Page 24 - Open Enrollment Guide Sample
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Evidence of Insurability Pre-Determined Estimate
A statement of proof of a For any dental work over $200 you should have the dentist complete
person’s physical condition their portion, and you complete your portion, of the dental claim form.
in order to be accepted for The claim ofice will notify you and the dentist in writing of the covered
supplemental life insurance amounts of the estimate.
coverage.
Preferred Provider Organization (PPO)
Health Savings Plan (HSA) A group of hospitals and doctors that contract with employers and
A high deductible health plan insurance companies to provide services at lower rates. Providers
which allows members to use a exchange discounted services for increased volume.
healthcare bank account. Members
pay the full cost of all medical Reasonable and Customary Charge (R&C)
services until the deductible is met. The R&C charge is the prevailing charge made by the doctors of similar
expertise for a similar procedure in a particular geographic area.
Life Event
A current team member enrolled Summary Plan Description (SPD)
in any [Client] insurance plan A written summary of an team member beneit plan, including a
and has experienced one of the statement of eligibility, coverage, team member rights and appeal
following life changes within procedure. It is provided to participants, beneiciaries and the Department
the past 30 days: loss of other of Labor.
insurance coverage, change in Term Insurance (Supplemental Life)
marital status, birth or adoption
of a child. Refer to page 4 of this Insurance payable to a beneiciary when the insured dies.
booklet. Waiting Period
Medically Necessary The period of time that must pass before coverage begins for an eligible
An intervention that is or will person enrolled in the plan.
be provided for the diagnosis,
evaluation, and treatment of
a condition, illness, disease, or
injury as determined by the Plan
administrator.
[Client]
Evidence of Insurability Pre-Determined Estimate
A statement of proof of a For any dental work over $200 you should have the dentist complete
person’s physical condition their portion, and you complete your portion, of the dental claim form.
in order to be accepted for The claim ofice will notify you and the dentist in writing of the covered
supplemental life insurance amounts of the estimate.
coverage.
Preferred Provider Organization (PPO)
Health Savings Plan (HSA) A group of hospitals and doctors that contract with employers and
A high deductible health plan insurance companies to provide services at lower rates. Providers
which allows members to use a exchange discounted services for increased volume.
healthcare bank account. Members
pay the full cost of all medical Reasonable and Customary Charge (R&C)
services until the deductible is met. The R&C charge is the prevailing charge made by the doctors of similar
expertise for a similar procedure in a particular geographic area.
Life Event
A current team member enrolled Summary Plan Description (SPD)
in any [Client] insurance plan A written summary of an team member beneit plan, including a
and has experienced one of the statement of eligibility, coverage, team member rights and appeal
following life changes within procedure. It is provided to participants, beneiciaries and the Department
the past 30 days: loss of other of Labor.
insurance coverage, change in Term Insurance (Supplemental Life)
marital status, birth or adoption
of a child. Refer to page 4 of this Insurance payable to a beneiciary when the insured dies.
booklet. Waiting Period
Medically Necessary The period of time that must pass before coverage begins for an eligible
An intervention that is or will person enrolled in the plan.
be provided for the diagnosis,
evaluation, and treatment of
a condition, illness, disease, or
injury as determined by the Plan
administrator.
[Client]
