I spent an hour talking to 4 agents with Unified Health about a discount health plan that is not qualified medical coverage. They pressured me to sign up and obtained one of my credit card numbers. They gave me a confirmation number and when I asked for more information or verification of their network, they would send me to a different agent. They said I had to sign up today via an email link.
When I clicked on the link to see the network, it pulled up a web site to create a url, not a network. They claimed to be a PPO with half a million providers, but I could not get the list of providers until I signed their contract. It includes unlimited number of office visits and tests. It is a "lower tiered plan." It excludes maternal care, substance abuse and mental healthcare and offers "cash benefits." Member has to pay 10%.
Product Information Unified 100 PLUS Series
Limited Benefit plan with NCE Gap Afford plus and Accident Accidental Death and Dismemberment add-on which pays an additional sum in the event of an accidental death, or percentages of that sum for accidental dismemberment.
$196.03 per Month for Individual $25.00 one-time Enrollment Complete Care Plus - Add-on
Aetna Dental
Vision Outlook
Hearing Epic
Rx Discount Card (Walk in pharmacy)
Rx Discount Global (International brand name mail-order)
$96.98 per Month for Individual $0.00 one-time Enrollment Terms and Conditions for Unified 100 PLUS Series Health Insurance Program
LIMITED MEDICAL BENEFIT PLAN
This is a limited benefit health insurance plan. Policy #ULI0032013
Membership Eligibility Information
The Limited Benefit Health Insurance Plan is provided to eligible members of National Congress of Employers (NCE) Association who are under age 65 and not Medicare eligible.
Spouses and dependent children up to age 26 if a full time student.
Coverage cannot be issued to a child only (under age 18).
There are no waiting periods or pre-existing condition limitations on the following membership benefits!
• Medical PPO Discount through MultiPlan
• Pharmacy Discount Card
• Vision Care
• Dental Care
• Hearing
• Alternative Care
• Infertility Treatment
Waiting Period For Sickness
Loss caused by or relating to Sickness will not be covered for this first 30 days after the Certificate Effective Date of each Covered Person.
Limitations and Exclusions
We will not pay benefits for treatment, services or supplies which:
• Are not Medically Necessary;
• Are not prescribed by a Doctor as necessary to treat Sickness or injury;
• Are experimental/investigational in nature, except as required by law;
• Are received without charge or legal obligation to pay; or
• Is provided by an immediate family member.
• Additional Limitations and Exclusions:
• Except as specifically provided for in this Policy or any attached Riders, We will not pay benefits for Sickness or injuries that are caused by:
• Dental Procedures – Dental care or treatment except for such care or treatment due to accidental injury to sound natural teeth within 12 months of the accident and except for dental care or treatment necessary due to congenital disease or anomaly.
• Elective Procedures and Cosmetic Surgery – Cosmetic surgery, except that cosmetic surgery shall not include reconstructive surgery when such service is incidental to or follows surgery resulting from trauma, infection or other disease of the involved part and reconstructive surgery because of congenital disease or anomaly of a covered dependent child which has resulted in a functional defect.
• Felony or Illegal Occupation Commission of or attempt to commit a felony or to which a contributing cause was the insured’s being engaged in an illegal occupation.
• Manipulations of the Musculoskeletal System –care in connection with the detection and correction by manual or mechanical means of structural imbalance, distortion or subluxation in the human body for purposes of removing nerve interference and the effects thereof, where such interference is the result of or related to distortion, misalignment or subluxation or of or in the vertebral column.
• Policy maximum limits are based on coverage year.
• Suicide or Injuries Which Any Covered Person Intentionally Does to Himself- suicide, attempted suicide or intentionally self-inflicted injury.
• War or Act of War. War or act of war (whether declared or undeclared; participation in a felony, riot or insurrection; service in the Armed Forces or units auxiliary thereto. Losses as a result of acts of terrorism committed by individuals or groups will not be excluded from coverage unless the Covered Person who suffered the loss committed the act of terrorism.
• Work-related Injury or Sickness. Work-related Injury or Sickness, whether or not benefits are payable under any state or federal Workers’ Compensation, employer’s liability or occupational disease law or similar law.
• Pregnancy
Pre-existing Condition Limitation:
There is no coverage for a pre-existing condition for a continuous period of 12 months following the effective date of coverage under this Policy.
This limitation does not apply to:
• genetic information in the absence of a diagnosis of the condition related to such information; and
• a newborn child who is enrolled in the plan within 31 days after birth; nor to a child who is adopted or placed for adoption before attaining 18 years of age; and as of the last day of the 31-day period beginning on the date of birth, adoption or placement for adoption, is covered under creditable coverage.
Always refer to the certificate for full definitions of benefits and eligible expenses. You will receive the Certificate in your fulfillment package.
Acknowledgement that you are joining an Association: I understand that I am enrolling for membership in the National Congress of Employers (NCE), who is the group policyholder for the limited benefit medical plan in which I am also enrolling. The monthly association fee includes the cost of the insurance and other benefits provided by the association. I understand that Unified Life Insurance Company is the underwriter, claims processor and provides customer service for claims related items. First Enroll is the third party administrator who is responsible for billing and member services for non-claim related items.
I understand that the insurance is not basic health insurance or major medical coverage, and is not designated as a substitute for basic health insurance or major medical coverage. I understand that this coverage provides limited benefits for specified medical care. If I have a pre-existing condition the limited medical benefits may not be immediately available for claims associated with that condition. I have a waiting period of 12 months before any claims related to my condition will be covered. If my medical costs exceed the benefit limits then I will be responsible for any charges above those limits as defined in this plan. The limitations are disclosed in the certificate of coverage which is provided via access through the portal shortly after completion of enrollment.
Cancelable Policy and Premium Increases by Insurer: I understand that the insurer has the right to increase premium rates and has the option to cancel coverage.
Disclosure of Free-Look Period: I understand that I have the right to examine the certificate of coverage and within 30 days of the date of receipt, I have the right to cancel the coverage (with written notice) and I will receive a full refund of premium as long as I do not use the benefits or submit a claim.
Enrollment Fee for Membership in Association: I understand that the one-time enrollment fee for membership in the National Congress of Employers (NCE) is non-refundable, even if I choose to cancel insurance coverage or other benefits of membership in the association.
I understand that the monthly payment will be charged to my account for the association fees. The charge date is based on the effective date of my policy. I understand this authority is to remain in full force and effect until the company has received written notification from me of its termination (in writing) in such time and such manner as to afford the company and depositor a reasonable opportunity to act on it. There is a $34 insufficient funds fee.
In the event of a benefit payable due to Accidental Death: If benefits are due under the Accidental Death benefit, I understand it will be paid to the Named Insured’s beneficiary. The beneficiary is the person the Named Insured designated in the enrollment form as the beneficiary, unless it was changed at a later date. If a beneficiary was not named or if the person named is not living at the Named Insured’s death, any Accidental Death benefit due will be paid in this order to: The Insured’s Spouse; or children; or parents; or brothers and sisters; or estate. In the event of a benefit payable due to the death of a Spouse or Dependent Child, the Accidental Death benefit will be paid to the Named Insured, if living, otherwise to the estate of the insured Spouse or Dependent Child. If benefits are payable to a Covered Person’s estate, we can pay benefits up to $5,000 to someone related to the Covered Person by blood or marriage who we feel is fairly entitled to them. If we do this, we will have no responsibility for this payment because we made it in good faith. To change your beneficiary please contact Unified Life Insurance Company at 800 237 4463.
I understand that if there are any discrepancies between what the agent told me about the plan and what the actual plan states that the certificate terms will apply.
Insurance Disclosures Certain state insurance departments require that we advise you of the following statements: Any person who, with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement may be guilty of insurance fraud as determined by a court of law.
Arkansas and West Virginia Residents: Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefits or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison.
California Residents: Any person who knowingly presents a false or fraudulent claim of payment of a loss is guilty of a crime and may be subject to civil fines and confinement in state prison.
District of Columbia Residents: It is a crime to provide false or misleading information to an insurer for the purpose of defrauding the insurer or any other person. Penalties include imprisonment and/or fines. In addition, an insurer may deny insurance benefits if false information materially related to a claim was provided by the applicant.
Florida Residents: Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree.
Kentucky and Pennsylvania Residents: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and may subject such person to criminal and civil penalties.
Tennessee Residents: It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties may include imprisonment, fines or a denial of insurance benefits.
New Mexico Residents: Any person who knowingly presents a false or fraudulent claim for payment or loss or benefit or knowingly presents false information in an application for insurance may be subject to civil fines and criminal penalties.
North Carolina Residents: Any person who knowingly and with intent to injure, defraud or deceive any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which may be a crime and subjects such person to criminal and civil penalties.
Ohio Residents: Any person who, with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud.
Oklahoma Residents: WARNING: Any person who knowingly, and with intent to injure, defraud or deceive any insurer, makes any claim for the proceeds of an insurance policy containing any false, incomplete or misleading information is guilty of a felony.
Oregon Residents: Any person who with intent to injure, defraud or deceive any insurance company or other person submits an enrollment form for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto may have violated state law.
Vermont Residents: Any person who knowingly and with intent to injure, defraud or deceive any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which may be a crime and may subject such person to criminal and civil penalties.
Health Discount Benefits – Not affiliated with Unified Life Insurance
Member Participation Agreement
As a member of this Discount Health Plan you are a participant in a Discount Medical Plan Organization provided by Access One Consumer Health. Below are the terms and conditions of your participation. This agreement is between you and Access One Consumer Health.
DISCLOSURES:
The plan is not insurance;
The plan provides discounts at certain healthcare providers for medical services;
The plan does not make payments directly to the providers of medical services;
The plan member is obligated to pay for all healthcare services but will receive a discount from healthcare providers who have contracted with the discount plan organization;
The name and address of the licensed discount medical plan organization: Access One Consumer Health, 84 Villa Road, Greenville, SC 29615; 800-896-1962; www.AccessOnedmpo.com.
You may find a list of participating providers online. You will be able to apply plan discounts to all participating providers of each participating network.
You will receive discounts at participating chiropractors & diagnostic imaging centers ranging from 5% to 40%, prepaid Labs discounts of 5% to 70%, hearing services discounts of 5% to 20% and participating pharmacies provide discounts of 5% to 40%.
The discounts for participating dentists range from 15-50% per visit off standard billed charges. The vision services (including lenses and frames) are available at participating providers at discounts of 5% to 50% with an average of 25%. The medical services discounts average 39%.
The Member Agreement and Member ID Card represent the entire Agreement between you and Access One Consumer Health.
You will be billed at the time services are provided by the participating provider who will apply the applicable discounts to that bill. In no instance can Access One Consumer Health make payments directly to a provider on your behalf.
Your participation in the plan will continue from month to month upon payment of your monthly dues and shall cease upon (i) your failure to make the monthly payment; or (ii) notification in writing (USPS, email or facsimile) of your desire to cancel.
Participation in the program may be terminated if you fail to make a payment when due.
If you have a complaint regarding the plan you may go to: www.AccessOnedmpo.com or call 800-896-1962. You may also write to Access One Consumer Health 84 Villa Rd. Greenville, SC 29615. The complaint will be addressed and you will receive a response within 15 days.
THIS PLAN IS NOT INSURANCE and is not intended to replace health insurance. This plan does not meet the minimum creditable coverage requirements under M.G.L. c.111M and 956 CMR 5.00. This plan is not a Qualified Health Plan under the Affordable Care Act. This is not a Medicare prescription drug plan.
This Agreement and its Benefit Descriptions represent the entire agreement between you and Access One Consumer Health and supersedes all other prior representations, statements, or written agreements between you and Access One Consumer Health. Access One Consumer Health does not have liability for providing or guaranteeing service or any liability for the quality of services rendered.
Maryland Residents: The membership fee and one-time registration fee (minus $5.00) will be refunded if cancelled within the first 30 days and upon return of the discount card.
Massachusetts Residents: The Plan is not insurance coverage and does not meet the minimum creditable coverage requirements under M.G.L. c. 111M and 956 CMR 5.00. The range of discounts for medical or ancillary services provided under the Plan will vary depending on the type of provider and medical or ancillary service received.
Nebraska Residents: If you have cancelled at any time after the 30 day period, and you have pre-paid any membership fees, the prepayment will be refunded on a pro-rata basis for months you have not used.
Texas Residents: If you are paying for the discount medical Plan, AccessOne or the Plan will cease collecting membership fees in a reasonable amount of time, but no later than (30) days after receiving a valid cancellation notice.
West Virginia Residents: If after receiving our response and you are not satisfied with the resolution you may write of call: West Virginia Insurance Commissioner.
This Plan is not available in the following states AK, MT, RI, UT, VT & WA.
NOTICE OF E-SIGNATURE CONSENT TO ELECTRONIC TRANSACTIONS, SIGNATURES AND DOCUMENTS
I consent and agree to the use of electronic signatures of documents. I consent and agree that if I participated in a recorded verification call, my voice consent shall serve as my signature. I agree I am fully responsible for reviewing this application verification and have reviewed such application carefully to ensure my full understanding of all provisions of the benefits.
UNIFIED LIFE INSURANCE COMPANY SPECIFIC DISCLAIMERS
You have applied to purchase a Unified Life Limited Benefit (LM) plan. Before your application can be processed you are required to read, and acknowledge your understanding of 7 facts regarding the LM plan offered by Unified.
1) This LM plan is not major medical insurance and should not be viewed as a substitute for major medical coverage.
2) This LM plan does not comply with the Affordable Care Act (ACA), otherwise known as "Obamacare."
3) This LM plan does not cover any pre-existing conditions.
4) This LM plan will not provide protection from potential tax penalties which may result from a failure to purchase major medical coverage.
5) This LM plan has a limited schedule of benefits and will only pay for those items specifically listed in the schedule of benefits.
6) This LM plan has no prescription drug benefits. Prescription drug costs will not be covered under any circumstances.
7) This LM plan has a 30-day waiting period before coverage is provided. (Not applicable in CA, ID or TX.)
THIS IS A SUPPLEMENT TO HEALTH INSURANCE AND IS NOT A SUBSTITUTE FOR MAJOR MEDICAL COVERAGE. LACK OF MAJOR MEDICAL COVERAGE (OR OTHER MINIMUM ESSENTIAL COVERAGE) MAY RESULT IN AN ADDITIONAL PAYMENT WITH YOUR TAXES.
By placing your signature below, you acknowledge that you have read and reviewed each of the statements listed above. You further acknowledge that you have no questions regarding any of the limitations and exclusions of your Unified Life LIMITED BENEFIT plan.
CONSENT TO ELECTRONIC TRANSACTIONS
I agree I have read, acknowledged and understood the above. I also agree that, by using this website, my agreement or consent shall be legally binding and enforceable and the legal equivalent of my handwritten or manual signature.
Authorization to debit or withdraw funds.
You understand that this authorization will remain in effect until you cancel it in writing, and you agree to notify First Enroll in writing of any changes in my account information or termination of this authorization at least 15 days prior to the next billing date. If the payment dates fall on a weekend or holiday, you understand that the payments may be executed on the next business day. For ACH debits to your checking/savings account, you understand that because these are electronic transactions, these funds may be withdrawn from your account as soon as the noted periodic transaction dates. In the case of a transaction being rejected for any reason, you understand that First Enroll may, at its discretion, attempt to process the charge again within 30 days, and agree to an additional First Enroll charge for each attempt returned fee which will be initiated as a separate transaction from the authorized recurring payment. You acknowledge that the origination of transactions to your account must comply with the provisions of U.S. law. You certify that you are an authorized user of this credit card/bank account and will not dispute the scheduled transactions with your bank or credit card company; provided the transactions correspond to the terms indicated in this authorization form.
If ACH: I hereby authorize First Enroll to initiate ACH debits to my bank account in the amount listed above on the date listed above. I may revoke this authorization by contacting us at (732) 876-9733, no less than 3 business days from the date above and/or the recurring monthly transaction date.
Terms and Conditions for Complete Care Plus - Add-on
Member Participation Agreement
As a member of the Compass Discount Health Program, referred hereafter as the “Plan”, you are a participant in a Discount Medical Plan Organization provided by Access One Consumer Health Below are the terms and conditions of your membership in the discount medical plan. This agreement is between you, Compass Discount Health, and Access One Consumer Health. The effective date of your enrollment is as of the date you receive your card.
La. R.S. 22:1260.7.D(1)(d) - The mode of payment of any processing fees and periodic charges and procedure for changing the mode of payment.
The cost for participation in the Plan is: Monthly [ $19.95 per month for an individual, 24.95 per month for an individual and spouse, 29.95 per month for an individual and child(ren), $39.95 per month for a household]. The initial payment includes a $30.00 fee upon enrollment, in addition to the Annual or Monthly fee.
DISCLOSURES:
The Plan is not insurance;
The Plan provides discounts at certain healthcare providers for medical services;
The Plan does not make payments directly to the providers of medical services;
The Plan member is obligated to pay for all healthcare services but will receive a discount from healthcare providers who have contracted with the discount Plan organization;
The name and address of the licensed discount medical Plan organization: Access One Consumer Health, Inc., 84 Villa Road, Greenville, SC 29615; (800)896-1962; www.AccessOnedmpo.com.
You may find a list of participating providers at: www.multiplan.comor you may call (732) 876-9733. You will be able to apply Plan discounts to all participating providers.
The discounts for participating dentists range from 15-50% per visit off standard billed charges. The vision services (including lenses and frames) are available at participating providers at discounts of 5% to 50%. You will receive hearing services discounts of 5% to 20% and participating pharmacies provide discounts of 15% to 55%.
At participating providers, you will be billed at the time of service and the applicable discount(s) will be applied to that bill. In no instance will the Plan make payments to the provider on your behalf.
Your participation in the Plan will continue monthly or annually upon timely payment of your monthly or annual dues and shall cease upon your failure to make the payment. You may terminate your participation in the Plan by returning your ID card to Compass Discount Health Program, 187 Route 36, suite 210, West Long Branch NJ 07764. If you return your card at any time within the first 30 days of receipt, you will be refunded the entire membership fee. This plan includes, as per application, you and your legal dependents at no additional charge. You are not required to list your dependents for them to participate in the Plan.
If you have a complaint regarding the Plan, you may contact NBBI Member Services at: www.nbbihome.com and (877) 271-6559 or, in writing to: NBBI Member Services, 25 Hanover Road, A200, Florham Park, NJ 07932. The complaint will be addressed and you will receive a response within 15 business days.
THIS PLAN IS NOT INSURANCE and is not intended to replace health insurance. This plan does not meet the minimum creditable coverage requirements under M.G.L. c.111M and 956 CMR 5.00. This plan is not a Qualified Health Plan under the Affordable Care Act. This is not a Medicare prescription drug plan.
This Member Agreement, the Member ID Card and its Benefit Descriptions represent the entire agreement between you, Compass Discount Health Program, and Access One Consumer Health and supersedes all other prior representations, statements, or written agreements between you, Compass Discount Health Program, and Access One Consumer Health. Access One Consumer Health has no liability for providing nor guaranteeing service or any liability for the quality of services rendered.
Maryland Residents: The membership fee and one-time registration fee (minus $5.00) will be refunded if cancelled within the first 30 days and upon return of the discount card.
Massachusetts Residents: The Plan is not insurance coverage and does not meet the minimum creditable coverage requirements under M.G.L. c. 111M and 956 CMR 5.00. The range of discounts for medical or ancillary services provided under the Plan will vary depending on the type of provider and medical or ancillary service received. Nebraska Residents: If you have cancelled at any time after the 30 day period, and you have pre-paid any membership fees, the prepayment will be refunded on a pro-rata basis for months you have not used.
Texas Residents: If you are paying for the discount medical Plan, Access One Consumer Health or the Plan will cease collecting membership fees in a reasonable amount of time, but no later than (30) days after receiving a valid cancellation notice. This Plan is: regulated by the Texas Department of Insurance, P.O. Box 12157 Austin Texas 78711: telephone 1-800-252-3439 or (512) 463-6515; website: www.tdi.state.texas.com.
West Virginia Residents: If after receiving our response and you are not satisfied with the resolution you may write of call: West Virginia Insurance Commissioner.
Renewal Conditions: By joining the plan, you are authorizing Compass Discount Health Program to bill your credit card or checking account. This charge shall remain in force until you notify Compass Discount Health Program in writing of its cancellation. This plan will automatically renew (monthly or annually) until cancelled.
This Plan is not available in the following states AK, MT, RI, UT, VT & WA.
Keep a copy of this Member Participation Agreement for your records.
Authorization to debit or withdraw funds.
You understand that this authorization will remain in effect until you cancel it in writing, and you agree to notify First Enroll in writing of any changes in my account information or termination of this authorization at least 15 days prior to the next billing date. If the payment dates fall on a weekend or holiday, you understand that the payments may be executed on the next business day. For ACH debits to your checking/savings account, you understand that because these are electronic transactions, these funds may be withdrawn from your account as soon as the noted periodic transaction dates. In the case of a transaction being rejected for any reason, you understand that First Enroll may, at its discretion, attempt to process the charge again within 30 days, and agree to an additional First Enroll charge for each attempt returned fee which will be initiated as a separate transaction from the authorized recurring payment. You acknowledge that the origination of transactions to your account must comply with the provisions of U.S. law. You certify that you are an authorized user of this credit card/bank account and will not dispute the scheduled transactions with your bank or credit card company; provided the transactions correspond to the terms indicated in this authorization form.
They said I had to pay a one time $99 fee to apply then when I disputed that, they lowered it to $25 "minimum Texas enrollment fee." They touted that this membership in a group does not require underwriting and that I would become a member of a group association with a 30 day waiting period and a 30 day preview period.
The direct phone number for one of the agents, Christopher Ramirez, is 877-401-3123 which pulled up on my phone as 855-204-2652; Bruce Ingraham and Alejandro Customer Service at 877-401-3123 ext. 304. This is a high pressure, misleading, and unscrupulous scam.
Daniela Farina a health insurance broker hired me as her virtual assistant here in the philippines. For 15days I performed the duty diligently as her virtual assistant. Scheduling her apppintments, contact all her clients, calling her prospective clients aa well. Everything wet smoothly when it is almoat payment period, I am logging in to my computer to start my work when I cannot enter the passwords she gave to me, I message her but no reply from her end. After 4 hours she replied that she lost her laptop and for security reasons she needs to change all her passwords but I am puzzled why she did not change her password in Skype as well as her gmail account as well as her company email just my credentials. So I am thinking differently already so I told her to just pay for my 15days of worked and I will just need to find another job. To my dismay she never paid me, she send me waiver letter that I need to sign before she will pay me. I contacted US department of labor and said they cannot help me because outsourcing work outside united states is not in there boundaries . The money that I worked for 15days aupposed to be the money that I will pay for the tuition fee of my daughter, sad to say until now she havent took her exam and she cannot graduate because I still didnt pay the tuition fee. Emotionally I am battling wih this. Please help me.
Unified Health Insurance Services Reviews
I spent an hour talking to 4 agents with Unified Health about a discount health plan that is not qualified medical coverage. They pressured me to sign up and obtained one of my credit card numbers. They gave me a confirmation number and when I asked for more information or verification of their network, they would send me to a different agent. They said I had to sign up today via an email link.
When I clicked on the link to see the network, it pulled up a web site to create a url, not a network. They claimed to be a PPO with half a million providers, but I could not get the list of providers until I signed their contract. It includes unlimited number of office visits and tests. It is a "lower tiered plan." It excludes maternal care, substance abuse and mental healthcare and offers "cash benefits." Member has to pay 10%.
Product Information Unified 100 PLUS Series
Limited Benefit plan with NCE Gap Afford plus and Accident Accidental Death and Dismemberment add-on which pays an additional sum in the event of an accidental death, or percentages of that sum for accidental dismemberment.
$196.03 per Month for Individual $25.00 one-time Enrollment Complete Care Plus - Add-on
Aetna Dental
Vision Outlook
Hearing Epic
Rx Discount Card (Walk in pharmacy)
Rx Discount Global (International brand name mail-order)
$96.98 per Month for Individual $0.00 one-time Enrollment Terms and Conditions for Unified 100 PLUS Series Health Insurance Program
LIMITED MEDICAL BENEFIT PLAN
This is a limited benefit health insurance plan. Policy #ULI0032013
Membership Eligibility Information
The Limited Benefit Health Insurance Plan is provided to eligible members of National Congress of Employers (NCE) Association who are under age 65 and not Medicare eligible.
Spouses and dependent children up to age 26 if a full time student.
Coverage cannot be issued to a child only (under age 18).
There are no waiting periods or pre-existing condition limitations on the following membership benefits!
• Medical PPO Discount through MultiPlan
• Pharmacy Discount Card
• Vision Care
• Dental Care
• Hearing
• Alternative Care
• Infertility Treatment
Waiting Period For Sickness
Loss caused by or relating to Sickness will not be covered for this first 30 days after the Certificate Effective Date of each Covered Person.
Limitations and Exclusions
We will not pay benefits for treatment, services or supplies which:
• Are not Medically Necessary;
• Are not prescribed by a Doctor as necessary to treat Sickness or injury;
• Are experimental/investigational in nature, except as required by law;
• Are received without charge or legal obligation to pay; or
• Is provided by an immediate family member.
• Additional Limitations and Exclusions:
• Except as specifically provided for in this Policy or any attached Riders, We will not pay benefits for Sickness or injuries that are caused by:
• Dental Procedures – Dental care or treatment except for such care or treatment due to accidental injury to sound natural teeth within 12 months of the accident and except for dental care or treatment necessary due to congenital disease or anomaly.
• Elective Procedures and Cosmetic Surgery – Cosmetic surgery, except that cosmetic surgery shall not include reconstructive surgery when such service is incidental to or follows surgery resulting from trauma, infection or other disease of the involved part and reconstructive surgery because of congenital disease or anomaly of a covered dependent child which has resulted in a functional defect.
• Felony or Illegal Occupation Commission of or attempt to commit a felony or to which a contributing cause was the insured’s being engaged in an illegal occupation.
• Manipulations of the Musculoskeletal System –care in connection with the detection and correction by manual or mechanical means of structural imbalance, distortion or subluxation in the human body for purposes of removing nerve interference and the effects thereof, where such interference is the result of or related to distortion, misalignment or subluxation or of or in the vertebral column.
• Policy maximum limits are based on coverage year.
• Suicide or Injuries Which Any Covered Person Intentionally Does to Himself- suicide, attempted suicide or intentionally self-inflicted injury.
• War or Act of War. War or act of war (whether declared or undeclared; participation in a felony, riot or insurrection; service in the Armed Forces or units auxiliary thereto. Losses as a result of acts of terrorism committed by individuals or groups will not be excluded from coverage unless the Covered Person who suffered the loss committed the act of terrorism.
• Work-related Injury or Sickness. Work-related Injury or Sickness, whether or not benefits are payable under any state or federal Workers’ Compensation, employer’s liability or occupational disease law or similar law.
• Pregnancy
Pre-existing Condition Limitation:
There is no coverage for a pre-existing condition for a continuous period of 12 months following the effective date of coverage under this Policy.
This limitation does not apply to:
• genetic information in the absence of a diagnosis of the condition related to such information; and
• a newborn child who is enrolled in the plan within 31 days after birth; nor to a child who is adopted or placed for adoption before attaining 18 years of age; and as of the last day of the 31-day period beginning on the date of birth, adoption or placement for adoption, is covered under creditable coverage.
Always refer to the certificate for full definitions of benefits and eligible expenses. You will receive the Certificate in your fulfillment package.
Acknowledgement that you are joining an Association: I understand that I am enrolling for membership in the National Congress of Employers (NCE), who is the group policyholder for the limited benefit medical plan in which I am also enrolling. The monthly association fee includes the cost of the insurance and other benefits provided by the association. I understand that Unified Life Insurance Company is the underwriter, claims processor and provides customer service for claims related items. First Enroll is the third party administrator who is responsible for billing and member services for non-claim related items.
I understand that the insurance is not basic health insurance or major medical coverage, and is not designated as a substitute for basic health insurance or major medical coverage. I understand that this coverage provides limited benefits for specified medical care. If I have a pre-existing condition the limited medical benefits may not be immediately available for claims associated with that condition. I have a waiting period of 12 months before any claims related to my condition will be covered. If my medical costs exceed the benefit limits then I will be responsible for any charges above those limits as defined in this plan. The limitations are disclosed in the certificate of coverage which is provided via access through the portal shortly after completion of enrollment.
Cancelable Policy and Premium Increases by Insurer: I understand that the insurer has the right to increase premium rates and has the option to cancel coverage.
Disclosure of Free-Look Period: I understand that I have the right to examine the certificate of coverage and within 30 days of the date of receipt, I have the right to cancel the coverage (with written notice) and I will receive a full refund of premium as long as I do not use the benefits or submit a claim.
Enrollment Fee for Membership in Association: I understand that the one-time enrollment fee for membership in the National Congress of Employers (NCE) is non-refundable, even if I choose to cancel insurance coverage or other benefits of membership in the association.
I understand that the monthly payment will be charged to my account for the association fees. The charge date is based on the effective date of my policy. I understand this authority is to remain in full force and effect until the company has received written notification from me of its termination (in writing) in such time and such manner as to afford the company and depositor a reasonable opportunity to act on it. There is a $34 insufficient funds fee.
In the event of a benefit payable due to Accidental Death: If benefits are due under the Accidental Death benefit, I understand it will be paid to the Named Insured’s beneficiary. The beneficiary is the person the Named Insured designated in the enrollment form as the beneficiary, unless it was changed at a later date. If a beneficiary was not named or if the person named is not living at the Named Insured’s death, any Accidental Death benefit due will be paid in this order to: The Insured’s Spouse; or children; or parents; or brothers and sisters; or estate. In the event of a benefit payable due to the death of a Spouse or Dependent Child, the Accidental Death benefit will be paid to the Named Insured, if living, otherwise to the estate of the insured Spouse or Dependent Child. If benefits are payable to a Covered Person’s estate, we can pay benefits up to $5,000 to someone related to the Covered Person by blood or marriage who we feel is fairly entitled to them. If we do this, we will have no responsibility for this payment because we made it in good faith. To change your beneficiary please contact Unified Life Insurance Company at 800 237 4463.
I understand that if there are any discrepancies between what the agent told me about the plan and what the actual plan states that the certificate terms will apply.
Insurance Disclosures Certain state insurance departments require that we advise you of the following statements: Any person who, with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement may be guilty of insurance fraud as determined by a court of law.
Arkansas and West Virginia Residents: Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefits or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison.
California Residents: Any person who knowingly presents a false or fraudulent claim of payment of a loss is guilty of a crime and may be subject to civil fines and confinement in state prison.
District of Columbia Residents: It is a crime to provide false or misleading information to an insurer for the purpose of defrauding the insurer or any other person. Penalties include imprisonment and/or fines. In addition, an insurer may deny insurance benefits if false information materially related to a claim was provided by the applicant.
Florida Residents: Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree.
Kentucky and Pennsylvania Residents: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and may subject such person to criminal and civil penalties.
Tennessee Residents: It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties may include imprisonment, fines or a denial of insurance benefits.
New Mexico Residents: Any person who knowingly presents a false or fraudulent claim for payment or loss or benefit or knowingly presents false information in an application for insurance may be subject to civil fines and criminal penalties.
North Carolina Residents: Any person who knowingly and with intent to injure, defraud or deceive any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which may be a crime and subjects such person to criminal and civil penalties.
Ohio Residents: Any person who, with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud.
Oklahoma Residents: WARNING: Any person who knowingly, and with intent to injure, defraud or deceive any insurer, makes any claim for the proceeds of an insurance policy containing any false, incomplete or misleading information is guilty of a felony.
Oregon Residents: Any person who with intent to injure, defraud or deceive any insurance company or other person submits an enrollment form for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto may have violated state law.
Vermont Residents: Any person who knowingly and with intent to injure, defraud or deceive any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which may be a crime and may subject such person to criminal and civil penalties.
Health Discount Benefits – Not affiliated with Unified Life Insurance
Member Participation Agreement
As a member of this Discount Health Plan you are a participant in a Discount Medical Plan Organization provided by Access One Consumer Health. Below are the terms and conditions of your participation. This agreement is between you and Access One Consumer Health.
DISCLOSURES:
The plan is not insurance;
The plan provides discounts at certain healthcare providers for medical services;
The plan does not make payments directly to the providers of medical services;
The plan member is obligated to pay for all healthcare services but will receive a discount from healthcare providers who have contracted with the discount plan organization;
The name and address of the licensed discount medical plan organization: Access One Consumer Health, 84 Villa Road, Greenville, SC 29615; 800-896-1962; www.AccessOnedmpo.com.
You may find a list of participating providers online. You will be able to apply plan discounts to all participating providers of each participating network.
You will receive discounts at participating chiropractors & diagnostic imaging centers ranging from 5% to 40%, prepaid Labs discounts of 5% to 70%, hearing services discounts of 5% to 20% and participating pharmacies provide discounts of 5% to 40%.
The discounts for participating dentists range from 15-50% per visit off standard billed charges. The vision services (including lenses and frames) are available at participating providers at discounts of 5% to 50% with an average of 25%. The medical services discounts average 39%.
The Member Agreement and Member ID Card represent the entire Agreement between you and Access One Consumer Health.
You will be billed at the time services are provided by the participating provider who will apply the applicable discounts to that bill. In no instance can Access One Consumer Health make payments directly to a provider on your behalf.
Your participation in the plan will continue from month to month upon payment of your monthly dues and shall cease upon (i) your failure to make the monthly payment; or (ii) notification in writing (USPS, email or facsimile) of your desire to cancel.
Participation in the program may be terminated if you fail to make a payment when due.
If you have a complaint regarding the plan you may go to: www.AccessOnedmpo.com or call 800-896-1962. You may also write to Access One Consumer Health 84 Villa Rd. Greenville, SC 29615. The complaint will be addressed and you will receive a response within 15 days.
THIS PLAN IS NOT INSURANCE and is not intended to replace health insurance. This plan does not meet the minimum creditable coverage requirements under M.G.L. c.111M and 956 CMR 5.00. This plan is not a Qualified Health Plan under the Affordable Care Act. This is not a Medicare prescription drug plan.
This Agreement and its Benefit Descriptions represent the entire agreement between you and Access One Consumer Health and supersedes all other prior representations, statements, or written agreements between you and Access One Consumer Health. Access One Consumer Health does not have liability for providing or guaranteeing service or any liability for the quality of services rendered.
Maryland Residents: The membership fee and one-time registration fee (minus $5.00) will be refunded if cancelled within the first 30 days and upon return of the discount card.
Massachusetts Residents: The Plan is not insurance coverage and does not meet the minimum creditable coverage requirements under M.G.L. c. 111M and 956 CMR 5.00. The range of discounts for medical or ancillary services provided under the Plan will vary depending on the type of provider and medical or ancillary service received.
Nebraska Residents: If you have cancelled at any time after the 30 day period, and you have pre-paid any membership fees, the prepayment will be refunded on a pro-rata basis for months you have not used.
Texas Residents: If you are paying for the discount medical Plan, AccessOne or the Plan will cease collecting membership fees in a reasonable amount of time, but no later than (30) days after receiving a valid cancellation notice.
West Virginia Residents: If after receiving our response and you are not satisfied with the resolution you may write of call: West Virginia Insurance Commissioner.
This Plan is not available in the following states AK, MT, RI, UT, VT & WA.
NOTICE OF E-SIGNATURE CONSENT TO ELECTRONIC TRANSACTIONS, SIGNATURES AND DOCUMENTS
I consent and agree to the use of electronic signatures of documents. I consent and agree that if I participated in a recorded verification call, my voice consent shall serve as my signature. I agree I am fully responsible for reviewing this application verification and have reviewed such application carefully to ensure my full understanding of all provisions of the benefits.
UNIFIED LIFE INSURANCE COMPANY SPECIFIC DISCLAIMERS
You have applied to purchase a Unified Life Limited Benefit (LM) plan. Before your application can be processed you are required to read, and acknowledge your understanding of 7 facts regarding the LM plan offered by Unified.
1) This LM plan is not major medical insurance and should not be viewed as a substitute for major medical coverage.
2) This LM plan does not comply with the Affordable Care Act (ACA), otherwise known as "Obamacare."
3) This LM plan does not cover any pre-existing conditions.
4) This LM plan will not provide protection from potential tax penalties which may result from a failure to purchase major medical coverage.
5) This LM plan has a limited schedule of benefits and will only pay for those items specifically listed in the schedule of benefits.
6) This LM plan has no prescription drug benefits. Prescription drug costs will not be covered under any circumstances.
7) This LM plan has a 30-day waiting period before coverage is provided. (Not applicable in CA, ID or TX.)
THIS IS A SUPPLEMENT TO HEALTH INSURANCE AND IS NOT A SUBSTITUTE FOR MAJOR MEDICAL COVERAGE. LACK OF MAJOR MEDICAL COVERAGE (OR OTHER MINIMUM ESSENTIAL COVERAGE) MAY RESULT IN AN ADDITIONAL PAYMENT WITH YOUR TAXES.
By placing your signature below, you acknowledge that you have read and reviewed each of the statements listed above. You further acknowledge that you have no questions regarding any of the limitations and exclusions of your Unified Life LIMITED BENEFIT plan.
CONSENT TO ELECTRONIC TRANSACTIONS
I agree I have read, acknowledged and understood the above. I also agree that, by using this website, my agreement or consent shall be legally binding and enforceable and the legal equivalent of my handwritten or manual signature.
Authorization to debit or withdraw funds.
You understand that this authorization will remain in effect until you cancel it in writing, and you agree to notify First Enroll in writing of any changes in my account information or termination of this authorization at least 15 days prior to the next billing date. If the payment dates fall on a weekend or holiday, you understand that the payments may be executed on the next business day. For ACH debits to your checking/savings account, you understand that because these are electronic transactions, these funds may be withdrawn from your account as soon as the noted periodic transaction dates. In the case of a transaction being rejected for any reason, you understand that First Enroll may, at its discretion, attempt to process the charge again within 30 days, and agree to an additional First Enroll charge for each attempt returned fee which will be initiated as a separate transaction from the authorized recurring payment. You acknowledge that the origination of transactions to your account must comply with the provisions of U.S. law. You certify that you are an authorized user of this credit card/bank account and will not dispute the scheduled transactions with your bank or credit card company; provided the transactions correspond to the terms indicated in this authorization form.
If ACH: I hereby authorize First Enroll to initiate ACH debits to my bank account in the amount listed above on the date listed above. I may revoke this authorization by contacting us at (732) 876-9733, no less than 3 business days from the date above and/or the recurring monthly transaction date.
Terms and Conditions for Complete Care Plus - Add-on
Member Participation Agreement
As a member of the Compass Discount Health Program, referred hereafter as the “Plan”, you are a participant in a Discount Medical Plan Organization provided by Access One Consumer Health Below are the terms and conditions of your membership in the discount medical plan. This agreement is between you, Compass Discount Health, and Access One Consumer Health. The effective date of your enrollment is as of the date you receive your card.
La. R.S. 22:1260.7.D(1)(d) - The mode of payment of any processing fees and periodic charges and procedure for changing the mode of payment.
The cost for participation in the Plan is: Monthly [ $19.95 per month for an individual, 24.95 per month for an individual and spouse, 29.95 per month for an individual and child(ren), $39.95 per month for a household]. The initial payment includes a $30.00 fee upon enrollment, in addition to the Annual or Monthly fee.
DISCLOSURES:
The Plan is not insurance;
The Plan provides discounts at certain healthcare providers for medical services;
The Plan does not make payments directly to the providers of medical services;
The Plan member is obligated to pay for all healthcare services but will receive a discount from healthcare providers who have contracted with the discount Plan organization;
The name and address of the licensed discount medical Plan organization: Access One Consumer Health, Inc., 84 Villa Road, Greenville, SC 29615; (800)896-1962; www.AccessOnedmpo.com.
You may find a list of participating providers at: www.multiplan.comor you may call (732) 876-9733. You will be able to apply Plan discounts to all participating providers.
The discounts for participating dentists range from 15-50% per visit off standard billed charges. The vision services (including lenses and frames) are available at participating providers at discounts of 5% to 50%. You will receive hearing services discounts of 5% to 20% and participating pharmacies provide discounts of 15% to 55%.
At participating providers, you will be billed at the time of service and the applicable discount(s) will be applied to that bill. In no instance will the Plan make payments to the provider on your behalf.
Your participation in the Plan will continue monthly or annually upon timely payment of your monthly or annual dues and shall cease upon your failure to make the payment. You may terminate your participation in the Plan by returning your ID card to Compass Discount Health Program, 187 Route 36, suite 210, West Long Branch NJ 07764. If you return your card at any time within the first 30 days of receipt, you will be refunded the entire membership fee. This plan includes, as per application, you and your legal dependents at no additional charge. You are not required to list your dependents for them to participate in the Plan.
If you have a complaint regarding the Plan, you may contact NBBI Member Services at: www.nbbihome.com and (877) 271-6559 or, in writing to: NBBI Member Services, 25 Hanover Road, A200, Florham Park, NJ 07932. The complaint will be addressed and you will receive a response within 15 business days.
THIS PLAN IS NOT INSURANCE and is not intended to replace health insurance. This plan does not meet the minimum creditable coverage requirements under M.G.L. c.111M and 956 CMR 5.00. This plan is not a Qualified Health Plan under the Affordable Care Act. This is not a Medicare prescription drug plan.
This Member Agreement, the Member ID Card and its Benefit Descriptions represent the entire agreement between you, Compass Discount Health Program, and Access One Consumer Health and supersedes all other prior representations, statements, or written agreements between you, Compass Discount Health Program, and Access One Consumer Health. Access One Consumer Health has no liability for providing nor guaranteeing service or any liability for the quality of services rendered.
Maryland Residents: The membership fee and one-time registration fee (minus $5.00) will be refunded if cancelled within the first 30 days and upon return of the discount card.
Massachusetts Residents: The Plan is not insurance coverage and does not meet the minimum creditable coverage requirements under M.G.L. c. 111M and 956 CMR 5.00. The range of discounts for medical or ancillary services provided under the Plan will vary depending on the type of provider and medical or ancillary service received. Nebraska Residents: If you have cancelled at any time after the 30 day period, and you have pre-paid any membership fees, the prepayment will be refunded on a pro-rata basis for months you have not used.
Texas Residents: If you are paying for the discount medical Plan, Access One Consumer Health or the Plan will cease collecting membership fees in a reasonable amount of time, but no later than (30) days after receiving a valid cancellation notice. This Plan is: regulated by the Texas Department of Insurance, P.O. Box 12157 Austin Texas 78711: telephone 1-800-252-3439 or (512) 463-6515; website: www.tdi.state.texas.com.
West Virginia Residents: If after receiving our response and you are not satisfied with the resolution you may write of call: West Virginia Insurance Commissioner.
Renewal Conditions: By joining the plan, you are authorizing Compass Discount Health Program to bill your credit card or checking account. This charge shall remain in force until you notify Compass Discount Health Program in writing of its cancellation. This plan will automatically renew (monthly or annually) until cancelled.
This Plan is not available in the following states AK, MT, RI, UT, VT & WA.
Keep a copy of this Member Participation Agreement for your records.
Authorization to debit or withdraw funds.
You understand that this authorization will remain in effect until you cancel it in writing, and you agree to notify First Enroll in writing of any changes in my account information or termination of this authorization at least 15 days prior to the next billing date. If the payment dates fall on a weekend or holiday, you understand that the payments may be executed on the next business day. For ACH debits to your checking/savings account, you understand that because these are electronic transactions, these funds may be withdrawn from your account as soon as the noted periodic transaction dates. In the case of a transaction being rejected for any reason, you understand that First Enroll may, at its discretion, attempt to process the charge again within 30 days, and agree to an additional First Enroll charge for each attempt returned fee which will be initiated as a separate transaction from the authorized recurring payment. You acknowledge that the origination of transactions to your account must comply with the provisions of U.S. law. You certify that you are an authorized user of this credit card/bank account and will not dispute the scheduled transactions with your bank or credit card company; provided the transactions correspond to the terms indicated in this authorization form.
They said I had to pay a one time $99 fee to apply then when I disputed that, they lowered it to $25 "minimum Texas enrollment fee." They touted that this membership in a group does not require underwriting and that I would become a member of a group association with a 30 day waiting period and a 30 day preview period.
The direct phone number for one of the agents, Christopher Ramirez, is 877-401-3123 which pulled up on my phone as 855-204-2652; Bruce Ingraham and Alejandro Customer Service at 877-401-3123 ext. 304. This is a high pressure, misleading, and unscrupulous scam.
Daniela Farina a health insurance broker hired me as her virtual assistant here in the philippines. For 15days I performed the duty diligently as her virtual assistant. Scheduling her apppintments, contact all her clients, calling her prospective clients aa well. Everything wet smoothly when it is almoat payment period, I am logging in to my computer to start my work when I cannot enter the passwords she gave to me, I message her but no reply from her end. After 4 hours she replied that she lost her laptop and for security reasons she needs to change all her passwords but I am puzzled why she did not change her password in Skype as well as her gmail account as well as her company email just my credentials. So I am thinking differently already so I told her to just pay for my 15days of worked and I will just need to find another job. To my dismay she never paid me, she send me waiver letter that I need to sign before she will pay me. I contacted US department of labor and said they cannot help me because outsourcing work outside united states is not in there boundaries . The money that I worked for 15days aupposed to be the money that I will pay for the tuition fee of my daughter, sad to say until now she havent took her exam and she cannot graduate because I still didnt pay the tuition fee. Emotionally I am battling wih this. Please help me.