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  • FIC Insurance Coverage

    - I missed the March 31 open enrollment deadline. Can I still sign up for a health plan?

    Outside of the open enrollment period, you can only enroll in an FIC health plan if you have a qualifying event such as marriage, birth or adoption of a child, or loss of existing health coverage.

    If you qualify, visit the enrollment page, complete the Qualifying Event Form and Enrollment Form, then mail your enrollment packet to the address listed.

    - If a qualifying event makes me eligible for health insurance, when do I need to enroll by?

    After the qualifying event occurs, you have 60 days to submit your Enrollment Form and Qualifying Event Form.

    - If I enroll due to a qualifying event, when will my health plan be effective?

    Your effective date will be the first of the month following our receipt of your enrollment packet, except in the case of a birth, when the effective date will be retroactive to the date of birth.

    - When will the next open enrollment period be and when would coverage be effective?

    The tentative Affordable Care Act open enrollment dates for the fall are November 15, 2014 through February 15, 2015 with coverage starting in 2015. However, the dates are defined by regulators and are subject to change.

    - Where can I view my plan benefits?

    When you log in to this website, you can view your Plan Highlights or download your Summary of Benefits to see an overview of your plan. To see your full plan details, you can download your Benefits Booklet and Certificate of Coverage.

    - What kind of insurance does FIC offer?

    We partner with the BlueCard PPO network to offer health plans that are tailored to the needs of freelancers which provide exclusive access to Freelancers Medical, a program only at our two Freelancers Union Halls in Brooklyn and Manhattan, featuring $0 copay primary care with a full range of wellness service - all for no additional cost. The innovative Freelancers Medical is integrated into our plans to provide quality care that helps independent workers achieve healthy well-balanced lives.

    - Why are the plans listed by metal level? What do the metal levels mean?

    We offer plans at four metal levels: Bronze, Silver, Gold, and Platinum. All of the plans cover the essential health benefits, but they differ in how much cost-sharing you are responsible for.

    A plan with a lower monthly premium (Bronze) has higher cost-sharing, meaning you would have a higher deductible and overall out of pocket expenses. A plan with a higher monthly premium (Platinum) has lower cost-sharing, meaning your deductible and overall out of pocket expenses would be lower.

    - When will my coverage start?

    If you submit a complete enrollment packet by March 31, 2014, your coverage will begin on April 1, 2014. After March 31, you can only enroll for insurance due to a qualifying event (marriage, birth, etc.) until the next open enrollment period in late Fall 2014.

    - How did you arrive at the new pricing for your health plans?

    This year our premiums increased as we modified our plans to comply with the Affordable Care Act, significantly reduced the total out-of-pocket maximums (the most you are expected to pay in a year), and integrated Freelancers Medical as a built in feature for all plans making it easier to access free unlimited primary care and a host wellness services at our Freelancers Union Halls.

    When looking at premiums, it is important to be mindful that rates are just one part of a plan's total cost and often not the best indicator of how inexpensive or expensive a plan may end up being once deductibles, coinsurance, and copays are factored in.

    - When is payment due?

    New members: You'll submit your first month's premium payment with your enrollment packet. After that, payment is due on the 15th of each month. You'll receive a paper bill in the mail.

    - I have Freelancers Insurance Company coverage, can I still go to my own primary care doctor?

    You can, but with most of our plans (bronze, silver and gold) your deductible will apply. This means you will need to pay out-of-pocket until you reach your deductible and then your insurance coverage will kick in. Only the FIC Platinum plan has a $50 copay for primary care visits outside of Freelancers Medical. The biggest value we offer with our insurance plans is access to Freelancers Medical.

    - I have the FIC Platinum plan. I thought there was no copay for primary care but my ID card says $50. What's the deal?

    If you use Freelancers Medical's Brooklyn or Manhattan primary care offices, you will be charged no copay. The $50 copay is charged if you visit BlueCard primary care doctors outside of Freelancers Medical.

    - Which New York counties do you offer coverage in?

    We offer coverage to residents of the following counties: Albany, Bronx, Clinton, Columbia, Delaware, Dutchess, Essex, Fulton, Greene, Kings, Montgomery, Nassau, New York, Orange, Putnam, Queens, Rensselaer, Richmond, Rockland, Saratoga, Schenectady, Schoharie, Suffolk, Sullivan, Ulster, Warren, Washington, Westchester.

    An important benefit for all our plans is access to Freelancers Medical at our Freelancers Union Halls in Brooklyn and Manhattan, where you get free primary care and wellness services. If you choose a primary care doctor outside of Freelancers Medical then a deductible will apply for the bronze, silver and gold plans and a $50 copay for the platinum plans.

    - Do I need to qualify in any way to get health coverage through Freelancers Insurance Company?

    No, our plans our now open to anyone and you don't have to be a member of Freelancers Union. If you're not a member of Freelancers Union, check out the benefits of becoming part of a movement of 250,000+ independents working toward a better future.

  • Freelancers Medical and FIC

    - What is Freelancers Medical?

    Freelancers Medical is a program for primary care combined with alternative and wellness services that was built by Freelancers Union to help independent workers live healthy and balanced 360-degree lives. It is a built-in feature of the Freelancers Insurance Company plans, and is located in the Freelancers Union Halls, spaces where members and freelancers can connect and build a supportive community.

    Through Freelancers Medical, health plan members will have access to unlimited primary care at no copay and a host of free wellness services including acupuncture, nutrition and stress management programs, plus yoga, Tai Chi and meditation classes at our Freelancers Union Halls in Brooklyn and Manhattan.

    - Where are the Freelancers Medical offices located?
    Brooklyn office:
    Phone: 718.971.5600
    408 Jay Street, 4th Floor
    Brooklyn, NY 11201

    Manhattan office:
    Phone: 646.843.4510
    80 Maiden Lane, Suite 2101
    New York, NY 10038
    - Can I see a specialist if I'm a member of Freelancers Medical?

    Yes, you can still see your specialists and depending on your plan a deductible will apply. Freelancers Medical covers primary care and includes pediatric and gynecological services for your convenience. Once you're a part of Freelancers Medical, you can select either the Brooklyn or Manhattan location for your primary care.

    - Do you only offer a $0 copay for primary care services through Freelancers Medical?

    Yes, the $0 copay primary care services are only available through the Freelancers Medical program at the Freelancers Union Halls in Brooklyn and Manhattan. If you visit a doctor outside of the Freelancers Medical program, the visit will be subject to a copay, deductible, or coinsurance, depending on your plan's benefits.

    - How can I change my primary Freelancers Medical office?

    To change your primary care office location, just fill out this short online form.

    - Do I need to be a member of Freelancers Union in order to enroll in a Freelancers Insurance Company plan?

    No. Our plans are open to the general public, but we designed them with member input so they are tailored to the needs of freelancers. That means we offer access to a national provider network – great if you travel – and Freelancers Medical, which provides quality primary care and wellness services for free.

    However, we encourage you to join Freelancers Union – it costs nothing to join and you can take advantage of other services and feel part of a community.

  • Claims

    - How do I file a claim?

    No medical claims need to be filed for primary and wellness care received from the Freelancers Medical program. If you need medical services from other in-network providers, the provider will file a claim for you. If you choose to seek care from an out-of-network provider, you are required to file the claims on your own behalf. Go to the Forms section and print the claim form. Complete the form and mail it with your receipt or provider's bill to:

    Freelancers Insurance Company
    P.O. Box 84224
    Seattle, WA 98124
    - How do I have a claims decision reviewed?

    If you disagree with a decision or feel a claim was processed incorrectly, contact customer service at 800.707.8802. If your issue doesn't get resolved, you can file a formal grievance or a medical necessity appeal in writing. For more information, please see your Certificate of Coverage, which you can access when logged in to this site.

    To have a pharmacy claim reviewed, contact FIC customer service and select the pharmacy option.

    To have a vision claim reviewed, contact Davis Vision's Quality Assurance Department at 800.584.1487.

    - How do I view my claims?

    To view your claims and those of your dependents under age 18, log in to this website. Your dependents age 18 or older must create their own accounts to view their claims.

    Once you're logged in, select Medical at the top of the page to view medical claims and Pharmacy to see prescription claims.

    - How do I get a copy of an Explanation of Benefits (EOB)?

    You can see your EOB online. When you're logged in to this website, go to Medical and then Claims. Search for your claims and click on the claim number to see more information about your claim, including the information from your EOB. You can print a copy or request that a copy of your original EOB be sent to you.

    To request a copy, call FIC customer service or request it online by going to Medical and then Express Requests. You'll see an option for requesting an EOB. It will be sent to you in the mail.

    - Can I submit my claims by email?

    You should send any claims through the mail and not by email. This helps protect your privacy and keeps your medical information secure.

  • Provider Network

    - What is FIC's provider network?

    FIC partners with the BlueCard PPO network. For primary care, all of our plans include access to Freelancers Medical, a program for $0 copay primary care that also offers free wellness classes along with pediatric and gynecological services. Insurance enrollees have vision coverage through Davis Vision, pharmacy coverage through US Script, and pediatric dental coverage through Guardian.

    - How can I find an in-network provider?

    At the top of FIC's website, you will see the link to the "Provider Search" page. From there, you'll see instructions to find in-network providers online.

    - Who administers the vision benefits on FIC plans?

    Davis Vision administers the vision benefits on all FIC plans. If you are already enrolled in coverage, you can find details about your vision benefits in your Certificate of Coverage, which is available to download after you log in to our site.

  • Insurance ID cards

    - When will I receive my ID card? Can I get a temporary ID card?

    Your ID card should arrive in the mail within three weeks of enrollment. You can print the information you need to use your insurance from FIC's website by logging in, going to "Medical," and clicking on "Temporary ID Information."

    - I lost my ID card. What should I do?

    You can request a new card after logging in to this website. Click "Medical" at the top of the page, then "Customer Service," and then click on "Please send me a new ID card."

  • Prescriptions

    - Who administers the pharmacy benefits on FIC plans?

    US Script administers the pharmacy benefits on all FIC plans. If you are already enrolled in coverage, you can find details about your pharmacy benefits in your Certificate of Coverage, which is available to download after you log in to our site.

    - Can I find out how much a prescription will cost me?

    You can look up an estimate of how your drug will be covered by visiting the Pharmacy section after logging in to this site.

    - Can I find out if my prescription is covered by my plan?

    Prescription coverage varies by plan. You can learn how your prescription is covered by logging in to this site and selecting Pharmacy at the top of the page.

    - What's the difference between a Generic, Brand Formulary, and Brand Non-Formulary prescription?

    Generic drugs are typically the least expensive option because they can be manufactured by anyone. Brand Formulary drugs are brand name drugs that are on the preferred medication list, while Brand Non-Formulary drugs are brand name drugs that are not listed on the preferred medication list.

    - How can I get mail-order prescriptions?

    FIC plans only allow mail-order prescriptions for specialty medications. However, you can get 90-day prescription refills at Walgreens and Duane Reade locations.

  • Pre-certification

    - When do I need a pre-certification?

    A pre-certification is required before certain services and procedures. These include services such as in-patient facility visits, non-standard and cosmetic services or treatment, specialized therapies, non-emergency mental health services, and certain diagnostic tests. For a complete list of services requiring pre-certification, see your Certificate of Coverage or call FIC customer service. You can download a Certificate of Coverage by logging in to this website.

    - How do I get a pre-certification?

    Call FIC customer service at 800.707.8802 or have your provider call the pre-certification phone number on the back of your insurance ID card.

    - What happens if I don't get a pre-certification?

    If you undergo a procedure or service for which pre-certification is required, but you haven't received pre-certification in advance, FIC may cover your care at a lower rate or deny coverage if the service is determined to not be medically necessary.

  • Emergency Care and Travel

    - What should I do if I have a medical emergency?

    If you have a medical emergency, please call 911 or go to your nearest emergency room. If you believe your situation is urgent, but may not require emergency room care, please call the doctors at Freelancers Medical. They are on call 24-7 to speak with patients over the phone.

    At the hospital, show your insurance ID card. Your benefits for emergency care will depend on your insurance plan. Generally, emergency care is covered at the same benefit level for both in- and out-of-network providers on any given plan.

    - If I'm traveling within the U.S. and need care, how do I find a doctor?

    Use the Provider Search to find a doctor in the BlueCard PPO network anywhere in the U.S.

    - I had to receive medical care while traveling abroad. How do I get reimbursed?

    You should pay out-of-pocket for the service received, then file a claim for reimbursement. When you're logged in to this website, go to the Forms section and print the claim form. Complete the form and mail it with the requested documentation to the address listed on the form.