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Accident and Health Product Filing

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Model Language

Subject Model Language

Cover Page

03/30/2016

Individual - Table of Contents

03/30/2016

Group - Table of Contents

03/30/2016

Definitions

03/30/2016

How This Coverage Works (Introduction, Selecting a Primary Care Dentist, Preauthorization, Medically Necessary)

03/30/2016

Access to Care and Transitional Care (Referrals, Specialty Care Provider as a PCD)

03/30/2016

Cost-Sharing Expenses and Allowed Amount

03/30/2016

Individual - Who Is Covered (Eligibility) (pediatric only coverage)

03/30/2016

Individual - Who Is Covered (Eligibility)

03/30/2016

Group - Who Is Covered (Eligibility) (pediatric only coverage)

03/30/2016

Group - Who Is Covered (Eligibility)

03/30/2016

Pediatric Dental

03/30/2016

Exclusions

03/30/2016

Claim Determinations

03/30/2016

Grievance

03/30/2016

Utilization Review

03/30/2016

External Appeal

03/30/2016

Coordination of Benefits (Group Only)

03/30/2016

Termination

03/30/2016

Extension of Benefits

03/30/2016

Continuation (Group Only)

03/30/2016

Temporary Suspension Rights for Members of the Armed Forces (Individual Only)

03/30/2016

General Provisions (Incontestability, Legal Actions, Subrogation, Unilateral Modification)

03/30/2016

Schedule of Benefits

03/30/2016

Domestic Partner Rider (Group Only)

03/30/2016


Updated 04/04/2016

 

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