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Getting Help with Insurance Claims is the Solution.

Call Us at 866-438-4274

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We help members with difficult claims and help provide instruction on how to file!

Learn More About Filing Claims

Navigating the claims process can sometimes be challenging, but we're here to help you every step of the way. Our team is available during business hours (Monday to Thursday: 8:00 AM - 5:00 PM CST; Friday: 8:00 AM - 1:30 PM CST) to assist with any claim-related inquiries you might have.

While HealthyAmerica and H A Partners, Inc. do not process any claims directly, we can provide support if you encounter issues, need assistance in obtaining the correct claim form, or require the guidance on the documentation necessary for filing a claim.

To help you understand the claims process, we have compiled some of the most frequently asked questions and their answers. This section is designed to provide you with essential information needed to manage your claims efficiently.

If you have further quetsions or require assistance with the claims process, please do not hesitate to contact us at 866-438-4274. We are here to ensure that you receive the support you need to manage your claims effectively. Your satisfaction and understanding of the claims process are important to us.



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Your Insurance Claim FAQs Explained

Healthy America Insurance Agency, Inc and H A Partners, Inc., serve as Third-Party Adminstrators (TPAs) for the United Business Association (UBA) and the Healthy America Association (HAA). While we manage billing, we do not administer claims. Claims are filed with the Claims Administrators of our insurance carrier partners. Below are some frequently asked questions regarding claims that we often encounter.

Claims FAQ Category FAQ Description
ID Card & Claims:
Do I Present my ID Card to Provider		 For most of the supplemental insurance plans we offer (exclusing dental, some vision plans, and TruGap), presenting your ID card to the provider is not necessary. The ID cards are primarily for your convenience, providing easy access to your Member ID# and the contact information for your claims administrator.
Provider Payments:
How are providers paid		 In most cases, you will pay the provider at the time of service unless the provider accepts another form of guarantee of payment. Be sure to keep all receipts related to the claim and request an itemized bill from your provider to submit with your claim form. It is crucial to start the claims process as soon as possible after receiving a covered medical service. If your plan has a different claims process, detailed instructions can be found on your Member Portal.
Claim Forms:
When Do I submit a claim form		 Submit your claim form, which can be accessed via the Member Portal, as soon as possible after receiving the covered service. Each insurance plan has specific time limits for filing claims, so it's important to review your Certificate(s) of Insurance to ensure your claim is submitted within the accepted timeframe.
Forms to Submit:
What Forms do I submit with Claim		 Include the claim form along with all itemized bills, Explanation of Benefits (EOBs), and any other requested information. Send these documents to the Claims Adminstrator specified on the claim form. Verify that you are using the correct claim form for your insurance carrier by logging into your Member Portal. For assistance, you can also contact us at: 866-438-4274.
Claim Payout:
When Am I Going To receive my claim payment		 The timeline for receiving your claim payment (subject to policy details, terms, limitations & exclusions) varies depending on the claim type. Delays may occur if all required information, such as itemized bills and primary insurance EOBs, is not provided. Ensure that you promptly supply any documents requested by the claims administrator to avoid delays.
Claim Status:
How do I find out status of claims		 To check the status of your claims, visit the claims portal listed in the Member Portal or on the claim form. Alternatively, you can call the number on the back of your ID card. If you encounter any issues, please call us at 866-438-4274 for assistance. We are here to help you navigate the claims process smoothly.
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Claim Forms and Plans

Below is a guide to help you understand which claim forms correspond to the various membership plans. Please note that not all of these plans are currently marketed or available in every state. This list includes all plans with active membership, regardless of their marketing status.

Plan Name Carrier Type of Supplemental Insurance Claim's Administrator Info States Claim Form
TruGap Hospital & Comprehensive SiriusPoint* Group Supplemental Medical Insurance HSR: 866-423-3452
ubaclaims@hsri.com		 AL, AZ, CA, FL, GA, IL, IN, MI, OH, TN, TX & WY Download TruGap Claim Form
Use this Policy# HASA-GAP-1000 when discussing TruGap Claims
UBA Accident &
UBA Accident+		 SiriusPoint* Blanket Group Accident Insurance HSR: 866-423-3452
ubaclaims@hsri.com		 AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NJ, NV, OH, OK, RI, TN, TX, VA, WI, WV, & WY Download Accident Claim Form
Gap 5000 &
Gap 5000+		 SiriusPoint* Blanket Group Accident Insurance HSR: 866-423-3452
ubaclaims@hsri.com		 AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NJ, NV, OH, OK, RI, TN, TX, VA, WI, WV & WY Download Accident Claim Form
Gap 5000 &
Gap 5000+		 SiriusPoint* Group Critical Illness Insurance HSR: 866-423-3452
ubaclaims@hsri.com		 AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NJ, NV, OH, OK, RI, TN, TX, VA, WI, WV & WY Download Critical Illness Claim Form
Gap 10 &
Gap 10000		 SiriusPoint* Blanket Group Accident Insurance HSR: 866-423-3452
ubaclaims@hsri.com		 AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NJ, NV, OH, OK, RI, TN, TX, VA, WI, WV, & WY Download Accident Claim Form
Gap 10 &
Gap 10000		 SiriusPoint* Group Critical Illness Insurance HSR: 866-423-3452
ubaclaims@hsri.com		 AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NJ, NV, OH, OK, RI, TN, TX, VA, WI, WV, & WY Download Critical Illness Claim Form
Gap 25 &
Gap 25000		 SiriusPoint* Blanket Group Accident Insurance HSR: 866-423-3452
ubaclaims@hsri.com		 AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NJ, NV, OH, OK, RI, TN, TX, VA, WI, WV & WY Download Accident Claim Form
Gap 25 &
Gap 25000		 SiriusPoint* Group Critical Illness Insurance HSR: 866-423-3452
ubaclaims@hsri.com		 AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NJ, NV, OH, OK, RI, TN, TX, VA, WI, WV & WY Download Critical Illness Claim Form
Complement Care SiriusPoint* Group Hospital Indemnity Insurance HSR: 866-423-3452
ubaclaims@hsri.com		 AL, AZ, AR, CA, CO, DC, DE, FL, GA, IL, IN, KY, LA, MI, MO, MS, MT, NC, ND, NE, NJ, NV, OH, OK, RI, SC, TN, TX, VA, WI, WV & WY Download Hospital Indemnity Claim Form
Gap Edge+ SiriusPoint* Blanket Group Accident Insurance HSR: 866-423-3452
ubaclaims@hsri.com		 AL, AZ, AR, CA, CO, DC, DE, FL, GA, IL, IN, KY, LA, MI, MO, MS, NC, ND, NE, NV, OH, OK, RI, TN, TX, VA, WI, WV, & WY Download Accident Claim Form
Gap Edge+ SiriusPoint* Group Critical Illness Insurance HSR: 866-423-3452
ubaclaims@hsri.com		 AL, AZ, AR, CA, CO, DC, DE, FL, GA, IL, IN, KY, LA, MI, MO, MS, NC, ND, NE, NV, OH, OK, RI, TN, TX, VA, WI, WV, & WY Download Critical Illness Claim Form
Gap Edge+ SiriusPoint* Group Hospital Indemnity Insurance HSR: 866-423-3452
ubaclaims@hsri.com		 AL, AZ, AR, CA, CO, DC, DE, FL, GA, IL, IN, KY, LA, MI, MO, MS, NC, ND, NE, NV, OH, OK, RI, TN, TX, VA, WI, WV, & WY Download Hospital Indemnity Claim Form
Gap Basic SiriusPoint* Blanket Group Accident Insurance HSR: 866-423-3452
ubaclaims@hsri.com		 AL, AR, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NJ, NV, OH, OK, RI, TN, TX, VA, WI, WV & WY Download Accident Claim Form
Gap Basic SiriusPoint* Group Critical Illness Insurance HSR: 866-423-3452
ubaclaims@hsri.com		 AL, AR, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NJ, NV, OH, OK, RI, TN, TX, VA, WI, WV & WY Download Critical Illness Claim Form
Gap Basic1 GTL* Group Term Life Insurance GTL Claims:
800-622-1993		 AL, AR, AZ, CA, CO, FL, GA, IL, IN, KY, MI, MO, MS, NE, OH, OK, TN, TX, & VA Download Term Life Claim Form
Gap AME 5K & 10K
& Gap AME 10K+		 GTL* Group Accident Only Insurance GTL Claims:
800-622-1993		 AL, AZ, AR, CA, CT, DC, DE, FL, GA, IL, IN, IA, KS, KY, MI, MS, NC, ND, NE, NV, OH, OK, PA, RI, SC, TN, TX, VA, WV, WI & WY -Accidental Death Claim Form

-Accidental Dismemberment & Loss of Sight Claim Form

-Accident Medical Expense Claim Form
Gap 5+ GTL* Group Accident Only Insurance GTL Claims:
800-622-1993		 AL, AR, AZ, DC, DE, GA, IA, IL, LA, MS, NE, OH, OK, SC, TX, VA, WI, WV & WY -Accidental Death Claim Form

-Accidental Dismemberment & Loss of Sight Claim Form

-Accident Medical Expense Claim Form
Gap 5+ GTL* Group Accident Riders
(Cancer, Heart Attack, Stroke, Sickness Hospital Stays)		 GTL Claims:
800-622-1993		 AL, AR, AZ, DC, DE, GA, IA, IL, LA, MS, NE, OH, OK, SC, TX, VA, WI, WV & WY Download Accident Riders Claim Form
Gap 5+ GTL* Group Term Life Insurance GTL Claims:
800-622-1993		 AL, AR, AZ, DC, DE, GA, IA, IL, LA, MS, NE, OH, OK, SC, TX, VA, WI, WV & WY Download Term Life Claim Form
HAA 5+ GTL* Group Accident Only Insurance GTL Claims:
800-622-1993		 AL, AR, AZ, DC, DE, GA, IA, IL, LA, MS, NE, OH, OK, SC, TX, VA, WI, WV & WY -Accidental Death Claim Form

-Accidental Dismemberment & Loss of Sight Claim Form

-Accident Medical Expense Claim Form
HAA 5+ GTL* Group Accident Riders
(Cancer, Heart Attack, Stroke, Sickness Hospital Stays)		 GTL Claims:
800-622-1993		 AL, AR, AZ, DC, DE, GA, IA, IL, LA, MS, NE, OH, OK, SC, TX, VA, WI, WV & WY Download Accident Riders Claim Form
HAA 5+ GTL* Group Term Life Insurance GTL Claims:
800-622-1993		 AL, AR, AZ, DC, DE, GA, IA, IL, LA, MS, NE, OH, OK, SC, TX, VA, WI, WV & WY Download Term Life Claim Form
Gap Term GTL* Group Term Life Insurance GTL Claims:
800-622-1993		 AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, IA, IL, IN, KS, KY, LA, MI, MO, MS, ND, NE, OH, OK, PA, RI, SC, TN, TX, VA, WI, WV & WY Download Term life Claim Form
HAA Lifepass 10 GTL* Group Term Life Insurance GTL Claims:
800-622-1993		 AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, IA, IL, IN, KS, KY, LA, MI, MO, MS, ND, NE, OH, OK, PA, RI, SC, TN, TX, VA, WI, WV & WY Download Term Life Claim Form
Gap+, Gap,
Gap Max+ &
SuperGap+		 US Fire (C&F)* Group Accident Insurance CBP: CBPConnect.com
1-877-442-7029		 AL, AR, AZ, DC, DE, FL, GA, IL, IN, IA, KY, LA, MI, MS, NE, NC, ND, OH, OK, RI, SC, TN, TX, VA, WI, WV & WY Download Accident Claim Form
Gap+, Gap,
Gap Max+ &
SuperGap+		 US Fire (C&F)* Invasive Cancer & Critical Illness Rider CBP: CBPConnect.com
1-877-442-7029		 AL, AR, AZ, DC, DE, FL, GA, IL, IN, IA, KY, LA, MI, MS, NE, NC, ND, OH, OK, RI, SC, TN, TX, VA, WI, WV & WY Download Critical Illness Rider Claim Form
Gap+, Gap,
Gap Max+ &
SuperGap+		 US Fire (C&F)* Group Hospital Fixed Indemnity Insurance CBP: CBPConnect.com
1-877-442-7029		 AL, AR, AZ, DC, DE, FL, GA, IL, IN, IA, KY, LA, MI, MS, NE, NC, ND, OH, OK, RI, SC, TN, TX, VA, WI, WV & WY Download Hospital Indemnity Claim Form
Gap Plus US Fire (C&F)* Group Accident Insurance CBP: CBPConnect.com
1-877-442-7029		 AL, AR, AZ, DC, DE, FL, GA, IA, IL, IN, KY, LA, MI, MS, NC, ND, NE, NM, OH, OK, PA, RI, SC, TN, TX, VA, VT, WI, WV, WY Download Accident Claim Form
Gap Plus US Fire (C&F)* Invasive Cancer & Critical Illness Rider CBP: CBPConnect.com
1-877-442-7029		 AL, AR, AZ, DC, DE, FL, GA, IA, IL, IN, KY, LA, MI, MS, NC, ND, NE, NM, OH, OK, PA, RI, SC, TN, TX, VA, VT, WI, WV, WY Download Critical Illness Rider Claim Form
Gap Plus US Fire (C&F)* Group Hospital Fixed Indemnity Insurance CBP: CBPConnect.com
1-877-442-7029		 AL, AR, AZ, DC, DE, FL, GA, IA, IL, IN, KY, LA, MI, MS, NC, ND, NE, NM, OH, OK, PA, RI, SC, TN, TX, VA, VT, WI, WV, WY Download Hospital Indemnity Claim Form
Gap Plus GTL* Group Term Life Insurance GTL Claims:
800-622-1993		 AL, AR, AZ, FL, GA, IL, IN, KY, MI, MS, NE, OH, OK, PA, SC, TN, TX, & VA Download Term Life Claim Form
Gap Max,
SuperGap &
Super Gap Plus		 US Fire (C&F)* Group Accident Insurance CBP: CBPConnect.com
1-877-442-7029		 AL, AR, AZ, CA, DC, DE, FL, GA, IA, ID, IL, IN, KS, KY, LA, MI, MS, NC, ND, NE, NJ, NM, OH, OK, PA, RI, SC, TN, TX, VA, VT, WI, WV, & WY Download Accident Claim Form
Gap Max,
SuperGap &
Super Gap Plus		 US Fire (C&F)* Group Hospital Fixed Indemnity Insurance CBP: CBPConnect.com
1-877-442-7029		 AL, AR, AZ, CA, DC, DE, FL, GA, IA, ID, IL, IN, KS, KY, LA, MI, MS, NC, ND, NE, NJ, NM, OH, OK, PA, RI, SC, TN, TX, VA, VT, WI, WV, & WY Download Hospital Indemnity Claim Form
Gap Max,
SuperGap &
Super Gap Plus		 US Fire (C&F)* Invasive Cancer & Critical Illness Rider CBP: CBPConnect.com
1-877-442-7029		 AL, AR, AZ, DC, DE, FL, GA, IA, IL, IN, KY, LA, MI, MS, NC, ND, NE, NM, OH, OK, PA, RI, SC, TN, TX, VA, VT, WI, WV, & WY Download Critical Illness Claim Form
Gap Max,
SuperGap &
Super Gap Plus		 Windsor* Group Critical Illness Insurance Windsor: 877-368-3927
Fax: 214-528-2777		 AZ, MO, TX Download Critical IllnessClaim Form
Gap Max,
SuperGap &
Super Gap Plus		 SiriusPoint* Group Critical Illness Insurance HSR: 866-423-3452
ubaclaims@hsri.com		 CA, KS, & NJ Download Critical Illness Claim Form
Gap Max,
SuperGap &
Super Gap Plus		 GTL* Group Term Life Insurance GTL Claims:
800-622-1993		 AL, AR, AZ, CA, FL, GA, IL, IN, KY, MI, MS, NE, OH, OK, PA, SC, TN, TX, & VA Download Term Life Claim Form
Gap Plus 7350 &
Gap Plus Legacy		 US Fire (C&F)* Group Accident Insurance CBP: CBPConnect.com
1-877-442-7029		 AL, AR, AZ, DC, DE, FL, GA, IA, ID, IL, IN, KY, LA, MI, MO, MS, NC, ND, NE, NM, OH, OK, PA, RI, SC, TN, TX, VA, WI, WV & WY Download Accident Claim Form
Gap Plus 7350 &
Gap Plus Legacy		 US Fire (C&F)* Group Hospital Fixed Indemnity Insurance CBP: CBPConnect.com
1-877-442-7029		 AL, AR, AZ, DC, DE, FL, GA, IA, ID, IL, IN, KY, LA, MI, MO, MS, NC, ND, NE, NM, OH, OK, PA, RI, SC, TN, TX, VA, WI, WV & WY Download Hospital Indemnity Claim Form
Gap Plus 7350 &
Gap Plus Legacy		 US Fire (C&F)* Invasive Cancer & Critical Illness Rider CBP: CBPConnect.com
1-877-442-7029		 AL, AR, DC, DE, FL, GA, IA, IL, IN, KY, LA, MI, MS, NC, ND, NE, NM, OH, OK, PA, RI, SC, TN, VA, WI, WV & WY Download Critical Illness Rider Claim Form
Gap Plus 7350 &
Gap Plus Legacy		 Windsor* Group Critical Illness Insurance Windsor: 877-368-3927
Fax: 214-528-2777		 AZ, ID, MO, & TX Download Critical Illness Claim Form
Gap Plus 7350 &
Gap Plus Legacy		 GTL* Group Term Life Insurance GTL Claims:
800-622-1993		 AL, AR, AZ, DC, DE, FL, GA, IA, ID, IL, IN, KY, LA, MI, MO, MS, NC, ND, NE, NM, OH, OK, PA, RI, SC, TN, TX, VA, WI, WV & WY Download Term Life Claim Form
Gap CI 25K+ &

Gap CI 25K
(ARAZMOMSOKTX)		 Windsor* Group Critical Illness Windsor: 877-368-3927
Fax: 214-528-2777		 AR, AZ, MO, MS, OK & TX Download Critical Illness Claim Form
Gap CI 25K US Fire (C&F)* Group Hospital Fixed Indemnity Insurance CBP: CBPConnect.com
1-877-442-7029		 AL, AR, DC, DE, FL, GA, IA, IL, IN, KY, LA, MI, MS, NC, ND, NE, NM, NV, OH, OK, PA, RI, SC, TN, VA, VT, WI, WV & WY Download Hospital Indemnity Claim Form
Gap CI 25K US Fire (C&F)* Invasive Cancer & Critical Illness Rider CBP: CBPConnect.com
1-877-442-7029		 AL, AR, DC, DE, FL, GA, IA, IL, IN, KY, LA, MI, MS, NC, ND, NE, NM, NV, OH, OK, PA, RI, SC, TN, VA, VT, WI, WV & WY Download Critical Illness Rider Claim Form
Gap CI 25K SiriusPoint* Group Critical Illness Insurance HSR: 866-423-3452
ubaclaims@hsri.com		 CA, KS & NJ Download Critical Illness Claim Form
Gap CI 25K Windsor* Group Critical Illness Insurance Windsor: 877-368-3927
Fax: 214-528-2777		 All other states including AZ, MO, & TX Download Critical Illness Claim Form
Gap CI 10K US Fire (C&F)* Group Hospital Fixed Indemnity Insurance CBP: CBPConnect.com
1-877-442-7029		 AL, AR, DC, DE, FL, GA, IA, IL, IN, KY, LA, MI, MS, NE, NM, NV, OH, OK, PA, RI, SC, TN, TX, VA, VT, WI, WV & WY Download Hospital Indemnity Claim Form
Gap CI 10K US Fire (C&F)* Invasive Cancer & Critical Illness Rider CBP: CBPConnect.com
1-877-442-7029		 AL, AR, DC, DE, FL, GA, IA, IL, IN, KY, LA, MI, MS, NE, NM, NV, OH, OK, PA, RI, SC, TN, TX, VA, VT, WI, WV & WY Download Critical Illness Rider Claim Form
Gap CI 10K Windsor* Group Critical Illness Windsor: 877-368-3927
Fax: 214-528-2777		 All other states including AZ, MO & TX Download Critical Illness Claim Form
Gap CI 10K GTL* Group Term Life Insurance GTL Claims:
800-622-1993		 AL, AR, AZ, FL, GA, IL, IN, KY, MI, MO, MS, NE, OH, OK, PA, SC, TN, TX, & VA Download Term Life Claim Form
Gap HCI Federal Ins Co / Chubb* Accident & Sickness Hospital Cash Insurance HSR: 866-423-3452
ubaclaims@hsri.com		 AL, AR, AZ, CA, DE, DC, FL, GA, IL, IN, IA, KY, MI, MS, NC, ND, NE, NM, NV, OH, OK, PA, RI, SC, TN, TX, VA, WI, & WY Download Hospital Indemnity Claim Form
FCL Dental 3000 FCL* Group Dental Insurance Verification & Claims:
877-493-6282
Group ID# MA2297-D+
PlanID: UBA-Dental 3000 MAC		 AL, AR, AZ, DE, DC, FL, GA, IA, IN, KS, KY, LA, MO, MS, MT, ND, NE, OK, TN, TX, & WV Download Dental Claim Form
FCL Dental OraQuest DHMO FCL* Group Dental Insurance Verification & Claims:
877-493-6282
Group ID# MB2297
PlanID: UBA-DHMO-110-01		 TX Download Dental Claim Form
UBA Dental Renaissance* Group Dental Insurance Verification & Claims:
888-358-9484
Group ID: 3621
Group Name: UBA
Payor ID is on ID card		 AL, AR, AZ, CA, CT, DC, DE, FL, GA, IA, ID, IN, KY, LA, MI, MO, MS, ND, NE, NM, NJ, NV, OH, OK, PA, SC, TN, TX, VA, WI, WV, & WY Download Dental Claim Form
UBA Vision Renaissance* Group Vision Insurance Verification & Claims:
800-877-7195
Group ID: 90112
Group Name: UBA
Tell Provider you have VSP
(no claim form needed
with VSP Providers)		 AL, AZ, AR, CA, CO, CT, DE, DC, FL, GA, ID, IL, IN, KY, LA, MI, MS, MO, NE, NV, NM, ND, OH, OK, PA, SC, TN, TX, VT, VA, WV, WI & WY Download Vision Claim Form
VSP Individual Vision Plan VSP* Individual Vision Insurance Tell Provider you have VSP
(No ID Card needed)		 AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, ID, IL, IN, IA, KS, KY, LA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NJ, NM, NV, OH, OK, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WI, WV, & WY No Claim form needed with VSP Providers.

Understanding Insurance Company & Claim Adminstrators

When dealing with insurance plans and claims, it's important to familiarize yourself with the full names of the underwriting insurance companies and claims administratros. This ensures clarity and helps in navigating the claims process efficiently.

*Underwriting Insurance Companies

Below are the names of the underwriting insurance companies associated with your membership plans:

  • SiriusPoint: SiriusPoint America Insurance Company
  • GTL: Guaranteed Trust Life Insurance Company
  • US Fire (C&F): United States Fire Insurance Company, a Crum & Forster company
  • Windsor: Windsor Life Insurance Company
  • Federal Ins Co. / Chubb: Federal Insurance Company, a member insurer of the Chubb group of companies
  • Renaissance: Renaissance Life and Health Insurance Company of America
  • FCL: First Continental Life and Accident Insurance Company
  • VSP: Vision Service Plan

These companies are responsible for underwriting the insurance plans you have enrolled in (based on the plan enrolled), providing you wiht financial protection and benefits outlined in your policy.

Claims Administrators

Claims administrators play a crucial role in the processing of claims. Here are the acronyms and full names of some of the claims adminstrators involved:

  • HSR: Health Special Risk, Inc.
  • CBP: Co-Ordinated Benefits Plans

These adminstrators manage the claims process for some of the underwriting insurance carriers, ensuring that each claim is reviewed and processed according to the the terms and conditions outlined in your policy.

Important Considerations

  • Role of HealthyAmerica, H A Partners, UBA and HAA: It is important to note that HealthyAmerica, H A Partners, Inc., the United Business Association (UBA), and the Healthy America Association (HAA) are not authorized to pay claims or make decisions regarding claim outcomes. All claim decisions are made by the Third-Party Adminstrator (TPA) claims adminstrator and the insurance carrier.
  • Need Assistance? If you require help or have questions about the claims process, feel free to contact us at 866-438-4274. While we cannot make decisions on claims, we are here to provide support and guidance to help you navigate any challenges you may encounter.

Understanding the entities involved in your insurance can claims processes will help you manage your policies more effectively and ensure that you receive the benefits you are entitled.


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How do TruGap Claims Work?

Here's a step-by-step guide on how TruGap claims are processed for current TruGap members.
TruGap is no longer being marketed as of 2/14/25. The claim information for TruGap is only for current members only.

Step-by-Step Claims Process

  1. Initial Provider Visit:
    When you receive treatment, whether inpatient or outpatient, present both your ACA Bronze ID card and your supplemental TruGap ID card to the healthcare provider.
  2. Primary Insurance Processing:
    Your healthcare provider will first submit the claim to your ACA Bronze primary insurance carrier. Once processed, your primary insurance carrier will send a payment and an Explanation of Benefits (EOB) to the provider.
  3. Filing the TruGap Claim:
    After receiving the EOB from your primary insurance, the provider will file a secondary claim with your TruGap supplemental plan. This is done using the contact information provided on the back of your TruGap ID card. Instruct the provider at time of service that they must include the TruGap Policy number (HASA-GAP-1000) on the back of their ID card when filing or discussing the claim.
  4. TruGap Processing:The TruGap claims administrator will process the claim and send the payment directly to the provider. An EOB statement will then be sent to you, detailing the payment and any remaining balance.
  5. IMPORTANT NOTE ON VERIFYING BENEFITS: Providers can verify your TruGap coverage using the information on the back of your TruGap ID card. They will need the policy number: HASA-GAP-1000 and the primary member's name to confirm eligibility.

TruGap Claim Form

HSR created a base TruGap claim form to help get you started. Use the claim form to start the claims process once you have visited a provider. That way, any claims coming in from providers will get attributed to the correct membership plan and policy number.

If you encounter any issues or have questions about your TruGap claims, please do not hesitate to contact us at 866-438-4274. We are here to assist you with any concerns you might have regarding your supplemental coverage.

You will have to refer to your ACA Bronze policy for details on any network restrictions on your primary insurance plan.

Important Considerations

Always refer to your ACA Bronze policy for any network restrictions or details concerning your primary insurance plan. Ensure that your provider follows the correct process by submitting claims to both your primary and secondary (supplemental) insurers to maximize your benefits.




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