HOW TO OBTAIN BENEFITS. Unless otherwise provided herein, you are entitled to Benefits from an EAP Provider. You must obtain Benefits by calling 0-000-000-0000. Upon contact, Plan will determine your eligibility for Benefits and arrange for Benefits. All Benefits must be provided by Plan or by an EAP Provider referred to by Plan. Local and toll-free telephone numbers are available to access Benefits. Appointments with EAP Providers are readily available and, depending on your desire for a particular time and location, most appointments are offered within forty-eight (48) hours of contact. Plan does not directly provide specialty services beyond assessment, brief counseling and/or referral. Plan’s role in the referral process is to function as an advocate for you to obtain necessary and appropriate levels of care; usually under your group health plan. Your EAP Provider will assist you in securing potential referral resources. During or after business hours, any Member may access a licensed mental health professional for a telephone assessment. The telephone assessor may provide crisis intervention over the telephone, arrange a same-day appointment with an EAP Provider in your area, or assist you in obtaining more intensive, acute care services.
HOW TO OBTAIN BENEFITS. You may apply for Benefits under this Debt Cancellation Agreement by contacting the Administrator by: email at xxxxxxxxxxxxxxx@xxxxxxxxxxxx.xxx; telephone at (000)000-0000; fax to (000)000-0000; or via U.S. mail at PO BOX 19795, Irvine, CA 92623. In the event of a Total Loss, You must provide to the Administrator, within ninety (90) days of the Date of Loss or the Settlement Date (whichever is later), the following documentation before any Benefit under this Agreement can be processed. You are not required to provide any additional documentation not listed in this Agreement. A. A complete copy of the Primary Insurance Settlement Statement substantiating the date of and the cause of the Total Loss of the Vehicle, the gross settlement amount, any deductible amount, and the net settlement amount. B. A copy of the Total Loss Evaluation Report from the Primary Insurance Provider substantiating the basis of how the Actual Cash Value was determined (must include all options on the Covered Vehicle and mileage on the Date of Loss, if available). C. A copy of any Police Report (if applicable). D. You agree that on reasonable advance notice to You, the Assignee, Lienholder, or Administrator may inspect the Covered Vehicle as a condition of receiving Benefits from this Agreement. There is no fee for inspection of the Covered Vehicle. 4.
HOW TO OBTAIN BENEFITS. In order to receive benefits under this Agreement, the Subscriber must furnish, or have furnished, an Explanation of Medicare Benefits if the services are covered by Medicare. Additionally, the Plan may require other necessary reports and records. If services are performed outside of Delaware and the Provider accepts Assignment, the Medicare carrier for that state will automatically submit the Subscriber’s claim to the Plan. However, in order to collect benefits under this Medicare Supplement Subscription Agreement when services are performed outside of Delaware and the Provider does not accept Assignment, the Subscriber must notify the Plan. For benefits which supplement Medicare Part A, and Hospital outpatient benefits that supplement Medicare Part B, the Subscriber must notify the Plan at: [Highmark Blue Cross Blue Shield Fifth Avenue Place 000 Xxxxx Xxxxxx Xxxxxxxxxx, XX 00000-0000] For all other benefits that supplement Medicare Part B, the Subscriber must notify the Plan at: [Highmark Inc. P. X. Xxx 000000 Xxxx Xxxx, XX 00000-0000] The Subscriber must mail a copy of the Explanation of Medicare Benefits with the Subscriber’s identification number written in the right-hand corner. This identification number may be found on the Subscriber’s Identification Card.
HOW TO OBTAIN BENEFITS. In order to receive benefits under this Agreement, the Subscriber must furnish, or have furnished, an Explanation of Medicare Benefits if the services are covered by Medicare. Additionally, the Plan may require other necessary reports and records. If services are performed outside of Pennsylvania and the Provider accepts Assignment, the Medicare carrier for that state will automatically submit the Subscriber’s claim to the Plan. However, in order to collect benefits under this Medicare Supplement Subscription Agreement when services are performed outside of Pennsylvania and the Provider does not accept Assignment, the Subscriber must notify the Plan. For benefits which supplement Medicare Part A and Hospital outpatient benefits which supplement Medicare Part B, the Subscriber must notify the Plan at: Highmark Blue Cross Blue Shield Fifth Avenue Place 000 Xxxxx Xxxxxx Xxxxxxxxxx, XX 00000-0000 For all other benefit which supplement Medicare Part B, the Subscriber must notify the Plan at: Highmark Inc. P. O. Xxx 000000 Xxxx Xxxx, Xxxxxxxxxxxx 00000-0000 The Subscriber must mail a copy of the Explanation of Medicare Benefits with the Subscriber’s identification number written in the right-hand corner. This identification number may be found on the Subscriber’s Identification Card.
HOW TO OBTAIN BENEFITS. You may apply for Benefits under this Debt Cancellation Agreement by contacting the Administrator by: email at xxxxxxxxxxxxxxx@xxxxxxxxxxxx.xxx; telephone at (000)000-0000; fax to (000)000- 0000; or via U.S. mail at PO BOX 19795, Irvine, CA 92623. In the event of a Total Loss, You must provide to the Administrator, within ninety (90) days of the Date of Loss or the Settlement Date (whichever is later), the following documentation before any Benefit under this Agreement can be processed. You are not required to provide any additional documentation not listed in this Agreement.
HOW TO OBTAIN BENEFITS. (1) Whenever the Covered Person receives Health Care Services, the Covered Person must provide the Provider with a copy of the Covered Person’s Identification Card.
