LEGAL NOTICES
Patient Protection Notice
Your carrier generally may require the designation of a primary care provider. You have the right to designate any primary
care provider who participates in your network and who is available to accept you or your family members. Until you make
this designation, your carrier may designate one for you.
For children, you may designate a pediatrician as the primary care provider. You do not need prior authorization from your
carrier or from any other person (including a primary care provider) in order to obtain access to obstetrical or gynecological
care from a health care professional in your network who specializes in obstetrics or gynecology. The health care
professional, however, may be required to comply with certain procedures, including obtaining prior authorization for
certain services, following a pre-approved treatment plan, or procedures for making referrals.
HIPAA Special Enrollment Notice
If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance
or group health plan coverage, you may be able to enroll yourself and your dependents in this plan if you or your
dependents lose eligibility for that other coverage (or if the employer stops contributing toward your or your dependents’
other coverage). However, you must request enrollment within 30 days after your or your dependents’ other coverage ends
(or after the employer stops contributing toward the other coverage).
In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be
able to enroll yourself and your dependents. However, you must request enrollment within 30 days after the marriage, birth,
adoption, or placement for adoption.
HIPAA Privacy Notice Please contact HR if you have any questions or need assistance obtaining a privacy notice.
Notice Extension Of Dependent Coverage To Age 26 And Enrollment Opportunity
Individuals whose coverage ended, or who were denied coverage (or were not eligible for coverage), because the
availability of dependent coverage of children ended before attainment of age 26 are eligible to enroll in medical, dental
and vision programs. For more information contact your plan administrator.
Notice Lifetime Limit No Longer Applies And Enrollment Opportunity
The lifetime limit on the dollar value of benefits under United Healthcare medical program does not apply. Enrollment
opportunities for individuals who previously lost coverage due to a lifetime limit are available. For more information contact
your plan administrator.
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PRIVATE PREP BENEFITS GUIDE
LEGAL NOTICES
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