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Employer Admin Guide

Billing Procedures The

Billing Procedures The Premium Invoice Summary 1 Premium payment address. The same address appears on the payment coupon. 2 3 Your company’s name and address. Your company’s account number, the billing period covered by the invoice, the premium due date, invoice number and date the invoice was produced (also located on page three of your invoice). You know us by . 2 1 3 4 4 5 Premium billing department phone number. Message box containing important billing information. 5 6 8 9 11 7 10 6 The amount of premium owed for the current billing period. 14 12 13 7 An adjustment code is assigned to any adjustment made to the previous or current billing period. The code appears here and is explained in the itemized portion of the invoice. 15 8 The current premium due after adjustments. 9 The monthly administration fee, if applicable. 10 Any outstanding balance carried over from a previous billing period appears here. 16 11 The amount of payment received since the last bill posting. 12 The total amount due for the current billing period. 13 Date premium payment is due. 14 Premium payment procedures. 15 All correspondences (other than premium payments) should be mailed to the address listed. 16 Premium due date and total amount due. 28

Billing Procedures The Premium Invoice 17 17 Premium payment information and requirements. Itemized 18 19 20 21 22 23 24 Contact name, number and contact type listed here. Benefit plan description if your group offers more than one benefit plan. Current monthly premium billed. Retro-active adjustments made to your account will appear in this section. Itemized amounts are totaled on each line for each contract holder. This is where you’ll find the adjustment code explained. This box provides a summary of premium dollars (current and adjustments) by contract year. Questions? 18 19 20 21 22 If you have questions about your invoice, please feel free to reference the Employer page of our website, www.connecticare.com, or call us at 1-800-333-1733, Monday through Friday 9:00 a.m. to 5:00 p.m. 23 24 29

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