, and plan administration costs. If total claims costs are higher or lower than expected, the carrier makes adjustments at the end of the plan year in the form of a refund to the employer for lower claims or a premium increase on the stop-loss insurance renewal for higher claims.

Stop-loss coverage is an essential part of this arrangement because it limits an employer's financial responsibility for claims over a certain amount, either on a per-employee basis or for the entire covered population.

At EHBA we work and contract with many different PPO networks.  A PPO is a network of health care providers who have agreed to discount (reduce) what they charge for services when treating members of a benefit plan. When you choose to see an in-network PPO health care provider, you will pay less for their services than if you had chosen an out-of-network (non-PPO) health care provider. You have the option to see non-PPO providers, but you will pay more for their services.

EHBA will provide you with prompt, personalized service. As a plan member served by us, you have a customer service team of helpful people available to assist you and answer questions about your health benefits.  We at EHBA are always just a phone call away you you will be able to speak to someone who can help you get the answers you need. You may also receive other services, depending on your health plan’s features, to help you and your covered family members use the health care system and receive appropriate health care at a reasonable cost.

Please refer to your plan documents or give us a call at 1-855-826-EHBA.

To request a replacement I.D. card email member.services@exemplarhba.com or give us a call at 1-855-826-EHBA.

Contact our customer service team at 1-855-826-EHBA.

Please contact our customer service team at 1-855-826-EHBA.