DISCOUNT MEDICAL PLAN INFORMATION BOOKLET VISION HEARING CHIROPRACTIC DENTAL PRESCRIPTION DRUGS VITAMINS & NUTRITIONAL SUPPLEMENTS 24-HOUR NURSELINE THIS IS AN OPTIONAL NONINSURANCE PLAN. UAPB-TC UAI0497 0111
This booklet and your other membership materials provide information (such as discount percentages) that is current as of July 2008. This booklet and your other membership materials are not a contract (except in Florida) and do not add to or otherwise vary the terms of the agreement set forth in your application form. For updated information on available discount medical services and maximums, please contact the participating location directly. NOTE: UA PARTNERS DISCOUNTS CANNOT BE USED IN CONJUNCTION WITH ANY OTHER DISCOUNT PLAN. Disclosure: This plan is NOT insurance. This plan is optional. The plan provides discounts at certain health care providers for medical services. The plan does not make payments directly to the providers of medical services. The plan member is obligated to pay for all health care services but will be entitled to receive a discount from those health care providers who have contracted with the discount medical plan organization. The range of discounts for services offered will vary depending on the type of provider and service. Discounts on hospital services are not available in Maryland. This is not a Medicare prescription drug plan. This plan is administered by Coverdell & Company, Inc., a discount medical plan organization at 8770 W. Bryn Mawr, Suite 1000, Chicago, IL 60631, 1-800- 308-0374, www.findbestbenefits.com. You have the right to cancel this plan within 30 days of the effective date for a full refund of fees paid. Note to Texas Consumers: Regulated by the Texas Department of Licensing and Regulation, PO Box 12157, Austin, Texas 78711; telephone 1-800-803-9202 or 1-512-463-6599; website: www.license.state.tx.us/complaints.
DISCOUNT MEDICAL PLAN WELCOME UA PARTNERS MEMBER This is not insurance. This is an optional noninsurance plan available for a separate fee. Carefully review your UA Partners discount medical plan membership materials which include this UA Partners information booklet, your personalized UA Partners membership identification card and any additional convenient resource pamphlet(s) like the 24-Hour Nurseline pamphlet. HOW DO I ACCESS THE DISCOUNT MEDICAL PLAN? If you are having a prescription filled by a participating pharmacy, be sure to give the pharmacist your UA Partners membership identification card with the prescription. Present your UA Partners membership identification card when you arrive and again before paying for healthcare services or products. WHAT IF I HAVE A QUESTION ABOUT THE DISCOUNT MEDICAL PLAN? Call toll free 1-800-308-0374 to speak to a customer service representative about the plan or to find participating locations. Even if you are traveling, our customer service representatives use a geographic locator program that will provide you with participating locations in that area. Just have the ZIP code or city name ready when you call. DO YOU HAVE A WEBSITE I CAN USE TO FIND PARTICIPATING LOCATIONS? Yes, visit www.findbestbenefits.com and use promo code 744402 to find the participating vision, hearing, dental, chiropractic, or prescription retailer in your area.
VISION UA Partners offers its members 20% to 60% discounts on eyeglasses, contact lenses (excluding disposable), and other retail eye wear items through a network of more than 12,000 eye care professionals nationwide, including JCPenney, LensCrafters, Pearle Vision, Sears Optical and Target Optical. In addition, members can receive discounts of 10% to 30% on eye examinations and surgical procedures, including LASIK, where available. Most frames, lenses, and specialty items such as tints, scratch resistant coatings and ultraviolet protection are available. There are no limits on the number of times you may use the UA Partners vision discount during the year. Simply present your UA Partners membership identification card at the participating optical location and you will be eligible to receive the membership price. Since the UA Partners plan is not insurance, there are no forms to file. HOW TO USE YOUR VISION DISCOUNT To select a participating vision location, call 1-800-308-0374, or visit www.findbestbenefits.com and use promo code 744402. When calling a participating vision location for an appointment, tell them you are a member of the Coast to Coast vision network. Be sure to present your UA Partners membership identification card both when you arrive, and again before paying for any health care services or products. Select the eye wear and lenses of your choice. Almost all lenses, colors, sizes, and add-ons, such as ultraviolet protection, scratch coating, and tints are eligible for the UA Partners vision discount. There are no limits to the number of times you may use your UA Partners vision discount. UAINS-406 4
Replacement Contact Lenses Replacement contact lenses can be ordered through the mail order service with a 10% to 40% savings through UA Partners. Call 1-800-878-3901 and give the operator the brand and type of lens you use for a price quote over the phone. Most major brands of soft contact lenses are available including disposable, torics, bifocals and gas permeable lenses. Mail a valid doctor s contact lens prescription to: America s Eye Wear, P.O. Box 810255, Farmers Branch, Texas, 75381, and include your name and I.D. Number from your UA Partners membership identification card. You may place orders as often as you wish prior to the expiration date of the prescription. You can also fax a doctor s contact lens prescription to 1-972-503-5671. Most orders are received within seven to 14 days and can be paid for by Visa, MasterCard, money order, or check. 30-Day Unconditional Guarantee Your satisfaction is guaranteed. If for any reason you are not happy with a purchase at the retail locations or through the mail, return the merchandise within 30 days for an exchange or full refund. If you find a lower price anywhere else on the exact same pair of prescription eyeglasses purchased at a participating location within 30 days, the difference will be refunded. NOTE: UA PARTNERS DISCOUNTS CANNOT BE USED IN CONJUNCTION WITH ANY OTHER DISCOUNT PLAN. UAINS-406 5
HEARING UA Partners hearing discounts are provided by one of the largest networks of audiologists in the United States. UA Partners offers its members savings on the following hearing services and products. Charges cannot exceed the maximums published in the following schedules. Hearing Tests & Price Comparisons SERVICE Comprehensive Audiometry Pure-tone air and bone conduction, word recognition measures AVERAGE PRICE UA PARTNERS MAXIMUM CHARGE $135 $49 ($59 in CA, NY) YOU SAVE* $86 Acoustic Immittance Test Battery $114 $35 $79 Environmental Risk Consultation Discussion of daily noise exposure, recommendations for hearing protection No Charge Hearing Aid Evaluation $135 No Charge $135 * All estimates are based on national average costs. Actual savings may vary per region. Hearing Aids UA Partners members receive a 10% to 20% savings from the participating location's usual fees on hearing aids (10% off programmable or digital hearing aids), hearing aid repairs, as well as related hearing products (excluding batteries). An additional charge may apply to an earmold for a Behind-the-Ear (BTE) Hearing Aid. There is no charge for an annual cleaning and check of hearing aids purchased through the UA Partners hearing discount. Any hearing aid not defined below is reduced 20% from the participating location's usual charge. AVERAGE UA PARTNERS YOU SERVICE PRICE MAXIMUM CHARGE SAVE* In-The-Ear (ITE) $873 $670 $203 In-The-Canal (ITC) $1,051 $770 $281 Behind-The-Ear (BTE) $880 $695** $185 Planmable or Digital Hearing Aid Varies 10% Savings * All estimates are based on national average costs. Actual savings may vary per region. ** Plus a custom earmold charge, if required. UAINS-405 6
During the first year from date of delivery, the retailer will replace any hearing aid with the same model if it has been repaired three times or more through no fault of the UA Partners member. UA Partners members will also receive a free loaner during any repair period if the style permits. In addition, there are no dispensing fees for UA Partners members. An unconditional 45-day refund on hearing aids will be provided to the UA Partners member. However, the retailer shall be entitled to retain a fee of $35 per returned hearing aid plus a custom earmold charge, if required. Return policies vary from state to state. HOW TO USE YOUR HEARING DISCOUNT To select a participating location, call 1-800-308-0374, or visit www.findbestbenefits.com and use promo code 744402. When calling a participating location for an appointment, tell them you are a member of the HearUSA network. Be sure to present your UA Partners membership identification card both when you arrive, and again before paying for any healthcare services or products. NOTE: UA PARTNERS DISCOUNTS CANNOT BE USED IN CONJUNCTION WITH ANY OTHER DISCOUNT PLAN. UAINS-405 7
CHIROPRACTIC UA Partners members have access to one of the largest networks of chiropractors in the United States. This chiropractic network provides UA Partners members with savings of 20% to 40% on their usual fees. SERVICE YOU PAY* Consultation No Charge Examination $35 X-Rays - AP & Lat. Cervical $40 - AP & Lat. Thoracic $40 - Full Spine $100 * All estimates are based on national average costs. Actual savings may vary per region. HOW TO USE YOUR CHIROPRACTIC DISCOUNT To select a participating chiropractor, call 1-800-308-0374, or visit www.findbestbenefits.com and use promo code 744402. When calling a participating chiropractor for an appointment, tell them you are a member of the UNI-CARE chiropractic network. Be sure to present your UA Partners membership identification card both when you arrive, and again before paying for any healthcare services or products. NOTE: UA PARTNERS DISCOUNTS CANNOT BE USED IN CONJUNCTION WITH ANY OTHER DISCOUNT PLAN. UAINS-404 8
DENTAL UA Partners members will realize significant savings on dental care expenses through one of the largest, independent networks of dental providers nationwide. Simply present your UA Partners membership card to any one of the more than 24,000 offices (including specialists where available) to receive discounted rates on dental procedures. You can save 10% to 50% on dental care expenses. When visiting a participating dental office, present your UA Partners membership identification card prior to treatment to be assured that the proper discount is applied. Participating offices and fees may change at any time. UA Partners is designed to save money not only on routine and preventive dental care, but also on more extensive dental treatments. Services available with UA Partners discounts include: Orthodontic (braces) Dentures Cosmetic dentistry Crowns Extractions Fillings Oral Surgery Periodontics HOW TO USE YOUR DENTAL DISCOUNT To select a participating dental office, call 1-800-308-0374, or visit www.findbestbenefits.com and use promo code 744402. When calling a participating dental office for an appointment, tell them you are a member of the UNI-CARE dental network. Be sure to present your UA Partners membership identification card both when you arrive, and again before paying for any healthcare services or products. NOTE: IF YOU HAVE A DENTAL INSURANCE PLAN THAT IS NOT A PPO OR HMO AND YOU SEE A PARTICIPATING DENTIST, YOU CAN USE YOUR UA PARTNERS MEMBERSHIP CARD TO RECEIVE ADDITIONAL SAVINGS. THIS IS NOT A PREPAID PLAN. UAINS-410 9
PRESCRIPTION DRUGS UA Partners offers immediate discounts on prescription drugs at participating pharmacies. Members can save an average of 20% off the retail price of prescription drugs with significant savings on generic drugs. Members can obtain savings at approximately 50,000 pharmacies nationwide. Members simply choose a participating pharmacy and present their UA Partners membership identification card to the pharmacist in order to receive a discount. The member s cost for the medication will be the discount price offered through the plan or the pharmacy s usual price, whichever is lower. Members are assured the lowest price in that store at the time the medication is purchased. SOME MAJOR CHAIN PARTICIPANTS INCLUDE: ALBERTSON S GIANT EAGLE PHARMACY SHOP N SAVE PHARMACY ANCHOR PHARMACY KERR DRUG SHOPRITE PHARMACY BI-LO PHARMACY KROGER DRUGSTORE SMITH S PHARMACY BROOKSHIRE PHARMACY MEDICAP PHARMACY SUPER D DRUGS COSTCO MEIJER PHARMACY TARGET PHARMACY CUB PHARMACY PATHMARK PHARMACY THRIFTY WHITE DRUG DILLON PHARMACY PHAR-MOR VONS PHARMACY DOMINICKS PHARMACY PRICE CHOPPER WALGREEN S DRUG EMPORIUM PUBLIX PHARMACY WAL-MART PHARMACY FRED S PHARMACY RITE AID PHARMACY WESTERN DRUG GENOVESE DRUG STORE SAFEWAY WINN-DIXIE PHARMACY SHOPKO PHARMACY PLUS THOUSANDS OF INDEPENDENT LOCATIONS MAIL ORDER SERVICE You can use the mail order service anytime, but it is most convenient when ordering medication that is taken on a regular basis. New Prescriptions To request a mail order form, call customer service at 1 800 308 0374. The mail order form will provide the address to which you will send your mail order form, an original written prescription from your doctor, and prepayment by check, money order, or credit card. UAINS-409 10
Refills If a credit card is used, refills can be ordered by calling Caremark customer service at 1-877-321-2652 or visit their web site at www.caremark.com. If a check or money order is used, refills can be ordered with an order form. Please allow 14 days from the date you mail your order for delivery of your medication. Caremark will substitute an available generic equivalent for certain brand name drugs whenever allowed by your doctor and applicable pharmacy law. If you do not want a generic substitution for a specific medication, please note in the Comments section on the order form. YOUR HEALTH AND SAFETY ARE IMPORTANT When you use a participating retail pharmacy or the mail service, the pharmacist s expertise, the information provided by your physician, and your prior prescription history through the plan are combined to process your prescription. Real time, point-of-service alerts, when indicated, are sent to your pharmacist with potential concerns about how your prescription may interact with other medications you are currently taking, your disease state, your age, etc. The alerts supplement your pharmacist s professional evaluation, assisting the pharmacist to determine whether follow-up action with you and/or your doctor is necessary before dispensing the prescription. HOW TO USE YOUR PRESCRIPTION DRUG DISCOUNT To select a participating location, call 1-800-308-0374, or visit www.findbestbenefits.com and use promo code 744402. When visiting a participating retail location, tell them you are a member of the Caremark Prescription Services network. Be sure to present your UA Partners membership identification card both when you arrive, and again before paying for any healthcare services or products. NOTE: UA PARTNERS DISCOUNTS CANNOT BE USED IN CONJUNCTION WITH ANY OTHER DISCOUNT PLAN. UAINS-409 11
VITAMIN & NUTRITIONAL SUPPLEMENTS UA Partners members can obtain a wide range of vitamins and mineral supplements through the vitamin and nutritional supplement mail order plan at an average savings of 25% to 50% below already reduced catalog prices. HOW TO USE YOUR DISCOUNT Simply call 1-800-308-0374 to request a catalog. Call the toll-free number listed in the vitamin and nutritional supplement mail order catalog to place an order or to ask questions about the available supplements. Be sure to identify yourself as a UA Partners member to receive your discount. Prescription drugs are not available through the vitamin and nutritional supplement mail order plan. Customer service representatives will be happy to answer any questions you might have about our products, but they do not offer any medical advice. Visit www.healthdirectonline.com to view a wide variety of products offered. Upon placing your first order online (minimum of $25), you can receive a free product by entering the promotion code DDS001. When ordering online, please have your UA Partners membership identification card available to be sure you receive the savings. NOTE: UA PARTNERS DISCOUNTS CANNOT BE USED IN CONJUNCTION WITH ANY OTHER DISCOUNT PLAN. UAINS-403 12
24-HOUR NURSELINE UA Partners members have unlimited access to registered nurses via a toll-free number 24 hours a day, 365 days a year. These nurses are specially trained to offer prompt, confidential medical counseling to help UA Partners members make informed decisions about health and medical care they receive. However, nurses do not diagnose or provide treatment. HOW TO USE THE 24-HOUR NURSELINE Call 1-800-982-2401 toll-free for confidential access to registered nurses 24 hours a day. Nurses can answer questions regarding: --self-care techniques for common symptoms -- what to expect during a medical test --diagnostic and surgical procedures --a recently diagnosed medical condition --prescription and over the counter medication information Use your 24-Hour Nurseline Pamphlet included in your membership materials to access and listen to a library of more than 700 health audiotapes. You can also go online to get valuable information on living healthy. Visit www.mycareallies.com and use bestbenefits as your login. UAINS-424 13
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Terms, Conditions and Disclosures This plan is not insurance. This is your agreement as Cardholder with Coverdell & Company, Inc. (a "discount medical plan organization," "DMPO"). It is effective on the date of acceptance of Cardholder s application for enrollment in UA Partners ( Plan ) and for the period of your plan. DMPO shall provide Cardholder with a listing of participating providers. Cardholder shall excuse DMPO from any liability for errors in such listings. Providers are subject to change without notice. Cardholder is responsible for choice of provider, verification that the provider is a current participant and for payment for goods and services. No portion of any provider s fee will be reimbursed or otherwise paid by DMPO. Cardholder is solely responsible for payment. Savings are based on the provider s usual fees or on national or regional fees for the service or product. Actual savings will vary depending upon your location and the specific products or services purchased. Providers may offer certain products or services to the general public at prices lower than the Plan price. In that event, members will always be charged the lower price. This is a discount plan and not insurance. Plan discounts cannot be used in conjunction with any other network based plan. Although DMPO screens participating providers to ensure appropriate credentials and qualifications to provide goods and services, DMPO does not otherwise guarantee nor is responsible for the quality of such service or product purchased by Cardholder. Payment of membership fee is made by the billing source authorized by you in accordance with the payment terms to which you agreed. DMPO reserves the right to increase or decrease the membership fee for each renewal membership term effective upon renewal of your membership. You will be notified at least 30 days prior to any membership fee changes. Membership is not transferable. Only you and your immediate family may use the membership. Immediate family means you, your spouse and children living at your home. Should a single member wish to add family members, call the customer service number shown on the membership I. D. Card. Life and Health Guaranty Association. This contract is not an insurance policy and is not protected by any Life and Health Guaranty Association. General Complaint Procedure. Complaints of any nature may be filed with Coverdell & Company, Inc. the discount medical plan organization at 8770 W. Bryn Mawr, Suite 1000, Chicago, IL 60631. Complaints will be acknowledged in writing within 5 business days and will be resolved in writing to you within 30 calendar days. Termination and Cancellation. You may terminate this agreement and your membership at any time by phone, e-mail or in writing. Call us at the toll free number on your membership card, send us an e-mail at custservice@torchmarkcorp. com, or notify us in writing at Member Services, 8770 W. Bryn Mawr, Suite 1000, Chicago, IL 60631. Your cancellation will be effective promptly upon the receipt of your cancellation notice, fees will cease to be collected no later than 30 days as it pertains to auto bank draft, and you will no longer be charged for your membership. You have the right to cancel this agreement within 30 days of the effective date for a full refund of fees paid. Governing Law and Arbitration for Florida Residents. This agreement and its interpretation and enforcement shall be governed and controlled by the laws of the State of Florida. Any dispute arising from or related to this agreement may be resolved by a voluntary binding arbitration conducted in accordance with the Rules of the American Arbitration Association in the local court of jurisdiction. This provision shall survive the termination of this agreement and its interpretation shall be subject to the Federal Arbitration Act. Disclosure. This plan is NOT insurance. This plan is optional. The plan provides discounts at certain health care providers of medical services. The plan does not make payments directly to the providers for medical services. The plan member is obligated to pay for all health care services but will be entitled to receive a discount from those health care providers who have contracted with the discount plan organization. The range of discounts for services offered will vary depending on the type of provider and service. Discounts on hospital services are not available in Maryland. This is not a Medicare prescription drug plan. This plan is administered by Coverdell & Company, Inc., a discount medical plan organization at 8770 W. Bryn Mawr, Suite 1000, Chicago, IL 60631, 1-800-308-0374, www.findbestbenefits.com. You have the right to cancel this plan within 30 days of the effective date for a full refund of fees paid. This is not insurance
For use as an informational booklet only. Booklet is not for solicitation of insurance. For all customers with or without an insurance policy from United American Insurance Company F3839-TC 0111