Virginia Provider Network |
| Q |
How can I become a provider in the Virginia DOA network? |
| A |
A provider agreement must be completed to join the Virginia DOA network. |
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| Q |
How do I obtain an agreement application? |
| A |
Contact FBMC Benefits Management at 1-800-872-0345.
Contact Persons:
Kilisha Parks, Client Services Coordinator, ext. 2171
Rosemary Cardenas, Senior Account Manager, ext. 2162
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| Q |
Is there a fee to join the network? |
| A |
Yes. The fee is $2,500 to join the network. |
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| Q |
Once a provider is in the network do they have to renew their agreement? |
| A |
Yes. Providers must renew their participation in the network annually. FBMC Benefits Management will send each participating provider an agreement to complete. The renewal period for the following plan year is usually during the month of September. If the provider fails to return the agreement they are removed from the network effective 01/01 of the following plan year. |
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| Q |
Is there a fee for renewal each year? |
| A |
No.
However if a provider fails to renew their participation in the network annually by completing an agreement application and desires to participate at a later time they must go through the enrollment process and will be assessed a $2500 fee to rejoin the network. |
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| Q |
What forms are utilized by vendors? |
| A |
There are three forms utilized by vendors.
1. Post-tax Salary Deduction Agreement (SDA)
2. Pre-tax Salary Reduction Agreement (SRA)
3. Cash Match Form (CMF) |
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| Q |
How do vendors request forms? |
| A |
To order printed carbon copy Post-Tax Salary Deduction Agreement (SDA) forms, please contact Barbara Reed, Senior Account Specialist, 1-800-533-2738 ext.2312
All vendor forms can be found under required forms.
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| Q |
Are there deadlines for forms to be submitted for payroll deduction? |
| A |
Yes. Please refer to the payroll cut-off date list provided on this website. Providers must submit forms by the FBMC Benefits Management Cut-off dates in order to make the next payroll. |
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| Q |
What will happen if the form(s) do not arrive at FBMC Benefits Management by the cut-off date? |
| A |
The deduction will begin on the next payroll. |
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| Q |
How are post-tax deductions started? |
| A |
A Salary Deduction Agreement (SDA) form must be completed between the employee and agent. The vendor will then forward the SDA to FBMC Benefits Management after underwriting is completed (if required). |
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| Q |
How are post-tax deductions stopped? |
| A |
The employee must notify FBMC Benefits Management in writing indicating the products they wish to stop. These requests can be sent by mail or faxed.
FBMC Benefits Management
3101 Sessions Road
Tallahassee, Florida 32302-1878
Fax: (850) 514-5803 |
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| Q |
How are pre-tax deductions started? |
| A |
A salary reduction agreement form (SRA) must be completed between the employee and vendor. The vendor will send the form t the provider’s main office. The form will then be sent to FBMC Benefits Management for data entry. |
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| Q |
How are pre-tax deductions stopped / changed? |
| A |
The employee would need to complete an SRA form and forward it to FBMC Benefits Management via mail or fax with the indicated changes and / or request to stop the deduction.
FBMC Benefits Management
3101 Sessions Road
Tallahassee, Florida 32302-1878
Fax: (850) 514-5803 |
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