HR Fast Facts: How Do Employees Select a Primary Care Physician During Open Enrollment?

Here’s how to provide answers to your employees who may be wondering what a Primary Care Physician (PCP) ID is, where to find one, and what to do with one.

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If an employee enrolls in an HMO or POS plan that requires a Primary Care Physician election, they will be prompted to enter the Provider ID for the doctor.

Each person enrolled in an HMO or POS plan that requires a Primary Care Physician (PCP) designation can have a different PCP. Here are some things they can look for when making their PCP election during open enrollment:

  • If they know the provider ID for their PCP, this can be entered in a “Provider ID” field.
  • If they would like to look through a list of possible providers, they can search for an option that allows them to “look up a list of [doctors, dentists, etc.]” link that will bring up the carrier website.
  • If they want a PCP automatically assigned, they can find a feature that allows their provider to auto-assign them one. The carrier will assign a PCP in the enrollee’s local area based on zip code.

What if an employees doesn’t know their primary care physician’s Provider ID?

If an employee doesn’t know their PCP’s provider ID, they can leave it blank and return to it before open enrollment is over. If they do not complete that field during open enrollment, they can change it later by logging into their profile on their insurance carrier’s website. Alternatively, they can call the Member Services number on their medical ID card.
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