Texas Senate Bill 51 Webinar Presented by: Blue Cross and Blue Shield of Texas December, 2005

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Texas Senate Bill 51 Webinar Presented by: Blue Cross and Blue Shield of Texas December, 2005"

Transcription

1 Texas Senate Bill 51 Webinar Presented by: Blue Cross and Blue Shield of Texas December, A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.

2 Agenda Key Aspects of Texas Senate Bill 51 Legislation Example of Applied Texas Senate Bill 51 Legislation BCBSTX Operational Impacts / Changes Identified operational changes are based on BCBSTX current understanding of the statute Operational change implementation is subject to the release and review of the final rules for Texas Senate Bill 51 Frequently Asked Questions (FAQ) 2

3 Key Aspects of Texas Senate Bill 51 - Disclaimer Information provided within this presentation is informational in nature and subject to change, pending the release of the Texas Department of Insurance (TDI) Final Rules. Information contained in this presentation is for Group Policyholder use only and is not to be distributed. Target date for release of Texas Senate Bill 51 final rules is in NOTE: This legislation is not a BCBSTX initiative but a Texas Legislative requirement. 3

4 Key Aspects of Texas Senate Bill 51 4 Texas Senate Bill 51 Overview: Passed by the 79 th Texas Legislature regular session Amends Chapters 843 and 1301 of the Texas Insurance Code (TIC) Applies to all fully-insured (inclusive of Minimum Premium, Cost and Prospective Retention) PPO and HMO benefit plans issued, delivered, offered or renewed, on or after January 1, 2006 Applies to all Enrollees/Insureds and Dependents covered under fully insured PPO and HMO benefit plan lines of business Does not impact self-funded (ASO) plans including Point of Service (POS) contracts Requires for the premium payment and coverage after an enrollee s/insured s termination from a group policy Requires Dental and Vision Single Service HMO s to provide verifications and telephone system coverage

5 Key Aspects of Texas Senate Bill 51, continued Under the new Texas Senate Bill 51 legislation, Group Policyholders are: Liable for an enrollee s or insured s premium payments, from the time the enrollee or insured ceases to be eligible for coverage, until the end of the month in which the Group Policyholder notifies the HMO or insurer, that the enrollee or insured is no longer part of the group and eligible for coverage; and Required to provide coverage for the enrollee or insured, under the policy, until the end of the month in which notification is received by the benefit plan, carrier or insurer. 5

6 Key Aspects of Texas Senate Bill 51, continued Under the new Texas Senate Bill 51 legislation, Dental and Single Service HMO s are required to provide verifications and telephone system coverage as follows: Appropriate personnel must be available for verification and preauthorization of health care services for Dental and Vision Single Service HMO s between 8 a.m. and 5 p.m. Central Standard Time (CST) Monday through Friday for each day that is not a holiday; and Single Service HMO s must have a telephone system capable of accepting or recording incoming phone calls for verification after 5 p.m. Monday through Friday and all day on Saturday, Sunday and Legal Holidays. Responses are required to calls accepted or recorded, not later than the next business day, after the date the call is received. NOTE: BCBSTX does not currently offer Single Service HMO s. 6

7 Key Aspects of Texas Senate Bill 51, continued In relation to Texas Senate Bill 51, BCBSTX will define month as the contract period. The contract period is defined as the following as applicable: 1 st of the month Time period from the 1 st day of the calendar month to the last day of the calendar month. 15 th of the month Time period from the 15 th day of the calendar month to the 14 th day of the following calendar month. 7

8 Key Aspects of Texas Senate Bill 51, continued Who is affected by Texas SB 51? 8 Texas Issued Contracts: All fully insured PPO and HMO benefit plans that are issued, delivered, offered or renewed in the state of Texas; All Enrollees written under Texas contracts regardless of the State of residence. Out of State Issued Contracts: Enrollees located within the State of Texas, but covered by contracts issued in another state, will not be subject to SB51 legislation; BCBSTX s interpretation is that coverage documents issued in another State will contain the provisions required by the State of issue.

9 Example of Applied Texas Senate Bill 51 Legislation An enrollee/insured terms employment with the Group Policyholder on August 20, The Group Policyholder notifies the carrier on September 6, Under the new Senate Bill 51 requirements, the Group Policyholder is responsible for premium payment for the entire month of September 2006, in which the Group Policyholder notified the carrier. 9

10 BCBSTX Operational Impacts / Changes Group Policyholder responsibilities under Texas Senate Bill 51 include: Premium payments for enrollees and their dependents from the time the enrollee ceases to be eligible for coverage, until the end of the contract month, in which BCBSTX was notified of loss of coverage Payment of any and all applied past due premiums to the account if BCBSTX was not notified timely of the enrollee s and dependent s termination. NOTE: Failure to pay any past due premiums will result in delinquent account status and/or termination of the account. 10

11 BCBSTX Operational Impacts / Changes Impacts / changes to current BCBSTX procedures necessary to administer the requirements of Texas Senate Bill 51 include: Elimination of Retro membership terminations and / or Oddday terminations for: New groups effective January 1, 2006 and after; Existing groups on or after the anniversary date during 2006 (E.g. Groups with Option 35 will no longer have Odd-day terminations upon the 2006 anniversary date). NOTE: Retro membership terminations will be accepted, in certain instances, of the death of an enrollee on an employee only policy. 11

12 BCBSTX Operational Impacts / Changes Notification will be required to terminate coverage of an enrollee or insured. Appropriate forms of notification include: Blue Access for Employers (BAE) portal entry (Preferred Method) Completion and submission of the Coverage Change / Termination Form by the Group Policyholder representative through U.S. Mail or Completion and submission of the Group Enrollment Application / Change Form by the enrollee through U.S. Mail or Submission through the Automated Eligibility Processing (AEP) tape process NOTE: Verbal statements of an enrollee s or insured s termination will no longer be accepted by BCBSTX. 12

13 BCBSTX Operational Impacts / Changes Example of BCBSTX Group Enrollment Application/Change Form. Located on the Employer section of the BCBSTX public Website at

14 BCBSTX Operational Impacts / Changes Example of Coverage Change / Termination Form. Located on the Employer section of the BCBSTX public Website at

15 BCBSTX Operational Impacts / Changes BCBSTX will no longer allow Odd-day terminations within it s billing options. Billing changes for Group accounts include: 1 st of the month: Terminations will occur on the last day of the contract month in which BCBSTX is notified of enrollee/insured termination by the Group; and Premiums must be paid through the last day of the contract month in which BCBSTX is notified. 15 th of the month: Terminations will occur on the 14 th day of the following contract month in which BCBSTX is notified of enrollee/insured termination by the Group; and Premiums must be paid until the 14 th day of the following contract month in which BCBSTX is notified. 15

16 BCBSTX Operational Impacts / Changes BAE on-line entry provides the best and most timely method of ensuring the receipt of an enrollee s and dependent s termination notifications. BAE hours of availability are: Monday through Friday from 6:30 a.m. to 11:30 p.m. CT Saturday from 7:00 a.m. to 3:00 p.m. CT For more information on BAE: Visit the Employer section of BCBSTX public website at and click on the link to Take a Tour. You may also contact your BCBSTX representative for additional information. 16

17 BCBSTX Operational Impacts / Changes 17 In the event BAE is inaccessible, due to an unscheduled system outage, the following termination notification methods should be utilized: U.S. Mail: P.O. Box Dallas, Texas Address: An will be provided on the system outage message for emergency cancellation submissions Facsimile (Fax) Transmission: A facsimile (fax) number will be provided on the system outage message for emergency cancellation submissions Expedited Mail (UPS/FedEx/Courier): Current physical address of your Account Executive

18 BCBSTX Operational Impacts / Changes BCBSTX will interpret the receipt date of submitted termination notifications as follows: Blue Access for Employers (BAE) (Preferred Method) Date of on-line system entry Facsimile (Fax) Date stamp applied by receiving BCBSTX facsimile machine U.S. Postal Service Date correspondence is received by BCBSTX Postmarks will not be used as the dates received Date is received by BCBSTX processing office Tape Submission (AEP) Date the Group Policyholder representative transmits the data file containing the termination data to the BCBSTX processing office 18

19 BCBSTX Operational Impacts / Changes BCBSTX coverage documents targeted for revision include: Amending the Termination of Coverage articles in our PPO group contracts and HMO Certificates of Coverage. Language modifications will include the Texas Senate Bill 51 legislative requirements that coverage ends at the end of the contract month, in which the Group notifies the carrier, of the termination of enrollee. Amending the 2006 BCBSTX Group Renewal Letters for fullyinsured PPO and HMO groups to include high-level disclosures of the Texas Senate Bill 51 requirements. NOTE: BCBSTX does not issue Summary Plan Descriptions. 19

20 BCBSTX COBRA Administration Texas SB51 does not impact the current COBRA administration process for BCBSTX. Important Note: COBRA continuation is not mentioned in the Texas Senate Bill 51 statute, however: Failure of the Group Policyholder to notify the insurer/hmo of a loss of eligibility for the enrollee could impact the effective date of COBRA continuation coverage. 20

21 Frequently Asked Questions (FAQ s) Who can I talk to about the aspects of the Texas Senate Bill 51 legislation? Your State Representative To locate your State Representative you may view the Texas Legislature Online website: and select Who Represents Me? Texas Department of Insurance (TDI) TDI website or by phone at

22 Frequently Asked Questions (FAQ s) Where can I locate a copy of Texas Senate Bill 51 to view? The Senate Bill 51 Legislation can be accessed through the Texas Legislature Online Webpage at: ILLTYPE=B&BILLSUFFIX=00051&VERSION=5&TYPE=B 22

23 Questions? Should you have additional questions that are not addressed during this presentation, please contact your BCBSTX representative. 23

COBRA & Billing Administration Administration Services Guide. Welcome!

COBRA & Billing Administration Administration Services Guide. Welcome! Welcome! V4.4/2009 Table of Contents: Welcome Message COBRA & Billing Administrator Contact Information COBRA & Billing Administration Overview COBRA Administration Functions Procedures for Full COBRA

More information

Finding Your Way to Prompt Pay. Texas Department of Insurance

Finding Your Way to Prompt Pay. Texas Department of Insurance Finding Your Way to Prompt Pay TDI s Strategy Education Helping you find the way Enforcement Applicability Applicable to: HMOs Insured PPO Plans Not applicable to: Self-funded funded ERISA plans Indemnity

More information

TIPS. for Submitting New Regulated Small Groups (groups with 2 50 employees)

TIPS. for Submitting New Regulated Small Groups (groups with 2 50 employees) TIPS for Submitting New Regulated Small Groups (groups with 2 50 employees) Blue Cross and Blue Shield of Texas (BCBSTX) is committed to providing excellent service. These tips should be helpful as you

More information

BlueCHiP for Medicare 2016 Plan Selection Form

BlueCHiP for Medicare 2016 Plan Selection Form 2016 Plan Selection Form Date: c c / c c / c c c c Instructions: Complete the following sections 1. Provide Demographics 2. Choose your Medical Plan 3. Choose your Optional Supplemental Dental Plan 4.

More information

Services Available to Members Complaints & Appeals

Services Available to Members Complaints & Appeals Services Available to Members Complaints & Appeals Blue Cross and Blue Shield of Texas (BCBSTX) resolves complaints and appeals related to any aspect of service provided by itself or any subcontractor

More information

NEW COMMUNITY SMALL GROUP APPLICATION ( Application ) Blue Cross and Blue Shield of Montana (herein called BCBSMT)

NEW COMMUNITY SMALL GROUP APPLICATION ( Application ) Blue Cross and Blue Shield of Montana (herein called BCBSMT) Legal Name of Employer Group: NEW COMMUNITY SMALL GROUP APPLICATION ( Application ) Blue Cross and Blue Shield of Montana (herein called BCBSMT) Requested Contract(s) Policy(ies) Effective Date (1 st or

More information

Aetna Golden Medicare Plan Aetna Golden Choice Plan

Aetna Golden Medicare Plan Aetna Golden Choice Plan Group Administration Manual Aetna Golden Medicare Plan Aetna Golden Choice Plan 7A-31168 (12/03) Group Administration Manual Overview The Aetna Golden Medicare Plan and the Aetna Golden Choice Plan are

More information

Mutual Savings Credit Union Internet Banking/ Electronic Statement (e-statement) Disclosure Agreement

Mutual Savings Credit Union Internet Banking/ Electronic Statement (e-statement) Disclosure Agreement Mutual Savings Credit Union Internet Banking/ Electronic Statement (e-statement) Disclosure Agreement Internet Banking Mutual Savings Credit Union Internet Banking Agreement and Disclosure Agreement is

More information

A Reference Manual for Group Administrators. Connecticut. with Prime and Complete Dental Programs. www.anthem.com

A Reference Manual for Group Administrators. Connecticut. with Prime and Complete Dental Programs. www.anthem.com A Reference Manual for Group Administrators with Prime and Complete Dental Programs Connecticut www.anthem.com TABLE OF CONTENTS WELCOME TO ANTHEM BLUE CROSS AND BLUE SHIELD DENTAL PROGRAM / EMPLOYER SERVICES..1

More information

REQUEST FOR PROPOSAL FOR EMPLOYEE BENEFIT BROKERAGE CONSULTING SERVICES City of Poway

REQUEST FOR PROPOSAL FOR EMPLOYEE BENEFIT BROKERAGE CONSULTING SERVICES City of Poway REQUEST FOR PROPOSAL FOR EMPLOYEE BENEFIT BROKERAGE CONSULTING SERVICES City of Poway I. INVITATION The City of Poway is interested in obtaining the services of a professional, highly qualified benefits

More information

Administration Guide for Voluntary Group Insurance Plans Endorsed by California Teachers Association (CTA)

Administration Guide for Voluntary Group Insurance Plans Endorsed by California Teachers Association (CTA) Administration Guide for Voluntary Group Insurance Plans Endorsed by California Teachers Association (CTA) Standard Insurance Company SI 14723-CTAvol 1 of 22 (2/11) Administration Guide for Voluntary Group

More information

New Jersey State Continuation

New Jersey State Continuation 2010 New Jersey State Continuation For Groups Not Subject to COBRA Similar to COBRA, NJ State Continuation provides rights to employees to continue health insurance under certain conditions. Page 1 of

More information

Authorized By: Holly C. Bakke, Commissioner, Department of Banking and Insurance

Authorized By: Holly C. Bakke, Commissioner, Department of Banking and Insurance INSURANCE DEPARTMENT OF BANKING AND INSURANCE OFFICE OF THE COMMISSIONER Electronic Transactions Proposed New Rules: N.J.A.C. 11:1-47 Proposed Amendments: N.J.A.C. 11:3-15.4, 15.7, and 47.3 Authorized

More information

Group Health Plans. Information to help you administer your group health insurance program

Group Health Plans. Information to help you administer your group health insurance program Group Health Plans Employer s Administrative Guide Information to help you administer your group health insurance program Group Health Plans Administrative Instructions for Employers Welcome! Your administrative

More information

SMALL EMPLOYER GROUP APPLICATION INSTRUCTIONS

SMALL EMPLOYER GROUP APPLICATION INSTRUCTIONS SMALL EMPLOYER GROUP APPLICATION INSTRUCTIONS This form should be completed with the assistance of your authorized Broker or Horizon Healthcare of New York Sales Representative. Please be sure that all

More information

COBRA AND Cal-COBRA. What is COBRA?

COBRA AND Cal-COBRA. What is COBRA? COBRA AND Cal-COBRA What is COBRA? The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) is a federal law enacted to help prevent gaps in healthcare coverage. COBRA applies in general to companies

More information

Producers Administrative Guide to Selling Individual Plans in Oregon Spring 2014

Producers Administrative Guide to Selling Individual Plans in Oregon Spring 2014 Producers Administrative Guide to Selling Individual Plans in Oregon Spring 2014 Table of Contents Eligibility and Enrollment Periods... 2 Application Process Outside of the Exchange... 4 Premium Payments

More information

www.waycrossbankandtrust.com

www.waycrossbankandtrust.com www.waycrossbankandtrust.com To apply for Waycross Bank & Trust Internet Banking, complete, sign and mail to the following address or drop by: Waycross Bank & Trust C/O Internet Banking 501 Tebeau Street

More information

2015 Individual Enrollment Form for Medicare Prescription Drug Plan

2015 Individual Enrollment Form for Medicare Prescription Drug Plan PO Box 17168 Winston Salem, NC 271167168 (PDP) 2015 Individual Enrollment Form for Medicare Prescription Drug Plan Please contact BCBSNC if you need information in another language or format (Braille).

More information

Quick Guide to Blue Cross and Blue Shield Member ID Cards

Quick Guide to Blue Cross and Blue Shield Member ID Cards Program from Quick Guide to Blue Cross and Blue Shield Member A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

More information

Companion Life Insurance Company. Administrative Guide

Companion Life Insurance Company. Administrative Guide Companion Life Insurance Company Administrative Guide Contents Section.Title About Your Companion Life Administrative Guide I. Online Services II. New Enrollments Who is Eligible for insurance? Processing

More information

ONLINE BANKING DISCLOSURE/AGREEMENT

ONLINE BANKING DISCLOSURE/AGREEMENT ONLINE BANKING DISCLOSURE/AGREEMENT Rev 4/10 YOUR ACCEPTANCE OF THESE TERMS OF USE - ONLINE BANKING ("ONLINE BANKING TERMS") Meridian Bank requires all visitors who access its Online Banking to follow

More information

COBRA & DIRECT PAY JOB AID

COBRA & DIRECT PAY JOB AID Table of Contents TABLE OF CONTENTS COBRA & DIRECT PAY JOB AID 1 2 10/2014 Table of Contents... 3 Direct Pay... 5 Invoicing & Terms of Payment... 5 Premium Remittance... 6 Non-Sufficient Funds and Stop

More information

HMSA s. COBRA Assist INSTRUCTION GUIDE C ONSOLIDATED O MNIBUS B UDGET R ECONCILIATION A CT

HMSA s. COBRA Assist INSTRUCTION GUIDE C ONSOLIDATED O MNIBUS B UDGET R ECONCILIATION A CT HMSA s COBRA INSTRUCTION GUIDE To assist employers in meeting their obligations under the final federal COBRA regulations, HMSA s COBRA contains sample notices that incorporate the new requirements. As

More information

COMMISSIONS COMMISSION PAYMENTS COMMISSION SCHEDULES

COMMISSIONS COMMISSION PAYMENTS COMMISSION SCHEDULES COMMISSIONS COMMISSION PAYMENTS The Company pays commissions according to the applicable commission schedule on a monthly basis. Commission payments, along with an accounting statement, will be provided

More information

We encourage you to keep this Agreement for your records. If you have any questions, please contact a Customer Service Representative.

We encourage you to keep this Agreement for your records. If you have any questions, please contact a Customer Service Representative. Internet Banking Terms and Conditions Agreement This Agreement describes your rights and obligations as a user of the Internet Banking Service or the Bill Payment Service ("Service" or "Services"). It

More information

A Reference Manual for Brokers with Prime and Complete Dental Programs

A Reference Manual for Brokers with Prime and Complete Dental Programs A Reference Manual for Brokers with Prime and Complete Dental Programs empireblue.com TABLE OF CONTENTS WELCOME TO EMPIRE BLUE CROSS AND BLUE SHIELD DENTAL PROGRAM..1 WHO TO CONTACT..2 WEB SITE 3 NEW GROUP

More information

Request for Qualifications (RFQ) Insurance Broker/Consultation Services City of Shenandoah Employee Benefits Plan

Request for Qualifications (RFQ) Insurance Broker/Consultation Services City of Shenandoah Employee Benefits Plan Request for Qualifications (RFQ) Insurance Broker/Consultation Services City of Shenandoah Employee Benefits Plan I. GENERAL INFORMATION/PUBLISHING The City of Shenandoah, Texas (CITY) is accepting Qualification

More information

Direct Energy, LP. Terms of Service Direct Energy PrePaid Effective Date:

Direct Energy, LP. Terms of Service Direct Energy PrePaid Effective Date: Terms of Service Direct Energy PrePaid Effective Date: We are glad you have chosen Direct Energy, LP (hereafter referred to as Direct Energy, we or us ) to be your Retail Electric Provider ( REP ). This

More information

Employer Administration Guide. dental vision life disability

Employer Administration Guide. dental vision life disability Employer Administration Guide dental vision life disability Table of Contents Welcome 3 Contact Information 4 Customer Service 4 Claims 4 Provider Lookup 4 Website 4 Find it Online 5 Employee and Dependent

More information

Small Employer Group Application Instructions

Small Employer Group Application Instructions Small Employer Group Application Instructions Instructions The attached forms should be completed with the assistance of your authorized Broker or Horizon Blue Cross Blue Shield of New Jersey Sales Representative.

More information

Medicare Advantage Plan Information

Medicare Advantage Plan Information Medicare Advantage Plan Information Thank you for your interest in applying for the HealthNet Medicare Advantage plan. Below are links to the items which are part of the Enrollment Packet you would receive

More information

To activate this service, read agreement and sign the Signature Page, and return it to CBIA.

To activate this service, read agreement and sign the Signature Page, and return it to CBIA. INSTRUCTIONS: To activate this service, read agreement and sign the Signature Page, and return it to CBIA. CBIA COBRA / State Continuation Services 350 Church Street Hartford, CT 06103-1126 In addition,

More information

Family and Medical Leave

Family and Medical Leave University of California This checklist explains how your benefits are affected by an approved family and medical leave under UC policy, the amended California Family Rights Act of 1991, and the Federal

More information

General Notice. COBRA Continuation Coverage Notice (and Addendum)

General Notice. COBRA Continuation Coverage Notice (and Addendum) University Human Resources Benefits Office 3810 Beardshear Hall Ames, Iowa 50011-2033 515-294-4800 / 1-877-477-7485 Phone 515-294-8226 FAX General Notice And COBRA Continuation Coverage Notice (and Addendum)

More information

02 LC 28 0671-ECS (SCS) The Senate Insurance and Labor Committee offered the following substitute to SB 476: A BILL TO BE ENTITLED AN ACT

02 LC 28 0671-ECS (SCS) The Senate Insurance and Labor Committee offered the following substitute to SB 476: A BILL TO BE ENTITLED AN ACT The Senate Insurance and Labor Committee offered the following substitute to SB : A BILL TO BE ENTITLED AN ACT To provide a short title; to amend Title of the Official Code of Georgia Annotated, relating

More information

APPLICATION FOR GROUP HEALTH INSURANCE GROUP AND INDIVIDUAL DIVISION

APPLICATION FOR GROUP HEALTH INSURANCE GROUP AND INDIVIDUAL DIVISION APPLICATION FOR GROUP HEALTH INSURANCE GROUP AND INDIVIDUAL DIVISION BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA An Independent Licensee of the Blue Cross and Blue Shield Association, an Association of

More information

Peoples Online Services and E-Sign Agreement

Peoples Online Services and E-Sign Agreement Peoples Online Services and E-Sign Agreement This Peoples Online Services Agreement and Disclosure ("Agreement") explains the terms and conditions governing basic online services and bill pay services

More information

CONTINUATION AND CONVERSION POLICIES

CONTINUATION AND CONVERSION POLICIES CHAPTER 5 CONTINUATION AND CONVERSION POLICIES What are they? Who are they for? How to obtain coverage INTRODUCTION Continuation and conversion policies are for certain people who lose their group health

More information

FIRST FEDERAL BANK. OnLine Banking Customer Agreement

FIRST FEDERAL BANK. OnLine Banking Customer Agreement FIRST FEDERAL BANK OnLine Banking Customer Agreement This agreement for OnLine Banking service is entered into between First Federal Bank (the Bank ) and any Customer of the Bank who subscribes to or accesses

More information

Anthem Blue MedicareRx (PDP) Medicare Prescription Drug Plan Individual Enrollment Form 2016

Anthem Blue MedicareRx (PDP) Medicare Prescription Drug Plan Individual Enrollment Form 2016 Anthem Blue MedicareRx (PDP) Medicare Prescription Drug Plan Individual Enrollment Form 2016 Be sure to complete the entire enrollment form. Then, mail the completed form to P.O. Box 659403, San Antonio,

More information

A Guide to Working with Delta Dental of Minnesota. A Reference Manual for Brokers

A Guide to Working with Delta Dental of Minnesota. A Reference Manual for Brokers A Guide to Working with Delta Dental of Minnesota A Reference Manual for Brokers TABLE OF CONTENTS Welcome to Delta Dental of Minnesota 2 Who To Contact 3 Web Site 4 Agent of Record 5 Commissions 6 HIPAA

More information

Employee Enrollment Application Blue Shield of California Blue Shield plans for groups with 1-50 eligible employees Effective January 1, 2014

Employee Enrollment Application Blue Shield of California Blue Shield plans for groups with 1-50 eligible employees Effective January 1, 2014 Employee Enrollment Application Blue Shield of California Blue Shield plans for groups with 1-50 eligible employees Effective January 1, 2014 * Please note: It is very important that all questions be answered.

More information

COBRA ADMINISTRATIVE SERVICES AGREEMENT

COBRA ADMINISTRATIVE SERVICES AGREEMENT COBRA ADMINISTRATIVE SERVICES AGREEMENT This Administrative Services Agreement ( Agreement ) is hereby made between Providence Health Plan ( Providence ) and the Employer ( Employer ) and applies to all

More information

SANGER BANK ONLINE BANKING AGREEMENT AND DISCLOSURE

SANGER BANK ONLINE BANKING AGREEMENT AND DISCLOSURE SANGER BANK ONLINE BANKING AGREEMENT AND DISCLOSURE This Online Banking Agreement and Disclosure ("Agreement") describes your rights and obligations as a user of the Online Banking service or the Bill

More information

IMPORTANT INFORMATION ABOUT YOUR COBRA CONTINUATION COVERAGE RIGHTS

IMPORTANT INFORMATION ABOUT YOUR COBRA CONTINUATION COVERAGE RIGHTS IMPORTANT INFORMATION ABOUT YOUR COBRA CONTINUATION COVERAGE RIGHTS What is continuation coverage? Federal law requires that most group health plans (including this Plan) give employees and their families

More information

SUBCHAPTER R. UTILIZATION REVIEWS FOR HEALTH CARE PROVIDED UNDER A HEALTH BENEFIT PLAN OR HEALTH INSURANCE POLICY 28 TAC 19.1701 19.

SUBCHAPTER R. UTILIZATION REVIEWS FOR HEALTH CARE PROVIDED UNDER A HEALTH BENEFIT PLAN OR HEALTH INSURANCE POLICY 28 TAC 19.1701 19. Part I. Texas Department of Insurance Page 1 of 244 SUBCHAPTER R. UTILIZATION REVIEWS FOR HEALTH CARE PROVIDED UNDER A HEALTH BENEFIT PLAN OR HEALTH INSURANCE POLICY 28 TAC 19.1701 19.1719 SUBCHAPTER U.

More information

Dilley State Bank RETAIL (Personal) ONLINE BANKING AGREEMENT - GENERAL TERMS AND CONDITIONS

Dilley State Bank RETAIL (Personal) ONLINE BANKING AGREEMENT - GENERAL TERMS AND CONDITIONS 1) Applicability This Agreement and Initial Disclosures (the "Agreement") governs your use of online banking. By subscribing to online banking or using online banking, you agree to the terms of this Agreement.

More information

Horizon Blue Cross Blue Shield of New Jersey Amendments to Chapter Law 375 Revisions to the Dependent to Age 30 Continuation Benefit

Horizon Blue Cross Blue Shield of New Jersey Amendments to Chapter Law 375 Revisions to the Dependent to Age 30 Continuation Benefit Horizon Blue Cross Blue Shield of New Jersey Amendments to Chapter Law 375 Revisions to the Dependent to Age 30 Continuation Benefit Questions and Answers General Q1. What does the amendment to Chapter

More information

SUBCHAPTER F. Group Health Insurance Mandatory Conversion Privilege 28 TAC 3.501-3.520

SUBCHAPTER F. Group Health Insurance Mandatory Conversion Privilege 28 TAC 3.501-3.520 Part I. Texas Department of Insurance Page 1 of 6 SUBCHAPTER F. Group Health Insurance Mandatory Conversion Privilege 28 TAC 3.501-3.520 1. INTRODUCTION. The commissioner of insurance adopts the repeal

More information

Member s Name First M.I. Last Dependent s Name (if enrolling in Medicare) First M.I. Last

Member s Name First M.I. Last Dependent s Name (if enrolling in Medicare) First M.I. Last Oklahoma State and Education Employees Group Insurance Board A Division of the Office of State Finance APPLICATION FOR MEDICARE SUPPLEMENT WITH PART D Member ID # *MCENRL* Phone ( ) Member s Name First

More information

2015 Individual Enrollment Form

2015 Individual Enrollment Form 2015 Individual Enrollment Form Easy ways to enroll: Fill out the enrollment form and return it in the postagepaid return envelope Enroll online at www.yourmedicaresolutions.com Contact your licensed sales

More information

Tips & Tools for Successful. Created by Choice Strategies

Tips & Tools for Successful. Created by Choice Strategies Tips & Tools for Successful Implementation Created by Choice Strategies Implementation www.choice-strategies.com Broker Implementation Tools: Enrollment Forms Welcome Kits Submit New Group Submit New Group:

More information

New York COBRA Continuation Coverage Q&A

New York COBRA Continuation Coverage Q&A New York COBRA Continuation Coverage Q&A IMPORTANT NOTE: All statements contained in this Q&A document are for informational purposes only and should not be viewed as either legal or income tax advice.

More information

Coverage Application and Social Security Disability Extension

Coverage Application and Social Security Disability Extension Coverage Application and Social Security Disability Extension COBRA Qualifying Events Who is Eligible? Any individual who, on the day before a qualifying event, is covered under a group health plan either

More information

New York Dependent to Age 29 Frequently Asked Questions

New York Dependent to Age 29 Frequently Asked Questions New York Dependent to Age 29 Frequently Asked Questions Governor David A. Paterson signed into law Chapter 240 of the Laws of 2009, which extends the availability of health insurance coverage to young

More information

Security Service Federal Credit Union (SSFCU) Mobile Banking Application Services Agreement

Security Service Federal Credit Union (SSFCU) Mobile Banking Application Services Agreement Security Service Federal Credit Union (SSFCU) Mobile Banking Application Services Agreement This Agreement sets forth the terms and conditions for use of Security Service Federal Credit Union s Mobile

More information

Security First Bank Consumer Online Banking Information Sheet, Access Agreement and Disclosures

Security First Bank Consumer Online Banking Information Sheet, Access Agreement and Disclosures Security First Bank Consumer Online Banking Information Sheet, Access Agreement and Disclosures Welcome to Online Banking with Security First. This Online Banking Agreement and Disclosure (Agreement) discusses

More information

STATE OF OREGON DEPARTMENT OF CONSUMER & BUSINESS SERVICES INSURANCE DIVISION. Quarterly Health Enrollment Report Instructions Revised April 16, 2015

STATE OF OREGON DEPARTMENT OF CONSUMER & BUSINESS SERVICES INSURANCE DIVISION. Quarterly Health Enrollment Report Instructions Revised April 16, 2015 Page 1 of 10 STATE OF OREGON DEPARTMENT OF CONSUMER & BUSINESS SERVICES INSURANCE DIVISION Quarterly Health Enrollment Report Instructions Revised April 16, 2015 A. HISTORY AND PURPOSE Since 1996, the

More information

Frequently Asked Questions: How Health Reform Law Protects Patients

Frequently Asked Questions: How Health Reform Law Protects Patients Frequently Asked Questions: How Health Reform Law Protects Patients In this section: Grandfathered Health Plans Patient Protections Medical Loss Ratio (MLR) Summary of Benefits and Coverage Grandfathered

More information

EPK & Associates, Inc. MBA Health Insurance Trust Administrative Manual Regence. MBA HEALTH INSURANCE TRUST Administrative Manual

EPK & Associates, Inc. MBA Health Insurance Trust Administrative Manual Regence. MBA HEALTH INSURANCE TRUST Administrative Manual EPK & Associates, Inc. MBA Health Insurance Trust Administrative Manual MBA HEALTH INSURANCE TRUST Administrative Manual Key Contacts For answers to questions about benefits issues and for help with claims

More information

Please review all plan information carefully before making your selection. Once you have selected a plan, make sure you:

Please review all plan information carefully before making your selection. Once you have selected a plan, make sure you: Instructions on How to Fill Out the Blue MedicareRx SM (PDP) Enrollment Form NOTE: If you would like to save time and enroll online in one of our Blue MedicareRx plans, please go to www.rxmedicareplans.com,

More information

STATE CONTINUATION RIGHTS. from YOUR North Carolina Department of Insurance. what HAPPENS TO MY IF MY JOB STATUS CHANGES?

STATE CONTINUATION RIGHTS. from YOUR North Carolina Department of Insurance. what HAPPENS TO MY IF MY JOB STATUS CHANGES? A CONSUMER'S GUIDE TO STATE CONTINUATION RIGHTS from YOUR North Carolina Department of Insurance what HAPPENS TO MY health Insurance COVERAGE IF MY JOB STATUS CHANGES? CONSUMER'SGUIDE A MESSAGE FROM YOUR

More information

CONTINUATION COVERAGE NOTIFICATION (COBRA)

CONTINUATION COVERAGE NOTIFICATION (COBRA) CONTINUATION COVERAGE NOTIFICATION (COBRA) This notice has important information about your right to continue your health coverage in the Texas Employees Group Benefits Program (GBP), as well as other

More information

Mississippi State and School Employees Life Insurance Plan Group Term Life Insurance

Mississippi State and School Employees Life Insurance Plan Group Term Life Insurance Mississippi State and School Employees Life Insurance Plan Group Term Life Insurance The Health Insurance Management Board is authorized by state law to provide certain specified group life insurance benefits

More information

ONLINE BANKING AGREEMENT

ONLINE BANKING AGREEMENT ONLINE BANKING AGREEMENT Online Bill Pay Terms and Conditions What this Terms and Conditions addresses: Payments and Transfers Payment Delivery Non-Business Hour Days Payment Notification Payment Guarantee

More information

Online Banking Agreement & Disclosure

Online Banking Agreement & Disclosure Online Banking Agreement & Disclosure This Agreement provides information about the CITIZENS FIRST Online Banking service and contains the disclosures required by the Electronic Funds Transfer Act, as

More information

WELCOME TO DEARBORN NATIONAL

WELCOME TO DEARBORN NATIONAL www.dearbornnational.com WELCOME TO DEARBORN NATIONAL UNDERWRITTEN BY DEARBORN NATIONAL LIFE INSURANCE COMPANY Guide to List Billing Products and services marketed under the Dearborn National brand and

More information

Important information regarding Healthy Choices / Avesis Vision Plans:

Important information regarding Healthy Choices / Avesis Vision Plans: Important information regarding Healthy Choices / Avesis Vision Plans: Q. When is the last date an agent can submit a vision case? A. We will take a vision case up to the 5 th day of the effective month.

More information

FAQs: Medicare Eligible Retiree Medical Coverage

FAQs: Medicare Eligible Retiree Medical Coverage FAQs: Medicare Eligible Retiree Medical Coverage June 2014 What is changing? Effective September 1, 2014, current retirees of Emory University and Emory Healthcare who are age 65 or older and Medicare

More information

State Of New Hampshire DIVISION OF PERSONNEL Department of Administrative Services State House Annex 28 School Street Concord, New Hampshire 03301

State Of New Hampshire DIVISION OF PERSONNEL Department of Administrative Services State House Annex 28 School Street Concord, New Hampshire 03301 State Of New Hampshire DIVISION OF PERSONNEL Department of Administrative Services State House Annex 28 School Street Concord, New Hampshire 03301 LINDA M. HODGDON Commissioner SARA J. WILLINGHAM Director

More information

Business Online Bill Pay Terms and Conditions

Business Online Bill Pay Terms and Conditions Business Online Bill Pay Terms and Conditions This Online Bill Pay Terms and Conditions ("Agreement") is between Customer and Spring Bank for the delivery of Business Online Bill Pay as described below:

More information

CONSUMER ONLINE BANKING DISCLOSURE AND AGREEEMENT

CONSUMER ONLINE BANKING DISCLOSURE AND AGREEEMENT CONSUMER ONLINE BANKING DISCLOSURE AND AGREEEMENT This Agreement describes your rights and obligations as a user of the Online Banking service and/or the Bill Payment and Presentment service ("Services").

More information

University of California Un H i u ve m r a s n it e o s f o C uracliefsornia ces COVERED 2016 Open Enrollment Oct. 29 Nov.

University of California Un H i u ve m r a s n it e o s f o C uracliefsornia ces COVERED 2016 Open Enrollment Oct. 29 Nov. ARE YOU COVERED? 2016 Open Enrollment Retirees in Medicare Outside of California Oct. 29 Nov. 24, 2015 YOUR OPEN ENROLLMENT TO DO LIST: FOR YOUR MEDICAL PLAN If you re new to the Medicare Coordinator Program,

More information

Please complete electronically, or in blue or black ink only. Employer name Group no. Subsection

Please complete electronically, or in blue or black ink only. Employer name Group no. Subsection Employee Enrollment Application For 51+ Employee s Georgia You, the employee, must complete this application. You are solely responsible for its accuracy and completeness. To avoid the possibility of delay,

More information

FUNDAMENTALS OF HEALTH INSURANCE: What Health Insurance Products Are Available?

FUNDAMENTALS OF HEALTH INSURANCE: What Health Insurance Products Are Available? http://www.naic.org/ FUNDAMENTALS OF HEALTH INSURANCE: PURPOSE The purpose of this session is to acquaint the participants with the basic principles of health insurance, areas of health insurance regulation

More information

Frequently Asked Questions (FAQs) for

Frequently Asked Questions (FAQs) for Frequently Asked Questions (FAQs) for AT&T Medicare-Eligible Retirees and Medicare-Eligible Dependents Transitioning to the Aon Retiree Health Exchange ( the Aon Exchange ) These questions and answers

More information

An Employee Guide to:

An Employee Guide to: An Employee Guide to: Medical/Health Care Spending Account Dependent Care Spending Account 2015 *** IMPORTANT *** ENROLLMENT IN THE FLEXIBLE SPENDING ACCOUNTS IS ONLY VALID FOR ONE CALENDAR YEAR. YOU MUST

More information

Plan Administrator s Quick Reference Guide

Plan Administrator s Quick Reference Guide FOR EMPLOYERS Plan Administrator s Quick Reference Guide It s easy to administer your health plan... 2 Online tools for plan administration... 3 Helpful Web tips... 5 Eligibility and enrollment... 6 Special

More information

Group Marketing Services, Inc. GROUP HEALTH INSURANCE HAS NEVER BEEN SO EASY

Group Marketing Services, Inc. GROUP HEALTH INSURANCE HAS NEVER BEEN SO EASY Group Marketing Services, Inc. GROUP HEALTH INSURANCE HAS NEVER BEEN SO EASY GROUP MARKETING SERVICES, INC. Overview What is Group Insurance? Insurance coverage purchased by an employer for the benefit

More information

SALEM FIVE ONLINE BANKING AGREEMENT

SALEM FIVE ONLINE BANKING AGREEMENT SALEM FIVE ONLINE BANKING AGREEMENT What This Agreement Covers This agreement (the Agreement ) between you and Salem Five Cents Savings Bank ( we, our, us, or Salem Five ) governs your use of Salem Five

More information

TRUCHOICE FEDERAL CREDIT UNION CONSENT FOR ELECTRONIC DISCLOSURES UNDER THE ELECTRONIC SIGNATURES IN GLOBAL AND NATIONAL COMMERCE ACT

TRUCHOICE FEDERAL CREDIT UNION CONSENT FOR ELECTRONIC DISCLOSURES UNDER THE ELECTRONIC SIGNATURES IN GLOBAL AND NATIONAL COMMERCE ACT TRUCHOICE FEDERAL CREDIT UNION CONSENT FOR ELECTRONIC DISCLOSURES UNDER THE ELECTRONIC SIGNATURES IN GLOBAL AND NATIONAL COMMERCE ACT Please read this information carefully and print a copy and/or retain

More information

ONLINE EXPRESS INTERNET BANKING CUSTOMER AGREEMENT

ONLINE EXPRESS INTERNET BANKING CUSTOMER AGREEMENT ONLINE EXPRESS INTERNET BANKING CUSTOMER AGREEMENT This Agreement is entered into between Farmers Trust & Savings Bank (the "Bank") and any customer of the Bank who subscribes to the Bank s Online Express

More information

Member Administration

Member Administration Member Administration I.2 Member Identification Cards I.4 Provider and Member Rights and Responsibilities I.5 Identifying Members and Verifying Eligibility I.9 Determining Primary Insurance Coverage I.16

More information

SMALL GROUP EMPLOYER APPLICATION FOR AMENDMENT

SMALL GROUP EMPLOYER APPLICATION FOR AMENDMENT SMALL GROUP EMPLOYER APPLICATION FOR AMENDMENT You have the option to choose a Consumer Choice of Benefits Health Insurance Plan or Consumer Choice of Benefits Health Maintenance Organization health care

More information

COBRA Procedures Template for Help Desk Subscribers Integrated with the Instant Click Notices

COBRA Procedures Template for Help Desk Subscribers Integrated with the Instant Click Notices COBRA Procedures Template for Help Desk Subscribers Integrated with the Instant Click Notices These COBRA Procedures are being provided to you as a template in Adobe Acrobat pdf format in order to protect

More information

SENATE BILL 1419 AN ACT

SENATE BILL 1419 AN ACT House Engrossed Senate Bill State of Arizona Senate Forty-ninth Legislature Second Regular Session SENATE BILL AN ACT AMENDING TITLE, CHAPTER, ARTICLE, ARIZONA REVISED STATUTES, BY ADDING SECTION -; AMENDING

More information

CASTLE ROCK BANK ONLINE BANKING AGREEMENT AND DISCLOSURE

CASTLE ROCK BANK ONLINE BANKING AGREEMENT AND DISCLOSURE CASTLE ROCK BANK ONLINE BANKING AGREEMENT AND DISCLOSURE This Online Banking Agreement and Disclosure ("Agreement") describes your rights and obligations as a user of the Online Banking service or the

More information

GROUP HEALTH INSURANCE INITIAL CONTINUATION NOTIFICATION

GROUP HEALTH INSURANCE INITIAL CONTINUATION NOTIFICATION Human Resources Development 200 Bloomfield Avenue West Hartford, CT 06117 www.hartford.edu/hrd Street City, State, Zip Code Date of Notification: Coverage Effective Date: RE: GROUP HEALTH INSURANCE INITIAL

More information

HEALTH INSURANCE PREMIUM PAYMENT (HIPP) REIMBURSEMENT PROGRAM 1.0 BACKGROUND. Office of Employee Benefits EFFECTIVE DATE: SEPTEMBER 1, 2001

HEALTH INSURANCE PREMIUM PAYMENT (HIPP) REIMBURSEMENT PROGRAM 1.0 BACKGROUND. Office of Employee Benefits EFFECTIVE DATE: SEPTEMBER 1, 2001 Office of Employee Benefits Administrative Manual HEALTH INSURANCE PREMIUM PAYMENT (HIPP) REIMBURSEMENT PROGRAM 260 EFFECTIVE DATE: SEPTEMBER 1, 2001 REVISION DATE: MARCH 2003; SEPT. 2008 PURPOSE: To provide

More information

User Guide. COBRA Employer Manual

User Guide. COBRA Employer Manual Experience Excellence COBRA Manual User Guide COBRA Employer Manual COBRA Responsibilities and Deadlines Under COBRA, specific notices must be provided to covered employees and their families explaining

More information

FIRST REPUBLIC BANK ONLINE BANKING AGREEMENT

FIRST REPUBLIC BANK ONLINE BANKING AGREEMENT FIRST REPUBLIC BANK ONLINE BANKING AGREEMENT I. Introduction This Agreement between you and First Republic Bank ("Bank"), governs the use of the Bank's Internet Banking services ("Online Banking"). These

More information

Billing and Payment. Chapter

Billing and Payment. Chapter Chapter 3 Billing and Payment Capital BlueCross billing process is simple. For our insured customers, we create a bill each month that is based on the information in our files as of the date the bill was

More information

Early Intervention Service Coordination Public and Private Insurance Use Determination

Early Intervention Service Coordination Public and Private Insurance Use Determination Early Intervention Service Coordination Public and Private Insurance Use Determination POLICY 1. Families whose children are enrolled under private insurance plans are required to use their child s benefits

More information

Paperwork Submission Instructions:

Paperwork Submission Instructions: Client Profile New Business Application Paperwork Submission Instructions: The following forms are to be completed and returned to CONEXIS Services Agreement and Fee Appendix New Business Application COBRA

More information

Frequently Asked Questions- New York State COBRA extension

Frequently Asked Questions- New York State COBRA extension Frequently Asked Questions- New York State COBRA extension When does this law take effect? The law is effective for policies or contracts issued, renewed, modified, altered or amended on or after July

More information

Please contact Blue Cross MedicareRx if you need information in another language or format (Braille).

Please contact Blue Cross MedicareRx if you need information in another language or format (Braille). Blue Cross MedicareRx SM Medicare Prescription Drug Plan Individual Enrollment Form Please contact Blue Cross MedicareRx if you need information in another language or format (Braille). To enroll in Blue

More information

02 SB476/CSFA/3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:

02 SB476/CSFA/3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA: Senate Bill By: Senators Thompson of the rd, Stokes of the rd, Tanksley of the nd and Hecht of the th AS PASSED SENATE A BILL TO BE ENTITLED AN ACT To provide a short title; to amend Title of the Official

More information

NOTICES OF PROPOSED RULEMAKING

NOTICES OF PROPOSED RULEMAKING NOTICES OF PROPOSED RULEMAKING Unless exempted by A.R.S. 41-1005, each agency shall begin the rulemaking process by first submitting to the Secretary of State s Office a Notice of Rulemaking Docket Opening

More information

Online Banking Agreement

Online Banking Agreement Online Banking Agreement Please read this Agreement carefully before accessing or using Morgan Federal Bank s Online Banking Services. By accessing or using these Services, you agree to be bound by the

More information