What phone number can I refer my employees to when they have questions I can’t answer?


For Medical questions:
Member Services is available Monday through Friday from 8:00 am to 5:00 pm at (775) 770-6060 (HMO) or (775) 770-6900 (PPO)
For Pharmacy questions:
Please contact Catalyst at (866) 358-9534



Where can I call to verify an Employee is enrolled?

Member Services is available Monday through Friday from 8:00 am to 5:00 pm at (775) 770-6060 (HMO) or (775) 770-6900 (PPO) or log onto our employer online services at www.saintmaryshealthplans.com. Enter your login and password and click on Eligibility lookup. If you do not have a login and password, call Stephanie Monette at 775-770-7998 to obtain one.



How do I order a new ID card for an employee?

The member can call member services at (775) 770-6060 HMO or (775) 770-6900 (PPO) and request a new ID card or login onto our member online services at www.saintmaryshealthplans.com. If the member has not used the online member services before, they can sign up by following the new user directions under the login box.



Can I call on behalf of my employees’ or employees dependents regarding claim issues?

Due to HIPAA regulations, an Authorization for Disclosure form needs to be completed by the covered member to discuss any personal Health Information.



What is a waiting period? How can I find what our company waiting period is?


A Waiting Period is a period of time set forth in a policy by the employer, which each employee must complete before coverage begins. To obtain the waiting period Saint Mary’s Health Plans has on file for your company, please refer to your Group Contract. Section VII. E. of the Group Contract clarifies the waiting period established by the group.



When is our company open enrollment?

A Group Open Enrollment Period Shall be held for at least 15 days once every 12 months at which time eligible employee may enroll or dependents may be added. This is set by the employer, usually in the month prior to the policy effective date.



What if my employee has not received their ID card?


- New Members will receive a spiral bound notebook with ID cards inside the front cover.
- Please allow 7-10 working days for delivery.
- Please verify employees’ address.
If member has not received ID card after verifying the above information please contact Member Services. They are available Monday through Friday from 8:00 am to 5:00 pm at (775) 770-6060 (HMO) or (775) 770-6900 (PPO). You can also request an ID card online. Log on to our employer online services at www.saintmaryshealthplans.com. Enter your login and password and click on Online Employer Services. Choose “Please send a new ID card.” If you do not have a login or password, call Stephanie Monette at 775-770-7998 to obtain one.



How do I order new member packets?

Contact your Client Services Representative or log onto our employer online services at www.saintmaryshealthplans.com. Enter your login and password, click on Online Employer Services and choose “Please forward new hire packets.” If you do not have a login or password, call Stephanie Monette at 775-770-7998 to obtain one.



Who do I call regarding my premium bill?

Premium billing can be contacted at 775-770-6474.



What is a qualifying event?

Employees who decline coverage for dependents, for any reason, and later decide they want coverage will not be eligible until the next Group Open Enrollment Period. However, if a Dependent refuses coverage at the time of enrollment because they have other Qualifying Coverage, they will be eligible to enroll if one of the following has occurred:
a. Dependent is no longer eligible for benefits under the other Qualifying Coverage;
b. Expiration of COBRA continuation coverage;
c. Termination of employment causing termination from the other Qualifying Coverage;
d. Reduction of the number of hours of employment, resulting in termination of the other Qualifying Coverage;
e. Employer contributions toward other Qualifying Coverage terminated; or
f. Death or divorce of a spouse resulting in the termination of the other Qualifying Coverage for Dependent Children.
g. Marriage



How can I obtain a Summary of Benefits?

Log onto our employer online services at www.saintmaryshealthplans.com. Enter your login and password and click on Subscriber Benefit Lookup. If you do not have a login or password, call Stephanie Monette at 775-770-7998 to obtain one.



Where can I find the current Provider Directory?

Log onto our employer online services at www.saintmaryshealthplans.com. On the left hand is a menu of services, click on Provider Directory.



How can a member view processed claims?

Members can logon to www.saintmaryshealthplans.com. Click on Secure Member Portal, Enter their login and password and click on My Claims and EOB’s. If the member has not used the Online member services before, they can sign up by following the new user directions under the login box.