Use your Benefit Convenience Card to pay for your covered:

• Medical premiums
• Out-of-pocket expenses (deductibles, copayments, coinsurance, and prescriptions)

You may be asked to show proof of your expenses, so keep the Explanation of Benefits (EOB) you receive from your insurance carrier and all receipts.

The Benefit Convenience Card can’t be used for:

• Premium or out-of-pocket expenses for dental, vision, and/or hearing services.
• ATM withdrawals or to get cash back when making a purchase.
• Expenses for your spouse or dependents.
• Expenses for products or services that your health insurance plan doesn’t cover.
• Premium expenses to anyone other than your current medical carrier.
• Expenses incurred while you were not eligible for Healthcare Cost Assistance benefits.
• Covered medical expenses from a previous calendar year; for these expenses submit a reimbursement request by filling out the Ameriflex Reimbursement Claim Form online.
• Your individual premium payment if your family is on the same premium bill; for your individual premium payment, submit a reimbursement request through MyCarewellSEIU503 or by filling out the Medical Premium Reimbursement Claim Form online.

You may be financially responsible for repaying funds to Carewell SEIU 503 if your card is used for expenses that are not covered medical expenses.

Set up automatic payments with your insurance carrier

Make sure your premium is paid on time every month! Contact your insurance carrier to set up automatic payments from your Benefit Convenience Card:

• Kaiser: Visit the Kaiser Permanente website.
• PacificSource: Visit the PacificSource website.
• Moda: Call Moda customer service at 1-503-243-3962 or toll-free at 1-877-605-3229, identify yourself as a homecare worker, and let them know you want to set up recurring automatic payments.
• Providence: Call Providence billing at 1-503-574-5791 or pay your premium online – for first time premium payments, use this link and select New individual & family applicants.
• Regence: Call Regence customer service at 1-888-675-6570 or visit the Regence website.

Make an appointment

Before you make an appointment with a medical provider, make sure that they are in your insurance carrier’s provider network. If you receive services from out-of-network providers, you will incur much higher out-of-pocket expenses.

To ensure you continue receiving Healthcare Cost Assistance, please remember to:

• Turn in your timesheets and/or payroll vouchers every pay period.
• Avoid recording 0 hours of work for 2 months in a row. Going 2 months in a row with no work could cause you to lose your Carewell SEIU 503 benefits, including Healthcare Cost Assistance. In this case, you would still have your Marketplace insurance plan, but you would have to start paying for premiums yourself or look for alternative coverage like the Oregon Health Plan. Eligibility rules are changing October 1, 2025. Learn more here.
• Keep your personal information up to date with Carewell SEIU 503 and your employer.
• Submit the Healthcare Cost Assistance Benefits Request Form every year you are eligible for this benefit.
• Pay your monthly premium to your insurance carrier on time, and monitor your premium payments. Your carrier may terminate your insurance plan if payments are missed.
• Report to the Marketplace any change in your information within 60 days. We’re here to help with this. Just call 1-844-503-7348 for assistance.
• Stay current on your tax filing.

The fastest way to get your reimbursement is by completing the following forms online!

Medical Premium Reimbursement Claim Form

Use the Medical Premium Reimbursement Claim Form for:

• Premium reimbursements if you are enrolled with family members on your plan. You can only claim the portion of your premium equal to your individual coverage if you are enrolled in an approved plan on a Health Insurance Marketplace. If you need help calculating your individual premium amount, contact your insurance carrier or Valley Insurance Professionals (503-480-0499 ext. 7). Please submit this form and a copy of your premium bill each month.
• You are eligible to receive a temporary Healthcare Cost Assistance benefit for a non-approved plan on a Health Insurance Marketplace.

Ameriflex Reimbursement Claim Form

Ameriflex Reimbursement Claim Form (Online)

Use the Ameriflex Reimbursement Claim Form to claim reimbursement for:

• Covered Medical Out-of-Pocket expenses if you paid with your own funds. For instance, if you paid for a prescription medication out-of-pocket because you didn’t have your Benefit Convenience Card with you at the time.
• Covered Medicare Out-of-Pocket expenses if you paid with your funds. For instance, if you paid for a prescription medication out-of-pocket because you didn’t have your Benefit Convenience Card with you at the time.
• Medical Monthly Premium – net monthly premium for qualifying individual plans purchased through the Marketplace (not family plan, not average premium reimbursement).

Losing Carewell SEIU 503 benefits does not mean you’re losing your health insurance coverage! But at the end of your waiting period month, your Benefit Convenience Card (BCC) will be turned off and you will have to start paying your own premiums and out-of-pocket medical expenses.

Don’t throw away your BCC! If you become eligible for Healthcare Cost Assistance benefits again, you’ll be able to use your card again.

Remember! If you set up automatic payment with your health insurance carrier, you’ll need to contact your carrier to update your payment information. See below for contact information for insurance carriers (like Kaiser Permanente, Regence, or Providence).

If you have coverage through a Marketplace plan:

• Make your premium payments on time, or you may lose coverage for not making a payment. Losing eligibility for Healthcare Cost Assistance is not a Qualifying Life Event, so you may need to wait until the next Open Enrollment to enroll in health insurance.
• Update your Marketplace application if your income has changed.

If your income is lower because you lost work hours, you may become eligible for Medicaid coverage. You can apply any time of the year for:

• Oregon Health Plan (OHP) in Oregon — click here to go to website.
• Apple Health in Washington — click here to go to website.

If you have a Marketplace plan

You’ll have to fill out the  Healthcare Cost Assistance Benefits Request Form to let us know about your plan and your premiums. We also recommend you call 1-844-503-7348 to ensure your Healthcare Cost Assistance (HCA) benefits start again without delays.

If you kept your Benefit Convenience Card (BCC)

You should still be able to use your card once you have submitted the Healthcare Cost Assistance Benefits Request form with supporting documents and it has been approved, unless the expiration date on the front of your card has passed. Please note that Ameriflex, the BCC Administrator, issued new cards in July 2022. If you received your BCC before that date, it is no longer valid, regardless of its expiration date.

If you don’t have a valid BCC, call Carewell SEIU 503 at 1-844-503-7348 to order a new card.

If you have no medical coverage

You may not be able to enroll in a medical insurance plan on the Health Insurance Marketplace until Open Enrollment, unless you qualify for a Special Enrollment Period. Open Enrollment usually begins on November 1 for coverage the following year. Until you enroll in an approved plan on the Marketplace, you would not be able to receive Healthcare Cost Assistance benefits.