Your Rights to Continue Coverage. If you lose coverage under the plan, then, depending upon the circumstances, Federal and State laws may provide protections that allow you to keep health coverage. Any such rights may be limited in duration and will require you to pay a premium, which may be significantly higher than the premium you pay while covered under the plan. Other limitations on your rights to continue coverage may also apply. For more information on your rights to continue coverage, contact the plan at 0-000-000-0000. You may also contact your state insurance department, the U.S. Department of Labor, Employee Benefits Security Administration at 0-000-000-0000 or xxx.xxx.xxx/xxxx, or the U.S. Department of Health and Human Services at 0-000-000-0000 x00000 or xxx.xxxxx.xxx.xxx.
Your Rights to Continue Coverage. There are agencies that can help if you want to continue your coverage after it ends. The contact information for us and those agencies is: the plan at 0-000-000-0000 or (000) 000-0000 or TDD 711, state insurance department at (000) 000-0000 or by email at XxxxxxXxxXxxxxxx@xxxx.xx.xxx, Department of Labor’s Employee Benefits Security Administration at 1-866-444-EBSA (3272) or xxx.xxx.xxx/xxxx/xxxxxxxxxxxx. or the Department of Health and Human Services, Center for Consumer Information and Insurance Oversight, at 0-000-000-0000 x00000 or xxx.xxxxx.xxx.xxx. Other coverage options may be available to you too, including buying individual insurance coverage through the Health Insurance Marketplace. For more information about the Marketplace, visit xxx.XxxxxxXxxx.xxx or call 0-000-000-0000.
Your Rights to Continue Coverage. If you lose coverage under the plan, then, depending upon the circumstances, Federal and State laws may provide protections that allow you to keep health coverage. Any such rights may be limited in duration and will require you to pay a premium, which may be significantly higher than the premium you pay while covered under the plan. Other limitations on your rights to continue coverage may also apply. For more information on your rights to continue coverage, contact the plan at 0-000-000-0000 or (000) 000-0000 or TDD 0-000-000-0000. You may also contact your state insurance department at (000) 000-0000 or by email at XxxxxxXxxXxxxxxx@xxxx.xx.xxx, the U.S. Department of Labor, Employee Benefits Security Administration at 0-000-000-0000 or xxx.xxx.xxx/xxxx, or the U.S. Department of Health and Human Services at 0-000-000-0000 x00000 or xxx.xxxxx.xxx.xxx.
Your Rights to Continue Coverage. There are agencies that can help if you want to continue your coverage after it ends. The contact information for those agencies is: the Department of Health and Human Services, Center for Consumer Information and Insurance Oversight at (000) 000-0000 x 00000 or xxx.xxxxx.xxx.xxx, or Charter Township of Clinton at (000) 000-0000 or Care Coordinators at (000) 000-0000. Other coverage options may be available to you too, including buying individual insurance coverage through the Health Insurance Marketplace. For more information about the Marketplace, visit xxx.XxxxxxXxxx.xxx or call (000) 000-0000.
Your Rights to Continue Coverage. If you lose coverage under the plan, then, depending upon the circumstances, Federal and State laws may provide protections that allow you to keep health coverage. Any such rights may be limited in duration and will require you to pay a premium, which may be significantly higher than the premium you pay while covered under the plan. Other limitations on your rights to continue coverage may also apply. For more information on your rights to continue coverage, contact the plan at 0-000-000-0000. You may also contact your state insurance department, the U.S. Department of Labor, Employee Benefits Security Administration at 0-000-000-0000 or xxx.xxx.xxx/xxxx, or the U.S. Department of Health and Human Services at 0-000-000-0000 x00000 or xxx.xxxxx.xxx.xxx. High Deductible Health Plan – HD33-TWA : Dex Media Coverage Period: 01/01/2015 – 12/31/2015 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual + Family Plan Type: PPO Your Grievance and Appeals Rights: If you have a complaint or are dissatisfied with a denial of coverage for claims under your plan, you may be able to appeal or file a grievance. For questions about your rights, this notice, or assistance, you can contact: CIGNA, X.X. Xxx 0000, Xxxxxxxx, XX 00000-0000 or call 0-000-XXXXX (1-800- 244-6224) or go to: xxx.xxXXXXX.xxx. For appeals on a prescription drug claim, your Physician needs to fax a letter of medical necessity to Caremark at 0-000-000-0000. Does this Coverage Provide Minimum Essential Coverage? The Affordable Care Act requires most people to have health care coverage that qualifies as “minimum essential coverage.” This plan or policy does provide minimum essential coverage. Does this Coverage Meet the Minimum Value Standard? The Affordable Care Act establishes a minimum value standard of benefits of a health plan. The minimum value standard is 60% (actuarial value). This health coverage does meet the minimum value standard for the benefits it provides. Language Access Services: Para obtener asistencia en Español, llame al 1-866-847-1300-Opcion 3. ––––––––––––––––––––––To see examples of how this plan might cover costs for a sample medical situation, see the next page.–––––––––––––––––––––– High Deductible Health Plan – HD33-TWA : Dex Media Coverage Period: : 01/01/2015 – 12/31/2015 Coverage Examples Coverage for: Individual + Family Plan Type: PPO About these Coverage Examples: This is not a cost estimator. Don’t use these examples to estimate y...
Your Rights to Continue Coverage. There are agencies that can help if you want to continue your coverage after it ends. The contact information for us and those agencies is: the plan at 0-000-000-0000 or (000) 000-0000 or TDD 711, state insurance department at (000) 000-0000 or by email at XxxxxxXxxXxxxxxx@xxxx.xx.xxx, Department of Labor’s Employee Benefits Security Administration at 1-866-444-EBSA (3272) or xxx.xxx.xxx/xxxx/xxxxxxxxxxxx. or the Department of Health and Human Services, Center for Consumer Information and Insurance Oversight, at 0-000-000-0000 x00000 or xxx.xxxxx.xxx.xxx. Other coverage options may be available to you too, including buying individual insurance coverage through the Health Insurance Marketplace. For more information about the Marketplace, visit xxx.XxxxxxXxxx.xxx or call 0-000-000-0000. Your Grievance and Appeals Rights: There are agencies that can help if you have a complaint against your plan for a denial of a claim. This complaint is called a grievance or appeal. For more information about your rights, look at the explanation of benefits you will receive for that medical claim. Your plan documents also provide complete information to submit a claim, appeal, or a grievance for any reason to your plan. For more information about your rights, this notice, or assistance, contact: contact the plan at 0-000-000-0000 or (000) 000-0000 or TDD 711. You may also contact the Department of Labor’s Employee Benefits Security Administration at 1-866-444-EBSA (3272) or xxx.xxx.xxx/xxxx/xxxxxxxxxxxx. Additionally, a consumer assistance program can help you file your appeal. Contact your state insurance department at (000) 000-0000 or by email at XxxxxxXxxXxxxxxx@xxxx.xx.xxx. Does this plan provide Minimum Essential Coverage? Yes. If you don’t have Minimum Essential Coverage for a month, you’ll have to make a payment when you file your tax return unless you qualify for an exemption from the requirement that you have health coverage for that month. Does this plan meet Minimum Value Standards? Yes. If your plan doesn’t meet the Minimum Value Standards, you may be eligible for a premium tax credit to help you pay for a plan through the Marketplace. Language Access Services: Para obtener asistencia en Español, llame al 0-000-000-0000. Kung kailangan ninyo ang tulong sa Tagalog tumawag sa 0-000-000-0000. 如果需要中文的帮助，请拨打这个号码 0-000-000-0000. Dinek'ehgo shika at'ohwol ninisingo, kwiijigo holne' 0-000-000-0000. ––––––––––––––––––––––To see examples of how this plan might cover costs...
Your Rights to Continue Coverage. There are agencies that can help if you want to continue your coverage after it ends. The contact information for those agencies is: Department of Labor’s Employee Benefit Security Administration at 1-866-444-EBSA (3272) or xxx.xxx.xxx/xxxx/xxxxxxxxxxxx. Other coverage options may be available to you, too, including buying individual insurance coverage through the Health Insurance Marketplace. For more information about the Marketplace, visit xxx.XxxxxxXxxx.xxx or call 1-800-318- 2596.
Your Rights to Continue Coverage. Federal and State laws may provide protections that allow you to keep this health insurance coverage as long as you pay your premium. There are exceptions, however, such as if: You commit fraud The insurer stops offering services in the State You move outside the coverage area Arches: Xxxxx City - QHDHP POS Plan Coverage Period: 07/01/2014 – 06/30/2015 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Large Group |Plan Type: High-Ded. POS For more information on your rights to continue coverage, contact the insurer at xxx.xxxxxxxxxxxx.xxx or 0-000-000-0000. You may also contact the Utah State insurance department at 000-000-0000 (Salt Lake City area), or 0-000-000-0000 (within the State of Utah), or xxxxx://xxxxxxxxx.xxxx.xxx/.
Your Rights to Continue Coverage. If you lose coverage under the plan, then, depending upon dle circumstances, Federal and State laws may provide protectic coverage. Any such rights may be liniited in dUration and will require you to pay a premium, which may be significandy hi! while covered under the plan. Otherliniitations on your rights to continue coverage may also apply. For more information coverage, contact the plan at 1-800:--278-3296. You may also contact your state insurance department; the U.S. Department Security.~dininistration, at 0-000-000-0000. or www.dol:gov /ebsa; or the U.S. Department of Health and Human Selvices : XXX.xxxxx.xxx.xxx.
Your Rights to Continue Coverage. There are agencies that can help if you want to continue your coverage after it ends. For more information on your rights to continue coverage, contact the plan at 0-000-000-0000. You may also contact your state insurance department, the U.S. Department of Labor, Employee Benefits Security Administration at 0-000-000-0000 or xxx.xxx.xxx/xxxx/xxxxxxxxxxxx, or the U.S. Department of Health and Human Services at 0-000-000-0000 x00000 or xxx.xxxxx.xxx.xxx. Other coverage options may be available to you too, including buying individual insurance coverage through the Health Insurance Marketplace. For more information about the Marketplace, visit xxx.XxxxxxXxxx.xxx or call 0-000-000-0000.
