Frequently Asked Questions

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You may submit a claim online or you may contact the Risk Management Division and request a claim form.

Texas Municipal League Intergovernmental Risk Pool (TMLIRP) is the City's insurance carrier. All liability claims are forwarded to TMLIRP by the City of Baytown's Risk Management Division. Once your claim has been received, TMLIRP will assign an adjuster to handle your claim. The adjuster will contact you in a few business days.

You must complete a claim form and return it to the City's Risk Management Division. You should hear from our insurance adjuster within a few business days.

Once a claim form is received by Risk Management, we will open a claim with our insurance carrier, the Texas Municipal League Intergovernmental Risk Pool (TMLIRP). If you do not hear from TMLIRP within 5 business days, you may contact them at 800-537-6655 or you may contact Risk Management at 281-420-5846.

No. Do not make repairs or incur other costs under the assumption that City will reimburse you when a claim is filed. Furthermore, you should not have repairs made or services performed and billed to the City. The City may settle a claim with you but it may not pay the costs of all the services that you ordered. The City also cannot approve a rental vehicle. That determination is made by Texas Municipal League Intergovernmental Risk Pool (TMLIRP). You may contact them at 800-537-6655. It is our goal to address each claim as fairly and promptly as possible as we understand you may have been inconvenienced by this incident.

Depending on the complexity and the nature of your claim, it may take several days or weeks for the adjuster to conduct the investigation. An investigation may include a visit to the site for inspection and photographs, contact with the City Department or workers involved in the area or incident and follow-up with you for additional information or documentation. Please allow a reasonable period of time to investigate and respond to your claim.

You will receive a written response to your claim from the assigned adjuster. Depending on the complexity and nature of your claim this may take several days or weeks. Should you have any questions or concerns about the results of their investigation or the status of your claim, please address these to the assigned adjuster or you may contact the Risk Management Division at 281-420-5846.

If your claim is valid and the City is legally obligated to pay, you will receive a letter advising you that your claim has been accepted. At this time the adjuster will advise you of the amount of the settlement and provide you with a Release of Claim Form. You must have your signature notarized and return the original Release to the assigned adjuster. Texas Municipal League Intergovernmental Risk Pool (TMLIRP) will send your settlement check.

If your claim is denied, you will receive a denial letter with an explanation of the reason(s) your claim was denied. There are situations where the City may not be responsible or obligated to pay your claim. For example, there may be another party responsible for the claim, a contractor may be doing work for the City and the contractor may be obligated to pay the claim.

The assigned adjuster will send you a claim acceptance letter with a Release of Claims Form which you must sign before a Notary Public and return the original to the adjuster. It may take several days after the receipt of your properly executed Release for the assigned adjuster to process your settlement check. Once you sign the Release and receive the settlement check your claim is concluded and is final.

Yes, the City often uses Independent Contractors and they may be responsible for damage they cause while performing work on behalf of the City. If an Independent Contractor is responsible for your damage, the assigned adjuster will provide you the name of the Independent Contractor.

Yes, when the City becomes aware that you are off for a FMLA qualifying event we will automatically place you on FMLA status. All workers compensation claims that miss more than 3 days are placed on FMLA paid status.

Yes, the act entitles the employees to maintain health benefits while on FMLA leave. If the employee is on unpaid leave, it is the employees responsibility to pay the insurance premiums while they are off.

Yes, in the event that you are on unpaid FMLA leave for more than a month, you must apply for the extended supplemental death benefits to maintain your life insurance with TMRS. Contact Human Resources for assistance in applying for this benefit.

For scheduled or known procedures, the request should be submitted in writing to the department director 30 days prior to a qualifying event. For unplanned situations, when you are absent for more than 3 consecutive days your timekeeper will notify HR. HR will then send you a packet to complete.

Yes, the act provides the employees the right to return to the same position or an equivalent position with equivalent pay, benefits and working conditions at the conclusion of the leave.

The time that you are out is completely protected. The time off cannot be used against the you for raises, promotions, or loss of service.

The birth of a child and/or to care for a newborn. The placement of a child for adoption or foster care. To care for the employee's spouse, child or parent with a serious medical condition. If the employee has a serious health condition that makes them unable to perform the functions of their job.

Common colds, Flu, Earache, Upset stomach, Headaches (other than migraines), Routine dental or orthodontia problems, Plastic surgery (unless after injury), Routine medical, dental or vision exams, Over-the-counter drugs, Bed rest, Exercise programs.

You may request an authorized leave of absence from the City Manager. However, approval is depending upon the hardship it would cause the City to have the position vacant and the employee's performance.

Inpatient Care (Overnight stay in hospital, hospice, or residential treatment), Absence plus Treatment - at least 3 consecutive full days of incapacity involving treatment by a health care provider, Pregnancy, Any absence involving treatment for a chronic health condition that requires medical supervision or multiple treatments for the same condition.

This act allows "eligible" employees to take job-protected, unpaid leave or to substitute appropriate paid leave for up to 12 work weeks in any 12 month period.

This form is required prior to beginning your leave and must be completed and signed off on by a doctor. It is your responsibility to ensure that HR receives the form.

You must have worked for the City for 12 months and have worked a minimum of 1250 hours. The 12 month period is determined by looking at the past 12 months from the date of the leave request.

No, you will not accrue sick or vacation leave for the unpaid status portion of your leave.

No. It can only access the available balance in the current FSA plan year.

Yes. If the merchant or provider accepts the card, you can provide the card number, expiration date, and any other information requested to pay eligible expenses. Make sure the charged amount is correct prior to providing your card number for billed expenses at UHC medical, dental or vision providers. Explanation of Benefits should be reviewed to make sure the amount due on the bill matches your portion of financial responsibility.

No, you can only use the card to pay for services within the current plan year.

It is valid for four years from the date of issuance if you continue to enroll each plan year. The expiration date can be found on the front of the card. New cards will automatically be issued 45 days prior to card expiration date.

Yes, if the merchant allows partial authorizations, the card will access only the remaining funds in the account. For example, if the item cost is $20, and there is only $10 in the account, you can use the card to fund $10, and then pay for the remainder of the transaction out-of-pocket. (Note: not all merchants allow partial authorization.)

Yes. The transaction information for the Consumer Accounts Card is updated daily. However, there could be an instance when the card is used on the same day that a manual/auto-rollover claim is received and the total amount of both services results in a negative balance in the account. If this occurs, we will advise you of overpayment procedures.

No, the dependent spending account is used for individuals that have children in daycare and would like to pay for the daycare pre-tax. For dependent medical expenses, you put that amount in the same medical flexible spending account you are using.

Please call United Healthcare at 866-755-2648.

Credit. Even though it says debit on the card, it does not require a PIN (personal identification number) for processing, so “credit” should be selected.

• The card is not activated
• One business day has not passed since activation
• The transaction is not for an eligible service or it does not match a pre-defined benefit co-pay amount, as required by the plan
• The transaction is for a non-eligible charge that was not elected in your company’s plan
• The transaction cannot be substantiated in real time at the pharmacy 
• The retailer does not accommodate partial authorization and the remaining funds in the account do not cover the expense 
• There is a problem with the merchant’s card terminal 
• It is an invalid location, e.g. a gas station or electronics store.

You should choose another payment method and save the receipt and submit the claim manually along with a claim reimbursement request form. Forms can be obtained from myuhc.com or the flexible spending account customer service team at 1-866-755-2648.

In lieu of using your card, you will need to submit claims reimbursement forms from your tax-advantaged account(s) in order to be reimbursed for expenses. The form is available on www.myuhc.com. In addition, you may also log-on to www.myuhc.com and select to turn on/off your medical claims automatically submitted to your account for reimbursement by using the ‘Auto-Rollover’ feature (as applicable to plan design).

You should call CAC Customer Service immediately at 1-866-755-2648. If the incident is reported to us within four (4) business days, you will not be liable for fraudulent use. If not, you may be liable for a maximum of $50. It is your responsibility to monitor account activity and report any unusual or fraudulent transactions to UnitedHealthcare®. Once reported, it will be deactivated immediately and new card(s) will be reissued.

A special purpose debit card offered to you by UnitedHealthcare (at your employer's request), that you can use to help pay for eligible expenses quickly and conveniently from your flexible spending account. 

Eligible expenses may include such things as: 

• Pharmacy prescriptions 
• Office co-payments 
• Eligible over-the-counter (OTC) health care items (visit myuhc.com for a list of eligible 213(d) expenses) 
• Deductibles, coinsurance

Your card may be used at a variety of locations based on the parameters of your employer’s benefit plan(s). In general, your card may be used at hospitals, doctor’s offices, many retailers and grocers, pharmacies and some dependent day care centers, if you also have the dependent saving account.

You and any eligible dependent(s) can use the card at approved locations. Two cards are sent for convenience. Additional cards may be requested by calling customer service at 1-866-755-2648.

All accounts start off each year with the "Auto-Rollover" feature selected. If you do not want to automatically receive payment, you will need to go to www.myuhc.com and turn off the feature.

1. If you do not already have access to the Follow My Health Portal (Wellness Center access to your online profile to schedule appointments and review health data), you will receive an email following an appointment at the Center.
2. The email will contain a unique link with instructions on how to activate your portal account.

1. If you have already setup a Follow My Health portal account, you can login to the portal and register for an appointment.

or

 2. You can always call the Center directly at 832-514-6548 to schedule an appointment.

You can schedule appointments by calling the Center directly at 832-514-6548. The Center also takes walk-in patients but wait times will vary depending on how many appointments are already scheduled.

• Full-time employees covered through the City's insurance (no cost)
• Dependents ages 4 and up covered through the City's health plan (no cost)
• Full-time employees not covered on the City health plan ($50 fee through payroll deduction)

Employee’s and their dependents covered on the City health plan as well as under 65 retirees on the health plan may use the center at no cost. Those employees who chose not to enroll in the health plan will be charged a nominal $50 usage fee in order to receive care (their dependents are ineligible). This has been found to be cost effective to the plan.

Yes, all records, including medical information, and evaluations, are kept confidential in accordance with Federal and State laws. All files are the property of Concentra, who will keep and maintain them at all times. The City will not be sent copies of your medical files.

Yes

Yes! You may be treated at the Wellness Center for chronic care.

If you are only on the vision or dental plan, and you are an employee, you may only use the Center for a $50 use fee.

Not at this time.

Yes, retirees on the City health plan may use the center.

The Center provides access to a payroll authorization form that you sign allowing permission to process. The form is then routed to payroll and “no-show” fee is taken out of your next pay check. No physical money or payment is ever exchanged at the Center.

No, there is no designated parking specific to the clinic. There is a parking lot in the front of 4002 Garth Road for a number of vehicles; Fire Trucks may need to park further away than those designated slots.

If you are 10 minutes late to your appointment, you are considered a “no-show.” “No-Shows” will be charged a $20 fee and their account will be deactivated until the fee is paid.

If your situation is serious or life threatening, you should go directly to a hospital emergency room or call 911 for assistance.

It is the City’s policy that if you are injured on-the-job you initially treat with the City physician unless you are in need of emergency medical care and then we request you seek care at the nearest emergency care facility. It is also the policy that before you are cleared to return to your job you must be cleared by the City physician, both of these are allowed under the Texas Workers’ Compensation law. Please note: if you want to treat with your own physician you may do so, however be certain the physician accept workers’ compensation insurance. You must also comply with the above policy.

The Center will be open only on days the City offices are open.

The Center will treat children age 4 and up. If the physician believes your child will benefit from the flu shot this will be provided at no cost.

If you have an order for lab work from a physician other than the City physician, you can have the lab work done at the Center. It is best to submit the orders in advance to the Center to ensure they have everything they need to perform the blood draw.