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IMPORTANT NOTICES AND DISCLAIMERS
PPO Plans DO NOT cover maternity
*Subject to Deductible/Coinsurance, In addition to applicable deductible and coinsurance, noncontracted providers may charge members for the difference between their bill charges and carrier's allowed amount.
This obligation to pay the difference between the providers bill charges and carrier's allowed amount continues after member's out of pocket maximum is met.
Rates are subject to change. Attached forms/spread sheets are for illustration purposes only. Please refer to insurance carrier contract for specific details. The policy certificate is the governing document.
Each applicant is individual underwritten by carrier and may be declined / waived based on carrier guidelines.
THE APPLICATION IS NOT AN OFFER OF COVERAGE AND SUBMISSION OF YOUR APPLICATION DOES NOT GUARANTEE THAT YOU WILL RECEIVE COVERAGE.
DO NOT CANCEL ANY HEALTH INSURANCE COVERAGE YOU CURRENTLY HAVE OR DECLINE COBRA BENEFITS UNTIL: 1. YOUR APPLICATION IS RECEIVED, REVIEWED, AND ACCEPTED BY CARRIER AND AN EFFECTIVE DATE OF COVERAGE IS ASSIGNED AND 2. YOUR COMPLETE AND CORRECT PAYMENT IS RECEIVED.