Billing and Reconciliation
- Billing and reconciliation processes.
- Billing and reconciliation assistance.
Billing and reconciliation processes
The following notices and forms are part of the monthly premium billing and reconciliation processes:
- Premium billing statement – monthly group premium bill.
- Payment voucher – last page of the monthly Premium Billing Statement.
- Group Audit Report – lists insurance premium discrepancies for each employee.
- Discrepancy Report – prepared by you to explain differences in the amounts billed to your employer and what is owed to EGID.
- Request for Insurance Premium Refund – used to request a refund of premium overpayment.
- Late notice – email or written notice that indicates a payment is past due.
Two types of billing statements are available:
- Online billing statement – If you use web enrollment, you can access your original bill or estimated bill online at any time. The manual received during web enrollment training has more information on the bill retrieval process. If you are not registered to use web enrollment, you can obtain limited access only to download the billing statements.
- Electronic billing statement – The electronic billing statement is available only through EGID’s secure portal, and an email is sent each month when your statement is ready to access. The bill shows each employee’s name, member ID, the premium for each benefit and the total amount billed. It does not include adjustments made to coverage for previous months.
The following steps can help ensure the payment process goes smoothly:
- Verify the insurance premiums deducted from your employees’ checks are correct.
- Audit your billing statement to make sure it is accurate.
- Collect premiums from any employees who are on leave.
- Send your monthly premium payment to EGID by the 10th of the month following the month of coverage.
- Maintain payroll records regarding premium deductions.
Payment and payment vouchers
Payments are due by the 10th of the month following the month of coverage. If payment is not received by the end of the month in which the payment is due, coverage shall be canceled effective the end of the month for which payment was last received. Prompt payment of group premiums ensures employees’ access to benefits.Use the payment voucher included in your billing statement to list all checks and warrants you are sending to EGID. Warrants and checks listed on the voucher should equal the total amount due. If the totals do not match, please explain the differences and note changes or corrections as a Discrepancy Report on a copy of your billing statement.
Auditing the premium billing statement
Use the following steps to reconcile your group bill and payroll records:
- Compare the amounts on your billing statement with your employer’s payroll records and identify any discrepancies. You must research discrepancies to determine if adjustments are needed.
- Review premium adjustments to determine if they were calculated into the previous month’s payment. If not, premiums may be outstanding or a refund may be due.
- Correct discrepancies by changing your next payroll, correcting eligibility through web enrollment, or mailing or faxing the appropriate form to EGID.
- Prepare a Discrepancy Report. Copy your billing statement and indicate changes or corrections on the pages that list the employees with discrepancies.
- Prepare warrants and checks for premium payment.
- Submit a copy of your Discrepancy Report with your payment voucher.
Please return the payment voucher, Discrepancy Report and actual warrants and checks to:
EGID ATTN: Member AccountsP.O. Box 269022Oklahoma City, OK 73157-8010
Member accounts researches all discrepancies listed on your Discrepancy Report. Discrepancies that cannot be resolved are listed on a Group Audit Report and returned to you. Review the Group Audit Report as soon as it is received.
When possible, a premium overpayment should be handled through your payroll department by adjusting the employee’s withholding for the next payroll period.
Refunds are issued only after EGID is notified in writing of a premium overpayment. Notification must be made within 60 days of the overpayment, unless the lack of notification is beyond your control as determined by EGID.
Complete a Request for Insurance Premium Refund form, which is available on the EGID website.
Refund requests are usually processed within 10 days. Any refund issued on behalf of an employee is paid directly to the employer.
NOTE: EGID cannot process a refund request if our records do not indicate an adequate group credit or the refund does not meet the criteria listed in the Administrative Rules. A denied refund request is returned to you along with a letter explaining the reasons for denial.
Submit your Request for Insurance Premium Refund form with supporting documentation, such as an Insurance Change Form or Insurance Termination Form, to:
EGID ATTN: Member AccountsP.O. Box 58010Oklahoma City, OK 73157-8010
Common billing issues
If a terminated or ineligible employee appears on your billing statement, do not make payment for that employee. Strike through the employee’s information and subtract their premium amount from the total due.
To the right of the employee premium line, indicate the termination date or date the employee became ineligible. Complete an Insurance Termination Form and process the termination through web enrollment. If you do not use web enrollment, send the form to EGID. Keep a copy of the form in the employee’s file.
NOTE: Education employees who terminate employment at the end of the school year can continue coverage until their contract ends.
If an eligible employee is not listed on the billing statement, verify the employee’s enrollment and the effective date of coverage using web enrollment or call member services. If information is incorrect or missing, correct the information in web enrollment or submit an Insurance Enrollment Form to EGID.
Enter the employee’s name, member ID and premium amount on the billing statement. Then add the premium to the total amount due.
If an employee’s premiums do not add up correctly, you can verify coverage and correct any errors within 30 days of the employee’s enrollment or change date through web enrollment or call member services.
If a coverage change is not reflected in your billing statement, the change may have been made after the bill was generated. Verify the correct coverage and effective date using web enrollment or call member services. Locate the employee’s name on the billing statement and change the amount billed to the correct amount. Always provide a brief explanation of the reason for the adjustment in the Explanation of Differences box, e.g., added a dependent child on 01/01/20.
NOTE: It is important that web enrollment is updated, or all forms are faxed or mailed, immediately. This includes all forms for terminations, changes and refunds.
An employee is eligible to continue coverage while on leave without pay for up to 24 months. The employee will still be listed on your billing statement, but it is their responsibility to pay premiums to you to forward to EGID.Age-rated Supplemental Life premiums increase Jan. 1 of the year following a birthday that advances a member into the next age bracket.
If a payment is returned for insufficient funds, EGID sends a letter to you requesting a replacement of funds by money order or cashier’s check.
An employee must have continuous coverage and premiums must be paid in full to continue coverage under retirement, vesting, disability or COBRA.
NOTE: You must send COBRA and retirement premiums separately. These payments are processed individually and should not be included with the group premium payment.
Billing and reconciliation assistance
If you need help with any billing or reconciliation issue, contact member accounts for assistance. Refer to the Contact Information section.