MAKING PLAN CHANGES AND FILING CLAIMS. All of the forms mentioned in this section can be obtained from the Employer’s personnel office, from one of the Claims Administrator’s local service offices, or from the home office of Blue Cross and Blue Shield of Louisiana. If the Plan Participant needs to submit documentation, the Plan Participant may forward it to Blue Cross and Blue Shield of Louisiana at P.O. Box 98029, Baton Rouge, LA 70898-9029, or to 0000 Xxxxx Xxxxxx, Baton Rouge, LA 70809. If the Plan Participant has any questions about any of the information in this section, the Plan Participant may speak to his Employer or call the Claims Administrator’s customer service department at the telephone number shown on his ID card. Adding or Changing the Plan Participant’s Family Members on the Plan The Schedule of Eligibility lets the Plan Participant know when it is necessary to enroll additional family members for Dependent coverage under the Plan. Please read the Schedule of Eligibility Article and this section as they contain important information for the Plan Participant. Group may require the Employee to use the Employee Enrollment Change Form to enroll family members not listed on the Employee’s original enrollment form. If the Plan Participant does not complete and return a required Employee Enrollment Change Form to the Plan so the Claims Administrator receives it within the timeframes set out in the Schedule of Eligibility, it is possible that the Employee’s health benefits coverage will not be expanded to include the additional family members. Completing and returning an Employee Enrollment Change Form is especially important when the Employee’s first Dependent becomes eligible for coverage or when the Employee no longer has any eligible Dependents. The Schedule of Eligibility explains when coverage becomes effective for new family members. Generally, an Employee Enrollment Change Form is used to add newborn children, newborn adopted children, a spouse, or other Dependents not listed on the Employee’s original enrollment form. The Plan should receive the Employee’s completed form within thirty (30) days of the child’s birth or placement, or the Employee’s marriage.
MAKING PLAN CHANGES AND FILING CLAIMS. All of the forms necessary to make changes to the plan can be obtained from the employer’s personnel office, from Our home office. If the Member needs to submit documentation to Us, the Member may forward it to Our home office at: Blue Cross and Blue Shield of Louisiana P.O. Box 98029 Baton Rouge, LA 98029-9029 or to Our street address, 0000 Xxxxx Xxxxxx, Baton Rouge, LA 70809 All the forms related to filing claims under this Benefit Plan can be obtained by contacting United Concordia Dental at: United Concordia Dental Customer Service P.O. Box 69441 Harrisburg, PA 17106-9441 0-000-000-0000 If the Member has any questions about any of the information in this section, the Member may speak to his Employer or call UCD. Members may be able to perform many of these functions online at xxx.xxxxxx.xxx. CHANGING FAMILY MEMBERS ON THE MEMBER’S PLAN The Schedule of Eligibility lets You know when You may add additional family Members to Your policy. Please read the Schedule of Eligibility and this section as they contain important information for You. A Group Enrollment Change Form is the document that We must receive in order to enroll family Members not listed on Your original application/enrollment form. The Group Enrollment Change Form is used to add newborn children, newborn adopted children, a Spouse, or other Dependents. It is extremely important that You follow the timing rules in the Schedule of Eligibility. If You do not complete and return a required Group Enrollment Change Form to Us within the timeframes set out in the Schedule of Eligibility, it is possible that Your insurance coverage will not be expanded to include the additional family Members. Completing and returning a Group Enrollment Change Form is especially important when Your first Dependent becomes eligible for coverage or when You no longer have any eligible Dependents.
MAKING PLAN CHANGES AND FILING CLAIMS. All of the forms mentioned in this section can be obtained from the Employer’s personnel office, from one of the Claims Administrator’s local service offices, or from the home office of Blue Cross and Blue Shield of Louisiana. If the Plan Participant needs to submit documentation, the Plan Participant may forward it to Blue Cross and Blue Shield of Louisiana at P.O. Box 98029, Baton Rouge, LA 70898-9029, or to 0000 Xxxxx Xxxxxx, Baton Rouge, LA 70809. If the Plan Participant has any questions about any of the information in this section, the Plan Participant may speak to his Employer or call the Claims Administrator’s customer service department at the telephone number shown on his ID card.
MAKING PLAN CHANGES AND FILING CLAIMS. ALL OF THE FORMS NECESSARY TO MAKE CHANGES TO THE PLAN CAN BE OBTAINED FROM THE EMPLOYER’S PERSONNEL OFFICE OR OUR HOME OFFICE. IF THE MEMBER NEEDS TO SUBMIT DOCUMENTATION TO US, THE MEMBER MAY FORWARD IT TO OUR HOME OFFICE AT: Blue Cross and Blue Shield of Louisiana Post Office Box 98029 Baton Rouge, Louisiana 70898-9029 or to Our street address, 0000 Xxxxx Xxxxxx, Baton Rouge, LA 70809 All the forms related to filing claims under this Plan can be obtained by contacting United Concordia Dental at: United Concordia Dental Customer Service P.O. Box 69441 Harrisburg, PA 17106-9441 0-000-000-0000 If the Member has any questions about any of the information in this section, the Member may speak to his Employer or call UCD. Members may be able to perform many of these functions online at xxx.xxxxxx.xxx.
MAKING PLAN CHANGES AND FILING CLAIMS. All of the forms necessary to make changes to the plan can be obtained from the employer’s personnel office or from Our home office. If the Member needs to submit documentation to Us, the Member may forward it to Our home office at: Blue Cross and Blue Shield of Louisiana P.O. Box 98029 Baton Rouge, LA 98029-9029 or to Our street address, 0000 Xxxxx Xxxxxx, Baton Rouge, LA 70809 All the forms related to filing claims under this Benefit Plan can be obtained by contacting United Concordia Dental at: United Concordia Dental Dental Claims P.O. Box 69441 Harrisburg, PA 17106-9441 0-000-000-0000 If the Member has any questions about any of the information in this section, the Member may speak to his Employer or call UCD. Members may be able to perform many of these functions online at xxx.xxxxxx.xxx.
MAKING PLAN CHANGES AND FILING CLAIMS. ALL OF THE FORMS NECESSARY TO MAKE CHANGES TO THE PLAN CAN BE OBTAINED FROM THE EMPLOYER’S PERSONNEL OFFICE OR OUR HOME OFFICE. IF THE MEMBER NEEDS TO SUBMIT DOCUMENTATION TO US, THE MEMBER MAY FORWARD IT TO OUR HOME OFFICE AT: Blue Cross and Blue Shield of Xxxxxxxxx Xxxx Xxxxxx Xxx 00000 Xxxxx Xxxxx, Xxxxxxxxx 00000-0000 or to Our street address, 0000 Xxxxx Xxxxxx, Baton Rouge, LA 70809 All the forms related to filing claims under this Plan can be obtained by contacting United Concordia Dental at: United Concordia Dental Customer Service X.X. Xxx 00000 Xxxxxxxxxx, XX 00000-0000 0-000-000-0000 If the Member has any questions about any of the information in this section, the Member may speak to his Employer or call UCD. Members may be able to perform many of these functions online at xxx.xxxxxx.xxx.
