["Update it below and resend.","What are your responsibilities?","For example, ifa family member or a caregiver calls us with prior knowledge of a claim, we may confirm whether or not the claim hasbeen received and paid.","Plan including any preexisting condition limitations, fraud provisions and employee actively at work and dependent health condition requirements.","The premium charges will be figured at the premium rates shown before.","Lenses Single vision, lined bifocal, and lined trifocal lenses.","Medicare through the Hospital Indemnity plan.","Explain difference in lastnamesin Setion H, Special Remarks.","This federal act ensures the privacy and security of health information.","See COBRA section for more information.","HOW AND WHEN SHOULD CLAIMS BE REPORTED?","Coverage that requires EOI is effective the first of the month after the company approves your EOI.","Service provided after a patient is admitted to the hospital.","Right of Continuation Notice to all qualified beneficiaries.","Control, suffix and account number: Fill in the prior control, suffix and account number.","Premium payments for employees enrolled in the optional part of the plan are made through payroll deductions.","It must give proof of your death or disability.","Aetna may also collect information about you from other sources.","The charges to receive coverage from an insurance company or carrier sometimes categorized by subscriber and additional dependents.","But faith and fortitude, mutual cooperation and resilience are essential life lessons that are accentuated during this period.","You are now leaving the Aetna Medicare website.","Indicates that the cost of a group insurance plan is made in part by the employer and in part by employees.","In Florida, by Aetna Health Inc.","At the end of a policy year, Aetna may declare an experience credit.","The disability extension applies only to employee basic and supplemental life insurance.","Unum to replace part of their salary.","This applies for each policy month in the premium paying period.","See your Employer for this definition.","There are different types of advance directives and living will\u00ba and \u00aapower of attorney for \u00ba are examples of advance directives.","Occurs after a person has met the benefit Elimination Period and qualified for disability benefits under the plan.","Composites are white and usually used on anterior, or front, teeth.","Thank you for subscribing!","Their planning has been guided by the latest medical information, government directives, direct input from our rabbis, faculty and students, and best practices from industry and university leaders across the country.","You may designate a beneficiary online during enrollment or anytime during the year.","In case of loss of life, benefits may also be available for education, child care and return of remains.","We comply with all applicable state and federal law pertaining to the security and confidentiality of personal information.","The Federal agency that administers Medicare.","This extended insurance will be the amount you were insured for on the date your total disability began.","For example, doctors may request medical information from us to supplement their own records.","Premium: The total premium for families enrolled in the plan.","This can be done in states which provide such rights and which grant immunity to insurers providing such access.","Rice University offers a wide range of health and welfare benefits and several retirement options.","The amount of money a member pays to a participating pharmacy for prescription drugs covered by a pharmacy benefits plan.","Nurse Line access, one call does it all.","The fee or charges incurred to receive coverage by an insurance company or carrier.","The services are available to you, your immediate family members and your parents and inlaws.","Invoice Identifies the invoice aan Administrative Services Contract or Stop Loss type.","Employee Resources and Your list may change.","What to do if you have a problem or complaint Part B prescription drug, you have the right to appeal.","Thisn mut be ompeted.","Do not total each page.","Legal Servicesccess to select legal forms and information at no extra cost.","In order to restore those rights, you must give up all such policies without claim, except for the return of the premiums you paid.","Employees may purchase basic and then either an additional one times, two times or three times their salary.","Typically, for those delivering their baby, once they are hospitalized they will be immediately eligible to begin using their EILB.","But in its very difference rests its enormous power.","They pay taxes only when they take a distribution or withdrawal from their account.","After an individual policy becomes effective for any person, that policy will be in exchange for all benefits and privileges under the group contract as regards the person involved and the amount that could have been converted.","Your employment may be deemed to continue beyond any limits shown above if Aetna and your Employer so agree in writing.","Since your PCP will provide and coordinate your medical care, we What is the role of the PCP in making decisions about or obtaining prior authorization?","Policyholder for the sole benefit of empolyees.","Sign ate he orm.","Aetna to be a covered benefit.","Two or more periods of disability that are related in diagnosis and separated by a period of time defined by the contract.","HSA plan each year.","Pay what you owe.","The timing of the annual renewal greatly affects the service your members receive.","UW System contributes a portion of the premium for the standard portion of the plan.","They can change this assignment at any time.","If the employee\u00d5s benefits are based upon earnings, it is important that you report all earnings changes to Aetna so that you will be billed for the correct amount of coverage.","The change request must be consistent with the qualifying event.","This can happen if an employee did not choose our coverage because they were already covered under another group plan and then lost that coverage because of one of the HIPAA qualifying events listed below.","You have the right to know the reasons for an unfavorable underwriting decision.","You will pay the applicable coinsurance amount subject to the retail minimum and maximum costs.","For example, list dependent children attending school.","Please contact us for other exceptions that may apply.","This includes intravenous feeding and enteral nutrition, which is the delivery of nutrients into the stomach by tube.","Your coverage is guaranteed, with no Evidence of Insurability.","No written statement made by an employee shall be used by Aetna in a contest unless a copy of the statement is or has been furnished to the employee or his beneficiary, or the person making the claim.","If your request is for a Medicare Part B prescription drug, we will after we receive your request.","Eligible employees waiving coverage must complete a waiver.","Aetna office, doing so would delay the processing of any enrollment changes.","The latest average premium rate will be used to figure premiums until a new one is determined.","If the revised rates are not shown on the Billing Statement, you should adjust the statement to reflect the proper bing rates and calculate the amount due based on the new rates.","Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional.","If you become covered, this Booklet will become your Certificate of Coverage.","Income Continuation Insurance premiums are waived effective the first of the month on or after the date your Income Continuation Insurance benefit begins or upon termination of employment, whichever occurs first.","Change in dependent care provider or cost for Dependent Day Care Flexible Spending Account See table below for events which require documentation.","Medicare program, leaving spouse or dependent children without coverage.","Flexibility to choose any provider.","It may also be given to law enforcement authorities when needed to prevent or prosecute fraud or other illegal activities.","One of the four equal sections into which the dental arches can be divided.","Death of a covered employee.","No evidence of insurability will be required.","Estue Estimated amount based on the latest finalized statement.","Some benefits are subject to limitations or visit maximums.","If youneed to add a new dependent to your ERS account, you can do it here.","EHN physicians include: Emory Clinic physicians and EHN physician or facility at www.","If you do not intend to leave our site, close this message.","It is often used when employees have been out of the workforce for a long period of time, and with individuals who have learning or psychiatric impairments.","Every effort has been made to ensure this information is current and correct.","That is measured solely from the date of the qualifying event or, if the plan provides, from the date of the loss of coverage.","The number in the shaded area reflects the estimated volume, based on the latest finalized statement.","Flex card claim form.","We suggest you enroll employees as soon as they are hired to avoid being late.","Privacy Practices describes our privacy policy.","Your broker can provide you with a list of valid waivers.","Participating doctors and hospitals agree not to bill the member for the difference between these two amounts.","Benefit and lifetime maximums also apply.","To enroll, visit infoarmor.","The volume equals the total amount of covered benefits or covered payroll.","In form and in content, this coming semester will be like no other.","The request is badly formed.","The formal name for \u00aamaking a complaint\u00ba is \u00aafiling a grievance.","Colorado, Florida, Kentucky, New Jersey, Ohio or Texas.","Standard EOI file is required.","If you wish to do this, an assignment form must be completed by you.","Please refer to the enrollment section of this manual for instructions on terminating coverage.","NOT PRECEDENTIAL UNITED STATES COURT OF APPEALS FOR THE THIRD CIRCUIT NO.","You have the right to be notified following a breach involving your health information.","It is offered through plan sponsors as a group product or sold to individuals.","When the group contract terminates as to the coverage.","Fields are being added to your document to make it really easy to fill, send and sign this PDF.","Funds must be used by the end of the calendar year or you will lose your accumulated funds.","See the HIPAA qualifying events section.","PL insurance can they buy?","If the number of employees increases, the volume should also increase.","To put load down, use these guidelines in reverse.","If there is no spouse, child or parent, in equal shares to your brothers and sisters.","This type of complaint does not involve coverage or payment disputes.","Any form of health plan in which members have access to a network of contracted health care professionals and hospitals, and that requires approval of some services.","Social Security on the web at www.","The ICI program has two different levels of coverage.","Payment of Premiums: The Policyholder will pay premiums in advance.","In any conflict between this information and Maine laws or administrative rules, the laws and administrative rules shall prevail.","How do I designate a beneficiary?","What are \u00aanetwork providers\u00ba and \u00aacovered services\u00ba?","In the case of a discrepancy, the official plan documents and insurance contracts will prevail.","Pocket maximum includes copays.","Note: If the effective date of the enrollee transaction occurs on a date other than a statement due date, we will not charge or credit for the days in the short month.","Under the Summary Biling process, our admistrative system calculates a \u00d2Total Premium Due\ud300 using the last finalized number of employee and dependent lives and the volume of Life Insurance reported to us.","All agreements made by Aetna are signed by one of its executive officers.","Gums may appear red, swollen, and bleed easily during brushing.","CVS or Emory, you will be charged the full retail cost on your The POS Plan works more like a conventional medical plan where members pay copays for some services.","Le bt atesage ba.","Medicare, or children reaching limiting age.","Speak with your Aetna representative to learn more.","Employees or their dependents may be able to enroll in the plan as late enrollees.","You must furnish all proof when requested.","These include: Termination of employment, either voluntarily or involuntarily, for reasons other than gross misconduct.","The amount of each credit Aetna declares will be returned to the Policyholder.","In bringing our students back to campus, safety is our first priority.","The longest time period for which disability benefits are payable, once all plan conditions are met.","The requested URL was not found on this server currently.","If you move outside of our plan service area, you cannot remain a member of our plan.","You will receive this coverage if you are in an Eligible Class.","This amount should be rounded to the nearest dollar and should not include cents.","IS THERE A PERMANENT AND TOTAL DISABILITY FEATURE?","For a listing of resources, go to www.","What coverage does Katy ISD provide?","The current charges based on active membership as of the prepared date.","Once the infection is treated the empty canals are filled with an inert, or inactive, material, with the goal of eliminating the need for extraction.","Insurance policy terms that define who is eligible to get coverage and the requirements for receiving coverage.","Aetna may contact you directly to.","Your account number: You should put this on all correspondence and forms.","YOU PRESERVE THE LIFESTYLE OF THE ONES YOU LOVEGovernment of the Virgin Islands including the University of the Virgin Islands Aetna Inc.","Make your vendor selections.","Specific questions should be addressed to your doctor.","Or the amount payable by an insurer to a person making a claim, assignee or beneficiary under each coverage in a group contract.","If you want to have an advance directive, you can get a form from your lawyer, from a social worker, or from some office supply stores.","The Office of Human Resources will be closed for winter recess starting Monday, Dec.","It explains how to get coverage for the health care services you need.","You will receive notice when necessary.","The date you are no longer permanently and totally disabled.","Say, for example, your group plan includes health coverage.","If you are not at work due to one of the following, employment may be deemed to continue up to the limits shown below.","You may change your salary reduction agreement at any time.","The mission of Yeshiva University is to enrich the moral, intellectual and spiritual development of each of our students, empowering them with the knowledge and abilities to become people of impact and leaders of tomorrow.","Weprotect the privacy of that information inaccordance with federal and state privacy laws, as well as ourown company privacy policies.","Coverage ends when the participant ceases to pay the premiums.","We will live differently, work differently and learn differently.","These individual plans are known as conversion plans.","EOI applications, now easier for everyone.","Are you sure you want to do this?","Many aspects of campus life will change for this coming semester.","Through your Aetna medical plan, you have access to a variety of suppliers of breast pumps at minimal or no cost.","We will accommodate reasonable requests.","In the event of a misstatement of any fact affecting your coverage under this Plan, the true facts will be used to determine the coverage in force.","Human Immunodeficiency Vis found in some human body fluids of infected people, most notably in semen and blood.","The employee is retired but has not already changed to Medicare for their primary coverage.","You can ask for a copy of the information regarding your medical decision and add more information to support your appeal.","Medicare drug plan later.","Please pay the total amount due listed on your invoice each month.","For additional information, go to www.","Informed Health Line nurses cannot diagnose, prescribe or give medical advice.","The general term we use in this EOC to mean all of the health care services and supplies that are covered by our plan.","COBRA continuation, please retain the original copy of the election form on file.","Set up online billing, and start viewing and paying your Aetna bills right online.","You should give a copy of the form to your If you know ahead of time that you are going to be hospitalized, and you have signed an take a copy with you to the hospital.","What do our customers and partners say about us?","Upon review of the evidence statement, we will advise you and the employee of our coverage decision.","You are automatically the beneficiary for the spouse life or child life, if enrolled.","Policyholder for the payment of each premium.","If the employee is eligible to receive a weekly temporary disabity benefit, benefits generally become payable after the first seven calendar days of a disabity period due to disease or injury.","Date The actual date the invoice was prepared.","Look at the late enrollees section that follows.","The terms of the group life insurance policy issued by the current insurance carrier, selected by the University, are binding on all participants.","Your browser sent a request that this server could not understand.","Provider Directory, or by accessing our website at aetnaretireeplans.","The information you will be accessing is provided by another organization or vendor.","Or, if you choose to submit a copy, mail it to the postal address or fax it to the number provided by when they sent the paper application.","Control, Suffiount Number and Plan Number.","Indicates that the entire cost of a group insurance plan is the responsibility of the employee, with no contributions by the employer.","Analyze items with a spreadsheet application.","An employee going on an approved leave without pay shall make arrangements with Employee Benefits to pay the cost of optional life coverage, or the benefit will terminate.","When a member is evacuated to an appropriate medical facility due to an emergency medical situation.","Generally, employees will want to choose a PCP for themselves and any eligible dependents when they enroll.","The periodic payment to Medicare, an insurance company, or a health care plan for health or prescription drug coverage.","Life Conversion in amount equal to Conversion, Dependent Life.","If experiencing a QLE, an employee will be able to elect the lowest level of coverage.","We will rely on you to notify us when you terminate the employee.","You can find enrollment forms for your state online at www.","It can also involve restructuring job duties.","Any medically necessary and reasonable health expense, part or all of which is covered under any of the health benefits or health insurance plans of the member for whom the claim is made.","If you have any questions about the terms of this Plan or about the proper payment of benefits, you may obtain more information from your Employer or, if you prefer, from the Home Office of Aetna.","The process of receiving approval for some health care, such as hospitalization, outpatient surgery or prescription drugs, before it can be covered.","If your plan includes insured coverages and you want to produce your own Summary Plan Description, we are happy to provide you our privacy policy.","After taking the health assessment, results will show particular areas employees may wish to focus on to improve their health.","If you continue to use your current browser then Fill may not function as expected.","THIS IS NOT INSURANCE BUT AN ONLINE TOOL TO SUBMIT EVIDENCE OF INSURABILITY INFORMATION FOR LIFE AND DISABILITY BENEFITS.","Diagnostic services are subject to the deductible and coinsurance.","The following pages provide informaticoncerning our group disability coverage, instructions for completing the necessary claim and evidence forms, and copies of the forms.","Providers are independent contractors and are not agents of Aetna.","Birth date: The employee must list their birth date and the birth dates for all dependents.","Please consult with your administrator.","Your Aetna representative can give you more information on what your plan requires.","Your spouse, if any.","Coverage is determined by Aetna and approval is not guaranteed.","This document is available for free in Spanish.","COBRA when they become entitled to Medicare will lose COBRA coverage, and certain retired members may lose coverage.","Aetna Health app from the App Store or on Google Play.","Cancel at any time.","What happens if you leave your plan and return to Original Medicare?","To receive STD you will medically necessary.","The period for which disability is certified.","Calling about an employee?","The contribution maximum is lower, and it can You can only change your contribution amounts during open enrollment, but you do have access to the full amount of your expected contributions at any time during the year.","Member Services can answer your questions.","Once your Income Continuation Insurance claim is approved, the third party administrator of the plan will notify you of your premium waiver.","As Required by Lawto comply with legal obligations and requirements.","Used to help members find information about participating doctors, hospitals, dentists, pharmacists and other providers in an area.","Find out which product is right for you.","Please keep it in a safe place.","COBRA direct billing services.","Aetna of any material changes to the information provided which take place between the time the form is completed and the time coverage becomes effective.","You receive a notice in writing.","To develop our plans for the fall, we have convened a Scenario Planning Task Force made up of representatives across the major areas of our campus.","PCP based on where they live.","This document may be made available in other formats such as braille, large print or other alternate formats.","Emergency Rooms and will charge accordingly.","We will consider, but may not agree to, such requests.","For a complete list, visit www.","The Social Security person was exceptional!","Aetna, in providing insurance services to you, relies mainly on the information you give on your group enrollment form and when you file claims.","Additional life insurance which members buy beyond the amount of basic coverage paid for by the employer.","Retiring specialist to discuss options and develop a game plan for retirement, including Medicare and Social Security.","COBRA election period does not begin until the date the qualified beneficiary is notified, if later than the date of the qualifying event.","You have the right to ask us to communicate with you in a certain way or at a certain location.","The policy defines eligibility, elimination periods, and terms and conditions.","Find a Nippon Life Benefits Provider Near You!","Unlike the Healthcare FSA, you can only access the money that is currently in your account.","Thisocessasterand easierhan mailiaxiyourompleted Life EOIapplication.","Others have four tiers, three tiers or two tiers.","Aetna must request this.","It does not include drugs on the Formulary Exclusions List.","This als o helps prev ent pote nti al cl aims problems caused by del ayed e nrollment or missing inform ation.","Tests and procedures ordered by a health care professional to determine if a person has a specific condition or disease based on signs or symptoms.","You can see the information in your records and know how it has been shared with You have the right to look at your medical records held at the plan, and to get a copy of your records.","Healthcare FSA Decide if you want to make a contribution to your Health Savings Account.","Copayment is the fixed dollar amount an employee pays when they visit the pharmacy or doctor.","Two or more periods of absence from work that are related in diagnosis and separated by a time period defined by the contract.","Rate Represents the rate that is charged for the line of coverage.","Information is believed to be accurate as of the production date; however, it is subject to change.","What makes you eligible to be a plan member?","The University will not permit an employee to assign the life insurance plan or any portion thereof.","To review t he full complement of services, visit their web site at: www.","To Join A Medicare Drug Plan?","This policy may be changed at any time by written agreement between Aetna and the Policyholder.","Search for another form here.","The box or boxes showing who is eligible for COBRA.","Information may be disclosed to other insurers if there may be duplicate coverage or a need to preserve the continuity of your coverage.","Follow the prompts to complete the onetime registration.","If we decide to take extra days to make the decision, we will tell you in writing.","To deal with your problem, which process should you use?","The child must depend chiefly on the employee for support and maintenance.","Failure to do so may prohibit them from being issued an individual policy later.","An application must be completed to obtain coverage.","Discounts offered hereunder are not insurance.","The Policyholder has asked for the change and Aetna has greed to it.","The effective date of COBRA.","See your Employer for details.","Income Continuation Insurance program.","This includes policyholder audits.","ARAG does not provide Aetna with any individually identifiable information whatsoever on legal information accessed or legal services utilized by eligible individuals.","How do I complete an Evidence of Insurability Statement?","You must pay total premiums each month, as they are due, until the termination date.","Otherwise, it is the date you commence active work for your Employer or, if later, the date you enter an Eligible Class.","SSN of each subscriber.","Your business telephone number.","Dependent Term Life Insurance on the day of retirement from state employment may keep it in retirement as long as he or she remains an eligible dependent.","We distribute this to members as the law requires.","This material is for informational purposes only and contains only a partial, general description of plan benefits or programs and does not constitute a contract.","At the start of each policy year, Aetna will compute a total premium based upon the number of premium payments then agreed upon between the Policyholder and Aetna.","Discount programs provide access to discounted prices and are NOT insured benefits.","What to do if you have a problem or complaint your first appeal.","Aetna does not endorse any vendor, product or service associated with these programs.","Am I a Protected Veteran?","Fill it out completely, indicating what coverage you are applying for or changing, and sign it.","Make sure the properties contain information that is safe for others to read.","Do you offer prescription coverage?","Through Aetna Life Insurance, the University provides basic term life and accidental death and dismemberment coverage at no cost to you.","You can use the money to pay for everyday expenses like mortgage payments, day care or utility bills.","For example, attaining the maximum age of coverage.","Log in to your ERS account at www.","This includes the Active Service Rule.","The pharmacy directory contains a list of local participating pharmacies.","The evidence must be reviewed and approved by the claims office before any benefits will be paid under this provision.","No premium payments will be required from your Employer.","IS THERE ANY LIFE INSURANCE AFTER TERMINATION?","All forms are printable and downloadable.","You may also buy life insurance coverage for your spouse and your children.","Please return this portion with your payment.","If your plan is not listed, then you should follow the steps below on the enrollment or change form.","The choice or requirement to visit another doctor or surgeon for an opinion about a diagnosis, treatment or type of optional surgery to be performed.","Discounts at the Emory Eye Centerdiscounts at the Emory Eye Center.","This is an important legal document.","This change will be effective the first day of the month following receipt of the request.","If you have given us an authorization, you may revoke it in writing at anytime, if we have not alreadyacted on it.","At times, you may notice terms or references that do not apply to your plan.","Drugs that can be bought without a prescription.","PCP can be a general or family care doctor, an internist or pediatrician.","Some plan sponsors offer retirees allowances towards the purchase of hearing aids or prescription eyewear as additional plan benefits.","FMLA, any extended continuation of coverage during that period will be subject to approval by Aetna, which will have sole discretion to continue or discontinue the coverage for that extended leave period.","Dependent Term Life Insurance.","There are many types, including term life, whole life, group universal life and others.","Coverage is provided through Aetna Life Insurance Company.","Member Employer may terminate this policy as to any or all coverage of all or any class of its employees.","Effective Date of Coverage.","These are medical devices ordered by your doctor or other health care provider.","An urgent situation requires prompt medical attention to avoid problems and unnecessary or severe pain, such as a high fever.","Aetna remains focused on implementing provisions of the ACA, fostering and sustaining compliance with the law, and helping our customers achieve the same.","Treatment to correct a speech problem present from birth, or caused by disease, injury or earlier medical treatment.","Electronic signatures are allowable as long as they are present on the standard Aetna enrollment application.","Your deadline for contacting this organization.","HMI Health Power Assessment that is part of the requirements to attain the Wellness Premium.","Helps eligible members get covered treatment for solid organ transplants, bone marrow transplants, and some other rare or complicated conditions at participating facilities experienced in performing these services.","You die during the uninterrupted continuance of the total disability.","This is the date that will be used to determine timely filing of the application and the due date of the first premium payment.","If your benefit is calculated by volume, multiply the volume by the rate and divide by the rate basis.","Clients are urged to consult with their own legal, accounting and tax advisors with respect to their specific situations.","The inability to perform the functions of any job because of an illness or injury.","Before our semester begins, we will provide more updates reflecting our most current guidance.","Aetna that has been replaced in whole or in part by this policy.","Be sure to ask for a \u00aafast review.","If you entered the URL manually please check your spelling and try again.","We may disclose personal information to other coveredusiness associates of those entities for treatment, payment and certain health careoperations purposes.","The effective date of a salary change will be the first day of the month following the month of the salary change.","To be sure that claims payments are not interrupted, be sure to mail your payment by the due date listed on your payment stub.","FMLA leave of absence, the following information describes how this will affect your Aetna group life insurance coverage.","Aetna has the right to examine you, at its expense, before approving the proof.","For forms and information about conversion plans, your employees can contact Member Services.","There are also additional election opportunities.","Online claims access when you sign up for the Aetna Navigator secure member website.","This is provided the child has not been issued an individual insurance policy.","For others, you pay less.","Section A is signed by a representative of your company having authority to sign such forms.","COBRA beneficiaries under the group plan.","Once finished you can manually add any additional fields and signatures to the document by dragging them from the toolbar.","This rule also applies to an increase in your coverage.","Aetna Resources for Living is sponsored by SAISD and is available at no cost to you ad all members of your household.","An outpatient program offered by licensed psychiatric facilities that includes a day or evening treatment program for mental health or substance abuse issues.","Law Enforcement to Government law enforcement officials.","Refer to ur plan doumentsfor plan definiion.","Additionally, we will also be holding community calls for faculty, students, staff and parents over the next couple of months.","Definitions of important wordsrelated to quality of care, waiting times, and the customer service you receive.","If the employee acquires a new dependent while coverage is being continued under the FMLA, the new dependent may also be eligible for coverage.","This will help to ensure that any claim in the event of your death is fulfilled according to your wishes.","Aetna Medicare network providers may belocated outside of listed plan service areas.","Refers to pharmacy plans covering eligible prescription drugs listed on a Preferred Drug List.","In a class for which a Certificate is not in this policy.","In the space below, describe all conditions checked in Ques.","Members who have not yet received their ID cards may still have their prescriptions filled at a participating pharmacy.","They may also be subject to precertification or step therapy.","Medicare Part A and o For some of your medical services covered by the plan, you must pay your Schedule of Cost Sharing tells what you must pay for your medical services.","They are not covered under most standard prescription benefits plans.","CAN MY INSURANCE BE ASSIGNED?","You also have the right to file acomplaint if you think your privacy rightshave been violated.","The Policyholder may act for all Member Employers in all policy matters.","These devices are necessary because the body part is permanently damaged, missing or not working properly.","The highest benefit amount payable under the plan design.","Things to know about getting your medical care What are \u00aanetwork providers\u00ba and \u00aacovered services\u00ba?","When you receive your billing statement, you are responsible for updating eporting the accurate number of lives and volume of Life Insurance, along with recalculating the new total premium due based on yourrent reporting for each statement period.","How do I enroll new employees?","You can reapply for coverage during the next enrollment opportunity.","Aetna does not receive a marketing fee from ARAG in conjunction with the Legal Reference Program.","Nippon Life Benefits is committed to providing our members who have been displaced by a State of Emergency access to the healthcare they need.","We will then reimburse them for the cost, less their copayment.","If your group plan does not include Life Insurance, the Total Premium Due wibe calculated using only the finalized number of employee and dependent lives from the prior month\ud500s statement.","With the exception of Aetna Rx Home Delivery service, all participating physicians, hospitals and other health care providers are independent contractors and are neither agents nor employees of Aetna.","However, the plan may contain exceptions to this list based on state mandates or the plan design purchased.","You do not have to apply for coverage for yourself in order to purchase spouse or child coverage.","AND check either or both continuation boxes.","The date the claim is received.","Setion FNotidene of ood Healthmaybe required.","Bacteria grow in dental plaque, which sticks to the tooth or root surface next to the gums, causing swelling.","This establishes an order in which the plans pay their benefits.","Please notethat we do not destroy personal information about you when you terminate your coveragewith us.","Healthcare FSA or a Dependent Day Care FSA.","Triad number: The number for the service center assigned to your account.","For example, if the amount or type of coverage you are entitled to depends on your earnings or job class, Aetna would obtain that information from your Employer.","Until changed in accordance with the terms of the group contract, the named beneficiary is the one named under your Group Life Policy and recorded with Aetna or the Employer.","Exclusions and limitations This plan has exclusions and limitations.","Approval in advance to get covered services.","Life insurance plans contain exclusions and limitations.","To close this Web Part, click OK.","Adjustment This field should notate errors in payments from previous statements.","PCP or you To change your PCP, call Member Services at the number on your member ID card before you set up an appointment with a new PCP.","The Privacy Notice describes certain aspects of who are covered under an Aetna group insurance policy.","The naming or any change will take effect as of the date you execute the request.","The specific dollar amount or percentage that the member must pay, or that must be paid on behalf of a member, when covered services are provided.","Please try again later.","Provides benefits payment to an eligible survivor after a disabled insured person has died.","You are now being directed to the Apple.","Please refer to the enrollment section of this manual for instructions for terminating coverage.","The routine care, testing, checkups and shots for a generally healthy child from birth through the age of eight.","Occasionally, it may be necessary to adjust your billing rates.","Citizen or Lawful Presence What other materials will you get from us?","Vantage site at any time to enroll, change your elections, stop contributions and change your vendor selections.","Your request must be in writing.","Neither your Employer nor Aetna guarantees or assumes any obligation concerning any assignment.","Please return your completed orm to your Human Resources Departmentease akeforour recods.","Nationwide that can be used for accidents, illness and preventive care with any veterinarian, anywhere.","Rates and benefits vary by location.","As a result, one or more Web Part properties may contain confidential information.","This document is locked as it has been sent for signing.","Each change shall be made by written notice to the Policyholder by Aetna.","It is important to you as a covered person under the group contract.","Assistance Program, which provides health, wellness and counseling services to Emory employees.","The amount of money paid to the beneficiary if the insured dies.","Please answer the following questions to the best of your knowledge and belief.","The requested file was not found on our document library.","Emergency Room for life threatening emergencies only in order to save on your out of pocket costs.","Coverage may be underwritten or administered by one or more of the following companies: Aetna Health Inc.","All statements made by the Policyholder or an insured employee shall be deemed representations and not warranties.","Primary care physician who often acts as the primary gatekeeper in health plans.","The email address cannot be subscribed.","What about the legal terms?","We expect all our members to respect the rights of other patients.","The term applies only to the determination by the plan whether health care services are covered benefits.","Your total accumulation of unused sick leave determines which premium category is used to calculate your premium and the amount the UW System will contribute to your premium.","Any employee who is lty benefits must that amount before insurance can becadditionty coverage ecome effective.","Any doctor, hospital, skilled nursing facility, other individual or entity involved in the delivery of health care or related services that contracts to provide covered services to members for a negotiated charge.","Benefit that provides for an annuity, or a series of payments made to the insured person on a regular basis, after retirement.","Our website uses anonymized Google analytics.","Amount due: The total amount due on the account as a result of the cumulative balance.","He used it toward his deductiblecopayand supplemental income for his missed work days.","The policy issued under Portability is term insurance.","Legal Proceedingsin response to a court order or other lawful process.","What to do if you have a problem or complaint Which section of this chapter gives the details for your situation?","Enroll your employees with the online enrollment tool.","The notice describes in greater detail our practices on the use and disclosure of personal information.","The index below contains important Human Resources forms.","Consult your broker or Aetna service representative.","Setion Noteidene of ood Healthmaybe required.","What kinds of problems are handled by the complaint process?","Please continue to provide this workshop and other similar ones.","Need to find out what something means?","When a covered employee or spouse elects to cover any other qualified beneficiary, the other qualified beneficiary is bound by that election.","This information should be included on all correspondence to Aetna.","Attending Physician Reports, etc.","Plan members must reside in a plan service area.","University of Pittsburgh faculty, staff, and retirees.","Mobile menu for the website.","It replaces and supersedes all Certificates issued to you by Aetna under the group contract.","The law requires these plans to continue offering coverage to individuals who would otherwise lose it.","Aetna Health of Illinois Inc.","This form is used to change or begin monthly HSA contributions for eligible employees.","These may include length of employment with the plan sponsor, job status and other provisions.","Services or supplies that are appropriate for or consistent with the diagnosis according to accepted medical standards as described in the Covered Benefits section of the plan.","The orrection is acomplished by taking a credit or a charge by the appropriate billing line.","Some types of compensation, such as commissions, are included or excluded depending on the policy.","There is no intent to imply or confirm participation or amounts of insurance in effect for an individual who reads this communication.","Submit the form to the Employee Resource Center.","Your genetic information cannot be used for underwriting purposes.","Reasonable and Customary charges.","Health Reform Connection can help you learn more about how the health care landscape is changing because of the law, and what health care system challenges remain.","Prescription drug service for pharmacy members, who receive medications by mail.","If you become permanently and totally disabled, your insurance may be extended.","You will also get it before the next period you can join a Medicare drug plan, and if this coverage through San Antonio Independent School District changes.","Our medical plans bring flexibilty and affordability to build a solution that meets your specific needs.","Health care professionals in our network should file claims for you.","The replacement of the entire base of a denture without changing the teeth.","During the plan year, employees who are not newly eligible or experiencing a Qualifying Life Event will not be allowed to enroll until an annual enrollment.","The box that describes the qualifying event making the beneficiary eligible for COBRA.","WHEN DOES COVERAGE TERMINATE?","These benefits are paid in addition to any other health coverage you may have.","You stop paying your share of the coverage.","However, for insurance on your life, if it is later determined that you were totally disabled at the time premium payments for your group life insurance ceased, you may be entitled to certain rights described in the Life Insurance Benefits section.","III neonatal units, and access to a full complement of lactation specialists and family support resources.","This plan provides limited benefits.","You decide when and how to pay.","Continue at the Click Submit after reading the Authorize Elections Statement.","By reason of a change in factors bearing on the risk assumed.","Was this page helpful?","At least two eligible employees must take part, unless state laws require just one.","Coverage may end if premium payments are not made in a timely manner.","Treatment is generally provided by a mental health professional such as a psychiatrist, psychologist or psychiatric social worker.","But since some group plans cover all injuries or diseases, check your plan documents for the specific terms that apply to your group plan.","Late applicants will be deferred to the next plan anniversary date of the.","Services received for an unexpected illness or injury that is not life threatening but requires immediate outpatient medical care.","Nippon Life Benefits is responsible for its own financial condition and contractual obligations.","Aetna health insurance plan policy.","Several states have requirements for continuation of coverage that does not begin until COBRA coverage ends.","This policy and the application of the Policyholder are the entire contract.","Limited Appointees, the UW System the employer contribution starts after you have more than one year of state service and varies based on the elimination period you elect.","This takes into effect the probationary period the employee would have to satisfy before eligibility becomes effective.","When making an adjustment, please rovide an explanation for the adjustment in the space provided at the top of the statement.","Send to someone else to fill in and sign.","Other Income Benefits are considered payable if they are actually received, or if they would have been payable had the employee made a claim for them.","For more information about Aetna plans, refer to www.","Name, subscriber ID: Lists the name and SSN of each subscriber.","Employer Information section on the form: Employer Name, EIN Number and Address Work Location: Indicate name of your company\ud500s location and its Supervisor\u00d5s Name and Phone Number: Indicate the employee\u00d5s supervisor name and phone number.","As you accumulate more sick leave, you may want to increase your elimination period.","Click on the links below to download the appropriate form.","COBRA does not require continuation of life or disability insurance coverage.","Member Basic Term Life Amount of Life Insurance Coverage?","Once Aetna has the completed form and reviewed it, a communication ill be provided to you indicating the status of the disability.","There is no known cure.","Aetna doesnot participate in pretext interviews.","An institution or a part of an institution that is licensed or approved under state or local law to provide skilled nursing care and related services as a Skilled Nursing Facility, extended care facility or nursing care facility.","We use and disclose personal information listed above without member consent to the extent the law allows.","If there is not enough PTO accrued to cover that, the PTO bank will be work week hours.","Notice of the change shall be provided in accordance with applicable state law.","All of this is described in this handbook.","In seconds, it will get you and your employees to the right customer service professional.","This is a condition existing at or dating from birth.","Certain medical equipment that is ordered by your doctor for medical reasons.","See policy or contact an Aetna representative for details.","An amount you may be required to pay as your share of the cost for services after you pay any deductibles.","For faculty on less than annual appointments, the amount for insurance benefits is automatically doubled January through April; the actual monthly amount is withheld September through December.","In these plans, prescription drugs may be covered at lower copays if they are preferred and higher copays if they are nonpreferred.","When these rights run out, other drug companies can make and sell generic versions of the drug.","You may also be contacted directly by Medicare drug plans.","To get the most out of Fill, please switch to a free modern browser such as Google Chome or Safari.","In most cases, the policy must remain in force for the provision to apply.","The Human Resources team at Rice University is committed to providing university faculty and staff with comprehensive information regarding benefits and other university services.","Aetna does not issue dental cards, as it is not required by the provider; however, you can log on to www.","Written notice of the termination date must be given by Aetna.","If you do not, you must pay a penalty through your tax return.","Premium: The total premium for single subscribers enrolled in the plan.","Fill out a written form to give someone the legal authority to make medical if you ever become unable to make decisions for yourself.","This notice is not required if your group plan is an administrative services contract.","Track your steps and participate in the Move More Challenge, learn healthy nutrition behaviors with Operation: Eat Right!","You have successfully completed this document.","We are allowed to charge you a fee for making copies.","Enrollment forms are processed by Employee Benefits.","Choosing a primary care doctor is NOT required but is recommended.","It is conducted by interviewing the worker and supervisor or observing the work place and the job being performed.","How to make a complaint about quality of care, If your problem is about decisions related to benefits, coverage, or payment, then What kinds of problems are handled by the complaint process?","The easiest way to do that is to use the official links that we have provided below.","These periods may be a quarter year, a calendar year or contract year.","Aetna has not credentialed or otherwise reviewed or assessed the quality of ARAG services or ARAG contracted law firms or lawyers.","This limit applies even if he or she has not applied for or paid the first premium on the individual policy.","ID number for the employee and each dependent.","You have the right to ask us to restrict the way we use or disclose healthinformation about you in connection with health care operations, payment and treatment.","Allows an insurer to deduct an amount from the life insurance benefit and pay it to a beneficiary, friend or relative before the final settlement of the claim.","Such refiguring will be made on the same basis as described above.","This notice describeshow we mayuse and disclose information about you inadministering your benefits, and it explains your legal rights regarding the information.","Includes a home communicator and pendant with falltection technology.","All money you elect to contribute is accessible immediately.","Each employee would then be compared to that monthly covered payroll threshold.","Premiums for continued coverage will be required.","Member Services number on your ID card or go to: www.","You can get a copy of our Notice of Privacy Practices from us.","You also can contribute to your HSA.","This is your primary business location.","If any fact as to a person to whom the insurance relates is found to have been misstated, a fair change in premiums will be made.","These should be delivered to each insured employee.","There will be no additional forms required to begin tprocess unless supplemental medical information is required.","The plan includes features to meet your needs.","Customer Service Information section Section C An Aetna representative, upon submission to the Medical Underwriting Unit, will complete this section.","If allowed by law, Life Insurance benefits are exempt from legal or equitable process for your debts.","The recalculated net tof all billing line amounts and adjustments should be entered in the total amount due box, located in the lower right corner on the last page of the statement, if there are multiple pages.","Employee\u00d5s Gender: Indicate gender of the employee.","Make driving through Plano easier with frequent updates on traffic and major construction projects from the City of Plano and WAZE.","If left untreated, the bacteria and inflammation will spread and destroy the gums and supporting bone around the teeth.","Leadership Workshop for Small Water Systems Register now with the enclosed form, or online at efcnetwork.","Above the shaded area to the right of the asterisk, enter the total volume as the current statement date.","EOI verifies your general health for underwriting purposes and provides the insurance company with information to determine if you can enroll.","Coverage for new optional life insurance shall be effective on the first day of the month consecutive with or following the date of hire with appropriate enrollment election.","If they apply, employees may be eligible for continuation as prescribed.","Bill package: The number assigned at plan setup.","Please submit forms to the Benefits Office.","Missing information will slow down the processing of your application.","If the misstatement affects the existence or amount of insurance, the true facts will be used to decide if insurance is in force and its amount.","If you answered yes to all three questions, you must have health coverage according to Massachusetts laws.","Terminated and rehired: Employees who leave the company and are then rehired within one year do not have to serve a new probation period before they become eligible for benefits.","Not all services are covered in allstates.","Half a million people call the county home.","When can you end your membership in our plan?","The period an employee must continuously be absent from work, because of disease or injury, in order to be eligible for extended life insurance.","Gatherings will be limited, larger courses will move completely online.","Cost is conveniently deducted from paycheck.","Payment due date: Date that payment is due.","But our tradition also teaches us that we are in control of our response to our circumstances.","Individual policies build up cash value.","Dependent Life to an individual whole life policy.","COBRA continuation after their termination.","How it worksyour retirement savings account.","These services include physical therapy, speech and language therapy, and occupational therapy.","We will call you as soon as we make the decision.","All services are subject to the exclusions and limitations described in the plan documents.","HMOs are required to designate a PCP for members who do not select one at the time of enrollment.","Made me feel better about retirement.","Indicate the amount of Life Insurance the employees is eligible for.","For more information and to enroll, log on to www.","We understand that even after reading through this guide, you might have many additional questions, so we will be posting an extensive FAQ section online as well.","If a named beneficiary dies before you, his or her share will be payable in equal shares to any other named beneficiaries who survive you.","DLW is changed to previous day worked.","The guides and resources cover the life cycle of a staff member from recruitment to leaving Rice.","If you are a minor, you also may have the right to block parental access to your health information in certain circumstances, if permitted by state law.","If the reviewers say yes to your appeal, then we must keep providing your covered services for as long as it is medically necessary.","Adjustment Amount The adjustment amount wiinclude any adjustments due to retroactive rate changes or volume changes.","It must be a date after the notice.","International Coverage copay or coinsurance level.","This material is for information only and is not an offer or invitation to contract.","Legal noticesplans may not be the primary payer for medical care you receive.","You can use your HSA to pay for prescription drugs.","Healthy Emory Connect Rewards: Earn points throughout the year on Healthy Emory Connect.","We consider these activities key for the operation of our health, disability and life plans.","Identifies the month in which the activity takes place.","SHIP is a state program that gets money from the Federal government to give free local health insurance counseling to people with Medicare.","The following additional provisions apply to your coverage.","Care to support and reduce pain for a terminally ill person, either on an inpatient or outpatient basis, and to support his or her family.","They are eligible on the day they are rehired.","Change in Eligibility Date: An increase in any required period of service will apply only to an employee who enters service on or after the effective date of the increase.","After taking the health assessment, Aetna will share programs specifically geared toward your health goals, including the potential to work with a health coach.","If the employee does not complete Section B entirely and signs the form, it wibe returned to the employee for completion.","Address Health and Life Insurance Svcs.","Each such act, or agreement made between Aetna and the Policyholder, or notice given by one to the other will be binding on all the Employers.","If you or your children are eligible for Medicaid or CHIP and you are eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage.","For a complete list of Tier Zero medications, go to ourehc.","Fill it out and sign it.","The date the claimant became disabled according to the policy or plan definition.","These guidelines apply unless your company has requested a special dependent age extension or other contract change, or unless state law mandates otherwise.","Optional dependent life insurance is also available at attractive group rates.","It is determined by factors such work experience, job history or the job market.","Rule that determines the benefit amounts available to retired employees.","If an employee does not convert, coverage ends on the last day of the month of termination, retirement or at the end of eligibility for Long Term Disability benefits.","Employee portion of the form.","Mths imp: The number of months affected by the transaction.","Note: Premiums for new employees who are enrolled off cycle of the policy month will not be charged until the first full policy month of enrollment as Aetna does not prorate premiums.","This is the beginning stage of periodontal disease.","These maximums will reset with the next plan year.","The Policyholder may terminate this policy as to any or all coverage of all or any class of employees of any one or more Member Employers.","Medicare program after the date of their COBRA election.","Nippon Life Benefits is committed to diversity, respect, and inclusion of all people regardless of their race.","Nippon Life Benefits has been an excellent insurance provider for our Firm the last few years.","In our health plans, participating network providers are also required to give you access to your medical records within a reasonable amount of time after you make a request.","Home Office or to its authorized agent.","The new amount due is the amount you should remit to or before the payment due date.","Any death benefit for your loss of life will be paid in accordance with the beneficiary designation.","You name your beneficiary.","Premium charges for insurance which terminates will cease as of the first day of the policy month on or right after the date the insurance terminates.","Evidence of insurability for continuation of coverage cannot be required.","Certification: I certify these answers and statements are complete and true to the best of my knowledge and belief.","Your signature: You as the employer must sign and date the form.","It includes a review of past jobs and education, as well as hobbies and household activities, in order to create a list of skills that might be transferred to other types of employment.","Drag and drop files into this library.","Aetna has in its files about you.","Unless state regulations require a carrier to prorate, all terminations will be processed the last day of the billing cycle.","Name The identifying name on the account.","Please consult the University of Pittsburgh Helpdesk with your support ID.","You can choose coverage for just yourself, or add coverage for your spouse or children.","All claims should be reported promptly.","Include the remittance stub, and use the mailing envelope provided.","Definitions of important wordsmattress systems, diabetic supplies, IV infusion pumps, speech generating devices, oxygen equipment, nebulizers, or hospital beds ordered by a provider for use in the home.","An employee is eligible only for the coverages shown in the Certificate which applies to this class.","Something that replaces all or a portion of a human body part.","My signature indicates that I have reviewed all information and statements on this form for completeness and accuracy.","Total Premium Due, and an example of a Summary Biling statement are shown on the following pages.","Call the phone number on your invoice.","Procedures that do not require an overnight stay in the hospital or ambulatory surgery facility.","It will cover the period then starting and ending right before the start of the next premium paying period.","Skilled nursing and other therapy provided by a home health care agency in the home instead of in a hospital or skilled nursing facility.","Pitt offers health insurance options for all types of students, fellows and postdocs.","Digital signatures are secured against your email so it is important to verify your email address.","Total current empl charges: The total amount by product and the total current charges.","Aetna is proud to be part of the CVS Health family.","Deeply rooted in our Jewish values and forward focused in preparing for the careers and competencies of the future, we journey together with you, our Yeshiva University community, through these uncharted waters.","It is currently providing data to other Web Parts, and these connections will be deleted if this Web Part is closed.","The first step in the process is to take a simple health assessment.","Reminder: Your employees can also print their ID cards from their member website at www.","Information may be made available to your Employer or his or her representative in connection with the claim and financial administration of the Plan.","Specific conditions or circumstances that are not covered for benefits under a plan.","The Express Care Clinic, through Occupational Injury Management, provides some clinical services to employees.","Ask your doctor or other health care professional if you need to submit a claim.","Are you a Massachusetts resident?","This Notice describes certain aspects of that policy which apply to you as a covered person in a plan of group insurance insured by Aetna.","The following pages contain the definitions of the fields you will see shown on your billing statement, along with an example of a Service Fee Invoice and Stop Loss Invoice.","Home Office to be approved.","This coverage does not extend the maximum coverage period under COBRA.","Flexible Spending Account Administrator.","If the billing area is notied prior to the effective date of the change, the revised rates wiappear on the next Biling Statement.","If you have any questions regarding the information shown on your statement, pleontact your Aetna service representative.","HOW WILL BENEFITS BE PAID?","POD Privacy Notice In evaluating your insurability we Aetna will rely primarily on the health information you furnish to us in this Evidence of Insurability Statement.","Which section of this chapter gives the details for your situation?","Remember: Planning for any life event is still necessary.","In that case, complete the claim form and mail it to the address on the claim form.","QLE, orduring Annual Enrollment.","Usually, you end your membership by enrolling in another plan Until your membership ends, you must keep Until your membership ends, you are still a member of our plan When must we end your membership in the plan?","We may disclose information to doctors, dentists, pharmacies, hospitalsand other health care providers who take care of you.","Pittsburgh Group Term coverage for reasons of termination, retirement, or change to ineligible status, Conversion and Portability are available, according to enrollment at the time of loss and subject to the provisions of the University of Pittsburgh Group Term Policy.","As the situation develops, we will update the webpage with pertinent information and recommend that members check back periodically.","To avoid forfeiture, purchase items such as prescriptions, eyeglasses, contact lenses and other approved Healthcare FSA expenditures.","Contact the Employee Resource Center Elective Deferred Compensation form.","The member must pay these before any expenses are paid under the plan.","These procedures can be performed in the hospital, a surgery center or physician office.","Attend one of our Bundles of Joy baby showers!","If you have any other health insurance coverage in addition to our plan, you are required to tell us.","Aetna can rely on such action.","If the rate change occurs prior to the current biling, but statements have already been paid based on the old rates, you will be informed of any additional amounts due or credits available.","Or find the name, address, and phone number of the Quality Improvement Organization for What should you ask for?","Skip to main content.","This is usually done to balance changes in the supporting tissues.","Have your employees complete their online health assessments.","The number in the shaded area reflects the estimated number of covered employees, based on the latest finalized statement.","Ceasing active work will be deemed to be cessation of employment.","Annuities and insurance products are provided by various insurance companies and offered through Chase Insurance Agency, Inc.","These states use funds from their Medicaid or CHIP programs to help people who are eligible for these programs, but also have access to health insurance through their employer.","For members who have medical and disability coverage, refers to the service that combines focused case management with individual contact.","Just sendus a Microsoft Excel push file when needed.","The removal of plaque and calculus from the area below the gum line, along the root.","The above terms apply in most instances; however, some plans do vary.","Summary of Coverage, and the findings by the Employer with regard hereto will be conclusive and binding upon all persons for the purposes of this Booklet.","You can only choose the last day of a month as a termination date.","In concert with the recommendations from our task force, I am announcing today that our fall semester will reflect a hybrid model.","Throughout our planning, we have used the analogy of a dimmer switch.","Make your contribution elections.","Safety in HR will coordinate leave of absence procedures with the employee and immediate supervisor.","Your own account may earn more or less than this example, and income taxes will be due when you withdraw from your account.","What to do if you have a problem or complaint phone number of the Quality Improvement Organization for your state in Addendum A at the back of this booklet.","Name Describes the line of coverage being biled.","You will not be penalized for filing a complaint.","Please Note If this form is not completed in its entirety and signed it will be returned unprocessed for your completion.","In addition, no one may be covered as a dependent of more than one employee, unless state law requires it.","The voluntary Medicare Prescription Drug Benefit Program.","These parties are required to keep personal information confidential as provided by applicable law.","Unless you state to the contrary, if more than one beneficiary is named, they will share on equal terms.","Complete the form, detailing your submit it to the Employee Resource Center.","The following is a partial list of services and supplies that are generally not covered.","Beneficiary is always the Employee.","You are now being directed to the CVS Health site.","This applies to the employee as a covered person in a plan of group insurance insured by Aetna.","Incomplete forms cannot be processed.","Other adjustments: A list of other adjustments made at an account level.","Whether you do this is up to you.","Getting started as a member How other insurance works with our plan Which plan pays first when you have other insurance?","However, if you wish to refuse this coverage, you must sign a waiver form, which can be obtained from your Employer.","For the most updated list of facilities, contact Aetna for assistance.","Employee\ud500s Occupation: Indicate the employee\ud500s job title.","See plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage.","Aetna Health of California Inc.","The form also contains instructions for completing the process online.","If evidence is also being requested for life insurance, use the combined Life and Disability coverage form.","If any benefit no longer applies to an employee, coverage for that benefit will stop right away for that employee.","If the box is checked, Aetna will move the member to your COBRA plan and they will continue to bill on your Aetna invoice.","If this policy is changed to provide more coverage to take effect on a date other than the first day of a premium paying period, a pro rata premium for the coverage will be due and payable on that date.","The plan that you are offered will depend upon your employee type.","In the management of this policy, the Policyholder and the Member Employers will act so as not to discriminate unfairly between persons in like situations at the time of the action.","No term available for this letter.","We may ask you tomake your request in writing, may charge a reasonable fee for producing and mailing the copies and, in certain cases, may deny the request.","What to do if you have a problem or complaint check to see if the decision about when you should leave the hospital was fair and followed all the rules.","The number of couples enrolled in the plan.","Programs or services that can help maintain good health, such as annual physical exams, or are meant to detect early signs of health problems or disease, such as mammograms and colon cancer screenings.","Aetna Life Insurance Company; Aetna Insurance Company of Connecticut; Aetna Health Insurance Company of Connecticut; Aetna Health Insurance Company of New York.","At the time the employee requests a leave, it is your responsibility to make arrangements with the employee to collect any contributions you may require for the continued coverage.","Benefits for claims incurred after the date the adjustment becomes effective are payable in accordance with the revised plan provisions.","What would happen to them if you were missing from this picture?","You could have your coverage cancelled and be expelled from the GBP.","An error has occurred while processing your request.","Your responses are confidential, and as a result, you will get personal support.","Need to order forms?","Wealso use personal information to obtain payment for any mail order pharmacy services provided to you.","Many drugs on it are subject to rebate arrangements between Aetna and the manufacturer.","EOI is a statement that verifies your general health.","There are two ICI plan designs that are offered.","It also enables students who prefer to not be on campus to have a rich student experience by continuing their studies online and benefitting from a full range of online student services and extracurricular programs.","Have them turn off paper and start viewing all their Aetna communications online.","Your sales support team can advise you.","Fill has a huge library of thousands of forms all set up to be filled in easily and signed.","New Jersey late entrants cannot be postponed.","They are effective only while you are covered under the group contract.","Submit the completed form to the vendor.","What oxygen benefits are you entitled to?","Just remember: If life or disability coverage requires EOI, that coverage must be approved before it can be effective.","Then you can log in any time to view past copies of EOBs and other claim information.","Coverage cancelled because of failure to make payment when due will not be reinstated for any reason.","NOT GUARANTEED BY THE BANK.","Group Legal Plan through Hyatt Legal Services is available to meet your needs.","From such total an average premium rate will be figured by dividing the total premium by the total amount of insurance then in force.","Due Date ue date for which the statement is being prepared and on which payment is to be expected.","See the definition for \u00aacost sharing\u00ba above.","If there is no spouse or child, to your parents, equally or to the survivor.","Program providers are solely responsible for the products and services provided thereunder.","Note: If you are being direct billed by Aetna, make sure premiums are being collected.","If this happens, you will be notified of the new rates prior to the effective date.","Debit and credit adjustments will be displayed separately by date.","Aetna processes all terminations using the last day of the billing cycle month.","Indicate date in which any salary continuation ends.","Occupation: Indicate the employee\u00d5s line of work.","With access to the industry leading vision network, our group vision insurance is designed to give members easy access to quality eye care.","Policies may not be available in all states.","In figuring when employment will stop for the purposes of termination of any coverage, Aetna will rely upon your Employer to notify Aetna.","During this review, we take another look at all of the information about your case.","Federal and state program that helps with medical costs for some people with low incomes and limited resources.","Call Member Services for help if you have questions or concerns.","How much is your plan premium?","Please check our website, yu.","It is only recognized in some states.","Aetna does not provide care or guarantee access to health services.","Eff date: The effective date of the transaction.","To avoid any delays in processing your paymentplease provide an explanation of the adjustments in the space provided.","When you are no longer in an Eligible Class.","It focuses on preventing illness and disability.","Employee not to exceed the IRS Annual Maximum listed below.","If your benefit line is calculated by number of employees, multiply the number of employees by the rate.","Plan features and availability may vary by location and are subject to change.","In many routine cases, this will be the extent of the needed informatiand the employee wireturn to work on the date indicated.","Biling statement consists of the Customer Identification, Insurance and Remittance Information sections.","Once completed you can sign your fillable form or send for signing.","The geographic area the HMO or PPO is licensed to operate in or, when licensing is not required, the area where an adequate network exists to provide covered services.","It is the process followed for an insurance requirement policy given by a university or state regulation.","Earnings anof hours worked are necessary for Aetna to calculate the LTD benefit the employee would be entitled to should she become eligible for LTD benefits in the future.","In Maryland, by Aetna Health Inc.","IRS guidelines require you to retain receipts for any eligible expense for which you receive reimbursement.","There is a problem with the page you are looking for, and it cannot be displayed.","These may include radiology, ultrasound, nuclear medicine, and laboratory and pathology services or tests.","John added an Aetna Accident Plan to his benefits package this year.","An applicant who experiences a qualifying life status change may also be able to enroll outside the open enrollment period.","Which plan pays first when you have other insurance?","Enter the telephone number of the person who is administering the COBRA continuation.","Notidene of ood Healthmaybe required.","For language services, please call the number on your member ID card and request an operator.","The invoice shows the amount due Aetna on or before your payment due date.","Written permission can be given by you or by someone you have given legal power to make decisions for you.","The first of the month on or following your hire date.","If none of the above survives, to your executors or administrators.","NOT PRECEDENTIAL UNITED STATES COURT OF APPEALS FOR THE THIRD CIRCUIT No.","That is because these forms need advance approval by Aetna and to be filed with the appropriate regulatory authority in the state the business is written.","This wiprevent a possible delay in processing the form.","Plan features, rates, eligibility and availability may vary by location and are subject to change.","The Aetna Accident Plan can help.","The second period of disability may not be separated from the first period of disability for longer than a specified period of time and must be caused by the same or related condition.","Premium: The total premium for couples enrolled in the plan.","Tell your doctor and other health care providers that you are enrolled in our Show your plan membership card whenever you get your medical care.","Some states, however, require that managed care organizations assign a PCP to members who do not select one at enrollment.","The college sponsors accounts with HSA Bank for eligible employees by paying for the fees associated with the account.","Product: Displays only those products with active membership.","Getting started as a memberpayment method, you are responsible for making sure that your plan premium is paid on time.","Click here for more information.","Ask your employees to sign up for the secure member website through www.","Aetna primary to Medicare primary.","The actual date the invoice was prepared.","Looks like something has gone wrong.","Employee must be enrolled for employee voluntary coverage in order to enroll spouse for coverage.","The maximum benefit that will be paid under the Policy for all Covered Medical Expenses incurred by a Covered Person that accumulate from one year to the next.","Aetna Medical Underwriting Unit.","Medicare for their primary coverage.","To be filled in by customer.","Aetna Rx Home Delivery, LLC, is a subsidiary of Aetna Inc.","And if we all commit to respond with graciousness, kindness, and love, we can transform new campus realities into profound life lessons for our future.","The only personal information we collect from this tool is the general location from where you access our website.","They may be able to do so, only if they satisfy our requirements for what we callevidence of insurability.","Click the verification link in your email to start sending, signing and downloading documents.","Not the right email?","What is the most you will pay for covered medical services?","What happens if the answer is no?","The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change.","This smoothing of the root surface is performed to help remove the uneven surface that would allow bacteria to attach easily.","You are about to permanently delete this Web Part.","EOI provides the insurance company with information to determine if you can enroll.","Health Savings Account with your own funds.","Listed on the following charts is a summary of these services.","We can assume no responsibility for providing this statement.","The total net amount of the retroactivity and other adjustments to transactions.","Insert your pixel ID here.","Aetna Life Insurance Company.","Getting started as a member Your monthly premium for How much is your plan premium?","This was a great way to spend part of a Saturday.","When employees make pretax contributions, they local income taxes on the money earned on their contributions.","Date of Hire: Indicate the employee\ud573 date of hire.","Schedule of Cost Sharing.","Are you trying to login to Aetna Eoi Portal?","Let us know what we can do to make your job easier.","These drugs are under patent protection.","To finish the enrollment process, you must complete, sign and return the EOI form by the date specified.","The consent of any employee or other person is not needed.","Any manual or systematic adjustments that are processed to the account.","Continuation because of a disease or injury, for instance.","Search autocomplete is currently not responding.","Give copies to appropriate people.","It must be approved by the appropriate industry organizations.","The information in this Notice is not a part of either the group contract, your Certificate of Coverage or the Booklet.","Know your role in an emergency.","Medicare as primary coverage, refer to the enrollment section of this manual.","We can help o If you move within our service area, we still need to know so we can keep your membership record up to date and know how to contact you.","Use Fill to complete blank online EASTERN MICHIGAN UNIVERSITY pdf forms for free.","Have you been affected by a recent natural disaster?","If you ask for any health information, Aetna may disclose details of the information you ask for to your doctor.","This Summary of Coverage replaces any Summary of Coverage previously in effect under the group contract.","Synchronize items and make them available offline.","If there is no spouse, in equal shares to your children.","Account: Determine the account number that is specific to your location from the following list and identify it on the form.","An amount of money that a member must pay for covered services, including prescription drugs, in a specified time period, before the plan will pay benefits.","Step One: You can enroll in Optional or Dependent Term Life Insurance or make coverage changes online or by working with your benefits coordinator.","The above premiums apply only to males.","File or directory not found.","Certificate to determine which health care services are covered and to what extent.","Upon request by the Policyholder, part or all of it will be applied against the payment of premiums or in any other manner as may be agreed to by the Policyholder and Aetna.","Aetna network, and you need to submit a claim, please complete and mail one of the forms below to the address on your ID card.","All questions must be answered.","The Life Insurance Conversion Privilege will also be described.","The written notice you received tells you how to reach this organization.","Additional provisions are described elsewhere in the group contract.","Each main plan type has more than one subtype.","For a complete list of plan details, go to www.","Do you want to continue?","You are about to close this Web Part.","Please make your check payable to Aetna and remit both the statement and check to the lock box address.","If possible, get the name of the Hospital where the employee will be taken.","Plan type: The unique identifier code for those products with active membership.","An additional benefit may be available if the member dies while properly using a passenger restraint system.","Increase or add new spouse life coverage.","HIV tests performed on a criminal offender or a crime victim.","The requested URL was rejected by ASM.","If additional beneficiaries, use Section H, Special Remarks.","Retroactivity and other adjustments: Charges for activity that has not been billed before, or adjustments to amounts billed earlier.","CVS an Emory pharmacy.","Aetna medical member, we can use your medical claims information to help speed the processing of your accident claims.","Withdrawal requests do not have to meet certain reason requirements, are not subject to IRS penalties for early withdrawal and do not require you to cease participation in the plan.","Name and Phone Number of Person Providing the Information Above: Indicate your namand phone number.","Volume of each tier billed and total premium for each tier billed.","This example is for illustrative purposes and does not reflect events experienced by an actual participant.","Members are responsible for finding care, getting precertification, paying for services provided, and sending in claims for repayment of covered services.","Employees who go from part time to full time should be enrolled the day they become full time, once the probation period has been met.","The goal is to let terminally ill patients remain in familiar surroundings for as long as possible.","It replaces pension benefits that were unearned because of a disability period.","United States economic and trade sanctions.","Not receiving a WRS annuity.","Termination includes strikes, layoffs and walkouts.","Family and Medical Leave Act.","Tier Zero prescription drugs.","The least benefit amount payable under a disability period regardless of income from other sources.","Who is required to provide Life EOI?","LTD Coverage Effective Date: Indicate the date the employee\u00d5s eligibility LTD coverage became effective.","Please call the phone numbers below OR visit our Emergency Disaster Resources page for more details on specific State of Emergency programs.","The availability of a plan or program may vary by geographic service area and by plan design.","Create single site tracking.","An increase will be subject to the Active Service Rule.","They must continue to live within the Aetna HMO service area, however.","If the information in Section A is accurate, the employee should complete Section B and send it tthe address shown on the form.","Not all health services are covered.","It shall not be effective during a period for which a premium has been paid to Aetna as to the coverage.","It is also possible that they will remain enrolled under your Aetna group plan.","All pages must be returned.","Departmentof Health and Human Services.","Healthy eyes and clear vision are an important part of your overall health and quality of life.","Total retroactivity: The total of all subscriber retroactive changes.","Then this continuation coverage will end on the date the plan ends.","At the Member Home Page, click on the appropriate action under My Insurance Information.","Emory Healthcare work well for you and your loved ones.","Do not use nicknames.","What is a \u00aaclinical research study\u00ba?","Opening balance: The balance due from earlier months.","If no Eligible Class of retired employees is shown, there is no coverage for retired employees.","Certificate included in the policy, will refer to a covered Employee.","Your plan documents can tell you the specific terms that apply to your group plan.","Previousunfavorable underwriting decisions may not be used as the basis for future underwriting decisions unless we make an independent evaluation of the basic facts.","Note: Prescription, dental and certain other plans and benefits cannot be converted to individual plans.","Rates vary by area.","This portal is our system of record for benefit coverage and elections, beneficiaries and more.","Fill submit aetna instantly, Edit online.","Web server received an invalid response while acting as a gateway or proxy server.","Enrol lm ent can b e mad e an integ ral p art of th e orient ation proce s s fo r new employees.","They may also get a paper application they can send to us.","To enroll or make coverage changes working withyour benefits coordinator: Get a Benefits Election Form from your benefits coordinator.","Optional amounts of term life insurance may be purchased by the employee in addition to the basic coverage.","Due to our focus on minimizing risk, our undergraduate students will begin the first few weeks of the fall semester online and move onto the campus after the Jewish holidays.","Since there are a number of factors that determine whether a discount will be given, Aetna is unable to guarantee any level of discount under this program.","You cannot receive multiple coverage under this Plan because you are connected with more than one Employer.","Your Employer hopes to continue this Plan indefinitely but, as with all group plans, this Plan may be changed or discontinued with respect to all or any class of employees.","These guidelines will help you determine when someone is eligible for Medicare primary health coverage.","You need to complete only one Aetna Form.","Next semester will present significant challenges and changes.","Aetna sites are provided for your convenience only.","Student Connection for specific terminology as it relates to your school health insurance plan benefits.","It requires us to distribute a Notice of Privacy Practices to plan sponsors and subscribers of our fully insured benefits plans.","Product type and premium: The product and total premium charged per subscriber.","What is your plan deductible?","Your benefits coordinator will enter the information and indicateif you prefer to receive your Life EOI application by mail or email.","Aetna has provided its policyholders with access to ARAG programs and services but has no responsibility for those services.","This can be done by telling Aetna or by stopping premium payments.","We cannot accept plan changes submitted after the date listed in the letter.","Maine Public Employees Retirement System.","The weekly or monthly rate of basic earnings in effect on the day before becoming disabled.","Treatment of cancer by chemical or biological drugs.","Customer name and address: The name and address of the customer to which the invoice will be sent.","Calls to this number are free.","These include benefits that may be payable under the federal Social Security Act.","Need Help Quitting Tobacco?","If premiums are payable monthly, any insurance becoming effective will be charged for from the first day of the policy month on or right after the date the insurance takes effect.","Both are included at the end of this section.","Employer secure website EOI file.","To find forms customized for your benefits, log in to your member account.","Prepared date: The date the statement was prepared.","It does not include overtime, bonuses, commissions and other extra compensation.","Aetna Health of Washington Inc.","New coverage becomes effective the first day of the month following the date when the required form and any additional information requested is approved by Aetna.","Can you afford health insurance?","This notice describeshow medical information about youmay be used and disclosed and howyou can get access to this information.","The insurance in force will be set forth.","PCP must approval referrals to specialists.","Coverage under any extension of benefits provision becomes effective only after any other continuation of coverage period, if elected, ends.","If dependent coverage is desired, please indicate this when enrolling.","All Medicare drug plans provide at least a standard level of coverage set by Medicare.","You, as a company representive, should complete the Employer Information section and ensure the Employee Information section is properly completed by the employee.","COBRA, or Consolidated Omnibus Budget Reconciliation Act.","The requested URL was rejected.","For more detailed information, go to ourehc.","By continuing to use the site or closing this banner without changing your cookie settings, you agree to our use of cookies and other technologies.","Members are free to change this selection at any time.","EOI is not required.","It will not have to probe into the details.","The amount of life insurance coverage up to which an applicant is guaranteed coverage under the group plan without needing to provide Evidence of Insurability.","This section also includes the address for you to use when remitting payment.","The maximum length of time for which benefits will be paid.","Adjustment When making any type of adjustment exceding thrpercent of the total premium, please provide us with an explanation in this space.","This might happen when an employee goes from full time to part time or when an increase in premium costs results in the loss of coverage.","It is important to understand that the same rules of the Internal Revenue Code for controlling employers apply to COBRA.","Member Employers are those employers which are included under this policy by written agreement between the Policyholder and Aetna.","Because COBRA is directed to employers rather than to carriers, employers have to abide by its mandates and to consult their own legal counsel.","If so, provide a copy of the court order.","Summary of Coverage or Benefits.","Rules for Oxygen Equipment, Supplies, and What oxygen benefits are you entitled to?","Click the link below to watch a short video.","Employer, but not beyond the end of the policy month after the policy month in which the absence started.","Member Services number on your ID card.","Acknowledgment: I understand that, to the extent permitted by state law, false statements may result in the denial of claims or in my insurance coverage being void as of its effective date with no benefits payable.","Work Commitmentcompletes their degree, calculated from their last reimbursement.","These entities have been designated as a single affiliated covered entity for federal privacy purposes.","By noncontributory plan, we mean the whole premium is paid by you, the employer, or by the union.","SAISD provides Telemedicine at NO CHARGE to employees.","Your Employer has claim forms.","He or she also may talk with other doctors and health care providers about your care and refer you to them.","Treating someone at home with drug therapy that is given through a vein.","Definitions of important wordskeep you healthy.","If left untreated, plaque can begin to mineralize and harden into calculus or tartar.","The new total premium due is the amount you should remit to Aetna on or before the statement due date.","Premium rates are market competitive because of the tie to group term rates and group term policy, which is fully contributory with no University contribution and does not build cash value.","But since each qualified beneficiary is entitled to elect continuation coverage, the covered employee or spouse may not decline coverage on behalf of another qualified beneficiary.","Virgin Islands and Guam.","Products not available in all states.","It is your responsibility to make sure your HSA contributions, including any employer or incentive contributions, do not go over the IRS maximum.","Fill Aetna Eoi Submit, Edit online.","Premium rates are not group term rates, but rather the customary rates applicable to the effective dates of any individual policies issued to any persons of the same class of insurance table age and risk.","Chase Investment Services Corp.","We have bound it into this document only as an aid to you in keeping insurance related material together.","Employee Ceased Work: Indicate the reason why the employee is disabled and unable to work.","Not all forms may apply to your coverage and benefits.","Decedentsto a coroner or medical examiner for the purpose of identifying a deceased person, determining a cause of death, or as authorized by law; and to funeral directorsas necessary to carry out their duties.","Can we change your monthly plan premium during the year?","ID card, they can then send us a copy of the prescription receipt with their member ID number marked on it.","If the member is entitled to Medicare because of disability, various factors are used to determine the primary payer.","If it is a verbal order, it must promptly be put in writing by the pharmacy.","The notice must state when such termination shall occur.","They must follow all the terms and conditions of the group agreement or group insurance policy.","Pay particular attention to what needs to be included on an enrollment or change form.","If it is not given, Aetna will not have to pay this benefit.","Some of the group plan provisions that allow for continuation are required by the federal government.","This Plan will pay as a Life Insurance benefit the amount of Life Insurance in force for you if you die from any cause while insured.","HMO has made or with the operation of the HMO.","You also have the right to ask usto restrict disclosures to persons involved in your health care.","The medicine may start as a powder that is mixed with water.","The subscriber can sign up eligible dependents, as determined by the policy, under family coverage.","New hires living in a new service area may need a new OOS PPO service area and plan set up.","Valid waivers differ by state.","Contact Name The name and phone number of the individual responsible for your group plan.","Step Four: Submit your online Life EOI application as instructed on the form or website.","This information will be used for the purpose of determining eligibility for coverage.","If the review organization says no to your appeal, they are saying that your planned discharge date is medically appropriate.","Policyholder and the Employer shall be jointly and severally liable to Aetna for the unpaid premiums.","Want to add a signature?","Medicare supplement insurance sold by private insurance companies to fill \u00aagaps\u00ba in Original Medicare.","This right is subject to the terms of any applicable law or regulation.","Getting started as a member What makes you eligible to be a plan member?","If EOI is required, you are alerted during the enrollment process and Aetna sends the appropriate forms to your home address.","Life and disability products are underwritten or administered by Aetna Life Insurance Company.","All facts will be taken as of the date of the refiguring.","These those typically available to individual policyholders.","Before making this change, please see the Medicare section of this manual.","Personal information does not include publicly available information or information that is available or reported in a summarized or aggregate fashion but does not identify the member.","Skilled nursing care and rehabilitation services provided on a continuous, daily basis, in a skilled nursing facility.","This can be done in states that provide such rights and that grant immunity to insurers providing such access.","Aetna will be fully discharged of its duties as to any payment made by it before your request is received at its Home Office.","Indicate the Social Security number of the employee.","All of this information will be treated as confidential.","In addition, we make claims information contained on oursecure member websiteand telephonic claims status sites available to the subscriber and all covered dependents.","If an employee is away from work because of illness or injury on the date any coverage other than health coverage would have taken effect, coverage does not start until the employee returns to work for one full day.","Your Eligibility Date, if you are then in an Eligible Class, is the Effective Date of this Plan.","Aetna group plan is summarized here.","Children or Family level coverage is elected.","If we deny therequest, you may file a written statement of disagreement.","Any continuation will be available on the same terms as those for which employment is terminated.","GYN or your pediatrician with reminders.","Street, city, state, ZIP code.","By probation period, we mean the period of time before a new employee can join the group plan.","Employee\u00d5s Earnings: Indicate the employee\u00d5s earnings as defined within your plan documents.","Please make your check payable to the plan.","Next year will be a formative year in the lives of our students, and together we will rise to the moment so that our students will emerge stronger and better prepared to be leaders of the world of tomorrow.","Vantage to log in with Select Self Service from the top dropdown, then click Choose Select to view your election options.","We pledge to stand up to racism, in all of its forms, not only in the workplace but within our communities.","Fill Aetna Eoi Form, Edit online.","Corporate Officer or an Executive of General Dynamics eligible for Incentive Compensation.","When must we end your membership in the plan?","Benefits will be paid as soon as the necessary written proof to support the claim is received.","Our plan designs give you customizable options to fit your company\u02bcs needs while being backed by the financial strength of Nippon Life Benefits.","Additional information if required.","For University Staff employees, the employer contribution varies based on the category level you are in which is determined by the amount of sick leave you have earned.","Special rules apply to California applicants.","You can also choose the types of coverage for which the permission applies.","In case of an emergency, or when traveling, you may need to use a pharmacy that is not in our network.","Before performing any work during your elimination period, contact your claims representative at The Hartford.","Portability is available for Optional Life and Optional Dependent Life, even without a conversion of Basic Life.","If not already preprinted, please add.","Refers to specific pharmacy benefits plans that cover all eligible prescription drugs.","Instead of figuring premiums as described above, premiums may be figured in any way approved by Aetna that comes up with about the same amount of premiums.","Please log in to your secure account to get what you need.","HIPAA rules also improve the efficiency of the health care system, by: providing a standard way to electronically send health information and; protecting the security and privacy of information that can identify a member.","The complaint process is used for certain types of problems only.","Any paid job for which a disabled employee is, or may reasonably become, suited by training, education or experience.","The greatest amount of benefits that will be paid under an insurance plan.","In effort to best serve you, we have researched information from the most reliable sources and summarized what you should know about the virus and how related claims will be handled.","Optional Life and Dependent Life.","Aetna Health of the Carolinas Inc.","In other words, there are no vested rights to benefits based upon provisions of this Plan in effect prior to the date of any adjustment.","Insurability Statement for Disabity Coverage.","Billing Line Code Internal code for company use to further identify the bing line.","Aetna Health of Utah, Inc.","Worksheetyourself for eligible health care expenses.","You do not need to fill a prescription or use CVS Pharmacies for any of your prescriptions in order to take advantage of this payment method.","Check if I can initialize it in every loop or if i need an addtional list.","Policies contain detailed plan descriptions, limitations and exclusions for each type of coverage.","You can easily finish the assessment in a short period of time; however, the secure site will save your answers, so you can always return to finish it another time.","Please check periodically to make sure your designation is current.","The elimination period begins on the first full day that you are continuously and completely absent from work due to disability.","View it online at www.","Health care services, supplies, treatments or drug therapies that have not yet been determined to be effective and safe in treating the illness or injury for which their use is proposed.","It also may explain the claims appeal process and provide other information.","Social Security Number, as well as financial, health and other information about you that is nonpublic, and that we obtain so we can provide you with insurance coverage.","Early to taxes you pay.","PCP is printed on your membership card.","Make sure all eligible employees are included on the statement and that premiums are correct.","It does not build up cash value.","Premium payments for your Life Insurance case while you are totally disabled by disease or injury which stops you from engaging in the duties of your own job.","To keep this Web Part, click Cancel.","Throughout campus everyone will need to adhere to our medical guidelines, including social distancing, wearing facemasks, and our testing and contact tracing policies.","Teeth that never existed.","Ending your membership in the planabout our decision to end your membership.","You will not have to make any further contribution.","This is the kind of teachable moment that Yeshiva University was made for.","How do you choose your PCP?","The date COBRA will be exhausted.","In general, you have a right to learn the nature and substance of any information Aetna has in its files about you.","Human Resources is located on the third floor of the Cambridge Office Building on the Rice campus.","Otherwise he is eligible on the date he completes it.","Others are standard features of your Aetna group plan.","The process of ending your membership in our plan.","If you think we are not meeting this deadline or other deadlines, you can make a complaint.","Employee\u00d5s Name: Indicate full name of the employee.","Enrollment changes should be processed via the online enrollment tool.","You can find what you need to know about health care reform on our health care reform website atwww.","Emory University then she cannot be listed as your insurance for herself.","We will gather more information if we need it.","COBRA Direct Bill unit.","Preparing for the Baby, Children and Money and Generational Wealth.","When a person is unable to pressthe button, the autoalert service will automaticallysummon a Personal Response Associate.","Payment will be made in one sum unless you have elected an installment method which has been agreed to by Aetna.","HSA if you are enrolled in the High Deductible Health Plan.","Enter the address to which the qualified beneficiary must return the application and premium payments.","The University group life insurance is term insurance and no cash value accumulates.","Answer EOI questions truthfully and thoroughly.","Your request must be in writing and must include the reason for the request.","It will show you whether a drug is covered or not covered, but the tier information may not be the same as it is for your specific plan.","PCP that direct a member to a participating health care professional for medically necessary care.","Break out early, do not processing if a downgrade reqeust was already sent.","The amount you must pay for health care before our plan begins to pay.","Providing false answers on an EOI application for any GBP coverage is a violation of state insurance laws.","If you wish to validate your Summary Billing statement membersplease refer to your AAS Audit Certification List.","You will also be given the opportunity to select supplemental ICI coverage if you are eligible.","This takes into effect the probationary period the ployee would have to satisfy before eligibility becomes effective.","This means you may need to use more than one form for your workforce.","DIFFERENT ABOUT A HEALTH SAVINGS ACCOUNT?","The treatment can be a part of care after a disease, illness, injury or operation.","In Utah and Wyoming, by Aetna Health of Utah Inc.","Save my name, email, and website in this browser for the next time I comment.","An employee may cancel or change to a lower optional amount by completing a new enrollment form and submitting the form to Employee Benefits.","Please activate the card when you receive it.","Aetna Life Insurance Co.","Maryland and site of the state capital of Annapolis, Anne Arundel County is in many ways the heart of Maryland.","You may call us if you have questions about our coverage decision process.","Character is formed and developed in times of deep adversity.","Any change in coverage will be effective on the date the change in earnings or status is made.","Group Dental Service of Maryland Inc.","It will tell you how coverage may be affected.","An employee or dependent cannot retroactively elect a continuation provision, such as a state or COBRA continuation, while they have an extension of benefits.","Excess coverage EOI is approved by the insurance coverage.","Priority Access Specialists, answering Friday, can assist you in making appointments with Emory Clinic and Emory Specialty Associates providers.","Number of Hours Per Week: Indicate the number of hours the employee was expected to work.","Treatment of illness or disease done by bringing dry or moist gases into the lungs.","ID cards vary according to the plan selected and state legislation.","Aetna arranges for the provision of health care services.","Nippon Life Benefits offers Group Insurance with complete coverage.","Your coverage will take effect on your Eligibility Date.","SERVE with Team Plano!","The Preferred Drug List is subject to change.","Following initial enrollment, you may change a beneficiary designation at any time.","Like all Medicare health plans, we cover everything that Original Medicare covers.","The contractual plan documents, describing the terms and conditions of coverage, that are provided to the plan sponsor.","Aetna must be given written notice.","FOR OTHER MEDICAL You pay for additional medical and is met.","Coverage for dependent life insurance shall be effective on the first day of the month consecutive with or following the date of hire with appropriate enrollment election.","This document has been signed by all parties.","Anne Arundel County, Maryland.","Getting started as a member Can we change your monthly plan premium during the year?","HSA or receive employer contributions.","Within one full day after they have all the information they need, the What happens if the reviewers say yes to your appeal?","The Policyholder and each Member Employer must give Aetna all data required as to policy matters.","If you sign up during benefits enrollment, your coverage cannot start before the new plan year begins.","Claim forms, order forms, change forms, direct deposit forms, worksheets, etc.","This Coronavirus has reminded us time and time again of the lessons from our Jewish tradition that we are not in full control of our circumstances.","Another great way to save on drug costs is to buy generic.","Do I need a Permit?","Services that are not normally covered when you have Original Medicare.","Any amount payable to a beneficiary will be paid to those you name.","Legible copies of required documents are acceptable.","Custodial care is personal care provided in a nursing home, hospice, or other facility setting when you do not need skilled medical care or skilled nursing care.","It may include important information about your agreement and payment terms.","My team and I have had a wonderful experience with Nippon Life Benefits on the implementation of our client.","Safety Specialist will contact you immediately upon receiving the Report.","You can also contact your broker or Aetna service representative.","Your use of direct billing does not exempt you as the employer from your obligation under COBRA.","Coverage will be effective in line with the Eligibility provisions as described elsewhere in the group policy.","Necessary services and supplies that are covered under the plan.","MAY GROUP LIFE INSURANCE BE CONVERTED?","An organization providing inpatient and outpatient medical services, which is accredited as a hospital by the appropriate industry organizations, or otherwise determined as meeting reasonable standards.","Personal life events typically require a review and perhaps an update to your beneficiary designations.","When you participate in a clinical research study, who pays for what?","Aetna may also terminate this policy in its entirety or as to any or all coverage of all or any class of employees of a Member Employer by giving the Policyholder advance written notice of when it will terminate.","What is your cost sharing?","Also, they must be open until the final rights and duties under this policy have been resolved.","Evidence of Insurability Online.","If your group plan includes a separate disability feature applicable to life insurance, coverage for a totally disabled employee may be continued beyond the limits shown in your plan documents.","You may also have a right of access to such files, except information which relates to a claim or a civil or criminal proceeding, and to ask for correction, amendment, or deletion of personal information.","Chase Insurance Agency Services, Inc.","Basis dicates what rate basis will be used to calculate the premium or fee for a particular benefit or service.","What services are not covered by the plan?","Booklets on life insurance coverage may be obtained from Employee Benefits.","The premium due under this policy on any premium due date will be the sum of the premium charges for the coverages then provided under this policy.","Secretary of the Department of Health and Human Services, as necessary, for HIPAA compliance and enforcement purposes.","This Web Part Page has been personalized.","To explore the plans and enroll, visit petinsurance.","Evidence of Insurability Statement Life and Disability Coverage Aetna Life Insurance Company Read This Instruction Page Carefully.","Coverage under this basic plan takes effect on the first day of work and terminates on the last day of the month in which employment is terminated.","Fill aetna insurability online aetna instantly, Edit online.","Employee status: Indicate whether the employee is active, COBRA or state continuation.","Notices are mailed to Aetna members and are included in standard enrollment packages.","Check your invoice carefully.","Fill is the easiest way to complete and sign PDF forms online.","Your primary care provider is the doctor or other provider you see first for most health problems.","Planning for the future during this moment has certainly been humbling.","SAISD helps you care for your eyes while saving money.","The program may include educational materials and member support for monitoring the condition and treatment.","Aetnaconsiders personal information to be confidential.","The tissues surrounding the end of the tooth root.","No other person can change or waive any of the policy terms or make any agreement binding Aetna.","This applies even if the premium was paid in error.","Requests for amounts of coverage other than those to which you are entitled in accordance with this Summary of Coverage cannot be accepted.","Above the shaded area to the right of the asterisk, enter the total number of employees who are covered as of the current statement date.","Your group plan can be terminated if not enough employees take part.","Try finding it in our glossary.","The content on this website is intended for general information only.","If you cease active work, ask your Employer if any coverage can be continued.","Note: If you participate in the Retirement Program, you will need to make vendor selections for the employer contribution, even if you choose not to contribute to the plan.","Benefits are payable no matter what other medical coverage you might have.","Dependent coverage is available with the purchase of basic coverage.","Coverage period: The time period for which you are being billed for coverage.","The premium waiver remains in effect through the end of the month in which your leave of absence ends.","What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan?","Upload your own documents or access the thousands in our library.","Member Servicesnumber on your ID card.","Negotiate with insurers to provide services for insureds on a flat fee or retainer basis.","The benefit payments are not intended to cover the full cost of medical care.","However, Aetna itself is not a provider of health care services, and therefore, cannot guarantee any results or outcomes.","Thank you so much!","We urge you to consult your legal counsel about your responsibilities for continuation under state laws.","Dependents do not have to take part in the plan.","You can get a fast coverage decision only if you are asking for coverage for you have not yet received.","You can find the forms on www.","Employees must pay taxes when they withdraw their money.","Amalgams are silver in color and usually used on posterior, or back, teeth.","Aetna has adopted a comprehensive insurance privacy policy based on the recommendations of the Federal Privacy Protection Study Commission.","Monthly plan st day of each month for coverage of the current month.","This is information necessary for Aetna to perform its function with regard to the insurance transaction in question.","Credits for retroactive terminations may be limited.","You may change your choice at any time.","Of course, this applies only if you keep making premium payments to Aetna on behalf of the employee.","Control, suffix and account numbers: If not already preprinted, please add.","Direct data entry is available for employers with smaller groups of employees.","It shows, for example, how to add new dependents or end coverage when employment ends.","We may also require examination of the child as often as needed to determine continued eligibility.","If eligible dependents do not sign up at open enrollment or when they become eligible, they must wait until the next open enrollment period.","The Quality Improvement Organization conducts an independent review of What happens during this review?","If difficulties persist, please contact the System Administrator of this site and report the error below.","Please enable scripts and reload this page.","Aetna will issue to the Policyholder individual certificates.","How can you contact this organization?","So does our online provider directory at www.","Disclosure cannot be contrary to any law which applies.","Aetna does not provide legal services and makes no representations or warranties as to the quality of the information on the ARAG website, the services of ARAG or of any attorney in the ARAG network.","Please refer to the Temporary Disabity Income Coverage section of your plan documents for the specific terms that apply to your plan.","EVIP, Emory expedited access to Emory providers.","You will recieve an email notification when the document has been completed by all parties.","Ending your membership in the plan How do you end your membership in our plan?","Start by calling, writing, or faxing our plan to make your request for us to authorize or provide coverage for the medical care you want.","You may be trying to access this site from a secured browser on the server.","Symptoms Treatments Received Full Recovery Date Check here if you are providing additional information on a separate attachment.","We will be happy to help you.","An event or process that occurs during pregnancy that is not associated with a normal pregnancy.","Treatment that uses exercise and physical movement to relieve pain, restore use, promote healing and prevent disability in a part of the body.","What to do if you have a problem or complaint To deal with your problem, which process should Should you use the process for coverage decisions and appeals?","All data which may have a bearing on insurance or premiums will be open for Aetna to inspect while this policy is in force.","Important: If a person is eligible to convert their coverage to an individual insurance policy from their group health plan, they must do so when applying for any extension of benefits.","If there was no matching functions, do not try to downgrade.","Each insurer has sole financial responsibility for its own products.","Ask your Employer for the forms.","If a claimant worked a half day or more, then the DLW is that day.","Research to researchers, provided measures are taken to protect yourprivacy.","You can even bring your spouse!","If you do not do so prior to your death, your beneficiary will have this right before any payment is made.","Tell us if you move.","Certain conditions must be met for coverage to be continued.","Pharmacy Management Precertification Unit to request coverage as a medical exception.","The employee must sign and date the form.","Basic Will, Living Will, Durable and Financial POW and Health Care Directives.","Most of your administrative work is likely to be enrollment and benefits changes.","University of Wisconsin System.","It lets the insured collect a regular pension at retirement, without penalty for the period of disability.","What other materials will you get from us?","Automatically reload the page if a deprecation caused an automatic downgrade, ensure visitors get the best possible experience.","Aetna does not require a copy of the Right of Continuation Notice.","How are your medical services covered when you What is a \u00aaclinical research study\u00ba?","Aetna considers personal information to be confidential and has policies and procedures in place to protect it against unlawful use and disclosure.","If you send your application via mail or fax, you will hear from within two weeks.","Your rights and responsibilities How to get more information about your rights You have some responsibilities as a member of the What are your responsibilities?","The provider network may change at any time.","Many pharmacies will not accept insurance unless the member presents their member ID card.","HIPAA stands for the Health Insurance Portability and Accountability Act.","You may increase your waiting period at any time.","This document describes the main features of this Plan.","Organ Procurementto respond to organ donation groups for the purpose of facilitating donation andtransplantation.","Coverage is effective upon approval.","Social Security numbers: List the SSNs of any dependents being covered.","The STD policy defines eligibility requirements, elimination periods, and terms and conditions.","Binding terms and conditions that are applied to insurance plans.","Definitions of important wordscalled \u00aacoverage decisions\u00ba in this booklet.","Resources section below for more information.","Addition or Deletion of a Benefit: Except as set forth in the next paragraph, if any benefit becomes applicable to an employee who is already covered under the policy, that employee will be eligible for that benefit right away.","Review the guide at emoryhealthcare.","The actual terms of your plan are spelled out in your plan documents.","The customer team field, whplicable, is a field used for for internal purposes only.","Such premium will be the sum of the individual premiums of the employees then insured, figured from the table of premium rates then in effect.","Resources section below for plan details.","All pages must be returned, since those figures are used in the preparation of your employee benefitplans annual financial reports.","For making this determination under COBRA, employees working for employers under common control must all be aggregated.","How do I go through the Life EOI process?","Withdrawals are taxable to the participant at the time they are received.","NOT INSURED BY ANY FEDERAL GOVERNMENT AGENCY.","Business Associatesto personswho provide services to us and assure us they will protect the information.","Early detection can prevent colorectal cancer.","The methods of settlement allowed will be those offered by Aetna under the individual life insurance policies Aetna is issuing when the election is made.","Do not send any other request or correspondence with premium payments.","Plans More Medical Plan Information FSA Planning Worksheet Important Numbers and Websites Team EHC: The improve health for humankind.","Enter the amount of premium the employee pays toward the cost of medical, life, or other coverage that is to be deducted from the employee\u00d5s disability payment.","An Aetna Accident Plan can help you manage unexpected costs that come with an accident.","The policy does not apply where a different approach is required by law.","Your rights and responsibilitieso If you get any medical services that are not covered by our plan or by other insurance you may have, you must pay the full cost.","The University pays the premium cost for these individuals.","It is not a valid request!","May be taken by both or either spouse.","Invoice number: Unique to every bill.","If the employee does not return to work when this continuation period ends, the employee, along with any covered dependents, may be eligible for any other continuation provision of your group plan for terminated employees, such as COBRA.","Amount The recalculated amount based on changes or adjustments.","Ending your membership in the plan Introduction This chapter focuses on ending your membership in our plan When can you end your membership in our plan?","Aetna will not have to see to the use of such excess.","Innovative and flexible dental solutions designed to stretch your benefit dollars, while offering comprehensive dental coverage.","Coverage Service Describes the benefits or services that are being billed in each service line.","Only funds in your account are available for the reimbursement.","The following two conditions must be met and are subject to applicable law and your plan documents: The child is not able to earn their own living because of mental illness or physical handicap.","We, your plan, must provide you with a list of hospices in your geographic area.","This is usually a check or wire transfer number.","During this period you have the opportunity to increase your.","Consists of the control, suffix and account numbers.","The scope and content reflect plan provisions.","GHA Travel, to employees of GHA member hospitals.","If any individual policy has been issued to you under the Conversion Privilege, your rights under this section may be restored.","Coverage for your dependents ends on the last day of the month that the dependent is no longer eligible.","We recommend that you make this part of your salary adjustment process.","Basic coverage is provided by the University through Aetna, and you may elect from optional programs of insurance sponsored by the University through Aetna.","The resource you are looking for might have been removed, had its name changed, or is temporarily unavailable.","Self Statement of Health for Individual Listed Above.","Medical evidence is also required when increasing coverage after the initial eligibility period.","Aetna may change them due to experience or a change in factors bearing on the risk assumed.","Give your doctors written instructions about how you want them to handle your The legal documents that you can use to give your directions in advance in these situations advance directives.","When Can You Join A Medicare Drug Plan?","If we do, the new terms and policies will be effective for all of the information that we already have about you, as well as any information that we may receive or hold in the future.","Aetna for certain specialists who have met certain levels of clinical performance and efficiency.","You must ask the Quality Improvement Organization for a \u00aafast review\u00ba of your discharge.","HMO and licensed insurer subsidiaries of Aetna Inc.","Your Life Insurance must be in force when you become permanently and totally disabled.","Based on the requirements of your Plan, your spouse may be required to submit evidence of good health.","The resources on these pages were created specifically for faculty and staff members who are responsible for managing and supervising Rice University staff members.","Any clerical error by anyone in keeping records, or a delay in making an entry, will not alone decide if insurance is valid.","You can read about those in the late enrollees section.","No extra charge for shipping.","You cannot ask for a fast coverage o You can get a fast coverage decision only if using the standard deadlines cause serious harm to your health or hurt your ability to function.","Handicapped Child Attending Physician Statement.","Other parties need to complete fields in the document.","Itmay be necessary to use and disclose this information for the purposesdescribed above even after your coverage terminates, although policies and procedures will remain inplace to protect against inappropriate use or disclosure.","Are considered a small employer under COBRA.","Complete your HRA on Healthy Emory Connect.","The medicine is put under the skin, into a muscle, or into a vein.","From your account dashboard, you can file a claim or request funds.","For more information about this qualifying event, contact your legal counsel.","Nippon Life Benefits App Today!","Any rights under the benefit gained by the employee while the coverage was in force will not be affected.","Employee Resources tab on ourehc.","By providing en rollment m ateri al and b en efits lit er ature to your employees when they first b egin work, you ar e assisting th em in making informed benefit dec isions.","If you do not currently receive an AAS Audit Certification List or if you have any other questions, please contact your Aetna service representative.","In some cases, however, the expected disability duration stated may only be the first certification.","Our Emory University Hospital Midtown location is a to preventing early elective deliveries.","Render slideshow if info advacned items contain one.","Keep you room locked when not in use.","The policy defines eligibility, elimination period, and terms and conditions.","Periodontal disease is a chronic bacterial infection combined with inflammation.","Eligibility is limited by government regulations to senior leaders in an organization.","Balances roll over from year to year and the amount is portable.","Information may be disclosed to Peer Review Organizations and other agencies to determine whether health services were necessary and reasonably priced.","The enrollment section of this manual has details on terminating coverage.","Nippon Life Benefits is dedicated to the wellness and health of our members.","ERS will enter your information into the system.","Evidence of insurability means the employee must complete an individual health statement and may have to submit medical evidence, via medical records, at their expense.","Date Last Worked: Indicate the date the employee last worked prior to the disability.","Through this process, eligibility and determination of coverage can be confirmed and communicated before a member receives treatment or services.","Vantage, you will need your network ID and password.","Provide exceptional wellness care with with a medical insurance plan from Nippon Life Benefits.","Some subtypes have five tiers of coverage.","To delete this Web Part, click OK.","Please review it carefully.","An inclusive term for the family of disability and absence management products and services.","It is for information only as it contains only partial and general descriptions of the process and obligations from the COBRA statutes and rules.","While you as the employer may pay for part or all of the premiums, COBRA does not require you to contribute to the cost of the coverage.","An employer may be a Member Employer if not against the law of the jurisdiction in which this policy is delivered.","The numbers are listed below and also on their Aetna ID card.","The effective date of an age change is the first day of the birth month.","Health insurance plans contain exclusions and limitations.","As the employer, you can decide whether you will allow coverage to continue up to the limits stated in your plan documents or whether you will continue coverage at all.","Information subject to change.","This wiprevent claim problems due to underbilling when a disability claim is presented.","You may also have a right of access to such files, except information that relates to a claim or a civil or criminal proceeding, and to ask for correction, amendment or deletion of personal information.","Network coverage is not available.","It may vary depending on the insured product.","Adjustments should be included when calculating the total amount due.","The number of entries displayed in this section may vary.","An insurance enrollment process that requires showing or demonostrating proof in hard copy that a student is properly insured.","If you do not enroll in Income Continuation Insurance when you are initially eligible, you may have an opportunity to enroll once you sick leave balance reaches certain levels.","Aetna does not warrant or guarantee and makes no representations as to the quality of services offered by CISC.","Aetna Dental of California Inc.","Statements as to whom benefits are payable will appear.","For example, we may use the information to provide disease management programs for members with specific conditions, such as diabetes, asthma or heart failure.","An injury or disease resulting from performing a job.","The amount charged to the policyholder when a covered member chooses to convert group policy coverage to an individual policy.","If a terminated person later elects COBRA, coverage will be reinstated retroactive to the termination date.","Total payments received since last invoice: The total of payments received since the last invoice.","Optional amounts of term life insurance may be purchased by the employee for dependents.","Copay waived if admitted.","This also applies to the debts of your beneficiary.","FMLA leave has ended.","This is performed in rare instances when the patient has not had a dental cleaning in a very long time and a gross amount of debris has built up.","MAY GO DOWN IN VALUE.","Why Nippon Life Benefits?","You have the right to ask us to provide a list ofcertain disclosures we have made about ysuch as disclosures of health information to government agencies that license us.","Birthdate houldlude foudigear of birth.","Vermont, Rhode Island, and California.","See table below for details.","Nippon Life Benefits delivers a full range of products so each employer can create the perfect benefit package for their company.","Please note: Aetna does not prorate premium for terminations.","Return it to your benefits coordinator.","The benefits and main points of the group contract for persons covered under this Plan are set forth in this Booklet.","EOI form and be approved by Unum.","You also have the right You have the right to know how your health information has been shared with others for any purposes that are not routine.","The determination by an insurer or health plan of the availability of health insurance or health benefits for a claim and the level of benefit to be paid.","Guide to our plans for the upcoming fall semester and reopening of our campuses.","Do you want to end your contract with us?","LTD eligible status, your waiting period will start over.","The number of families enrolled in the plan.","What to do if you have a problem or complaint Introduction What to do if you have a problem or concern What about the legal terms?","Plan changes must be submitted to us within the specified time frame on your renewal proposal.","HMO plans may offer reduced benefits for care received outside of the network.","If you have any questions, be sure to ask.","ARE YOU A LEGAL CONSUMER?","How do you end your membership in our plan?","Aetna Life Insurance Company Make a copy for your records."]