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Why are you ordering medical records and why do they take so long to obtain? |
| An applicant’s medical history will determine if additional medical information is needed. Typically, a phone interview is the first step in this process. Based on the disclosure on the application or the disclosure in the phone interview, we may request medical records. We make every effort to obtain these records in a timely manner; however, we are dependent upon the medical provider to cooperate in furnishing this information to us. The agent or applicant can contact the medical provider to urge action to expedite the process. |
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Why does the List Bill Election Form need to be completed and submitted with my application for individual coverage? |
| This is your authorization to allow IAC to bill your monthly premium through your employer (or association). IAC will be unable to bill your premium on a payroll deduction basis without your authorization. |
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Why do we need to send in separate checks with the individual applications for list bill mode of payment? |
| To insure that the money will be applied to the correct applicant, we ask that separate checks be submitted for each application. |
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Why was my check cashed but I have been told I do not have insurance yet? |
| The money submitted with the application is placed in a special holding account until coverage is approved. If approved, this money is transferred from the special holding account and applied toward the first month’s premium. If not approved, the money in the special holding account is refunded directly to the primary applicant, less any non-refundable items. |
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How is the monthly premium calculated? |
| The monthly premium is based on age, geographic area, gender, tobacco use, the plan and benefit options selected, and any appropriate fees. Premiums may then be adjusted based on the applicant’s health status and/or occupation. |
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I requested a specific effective date but my coverage won’t be issued until after that date. What effective date will I get? |
| As long as an underwriting determination can be made within sixty days from the date on which the application was signed, coverage may be issued with your requested effective date. You can assist us in our ability to make an underwriting decision within this time frame by timely meeting any requirement for the issuance of the policy, such as completing telephone interviews, or encouraging your physician to provide medical records if requested. If coverage cannot be issued within sixty days of the date the application was signed, a new fully completed and signed application and a date other than the original requested effective date might be required. |
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If we remove the Optional Prescription Drug card benefit, will you remove the additional premium charged for prescription medication? |
| Yes, if the Optional Prescription Drug card is removed, the premium applicable to the drug coverage will be eliminated. However, if there is a separate distinct increase in premium for medical history, this will not be removed. |
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How long does the Specified Condition Waiver Rider remain in effect? |
| Specified Condition Waiver Riders do not expire. In most situations, they can be reviewed for possible removal after a minimum of 12 months provided the insured has not been seen or treated within the previous 12 months and complete medical records are submitted with the request. |
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Why is it necessary to submit a new application if a question is missed? |
| The application becomes part of the Certificate of Insurance and, as such, the applicant must complete all changes or amendments in writing. |
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Why is our initial premium deposit check cashed before notice is received of a final underwriting decision? |
| The initial premium deposit is placed in a holding account until a decision is made. If approved for coverage, but additional premium (or other requirements) is required, such additional premium (or requirements) is requested. When the additional premium (or other requirements) is remitted, coverage is placed inforce and funds from the holding account are applied to the premium due. If coverage is not approved, the original deposit is refunded. |
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Why is our monthly premium different than what was initially quoted? |
| Initial quotes are based on standard risk rates. Final premium rates may be affected by medical disclosure, as well as a delay of the effective date, employee census, plan selection, and other underwriting factors. |
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How are loads (or ratings) determined? |
| Loads or ratings are determined by a variety of factors including group size, group demographics, employee participation rates, the nature or type of business, employee health status, projected utilization, and cost of health care in the group’s geographic area. |
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Where is the issue Administrative Kits (certificates, ID cards, etc.) mailed? |
| Issue Administrative Kits are mailed to the Producer for delivery to the group, unless written instruction from the agent or employer is received requesting that they be mailed directly to the group. |
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