DVH/DVH Select Agent Guide

Agent Guide | Dental, Vision & Hearing

ManhattanLife Insurance and Annuity Company

Definitions Claim Processing:

Claims billing is determined by the provider; Providers can bill MIAC by completing the ADA form or insured can file a claim by completing the MIAC claim form. Claims forms must be submitted with supporting documentation. DVH Select: The policy form is a Limited Dental, Vision & Hearing product. The product has the Vision and Hearing benefits filed as Riders. Claims may be filed up to 15 months from the service date. Effective Dates The Effective Date of a policy will be the policy date on the policy schedule page. It is not the date the application is signed. The effective date cannot be the application signature date. Policyholders can choose 1 day after, or up to 6 months from the signature date. Effective dates can only be from the 1st to the 28th of any month. Effective Date Changes Policyholders can request an effective date up to 180 days from the signature date. Changes can be made by contacting customer service at 1-800-999-2971. We do not back date policy effective dates beyond the application signature date. Rider Additions DVH Select: The Vision and Hearing Riders can be added during the 30-day free look period by submitting a new application and referencing the existing policy number.

To add Riders after the Free Look period, the agent/policyholder would need to re-apply, via paper or ManhattanLife 2.0, including the riders and referencing the original policy number. The original policy would then need to be closed after the new policy with Riders is established. Waiting periods and benefit tenure will not be waived under the new policy. If a Rider is added, waiting periods reset.

Benefit Increases • Benefit increases (Policy Year Maximum) can be processed via amendment within 30 days prior to the policy anniversary date by submitting a new application and referencing the original policy number • After the 30-day free look period, a new application is required for the benefit increase, and the original policy number should be referenced upon submission • If the original policy included the Vision and Hearing Rider and the insured wishes to keep the original

benefits, the new application needs to include the Riders and the premium • Waiting periods on added benefit will reset upon an increase in benefits

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