Page 11 - 2020 NextCare Enrollment
P. 11
2020
NextCare Holdings Benefits Enrollment
Additional Voluntary Life Details
Should you wish to enroll in an amount greater than $150,000 for
yourself or greater than $30,000 for your spouse, please complete the
personal health application process through ADP self-service.
If you decline this coverage when irst eligible, you may join at the next
open enrollment period but will be subject to completing the personal
health application for any amount of coverage elected. A personal health
application will be required for any change in coverage once elected also.
Please see the NextCare Intranet beneits page for more details.
Conversion Benefit
If you are an active employee, terminated employee, retiree, or
dependent who may be faced with losing all coverage or even a portion
of your coverage under NextCare’s Group life plan(s), you and/or your
dependents may be eligible to continue the lost amount of coverage
without submitting evidence of good health.
Please contact Michelle Geeve to obtain the Notice of Conversion and/
or Portability Rights Form. This form must be completed and submitted
to The Hartford within 91 days of the date of your coverage change.
11
NextCare Holdings Benefits Enrollment
Additional Voluntary Life Details
Should you wish to enroll in an amount greater than $150,000 for
yourself or greater than $30,000 for your spouse, please complete the
personal health application process through ADP self-service.
If you decline this coverage when irst eligible, you may join at the next
open enrollment period but will be subject to completing the personal
health application for any amount of coverage elected. A personal health
application will be required for any change in coverage once elected also.
Please see the NextCare Intranet beneits page for more details.
Conversion Benefit
If you are an active employee, terminated employee, retiree, or
dependent who may be faced with losing all coverage or even a portion
of your coverage under NextCare’s Group life plan(s), you and/or your
dependents may be eligible to continue the lost amount of coverage
without submitting evidence of good health.
Please contact Michelle Geeve to obtain the Notice of Conversion and/
or Portability Rights Form. This form must be completed and submitted
to The Hartford within 91 days of the date of your coverage change.
11
