© 2013 Continental American Insurance Company. %PDF-1.6 %���� 433-3036 for a Service Request form to be mailed out to you. A premium due notice will be generated when the premium is due. fund value exceeds the surrender charge is when the cash value begins to grow.
The rates at which the interest is credited are declared by the company or may be specified in the certificate. Please be sure to also sign and date the medical authorization section. �a�����75s2⟲F��.�"�^2��h^փ������dL �\�t�����]����=q��Y��7���S��*�'7�(d���B��:-�I��.2&���f?��QS�bzU����鳶2������s��̧yy���_.��~�W�zx�Vh�3-��z e-���1�S�6���������Y��')3�53��FDq�0�S���Ʀ��)�. Claims delivered in this manner will expedited the delivery of mail time but will not expedite the processing of the claim. Total processing of the claim, including pre-processing is 7-10 business days. to refer to. Train their workforce on privacy policies and procedures. Notify individuals about their privacy rights and respond when individuals invoke their rights.
Business hours: 8 a.m. to 8 p.m. Eastern Time, M-F. Limit the use and disclosure of protected health information. h�̏�j�0�_EO0�O�6PrXG/cb�B^jJa��v�{��Nacl��v��Y�,�'�AU�a�)5 9���~���|=�A1A������. 558 0 obj <>/Filter/FlateDecode/ID[<77482A47FA805F43B47F1FCD4DB6AE2A>]/Index[546 23]/Info 545 0 R/Length 80/Prev 902629/Root 547 0 R/Size 569/Type/XRef/W[1 3 1]>>stream If not otherwise required by law, benefits will be paid directly to you, the insured, unless you authorize a hospital, physician or other health care provider to receive your benefits. %%EOF You may receive a W-2 form from your employer that will include the benefit amount you received that may be taxable. 1349 0 obj <>stream The initial surrender charge is determined at the beginning of each certificate year. benefits under your existing certificate. If you pay your premiums under a flexible benefits plan with pretax dollars, or if your employer pays part or all of your premiums, some of the Continental American Insurance Company. 1. Itemized bill that includes date of service, type of test performed, charges, and provider's name, address and phone number. that deals with privacy provisions is called the Privacy Rule. h�,�Aς0����Aa���p@�x0!���0g�����V�{��'볷�J�H�� G7��J2~��n�ֆ��_�� �7c����~`�LŪ�+>_�v�-��*����;t�JBn�=7{��s���!s�K��4��;���І�b�IE���H�"bƨ"�eĂqQ1�Q�wV#ݠ;50�Bp�7X�r��rgS��-�̓�a0����^۱TU_ >stream The original claim form is required to process your claim. @���C��'��6"<>��N��p�K[�0n������|#��@�h��6f��} Paying your premiums other than monthly cannot be set up electronically. The part of HIPAA
The date of the insured's death. You can assign your benefits by signing the appropriate section on the claim form or 3.) A Service Request form can be downloaded from the website (located under the Customer Service tab) or you can call our Customer Service Department at 1-800-433-3036 for this form. Generally, the Privacy Rule requires health care providers, health plans and health
care clearinghouses to: You can download a Service Request form from the website (located under the Customer Service tab) or call our Customer Service department at 1-800- Cash values are accumulated by crediting premium payments and interest to a fund from which deductions are made for expenses and cost of insurance. Once the If not otherwise required by law, benefits will be paid directly to you, the insured, unless you authorize a hospital, physician or other health care This is an authorization form that is completed by the insured for the purpose of evaluating your eligibility for insurance and eligibility for © 2013 Continental American Insurance Company. This statement shows the current certificate values, premiums paid and deductions made since the last report and any outstanding certificate
SHORT TERM DISABILITY CLAIM FORM. by signing an assignment of benefits at the provider's office in the event that the provider files the claim for you. A claim form and instructions may be obtained by calling our Customer Service Center at 1-800-433-3036, downloading the form from our website (located under the Claims tab) or in your certificate package that you received. %PDF-1.7 %���� Yes. Continental American Insurance Company (CAIC), a proud member of the Aflac family of insurers, is a wholly-owned subsidiary of Aflac Incorporated and underwrites group coverage. Require their business associates, including sales representatives, to agree to safeguard the privacy of protected health information.
Secure protected health information so it's not available to those who don't need it. provider to receive your benefits. �f���"!������1�����L�ut4Xt0xt0�w4p4`� 4V��7�Hs� �A! The fund value (not to be confused with the surrender value) is accrued based on the premium deposited. Typically under the Family Medical Leave Act, which is Short-Term Disability Claim Form Instructions. h�b```�LV��B ��ea�p`Qh �p�lׅ��Sf�N����9VRg�,��|��";[.x�A���-%� endstream endobj 547 0 obj <>/Metadata 58 0 R/Outlines 104 0 R/Pages 544 0 R/StructTreeRoot 119 0 R/Type/Catalog>> endobj 548 0 obj <>/ExtGState<>/Font<>/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 549 0 obj <>stream In the event that your plan is portable and your previous employer terminates the plan, your plan would also terminate.
However, it normally takes about 3 - 5 years before the cash value begins to accumulate. The certificate will remain inforce until the earlier of the following dates: 1.) ... Continental American Insurance Company (CAIC), a proud member of the Aflac family of insurers, is a wholly-owned subsidiary of Aflac Incorporated and underwrites group coverage. You can call our Customer Service Center at 1-800-433-3036 between the hours of 8:00 a.m. to 5:00 p.m. Eastern Standard Time or you can email our Customer Service Center at CSC@caicworksite.com.
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