USERRA. If you are called to active duty in the uniformed services, you may be able to continue your coverage under this EOC for a limited time after you would otherwise lose eligibility, if required by the federal USERRA law. Members are not ineligible for USERRA continuation coverage solely because they live in another Xxxxxx Foundation Health Plan or allied plan service area. You must submit a USERRA election form to your Group within 60 days after your call to active duty. Please contact your Group if you want to know how to elect USERRA coverage or how much you will have to pay your Group for it. Coverage Available on Termination For information about non-group plans available through us with no waiting period or pre-existing condition limitations, visit our Website at: xxx.xx.xxx Or call our Member Services Call Center at: Inside the Washington, D.C., Metropolitan area (000) 000-0000 TTY (000) 000-0000 Outside the Washington, D.C. Metropolitan area 0-000-000-0000 SECTION 7 – Miscellaneous Provisions Administration of Agreement We may adopt reasonable policies, procedures, and interpretations to promote orderly and efficient administration of the Group Agreement and this EOC. Advance Directives The following legal forms help you control the kind of health care you will receive if you become very ill or unconscious: • A Durable Power of Attorney for Health Care lets you name someone to make health care decisions for you when you cannot speak for yourself. It also lets you write down your views on life support and other treatments. • A Living Will and the Natural Death Act Declaration to Physicians lets you write down your wishes about receiving life support and other treatment. For additional information about Advance Directives, including how to obtain forms and instructions, contact our Member Services Call Center. Inside Washington, D.C., Metropolitan area (000) 000-0000, or in the Baltimore, Maryland TTY (000) 000-0000 Outside the Washington, D.C. Metropolitan area 0-000-000-0000 Amendment of Agreement Your Group’s Agreement with us will change periodically. If these changes affect this EOC, a revised EOC will be issued to you. Applications and Statements You must complete any applications, forms, or statements that we request in our normal course of business or as specified in this EOC.
Appears in 3 contracts
Samples: Group Agreement, Group Agreement, Group Agreement
USERRA. If you are called to active duty in the uniformed services, you may be able to continue your coverage under this EOC for a limited time after you would otherwise lose eligibility, if required by the federal USERRA law. Members are not ineligible for USERRA continuation coverage solely because they live in another Xxxxxx Foundation Health Plan or allied plan service area. You must submit a USERRA election form to your Group within 60 days after your call to active duty. Please contact your Group if you want to know how to elect USERRA coverage or how much you will have to pay your Group for it. Coverage Available on Termination For information about non-group plans available through us with no waiting period or pre-existing condition limitations, visit our Website at: xxx.xx.xxx Or call our Member Services Call Center at: Inside the Washington, D.C., Metropolitan area (000) 000-0000 TTY (000) 000-0000 Outside the Washington, D.C. Metropolitan area 0-000-000-0000 SECTION 7 – Miscellaneous Provisions Administration of Agreement We may adopt reasonable policies, procedures, and interpretations to promote orderly and efficient administration of the Group Agreement and this EOC. Advance Directives The following legal forms help you control the kind of health care you will receive if you become very ill or unconscious: • A Durable Power of Attorney for Health Care lets you name someone to make health care decisions for you when you cannot speak for yourself. It also lets you write down your views on life support and other treatments. • A Living Will and the Natural Death Act Declaration to Physicians lets you write down your wishes about receiving life support and other treatment. For additional information about Advance Directives, including how to obtain forms and instructions, contact our Member Services Call Center. Inside Washington, D.C., Metropolitan area (000) 000-0000, or in the Baltimore, Maryland TTY (000) 000-0000 Outside the Washington, D.C. Metropolitan area 0-000-000-0000 Amendment of Agreement Your Group’s Agreement with us will change periodically. If these changes affect this EOC, a revised EOC will be issued to you. Applications and Statements You must complete any applications, forms, or statements that we request in our normal course of business or as specified in this EOC.. Assignment You may not assign this EOC or any of the rights, interests, claims for money due, benefits, or obligations hereunder without our prior written consent. Attorney Fees and Expenses In any dispute between a Member and Health Plan or Plan Providers, each party will bear its own attorneys’ fees and other expenses. Contracts with Plan Providers Health Plan and Plan Providers are independent contractors. Your Plan Providers are paid in a number of ways, including salary, capitation, per diem rates, case rates, fee for service, and incentive payments. If you would like further information about the way Plan Providers are paid to provide or arrange medical and hospital care for Members, please call our Member Services Call Center in the Washington, D.C., Metropolitan area at (301) 468- 6000, or in the Baltimore, Maryland Metropolitan Area at 0-000-000-0000. Our TTY is (000) 000-0000. Our contracts with Plan Providers provide that you are not liable for any amounts we owe. However, you may be liable for the cost of non-covered Services or Services you obtain from Non-Plan Providers, except for Emergency Services or authorized referrals. If our contract with any Plan Provider terminates, for reasons unrelated to fraud, patient abuse, incompetence, or loss of licensure status, while you are under the care of that Plan Provider, you may continue to see that provider and we will retain financial responsibility for covered Services you receive, in excess of any applicable Copayments, Coinsurance or Deductibles for a period not to exceed 90 days from the date we have notified you of the Plan Provider’s termination. Governing Law Except as preempted by federal law, this EOC will be covered in accord with law of the District of Columbia and any provision that is required to be in this EOC by state or federal law shall bind Members and Health Plan whether or not set forth in this EOC. Groups and Members are not Health Plan’s Agents Neither your Group nor any Member is the agent or representative of Health Plan. Xxxxxx Foundation Health Plan of the Mid-Atlantic States, Inc.
Appears in 1 contract
Samples: Your Group Agreement
