Group Hospital Insurance Certificate

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. IMPORTANT NOTICE REGARDING YOUR INSURANCE In the event You need to contact someone about this insurance for any reason please contact Your agent. If no agent was involved in the sale of this insurance, or if You have any questions you may contact Us at the address above or by calling toll-free 1-800-732-1603. If you are unable to contact or obtain satisfaction from the company or agent, you may contact the Virginia State Corporation Commission’s Bureau of Insurance at the following address and telephone numbers: P.O. Box 1157 Richmond Virginia 23218-1157 (804) 371-9741 (local) (800) 552-7945 (VA toll-free) (877) 310-6560 (national toll-free)

Written correspondence is preferable so that a record of your inquiry is maintained. When contacting your agent, company or Bureau of Insurance, have your policy number available.

West Virginia residents :

THIS POLICY DOES NOT QUALIFY FOR MINIMUM ESSENTIAL COVERAGE

TEN DAY RIGHT TO EXAMINE POLICY The Policyholder has the right to return this Policy to Us within 10 days of receipt, and to have the premium refunded if, after examination, the Policyholder is not satisfied with this Policy for any reason.

Made with FlippingBook - PDF hosting