Frequently Asked Questions

STUDENT HEALTH

To find a provider in the network used by your plan, locate the network logo found on your ID card, Student Health Brochure or Plan document. You can access your provider directory by clicking on the Provider Search link below or clicking on the PPO network link found on your individual group page. Look up providers by finding your network logo here.

Yes. The office should look on your ID card to identify the network you have and to confirm they are participating in that network.

Typically plans do not offer dental or vision coverage, only coverage for sickness or accidents to the teeth or eyes. Wellfleet offers a discount dental card program. Please visit here for details. If your plan does not have coverage for dental you can also purchase an individual plan by visiting here. Most of our plans include a discount vision program. To learn more about our vision discount program please visit here. Consult you’re the details of your plan.

To learn how to read an EOB, please click here.

CLAIMS

You can login here and check the status of a claim that you have submitted.

If you are a Wellfleet member, you will create your own username and password when you first register for access. If you are a provider, group administrator or broker, please contact us for initial access.

If you are a Wellfleet member, you will create your own username and password when you first register for access. If you are a provider, group administrator or broker, please contact us for initial access. If you are registered, but forget your password, click here to re-set it. If you need additional assistance, please contact us.

Passwords are case-sensitive. Please be sure you have entered it exactly as required. If you have forgotten your password, click here to re-set it. If you continue to have a problem, please contact us.

Other insurance may be responsible for paying the claim; the services may not be covered according to the exclusions listed in your brochure or Plan Document; the claim may not have occurred while you were covered; or the charges may be over Reasonable and Customary. A letter from Wellfleet will accompany any denial of claim indicating the reason for non-payment.

You will be asked for a description of the accident, other coverage information and perhaps a police report. Wellfleet will send a letter to you requesting the pertinent information.

Reasonable & Customary (R&C) charges are guidelines developed by an independent source and used by insurance companies to help assure that the fees providers are charging for services are reasonable for their geographic area.

Please mail all dental claims to Wellfleet Group LLC, PO Box 15369 Springfield, MA  01115-5369.

ENROLLMENT

You can enroll in our plan with a qualifying life event (QLE) (loss of other coverage) regardless of our enrollment deadline. You must supply written proof that your other coverage terminated due to a qualifying life event, such as loss of employment or losing coverage under a parent’s plan due to your age.  Cancelling coverage for which you are still eligible or ceasing to pay premiums under another plan is not a qualifying event.

Please refer to your plan’s Brochure or “Benefits at a Glance” document for information about dependent coverage.

PROVIDER

If you have access to the Wellfleet online portal, click here to log in.

To verify eligibility and benefits, members and providers can call the number listed on the ID card.

Providers should submit claims to the network address on the patient’s ID Card.

If you have change to your name, address or phone number please email an updated W-9 form to [email protected]. This will assure claims payments are submitted to the correct address.

Wellfleet sends 1099-Misc tax forms to providers who were issued claim payments. This form is mainly used for filing your tax return. Wellfleet typically mails 1099-Misc forms each year by the end of January.

Get in touch

Whether you’re a current Wellfleet Student member, administrator, or partner — or would like to become one — contact us with any questions you have. We’ll look forward to hearing from you. 

Wellfleet is the marketing name used to refer to the insurance and administrative operations of Wellfleet Insurance Company, Wellfleet New York Insurance Company, and Wellfleet Group, LLC. All insurance products are administered or managed by Wellfleet Group, LLC. Product availability is based upon business and/or regulatory approval and may differ among companies. ©2019 Wellfleet Group, LLC. All Rights Reserved.