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The staff of the Student Health Insurance Office would like to welcome you to the new school year and wishes you the best of health during your college experience at the University of Northern Colorado. . It is a policy of the UNC Board of Trustees that all students who are enrolled for 9 credit hours or more are required to have health insurance. All students are automatically enrolled in the university student health insurance plan and billed along with other university services. If you prefer to have other insurance, it will be necessary for you to show proof of insurance and submit a waiver form to the UNC Health Insurance Office by the 10th day of classes. I encourage you to review the benefits of the university student health insurance plan that is described in this brochure. These students have the option to waive the insurance if they complete a waiver form and provide a copy of their valid insurance card by the 10th day of classes. If you request the re-enrollment during the open enrollment period at the start of the semester (no later than the 10th class day), you will be insured with the Student Insurance beginning on the effective date of coverage for that semester. If you want to enroll in the Student Insurance after the open enrollment period, you must show proof of the loss of your other coverage and the enrollment form needs to be approved by the insurance company before the coverage will be effective. Dependent coverage cannot exceed the coverage of the Insured student and expires concurrently with that of the Insured student. Eligible child(ren) are the insured students own children, stepchildren, lawfully ... Saint Louis University requires all its students traveling to a foreign country on University-related business to have appropriate insurance coverage for the time they are abroad.http://www.slu.edu/centers/study_abroad/pdf/insurance_waiver_form.pdf. Below you will find the personal information for one of our students insured through your company who is planning on spending a specific amount of time in a foreign country: I hereby authorize the insurance company specified above to release the information on my coverage requested below to the International Center of Saint Louis University: We would like to request you to complete the following section of this form based on the coverage provided to the individual above by your company and return it to the International Center at the above address or fax number. Thank you very much in advance for your assistance. Every Saint Louis University student going to a foreign country in any SLU-affiliated or non-SLU affiliated program, whether to study or otherwise, is required to have adequate insurance coverage for the length of the time abroad. That insurance must cover the student while abroad for the following situations: Travel from the United States to the foreign destination. Visits to a local doctor due to illness and/or a chronic condition. After careful research, the university has selected a travel insurance plan through AIG that provides appropriate coverage for the above scenarios for $1.49 a day. Please note that you will be required to purchase this plan unless you believe that your own insurance policy provides equal or better coverage to that offered by the University’s plan. In that case, you must fill out the waiver request section ... Insurance Discussion Form Open for Business Worksheet Insurance Coverage Discussion Form Use this form to discuss your insurance coverage with your agent.http://www.ready.gov/business/_downloads/insuranceform.pdf. Having adequate coverage now will help you recover more rapidly from a catastrophe. Insurance Agent: Address: Phone: ___________________ Type of Insurance Do you need Flood Insurance? INSURANCE POLICY INFORMATION Do you need Earthquake Insurance? Do you need Business Income and Extra Expense Insurance? Other disaster-related insurance questions: As a courtesy, we will file to your insurance company, but this does not guarantee payment.http://www.purdue.edu/push/assets/forms/insurance.pdf. It is recommended that you contact your insurance company to determine if your policy will cover charges incurred at PUSH. It is vital to have this form completed in its entirety to allow for proper filing of your claim. A claim may be rejected without this information. Please carry a copy of your insurance card to verify current information. Please attach a copy of your insurance card (both sides) to this form. Street Address the address for out of network claims) A Phone number is not sufficient - Please check this box if your insurance ID number includes your Social Security Number. If this is the case, PUSH may only submit claims to your insurance company if you give us authorization to do so: I hereby authorize PUSH to release my Social Security Number, as necessary, to file a claim with my insurance. For questions about insurance or billing, call (765) 494-1677 Questions about immunizations should be directed to (765) 494-1837 For prescriptions, this information must also be provided to the Pharmacy. DPHHS-QAD/CCL-50A (Revised 06-2003) Replaces DPHHS-QAD-088a State of Montana Insurance Verification Form Based upon the Montana Child Care Act, § 52.http://www.dphhs.mt.gov/earlychildhood/forms/insuranceverification.pdf.2.723, it is required that all registered day care facilities have CURRENT PUBLIC LIABILITY INSURANCE and CURRENT FIRE INSURANCE This Must Be FILLED OUT and SIGNED By The INSURANCE AGENT (Provider Name) (Address that Insurance is effective for) Is covered by a PUBLIC LIABILITY insurance policy Provided by (Name of Insurance Company) This Must Be FILLED OUT and SIGNED By The INSURANCE AGENT (Provider Name) (Address that Insurance is effective for) The above named is covered by a FIRE INSURANCE policy Provided by (Name of Insurance Company) Does this fire insurance automatically renewal with the provider’s mortgage? [ ] Yes [ ] No Is this a new policy for the above named provider? [ ] Yes [ ] No Does the provider [ ] Own or [ ] Rent the building where your facility is located? Most people have their first contact with an insurance company through an insurance sales agent.http://www.bls.gov/oco/pdf/ocos118.pdf. Insurance sales agents who work exclusively for one insurance company are referred to as captive agents. Independent insur-ance agents, or brokers, represent several companies and place insurance policies for their clients with the company that offers the best rate and coverage. Health insurance agents sell health insurance policies that cover the costs of medical care and loss of income due to illness or injury. They also may sell dental insurance and short-term and long-term-disability insurance policies. College training may help agents grasp the technical aspects of insurance policies and the fundamentals and procedures of sell-ing insurance. College courses in fi nance, mathematics, accounting, econom-ics, business law, marketing, and business administration enable insurance sales agents to understand how social and economic conditions relate to the insurance industry. Separate licenses are required for agents to sell life and health insurance and property and casualty insurance. In most States, licenses are issued only to applicants who complete specifi ed prelicensing courses and who pass State examinations covering insurance fundamentals and State insurance laws. For example, The National Alliance for Education and Research offers a wide variety of courses in health, life and property, and casualty insurance for independent insurance agents. Agents can enhance their selling skills and broaden their knowledge of insurance and other fi nancial services by taking courses at colleges and universities and ... The Secretary of State's office does not maintain insurance information for all registered motor vehi-cles.http://www.cyberdriveillinois.com/publications/pdf_publications/vsd36110.pdf. Insurance information is available only from the motorist involved in the accident or from the report filed with IDOT. Contact an insurance agent to buy liability insurance for your vehicle. Some companies do not sell insur-ance to vehicle owners who have been driving unin-sured. If you have problems buying insurance, ask your insurance agent about the Illinois Automobile Insurance Plan. Under Illinois law, liability insurance policies auto-matically include uninsured motorist coverage at the legal minimum requirements for bodily injury or death. The Illinois Department of Insurance regulates insur-ance companies, agencies and agents. It maintains a Consumer Services Division that can answer your questions about auto insurance. Mandatory vehicle insurance is a necessary consumer protection measure that helps protect motorists from the risks associated with owning and driving a vehicle. In Illinois, all motorists are required by law to be covered by liability insurance to defray the cost of injuries or damages caused to other persons or their property in a crash. Keep in mind that the required minimum liability coverage is only the foundation of any auto insurance policy. If insurance companies decline your request for vehicle insurance, ask an insurance agent about the Illinois Automobile Insurance Plan. Your insurance company should send you an insurance card, usually when your policy is issued or renewed. Any person who receives court supervision for a mandatory insurance violation or who is convicted of a third ... Service Provider agrees to keep in full force and effect and maintain at its sole cost and expense the following policies of insurance with the specified minimum limits of liability during the term of this Agreement: (i) Workers’ Compensation and Employer’s Liability Insurance in full compliance with the The limits of liability of Workers' Compensation Insurance shall be not less than the limits required by applicable Law.http://www.dir.state.tx.us/datacenter/docs/Contract/ex24-insurance.pdf. The limits of liability of Employer’s Liability Insurance with minimum limits of $1,000,000 per employee by accident / $1,000,000 per employee by disease / $1,000,000 policy limit by disease (or, if higher, the policy limits required by applicable Law). (v) Comprehensive Crime Insurance including Employee Dishonesty Insurance and computer fraud insurance, covering the loss of money, securities, and other property belonging to DIR or a DIR Customer resulting from any fraudulent or dishonest acts committed by Service Provider employees, acting alone or with others, in an amount not All such insurance shall be procured with reputable insurance companies and in such form as is usual and customary to Service Provider’s business. Such insurance companies shall maintain a rating at least “A-” and be at least a Financial Size Category VIII (except for “all risk” property insurance, above, where Service Provider has the right to self insure via its captive insurance companies) as both criteria are defined in the most current publication of Service Provider’s insurance policies as required herein under Sections 1(a)(ii) and (iii) of this Exhibit 24 shall name DIR and DIR Customers and their respective officers, ... The objective of this paper is to introduce the concept of mortgage default insurance as developed in the United States into the context of Russian mortgage lending.http://www.urban.org/uploadedPDF/410832_mortgage_default.pdf. The first part of the paper discusses the broad principles and operations of mortgage default insurance offered by private companies as it works in the United States. The pricing of this product and the preconditions for offering such insurance are highlighted. The final part applies the foregoing information to the situation in Russia today and concludes that the conditions necessary for launching mortgage default insurance do not currently exist in the country. Mortgage guaranty insurance, sometimes called default insurance, protects against lender or investor loss by reason of borrower default (credit failure) accompanied by insufficient recoverable value in the property securing the insured loan. To mitigate this risk, it is desirable for mortgage default insurance to be issued over diverse regions of a country and for a large number of loans to be insured. However, an exception is granted for loans over 80 percent LTV that carry mortgage default insurance from a qualified insurance provider, in which instance the lender making such a “high-ratio” insured loan benefits from a reduced 50 percent capital standard. Standard practice among private insurance companies is to base the premiums for mortgage default insurance on the past experience of insurers providing such policies. In most countries, private insurers base their initial rates on the experience of pioneering public sector insurance companies. Typically defined as the percentage of insured loans ... Although every effort has been made to ensure the accuracy of the information contained in this document, all parties are advised to consult the Texas Insurance Code, the Texas Administrative Code and other applicable laws, regarding the extent and nature of their own requirements.http://www.tdi.state.tx.us/forms/lhlifehealth/lhl341ilckwt.pdf. Any overdue premium or installment and any interest charged, may be deducted from the death benefit if the insured dies during the grace period. The policy may provide that if the insured commits suicide, while sane or insane, within two years from the effective date, liability will be limited to the amount of premiums paid. If more than one person is insured, then the policy must address incontestability with respect to each insured. The policy must provide that all statements made by the insured, in the absence of fraud, are representations and not warranties. If more than one life is insured, the amount payable on death may be adjusted due to the misstatement in the age of a surviving insured. Policies with nonforfeiture benefits must provide for reinstatement within three years, or longer, upon submission of evidence of insurability and payment of all past due premiums with interest. Example: A suicide clause must define any effect the suicide of one insured would have on the insurance of other insureds. The application and the schedule page must disclose the deferred nature of the insurance and the amount of insurance in force during the deferred period. The contract of deferred insurance and accidental death benefit must reflect a different form number from any other contract of deferred insurance the company offers. If the same policy is ... Do you have health insurance? If yes, please attach a front and back copy of your insurance card If you have no insurance or if neither box is checked, you will be charged and enrolled in the Student Insurance Program.http://www.southern.edu/library/acceptancePacket/healthInsuranceInfo.pdf. SAU does not verify the existence or scope of the coverage claimed above. Plan verification is the responsibility of the student, parent or legal guardian. The University Health Center does not bill private insurance. For services rendered, a walk-out statement can be requested by the student to submit to their insurance company. The Student Insurance Plan provides sickness and accident protection for the student in coordination with the University Health Center. University policy requires students to be protected by Accident and Sickness insurance. This can be done by enrolling in the Student Insurance Plan or providing proof of adequate insurance coverage. If proof of insurance is not on file, you will be enrolled in the Student Insurance Plan and the premium will be charged to the student account. If you have any questions about the Student Insurance Policy or to inquire about current premium rates, please contact the Risk Management Department, (423)236-2566. Pennsylvania law requires all Pennsylvania motor vehicle owners to maintain vehicle liability insurance (financial responsibility) on a currently registered vehicle.http://www.dmv.state.pa.us/pdotforms/fact_sheets/fs-inla.pdf. Vehicle liability insurance covers the property damage or injuries you may cause others in an accident. A lapse in insurance coverage results in the suspension of your vehicle registration privilege for three months, unless the lapse of insurance was for a period of less than 31 days and the owner or registrant proves to the Department that the vehicle was not operated during this short lapse in coverage. Please note that insurance companies are required to notify PennDOT when an insurance policy is cancelled by the insured or the insurer. Insurance companies are NOT required by law to notify PennDOT when a vehicle owner acquires a new insurance policy with the same or different insurance company. You are in compliance with the law if you have liability insurance in the following amounts: $15,000 for injury or death of one person in an accident $30,000 for injury or death of more than one person in an accident $5,000 for damage to property of another person Your insurance company sends you an insurance identification (I.D.) card valid for only the period for which coverage has If your motor vehicle is not insured with liability insurance, you could face the following penalties and expenses: A minimum of $300 fine for driving uninsured A three-month suspension of your vehicle registration A three-month suspension of your driver’s license $50 restoration fee to restore your vehicle registration 3. In some cases, insurance information listed on vehicle ... PERS offers health and dental insurance to PERS retirees and eligible dependents.http://www.oregon.gov/PERS/RET/docs/health_insurance_program/retiree_health_insurance.pdf. Within 90 days following your effective retirement date, you may apply for coverage under one of the PERS group health and dental insurance plans. You may also enroll in the PERS health and dental insurance programs later, provided you were in a group plan for at least the two prior years. The insurance premiums may be deducted from your monthly retirement benefit. For information on PERS-sponsored health and dental insurance, call 503-224-7377 (in the Portland area) or 800-768-7377 (outside of Portland) or write to the PERS Health Insurance Program at PO Box 40187, Portland, OR 97240-0187. You should also determine what retiree insurance plans are available through your employer or as a dependent on your spouse’s insurance. For information on employer-sponsored health insurance, contact your personnel or payroll office. If you have any questions about your eligibility for enrollment, or RHIA or RHIPA contributions, or would like a copy of the complete eligibility rules, please call the PERS Health Insurance Program at 1-800-768- 7377 or visit http://arcweb.sos.state.or.us/rules/OAR_default.html. For more detailed information regarding requirements for coverage, contact the PERS Health Insurance Program at 1-800-768-7377. 4. c) The child is nineteen (19) years of age or more and has either been continuously dependent upon the retiree since childhood due to disability or physical handicap, or had been covered under a healthcare insurance plan as the retiree’s dependent for at least twenty-four (24) consecutive months If you drop your Part ... If the insurance coverage is under one parent/guardian, information must still be completed on the other parent/guardian.. If there is no insurance coverage, it is still necessary to complete all appropriate information on the page. Please include a copy of the insurance card, and please write the starting and termination dates for coverage. It may also be necessary to provide proof that the student-athlete is a full-time student to the insurance coverage. The insurance company may not tell you this. Please check with your insurance company to find out if they need such documentation. If you do not have insurance, you may purchase insurance through the University. They will be able to instruct you on how to purchase the insurance coverage. ATHLETE MEDICAL INSURANCE INFORMATION Our athletic accident policy, which provides insurance for your son/daughter for injuries occurring while participating in the play or practice of intercollegiate sports, is “EXCESS” or “SECONDARY” to any other group insurance benefits. Benefit claims must first be filed with the group insurance company providing primary coverage to you son/daughter. After they have paid all available benefits, our athletic insurance company will consider remaining amounts based on USUAL and CUSTOMARY charges. 1. We, as the school, do not have the option of waiving the requirement of filing with your group insurance. 2. Most employer’s group insurance allows dependents coverage to be continued to age 23 if the dependent is a full-time student. 3. Claims against your group insurance plan DO NOT increase your individual insurance premiums. In order to purchase individual life, health, or disability income insurance you usually have to prove that you are healthy through a process the insurance industry calls “medical underwriting. http://www.hcvadvocate.org/hepatitis/About_Hepatitis_pdf/1.1.1_Living_With_HepatitisC/Purchasing_individual_insurance.pdf.” In this process, the insurance company reviews the person’s medical history, statements from their physicians, and frequently, the results of a physical exam administered by the insurance company. The company then decides whether or not to sell insurance to the person and at what price. This applies to virtually all types of insurance that you want to purchase individually or for your family from an insurance company or through an insurance agent. Individual Health Insurance – Because persons with Hepatitis C can be expected to have higher than “normal” medical bills, a person with Hepatitis C, regardless of how well controlled or stable, will not be able to get health insurance if medical underwriting is required. [There are sources of health insurance that do not require medical underwriting. Look for next month’s article on how to get health insurance if you are “uninsurable.”] Disability Income Insurance – Likewise, persons with Hepatitis C will be unable to work due to medical problems more often than the average person so insurance companies will generally not accept someone with Hepatitis C for individual The best source of disability insurance for a person with Hepatitis C is employer based Long Term Disability (LTD) Insurance. Life Insurance – Unlike health and disability insurance, underwriters who review life insurance applications are interested only in life expectancy, not future medical bills or periods
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