Acceptance of Group Agreement. The Group agrees as having accepted the terms and conditions of this Group Agreement and any amendments issued during the term of this Group Agreement, upon receipt by KFHPWA of any amount of premium payment. Xxxxxx Foundation Health Plan of Washington CA-2562a21, Xxxxxx Foundation Health Plan of Washington (“KFHPWA”) recommends each Member choose a Network Personal Physician. This decision is important since the designated Network Personal Physician provides or arranges for most of the Member’s health care. The Member has the right to designate any Network Personal Physician who participates in one of the KFHPWA networks and who is available to accept the Member or the Member’s family members. For information on how to select a Network Personal Physician, and for a list of the participating Network Personal Physicians, please call Xxxxxx Permanente Member Services at (000) 000-0000 in the Seattle area, or toll-free in Washington, 1-888-901-4636. For children, the Member may designate a pediatrician as the primary care provider. The Member does not need Preauthorization from KFHPWA or from any other person (including a Network Personal Physician) to access obstetrical or gynecological care from a health care professional in the KFHPWA network who specializes in obstetrics or gynecology. The health care professional, however, may be required to comply with certain procedures, including obtaining Preauthorization for certain services, following a pre-approved treatment plan, or procedures for obtaining Preauthorization. For a list of participating health care professionals who specialize in obstetrics or gynecology, please call Xxxxxx Permanente Member Services at (000) 000-0000 in the Seattle area, or toll-free in Washington, 1-000-000-0000. If the Member is receiving benefits for a covered mastectomy and elects breast reconstruction in connection with the mastectomy, the Member will also receive coverage for: • All stages of reconstruction of the breast on which the mastectomy has been performed. • Surgery and reconstruction of the other breast to produce a symmetrical appearance. • Prostheses. • Treatment of physical complications of all stages of mastectomy, including lymphedemas. These services will be provided in consultation with the Member and the attending physician and will be subject to the same Cost Shares otherwise applicable under the Evidence of Coverage (EOC). Carriers offering group health coverage generally may not, under federal law, restr...
Acceptance of Group Agreement. The Group agrees as having accepted the terms and conditions of this Group Agreement and any amendments issued during the term of this Group Agreement, upon receipt by KFHPWA of any amount of premium payment.
Acceptance of Group Agreement. Group acknowledges acceptance of the Group Agreement by signing the Group Agreement Face Sheet and returning it to Health Plan. If Group does not return it to Health Plan, Group will be deemed as having accepted this Agreement if Group pays Health Plan any amount toward Premiums. Group GROUP AGREEMENT FACE SHEET INTRODUCTION: This Group Agreement consisting of the Group Agreement and Group Evidence of Coverage as supplemented by this Face Sheet, has been entered into between Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc., (hereinafter “Health Plan”), and the organization (hereinafter “Group.”) GROUP: DEPT OF EDUCATION AGREEMENT EFFECTIVE DATE: 01/01/2024 OPEN ENROLLMENT PERIOD: Applications made during the Open Enrollment Period from 12/01 to 12/31 provide coverage effective 01/01/2024. MONTHLY PREMIUM:
Acceptance of Group Agreement. Group acknowledges acceptance of the Group Agreement by signing the Group Agreement Face Sheet and returning it to Health Plan. If Group does not return it to Health Plan, Group will be deemed as having accepted this Agreement if Group pays Health Plan any amount toward Premiums. TABLE Of CONTENTS
