Keep Your Plan Informed of Address Changes Clause Samples

Keep Your Plan Informed of Address Changes. In order to protect You and Your family’s rights, You should keep the Group informed of any changes in Your address and the addresses of family members. You should also keep a copy, for Your records, of any notices You send to the Group Plan Administrator.

Keep Your Plan Informed of Address Changes. In order to protect your family’s rights, you should keep the Plan Administrator informed of any changes in the addresses of family members. You should also keep a copy, for your records, of any notices you send to the Plan Administrator. Contact your employer for the name, address and telephone number of the party responsible for administering your COBRA continuation coverage. This group health plan believes this plan is a “grandfathered health plan” under the Patient Protection and Affordable Care Act (the Affordable Care Act). As permitted by the Affordable Care Act, a grandfathered health plan can preserve certain basic health coverage that was already in effect when that law was enacted. Being a grandfathered health plan means that your plan may not include certain consumer protections of the Affordable Care Act that apply to other plans, for example, the requirement for the provision of preventive health services without any cost sharing. However, grandfathered health plans must comply with certain other consumer protections in the Affordable Care Act, for example, the elimination of lifetime limits on benefits. Questions regarding which protections apply and which protections do not apply to a grandfathered health plan and what might cause a plan to change from grandfathered health plan status can be directed to your Employer or the Plan Administrator. If your health plan is subject to the Employee Retirement Income Security Act (ERISA),you may also contact the Employee Benefits Security Administration, U.S. Department of Labor at ▇-▇▇▇-▇▇▇-▇▇▇▇ or ▇▇▇.▇▇▇.▇▇▇/▇▇▇▇/▇▇▇▇▇▇▇▇▇▇▇▇. This website has a table summarizing which protections do and do not apply to grandfathered health plans. For non- federal governmental plans, inquires may be directed to the U.S. Department of Health and Human Services at ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇. ALTHOUGH HEALTH CARE SERVICES MAY BE OR HAVE BEEN PROVIDED TO YOU AT A HEALTH CARE FACILITY THAT IS A MEMBER OF THE PROVIDER NETWORK USED BY YOUR HEALTH BENEFIT PLAN, OTHER PROFESSIONAL SERVICES MAY BE OR HAVE BEEN PROVIDED AT OR THROUGH THE FACILITY BY PHYSICIANS AND OTHER HEALTH CARE PRACTITIONERS WHO ARE NOT MEMBERS OF THAT NETWORK. YOU MAY BE RESPONSIBLE FOR PAYMENT OF ALL OR PART OF THE FEES FOR THOSE PROFESSIONAL SERVICES THAT ARE NOT PAID OR COVERED BY YOUR HEALTH BENEFIT PLAN. This notice is to advise you of certain coverage/benefits provided by your contract with Blue Cross and Blue Shield of Texas (HMO) and is required by le...

Keep Your Plan Informed of Address Changes. In order to protect your family’s rights, you should keep the Plan Administrator informed of any changes in the addresses of family members. You should also keep a copy, for your records, of any notices you send to the Plan Administrator. Contact your employer for the name, address and telephone number of the party responsible for administering your COBRA continuation coverage. This Notice is to advise You that in addition to the processes outlined in COMPLAINT AND APPEAL PROCEDURES section of the Certificate and in the Plan Description and Member Handbook, you have the right to seek and obtain a full and fair review by HMO of any Adverse Benefit Determinations made by HMO in accordance with the benefits and procedures detailed in Your Certificate.  The reasons for the determination;  A reference to the benefit Plan provisions on which the determination is based, or the contractual, administrative or protocol basis for the determination;  A description of additional information which may be necessary to perfect the claim and an explanation of why such material is necessary;  Subject to privacy laws and other restrictions, if any, the identification of the claim, date of service, health care provider, claim amount (if applicable), and a statement describing denial codes with their meanings and the standards used. Upon request, diagnosis/treatment codes with their meanings and the standards used are also available;  An explanation of HMO’s internal review/appeals and external review processes (and how to initiate a review/appeal or external review) and a statement of Your right, if any, to bring a civil action under Section 502(a) of ERISA following a final denial on internal review/appeal;  In certain situations, a statement in non-English language(s) that written notice of claim denials and certain other benefit information may be available (upon request) in such non-English language(s);  In certain situations, a statement in non- English language(s) that indicates how to access the language services provided by HMO;  The right to request, free of charge, reasonable access to and copies of all documents, records and other information relevant to the claim for benefits;  Any internal rule, guideline, protocol or other similar criterion relied on in the determination, and a statement that a copy of such rule, guideline, protocol or other similar criterion will be provided free of charge on request;  An explanation of the scientific or clinical judg...

Keep Your Plan Informed of Address Changes. In order to protect your family’s rights, you should keep the Plan Administrator informed of any changes in the addresses of family members. You should also keep a copy, for your records, of any notices you send to the Plan Administrator. Contact your employer for the name, address and telephone number of the party responsible for administering your COBRA continuation coverage. Form No. 0009.443 2 Stock No. 0009.443- 0804 Sample We are required by applicable federal and state law to maintain and safeguard the privacy of your Protected Health Information (PHI). PHI is information in any format (electronic, paper, or verbal), about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition or the payment or provision of related health care services. We are also required to give you this notice about our privacy practices, our legal duties, and your rights concerning your PHI. We must follow the privacy practices that are described in this notice while it is in effect. This notice takes effect September 23, 2013 and will remain in effect until we replace it. We reserve the right to change our privacy practices and the terms of this notice at any time, provided such changes are permitted by applicable law. We reserve the right to make the changes in our privacy practices and the new terms of our notice effective for all PHI that we maintain, including PHI we created or received before we made the changes. Before we make a material change in our privacy practices, we will change this notice and make the new notice available to you as required under the law. For more information about our privacy practices, or for additional copies of this notice, please contact us using the information listed at the end of this notice. We use and disclose PHI about you for treatment, payment, and health care operations. The following are examples of the types of uses and disclosures that we are permitted to make. Treatment: We may use or disclose your PHI to a physician or other health care provider providing treatment to you. We may use or disclose your PHI to a health care provider so that we can make prior authorization decisions under your benefit plan.

Keep Your Plan Informed of Address Changes. In order to protect your family’s rights, you should keep your university human resources office informed of any changes in the addresses of family members. You should also keep a copy, for your records, of any notices you send to your university human resources office. Any notification, which is your responsibility under law, will not be considered adequate unless it is made to the human resources office.