It is important to notify us right away when coverage is ending for a member of your group. Be sure to notify us when:
To notify us of a termination, please complete a Cancellation Authorization Form
Submitting termination information prior to the effective date reduces the chance of paying claims for services rendered after a member’s termination date. You can inform us any time before or during the month the termination is to be effective, and you may request a specific effective date for the termination. All requests should be received within 60 days of the termination date. Additionally, please note that our policy is to only refund current plus 60 days.
When an employee’s coverage is terminated, the coverage for his or her spouse and child(ren), if any, also ends. All retroactive cancellations must be received within 60 days of the requested effective date.
The employee should submit a Cancellation Authorization Form
, completing all necessary fields including Dependent Name to be cancelled, Cancellation Effective Date, and Coverage Being Cancelled. The employee needs to sign the form and return it to you for submission to us.