State Notices
Group Short Term Disability Income Insurance
Insured by Humana Insurance Company or Humana Insurance Company of Kentucky
11/2023
IMPORTANT INFORMATION FOR RESIDENTS OF CERTAIN STATES: Summarized below
are state specific requirements that may change the provisions described in the group disability insurance
certificate. If you live in a state that has such requirements, those requirements will apply to your group
short term disability insurance coverage. Additional contact information for questions or complaints are
also included in the summary if the state required it. Updated state-specific requirements are published on
our website at www.humana.com. If you have questions or need a printed copy of these requirements,
please contact us at 866-427-7478 (TTY 711) or at the address on your Certificate of Insurance.
If your policy is governed under the laws of Maryland:
1. Any of the benefits, provisions or terms that apply to the state you reside in as shown below
will apply only to the extent that such state requirements are more beneficial to you.
Alaska:
1.
The Policy Interpretation provision, if shown in the General Provisions section of the
Certificate, is not applicable.
Arizona:
1.
NOTICE: The Certificate may not provide all benefits and protections provided by law in
Arizona. Please read the Certificate carefully.
Arkansas:
1.
NOTICE: You have the right to file a complaint with the Arkansas Insurance Department
(AID). You may call AID to request a complaint form at (800) 852-5494 or (501) 371-2640
or write the Department at:
Arkansas Insurance Department
1 Commerce Way, Suite 102
Little Rock, AR 72202
2.
The Policy Interpretation provision, if shown in the General Provisions section of the
Certificate, does not apply to you.
California:
1.
NOTICE: READ YOUR CERTIFICATE CAREFULLY
You have a 30 day right from Your original Certificate Effective Date to examine Your
certificate. If You are not satisfied, You may return it to Us within 30 days of Your original
Certificate Effective Date. In that event, We will consider it void from its Effective Date and
any premiums paid will be refunded. Any claims paid under The Policy during the initial 30-day
period will be deducted from the refund.
PLEASE BE ADVISED THAT YOU RETAIN ALL RIGHTS WITH RESPECT TO YOUR
POLICY/CERTIFICATE AGAINST YOUR ORIGINAL INSURER IN THE EVENT THE
ASSUMING INSURER IS UNABLE TO FULFILL ITS OBLIGATIONS. IN SUCH
EVENT YOUR ORIGINAL INSURER REMAINS LIABLE TO YOU
NOTWITHSTANDING THE TERMS OF ITS ASSUMPTION AGREEMENT.
2.
The Policy Interpretation provision, if shown in the General Provisions section of the
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Certificate, does not apply to you. The following requirement applies to you:
Eligibility Determination: How will We determine Your eligibility for benefits?
We, and not Your Employer or plan administrator, have the responsibility to fairly,
thoroughly, objectively and timely investigate, evaluate and determine Your eligibility or Your
beneficiaries for benefits for any claim You or Your beneficiaries make on The Policy. We
will:
1)
obtain with Your cooperation and authorization if required by law, only such
information that is necessary to evaluate Your claim and decide whether to accept or
deny Your claim for benefits. We may obtain this information from Your Notice of
Claim, submitted proofs of loss, statements, or other materials provided by You or
others on Your behalf; or, at Our expense We may obtain necessary information, or have
You physically examined when and as often as We may reasonably require while the
claim is pending. In addition, and at Your option and at Your expense, You may
provide Us and We will consider any other information, including but not limited to,
reports from a Physician or other expert of Your choice. You should provide Us with all
information that You want Us to consider regarding Your claim;
2)
as a part of Our routine operations, We will apply the terms of The Policy for making
decisions, including decisions on eligibility, receipt of benefits and claims, or explaining
policies, procedures and processes;
3)
if We approve Your claim, We will review Our decision to approve Your claim for
benefits as often as is reasonably necessary to determine Your continued eligibility for
benefits;
4)
if We deny Your claim, We will explain in writing to You or Your beneficiaries the
basis for an adverse determination in accordance with The Policy as described in the
provision entitled Claim Denial.
In the event We deny Your claim for benefits, in whole or in part, You can appeal the decision
to Us. If You choose to appeal Our decision, the process You must follow is set forth in The
Policy provision entitled Claim Appeal. If You do not appeal the decision to Us, then the
decision will be Our final decision.
3.
For Your Questions and Complaints:
State of California Insurance Department
Consumer Communications Bureau
300 South Spring Street, South Tower
Los Angeles, CA 90013
Toll Free: (800) 927-HELP
TDD Number: (800) 482-4833
Web Address:
www.insurance.ca.gov
Colorado:
1.
Entering a civil union, terminating a civil union, the death of a party to a civil union or a party to
a civil union losing employment, which results in a loss of group insurance, will all constitute as
a Change in Family Status.
2.
The Complications of Pregnancy provision, if shown in the Definitions section of the
Certificate, is revised as follows:
Complications of Pregnancy means a condition whose diagnosis is distinct from pregnancy but
adversely affected or caused by pregnancy, such as:
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1)
acute nephritis or nephrosis;
2)
cardiac decompensation;
3)
missed abortion; and
4)
similar medical and surgical conditions of comparable severity.
Complications of Pregnancy will also include:
1)
pre-eclampsia;
2)
placenta previa;
3)
physician prescribed bed rest for intra-uterine growth retardation, funneling, incompetent
cervix;
4)
termination of ectopic pregnancy;
5)
spontaneous termination of pregnancy, occurring during a period of gestation in which
a viable birth is not possible;
6)
non-elective Cesarean section; and
7)
similar medical and surgical conditions of comparable severity.
However, the term Complications of Pregnancy will not include:
1)
elective Cesarean section;
2)
false labor, occasional spotting, or morning sickness;
3)
hyperemesis gravidarum; or
4)
similar conditions associated with the management of a difficult pregnancy not
consisting of a nosologically distinct Complication of Pregnancy.
3.
The Claim Appeal provision will always include the following:
In addition, if a claim for benefits is wholly or partially denied and all administrative remedies
have been exhausted, You are entitled to pursue such claim anew, from the beginning, in a
court with jurisdiction and entitled to a trial by jury.
4.
The Policy Interpretation provision, if shown in the General Provisions section of
the Certificate, is not applicable.
Florida:
1.
NOTICE: The benefits of the policy providing you coverage may be governed primarily by
the laws of a state other than Florida.
Georgia:
1.
NOTICE: The laws of the state of Georgia prohibit insurers from unfairly discriminating against
any person based upon his or her status as a victim of family abuse.
Idaho:
1.
For Your Questions and Complaints:
Idaho Department of Insurance
Consumer Affairs
700 W State Street, 3rd Floor
PO Box 83720
Boise, ID 83720-0043
Toll Free: 800-721-3272
Web Address: www.DOI.Idaho.gov
2.
Notice to Buyer: This is a disability income protection policy.
11/2023
3.
The Benefits Commence provision, shown in the Schedule of Insurance section of the
Certificate, cannot exceed:
1)
90 days for plan designs with a Maximum Duration of Benefits Payable of 1 year or less;
2)
180 days for plan designs with a Maximum Duration of Benefits Payable of more than 1
year but less than 2 years; or
3)
365 days for plan designs with a Maximum Duration of Benefits Payable of 2 years or more.
4.
The Maximum Duration of Benefits Payable provision, shown in the Schedule of Insurance
section of the Certificate, cannot be less than 6 months. If the plan design includes both short
term and long term disability benefits, the combined short term disability and long term
disability Maximum Duration of Benefits cannot be less than 6 months.
Illinois:
1.
The Policy Interpretation provision, if shown in the General Provisions section of the
Certificate, is not applicable.
2.
For Your Questions and Complaints:
Illinois Department of Insurance
Office of Consumer Health Insurance
320 West Washington Street
Springfield, Illinois 62767
Consumer Assistance: (866) 445-5364
Officer of Consumer Health Insurance: (877) 527-9431
3.
In accordance with Illinois law, insurers are required to provide the following NOTICE to
applicants of insurance policies issued in Illinois.
STATE OF ILLINOIS
The Religious Freedom Protection and Civil Union Act
Effective June 1, 2011
The Religious Freedom Protection and Civil Union Act (“the Act”) creates a legal relationship
between two persons of the same or opposite sex who form a civil union. The Act provides that
the parties to a civil union are entitled to the same legal obligations, responsibilities, protections
and benefits that are afforded or recognized by the laws of Illinois to spouses. The law further
provides that a party to a civil union shall be included in any definition or use of the terms
“spouse,” “family,” “immediate family,” “dependent,” “next of kin,” and other terms
descriptive of spousal relationships as those terms are used throughout Illinois law. This
includes the terms “marriage” or “married,” or variations thereon. Insurance policies are
required to provide identical benefits and protections to both civil unions and marriages. If
policies of insurance provide coverage for children, the children of civil unions must also be
provided coverage. The Act also requires recognition of civil unions or same sex civil unions or
marriages legally entered into in other jurisdictions.
For more information regarding the Act, refer to 750 ILCS 75/1 et seq. Examples of the
interaction between the Act and existing law can be found in the Illinois Insurance Facts,
Civil Unions and Insurance Benefits document available on the Illinois Department of
Insurance’s website at https://idoi.illinois.gov.
11/2023
Indiana:
1.
Questions regarding your policy or coverage should be directed to:
Humana Insurance Company
(866) 427-7478
If you (a) need the assistance of the governmental agency that regulates insurance; or (b)
have a complaint you have been unable to resolve with your insurer you may contact the
Department of Insurance by mail, telephone or email:
State of Indiana Department of Insurance
Consumer Services Division
311 W. Washington St. Suite 300
Indianapolis, IN 46204-2787
Consumer Hotline: (800) 622-4461; (317) 232-2395
Complaints can be filed electronically at www.in.gov/idoi.
Kansas:
1.
The following requirement applies to you:
Policy Interpretation: Who interprets Policy terms and conditions?
Pursuant to the Employee Retirement Income Security Act of 1974, as amended (ERISA), Your
Employer has delegated to Us the fiduciary responsibility to determine eligibility for benefits
and to construe and interpret all terms and provisions of The Policy. Therefore, We are a
fiduciary for The Policy and We have the continuing duty to act prudently and in the interest of
You, Your beneficiaries and the other plan participants. If You have a claim for benefits which
is denied or ignored, in whole or in part, then You may file suit in state or federal court for a
review of Your eligibility or entitlement to benefits under The Policy. This provision only
applies where the interpretation of The Policy is governed by ERISA.
Louisiana:
1.
The following requirement applies to you:
Reinstatement after Military Service: Can coverage be reinstated after return from active
military service?
If:
1)
Your coverage terminates because You enter active military service; and
2)
You are rehired within 12 months of the date You return from active military service;
then coverage for You may be reinstated, provided You request such reinstatement
within 30 days of the date You return to work.
The reinstated coverage will:
1)
be the same coverage amounts in force on the date coverage terminated; and
2)
not be subject to any Waiting Period for Coverage, Evidence of Insurability or Pre-
existing Conditions Limitations; and be subject to all the terms and provisions of The
Policy.
Maine:
1.
NOTICE: The benefits under the policy are subject to reduction due to other sources of income.
11/2023
This means that your benefits will be reduced by the amount of any other benefits for loss of time
provided to you or for which you are eligible as a result of the same period of disability for
which you claim benefits under the policy.
Other sources of income are plans or arrangements of coverage that provide disability-related benefits
such as Worker’s Compensation or other similar governmental programs or laws, or disability-
related benefits received from your employer or as the result of your employment, membership or
association with any group, union, association or other organization. Other sources of income
include disability-related benefits under the United States Social Security Act or an alternate
governmental plan, the Railroad Retirement Act, and other similar plans or acts. Other sources
of income may also include certain disability-related or retirement benefits that you receive
because of your retirement unless you were receiving them prior to becoming disabled.
What comprises other sources of income under the policy is determined by the nature of the
policyholder. Therefore, we strongly urge you to Read Your Certificate Carefully. A full
description of the plans and types of plans considered to be other sources of income under the
policy will be found in the definition of “Other Income Benefits” located in the Definitions
section of your certificate.
2.
NOTICE: The laws of the State of Maine require notification of the right to designate a
third party to receive notice of cancellation, to change such a designation and, to have the
Policy reinstated if the insured suffers from cognitive impairment or functional incapacity
and the ground for cancellation was the insured's nonpayment of premium or other lapse or
default on the part of the insured.
Within 10 days after a request by an insured, a Third Party Notice Request Form shall be
mailed or personally delivered to the insured.
3.
The following requirement applies to you:
Reinstatement: Can my coverage be reinstated after it ends?
We will reinstate The Policy upon receipt of all current and late premiums if:
1)
You, any person authorized to act on Your behalf, or any of Your dependents may
request reinstatement of The Policy within 90 days following cancellation of The
Policy for nonpayment of premium provided You suffered from cognitive impairment
or functional incapacity at the time the contract cancelled; and
2)
all current and late premium payments are received within 15 days of Our request.
We may request a medical demonstration, at Your expense, that You suffered from cognitive
impairment or functional incapacity at the time of cancellation of The Policy.
Massachusetts:
1.
The following continuation requirement applies to you:
In accordance with Massachusetts state law, if Your insurance terminates because Your
employment terminates or You cease to be a member of an eligible class, Your insurance will
automatically be continued until the end of a 31 day period from the date Your insurance
terminates or the date You become eligible for similar benefits under another group plan,
whichever occurs first. You must pay the required premium for continued coverage.
Additionally, if Your insurance terminates because Your employment is terminated as a result
11/2023
of a plant closing or covered partial closing, Your insurance may be continued. You must elect
in writing to continue insurance and pay the required premium for continued coverage.
Coverage will cease on the earliest to occur of the following dates:
1)
90 days from the date You were no longer eligible for coverage as an Active Employee;
2)
the date You become eligible for similar benefits under another group plan;
3)
the last day of the period for which required premium is made;
4)
the date the group insurance policy terminates; or
5)
the date Your Employer ceases to be a Participant Employer, if applicable.
Michigan:
1.
The Policy Interpretation provision, if shown in the General Provisions section of the
Certificate, is not applicable.
Minnesota:
1.
The Policy Interpretation provision, if shown in the General Provisions section of the
Certificate, is not applicable.
Missouri:
1.
The Exclusions provision shall only exclude for intentionally self-inflicted Injury, suicide
or attempted suicide, which occur while You are sane.
Montana:
1.
NOTICE: Conformity with Montana statutes: The provisions of the certificate conform to the
minimum requirements of Montana law and control over any conflicting statutes of any state in
which the insured resides on or after the effective date of the certificate.
2.
Pregnancy will be covered, the same as any other Sickness, anything in The Policy to the contrary
notwithstanding.
3.
The definition of Physician in the Definitions section will include the following freedom of
choice language: You have full freedom of choice in the selection of any health care provider
for treatment within the scope and limitations of his or her practice, including a licensed
physician, physician assistant, dentist, osteopath, chiropractor, optometrist, podiatrist,
psychologist, licensed social worker, licensed professional counselor, licensed marriage and
family therapist, acupuncturist, naturopathic physician, physical therapist or advanced
practice registered nurse.
New Hampshire:
1.
If Your claim is denied, You may appeal to Us within 180 days of receipt of the claim
denial, subject to the other terms of the Claim Appeal provision.
2.
The time period stated for legal action to start in the Legal Actions provision shown in the
General Provisions section cannot be less than 3 years after the time Proof of Loss is required to
be given.
3.
The time period for receipt of Medical Care, as described in the Pre-existing Condition
definition of the Exclusions and Limitations section, is 3 consecutive months. No benefit or
increase in benefits for a Pre- existing Condition will be payable until You have been treatment
free or continuously insured for 9 consecutive months, or less respectively, if shown in the
Certificate.
11/2023
4.
Termination of coverage will not affect benefits otherwise payable for a claim incurred while the
Policy is in force.
5.
Notice: This is an ancillary health certificate. The certificate provides limited benefits.
Benefits provided are supplemental and are not intended to cover all medical expenses.
6.
Notice: READ YOUR CERTIFICATE CAREFULLY - You have a 30 day right to examine
Your certificate. If You are not satisfied, You may return it to Us within 30 days from the later
of Your original Certificate Effective Date or the date The Policy was received by the
Policyholder. In that event, We will consider it void from its Effective Date and any premiums
paid will be refunded. Any claims paid under The Policy during the initial 30-day period will be
deducted from the refund.
7.
Notice: The Policy does not provide comprehensive health insurance coverage. It is not
intended to satisfy the individual mandate of the Affordable Care Act (ACA) or provide the
minimum essential coverage required by the ACA (often referred to as "Major Medical
Coverage"). It does not provide coverage for hospital, medical, surgical, or major medical
expenses.
New York:
1.
The Other Income Benefits definition will not include a portion of a settlement or judgment of a
lawsuit that represents or compensates for Your loss of earnings.
2.
The Subrogation provision, if shown in the General Provisions section of the Certificate, is not
applicable.
3.
The Reimbursement provision, if shown in the General Provisions section of the Certificate, is
not applicable.
4.
If the definition of Surviving Spouse within the Survivor Income Benefit requires the completion
of a domestic partner affidavit, the following requirement applies to you:
The domestic partner affidavit must be notarized and requires that You and Your domestic
partner meet all of the following criteria:
1)
you are both legally and mentally competent to consent to
contract in the state in which you reside;
2)
you are not related by blood in a manner that would bar marriage under laws of the
state in which you reside;
3)
you have been living together on a continuous basis prior to the date of the application;
4)
neither of you have been registered as a member of another domestic partnership within
the last six months; and
5)
you provide proof of cohabitation (e.g., a driver’s license, tax return or other sufficient
proof).
The domestic partner affidavit further requires that You and Your domestic partner provide
proof of financial interdependence in the form of at least two of the following:
1)
a joint bank account;
2)
a joint credit card or charge card;
3)
joint obligation on a loan;
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4)
status as an authorized signatory on the partner’s bank account, credit card or charge
card;
5)
joint ownership of holdings or investments, residence, real estate other than residence,
major items of personal property (e.g., appliances, furniture), or a motor vehicle;
6)
listing of both partners as tenants on the lease of the shared residence;
7)
shared rental payments of residence (need not be shared 50/50)
8)
listing of both partners as tenants on a lease, or shared rental payments, for property
other than residence;
9)
a common household and shared household expenses (e.g., grocery bills, utility bills,
telephone bills, etc. and need not be shared 50/50);
10)
shared household budget for purposes of receiving government benefits;
11)
status of one as representative payee for the other’s government benefits;
12)
joint responsibility for child care (e.g., school documents, guardianship);
13)
shared child-care expenses (e.g., babysitting, day care, school bills, etc. and need not be
shared 50/50);
14)
execution of wills naming each other as executor and/or beneficiary;
15)
designation as beneficiary under the other’s life insurance policy;
16)
designation as beneficiary under the other’s retirement benefits account;
17)
mutual grant of durable power of attorney;
18)
mutual grant of authority to make health care decisions (e.g., health care power of
attorney);
19)
affidavit by creditor or other individual able to testify to partners’ financial
interdependence;
20)
other item(s) of proof sufficient to establish economic interdependency under the
circumstances of the particular case.
North Carolina:
1.
The Subrogation provision, if shown in the General Provisions section of the Certificate, is not
applicable.
2.
The Other Income Benefits definition will not include a mandatory "no-fault" automobile
insurance plan.
3.
You are not required to be under the Regular Care of a Physician if qualified medical
professionals have determined that further medical care and treatment would be of no benefit to
You.
4.
The Exclusions provision shall only exclude for Workers’ Compensation if the final
adjudication of the Worker’s Compensation claim determined that benefits are paid, or may be
paid, if duly claimed.
5.
Within the Misstatements provision reference to fraudulent misstatements will not apply to
You.
6.
The Sending Proof of Loss provision is amended to state that written Proof of Loss must be
sent to Us within 180 days following the completion of the Elimination Period.
7.
The Claims to be Paid provision is amended to state that We may pay up to $3,000 to a person
who is Related to You and who, at Our sole discretion, is entitled to it. Any such payment shall
fulfill Our responsibility for the amount paid.
11/2023
8.
Notice of Claim may also be given to Our representative, if applicable.
9.
NOTICE: UNDER NORTH CAROLINA GENERAL STATUTE SECTION 58-50-40, NO
PERSON, EMPLOYER, FINANCIAL AGENT, TRUSTEE, OR THIRD PARTY
ADMINISTRATOR, WHO IS RESPONSIBLE FOR THE PAYMENT OF GROUP LIFE
INSURANCE, GROUP HEALTH OR GROUP HEALTH PLAN PREMIUMS, SHALL:
1) CAUSE THE CANCELLATION OR NONRENEWAL OF GROUP LIFE INSURANCE,
GROUP HEALTH INSURANCE, HOSPITAL, MEDICAL, OR DENTAL SERVICE
CORPORATION PLAN, MULTIPLE EMPLOYER WELFARE ARRANGEMENT,
OR GROUP HEALTH PLAN COVERAGES AND THE CONSEQUENTIAL LOSS
OF THE COVERAGES OF THE PERSON INSURED, BY WILLFULLY FAILING
TO PAY THOSE PREMIUMS IN ACCORDANCE WITH THE TERMS OF THE
INSURANCE OR PLAN CONTRACT; AND
2) WILLFULLY FAIL TO DELIVER, AT LEAST 45 DAYS BEFORE THE
TERMINATION OF THOSE COVERAGES, TO ALL PERSONS COVERED BY THE
GROUP POLICY WRITTEN NOTICE OF THE PERSON'S INTENTION TO STOP
PAYMENT OF PREMIUMS. VIOLATION OF THIS LAW IS A FELONY. ANY
PERSON VIOLATING THIS LAW IS ALSO SUBJECT TO A COURT ORDER
REQUIRING THE PERSON TO COMPENSATE PERSONS INSURED FOR
EXPENSES OR LOSSES INCURRED AS A RESULT OF THE TERMINATION
OF THE INSURANCE.
IMPORTANT TERMINATION INFORMATION
YOUR INSURANCE MAY BE CANCELLED BY THE COMPANY. PLEASE READ THE
TERMINATION PROVISION IN THE CERTIFICATE.
THE CERTIFICATE OF INSURANCE PROVIDES COVERAGE UNDER A GROUP
MASTER POLICY. THE CERTIFICATE PROVIDES ALL OF THE BENEFITS
MANDATED BY THE NORTH CAROLINA INSURANCE CODE, BUT YOU MAY
NOT RECEIVE ALL OF THE PROTECTIONS PROVIDED BY A POLICY ISSUED IN
NORTH CAROLINA AND GOVERNED BY ALL OF THE LAWS OF NORTH
CAROLINA.
PRE-EXISTING LIMITATION
READ CAREFULLY
NO BENEFITS WILL BE PAYABLE UNDER THIS PLAN FOR PRE-EXISTING
CONDITIONS WHICH ARE NOT COVERED UNDER THE PRIOR PLAN. PLEASE
READ THE LIMITATIONS IN THE CERTIFICATE.
READ YOUR CERTIFICATE CAREFULLY.
Oregon:
1.
The following Jury Duty continuation applies for Employers with 10 or more employees:
Jury Duty: If You are scheduled to serve or are required to serve as a juror, Your coverage
may be continued until the last day of Your Jury Duty, provided You:
1)
elected to have Your coverage continued; and
2)
provided notice of the election to Your Employer in accordance with Your Employer’s
notification policy.
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Rhode Island:
1.
The Policy Interpretation provision, if shown in the General Provisions section of
the Certificate, is not applicable.
South Carolina:
1.
The Physical Examinations and Autopsy provision will state that such autopsy must be
performed during the period of contestability and must take place in the state of South
Carolina.
2.
If You become insured under The Policy on the Policy Effective Date and were insured under
the Prior Policy within 30 days of being covered under The Policy, the Pre-existing Condition
Limitation will end on the earliest of:
1)
the Policy Effective date, if Your coverage for the Disability was not limited by a pre-
existing condition restriction under the Prior Policy; or
2)
the date the restriction would have ceased to apply had the Prior Policy remained in
force, if Your coverage was limited by a pre-existing condition limitation under the
Prior Policy.
This is subject to the other terms and conditions of the Continuity From a Prior Policy
provision.
South Dakota:
1.
The definition of Physician can include You or a person Related to You by blood or marriage
in the event that the Physician is the only one in the area and is acting within the scope of their
normal employment.
2.
The Other Income Benefits definition will not include the amount of any benefit for loss of
income, provided to Your family, Your Spouse or Your Spouse’s family.
Texas:
1.
The Policy Interpretation provision, if shown in the General Provisions section of the
Certificate, is not applicable.
2.
NOTICE:
Have a complaint or need help?
If you have a problem with a claim or your premium, call your insurance company first. If you
can't work out the issue, the Texas Department of Insurance may be able to help.
Even if you file a complaint with the Texas Department of Insurance, you should also file a
complaint or appeal through your insurance company. If you don't, you may lose your right to
appeal.
Humana Insurance Company
To get information or file a complaint with your insurance company:
Call: Customer Care at 866-427-7478
Toll-free: 866-427-7478
Email: HumanaResolution@Humana.com
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Mail: Grievance and Appeal Department, P.O. Box 14546, Lexington, KY 40512-4546
The Texas Department of Insurance
To get help with an insurance question or file a complaint with the state:
Call with a question: 1-800-252-3439
File a complaint: www.tdi.texas.gov
Email: Consum[email protected]
Mail: Consumer Protection, MC: CO-CP, Texas Department of Insurance, P.O. Box 12030,
Austin, TX 78711-2030
¿Tiene una queja o necesita ayuda?
Si tiene un problema con una reclamación o con su prima de seguro, llame primero a su
compañía de seguros. Si no puede resolver el problema, es posible que el Departamento de
Seguros de Texas (Texas Department of Insurance, por su nombre en inglés) pueda ayudar.
Aun si usted presenta una queja ante el Departamento de Seguros de Texas, también debe
presentar una queja a través del proceso de quejas o de apelaciones de su compañía de seguros.
Si no lo hace, podría perder su derecho para apelar.
Humana Insurance Company
Para obtener información o para presentar una queja ante su compañía de seguros:
Llame a: servicio al cliente al 866-427-7478
Teléfono gratuito: 866-427-7478
Correo electrónico: HumanaR[email protected]
Dirección postal: Grievance and Appeal Department, P.O. Box 14546, Lexington, KY 40512-4546
El Departamento de Seguros de Texas
Para obtener ayuda con una pregunta relacionada con los seguros o para presentar una queja ante
el estado:
Llame con sus preguntas al: 1-800-252-3439
Presente una queja en: www.tdi.texas.gov
Correo electrónico: ConsumerPr[email protected]
Dirección postal: Consumer Protection, MC: CO-CP, Texas Department of Insurance, P.O. Box
12030, Austin, TX 78711-2030
Utah:
1.
If the Sending Proof of Loss provision provides a timeframe in which proof must be submitted
before it affects Your claim, this time limitation shall not apply to You.
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Vermont:
1.
The following requirement applies:
Purpose: Vermont law requires that health insurers offer coverage to parties to a civil union
that is equivalent to coverage provided to married persons.
Definitions, Terms, Conditions and Provisions: The definitions, terms, conditions or any
other provisions of the policy, contract, certificate and/or riders and endorsements to which this
mandatory endorsement is attached are hereby amended and superseded as follows:
1)
Terms that mean or refer to a marital relationship, or that may be construed to mean or
refer to a marital relationship, such as "marriage", "spouse", "husband", "wife",
"dependent", "next of kin", "relative", "beneficiary", "survivor", "immediate family"
and any other such terms, include the relationship created by a civil union established
according to Vermont law.
2)
Terms that mean or refer to the inception or dissolution of a marriage, such as "date of
marriage", "divorce decree", "termination of marriage" and any other such terms include the
inception or dissolution of a civil union established according to Vermont law.
3)
Terms that mean or refer to family relationships arising from a marriage, such as “family”,
“immediate family”, “dependent”, “children”, “next of kin”, “relative”, “beneficiary”,
“survivor” and any other such terms include family relationships created by a civil union
established according to Vermont law.
4)
"Dependent" means a spouse, a party to a civil union established according to Vermont
law, and a child or children (natural, stepchild, legally adopted or a minor or disabled
child who is dependent on the insured for support and maintenance) who is born to or
brought to a marriage or to a civil union established according to Vermont law.
5)
"Child or covered child" means a child (natural, step-child, legally adopted or a minor or
disabled child who is dependent on the insured for support and maintenance) who is born
to or brought to a marriage or to a civil union established according to Vermont law.
CAUTION: FEDERAL LAW RIGHTS MAY OR MAY NOT BE AVAILABLE
Vermont law grants parties to a civil union the same benefits, protections and
responsibilities that flow from marriage under state law. However, some or all of the
benefits, protections and responsibilities related to health insurance that are available to
married persons under federal law may not be available to parties to a civil union. For
example, federal law, the Employee Income Retirement Security Act of 1974 known as
“ERISA”, controls the employer/employee relationship with regard to determining
eligibility for enrollment in private employer health benefit plans. Because of ERISA, Act
91 does not state requirements pertaining to a private employer’s enrollment of a party to a
civil union in an ERISA employee welfare benefit plan. However, governmental employers
(not federal government) are required to provide health benefits to the dependents of a party
to a civil union if the public employer provides health benefits to the dependents of married
persons. Federal law also controls group health insurance continuation rights under COBRA
for employers with 20 or more employees as well as the Internal Revenue Code treatment of
health insurance premiums. As a result, parties to a civil union and their families may or
may not have access to certain benefits under the policy, contract, certificate, rider or
endorsement that derive from federal law. You are advised to seek expert advice to
determine your rights under this contract.
11/2023
Virginia:
1.
For Your Questions and Complaints:
State Corporation Commission
Bureau of Insurance
Life and Health Division
P.O. Box 1157
Richmond, VA 23218
(804) 371-9691 (inside Virginia)
(877) 310-6560 (outside Virginia)
Washington:
1. The following continuation applies to you:
General Work Stoppage (including a strike or lockout): If Your employment terminates due
to a cessation of active work as the result of a general work stoppage (including a strike or
lockout), Your coverage shall be continued during the work stoppage for a period not
exceeding 6 months. If the work stoppage ends, this continuation will cease immediately.
Wisconsin:
1.
KEEP THIS NOTICE WITH YOUR INSURANCE PAPERS
PROBLEMS WITH YOUR INSURANCE? - If you are having problems with your insurance
company or agent, do not hesitate to contact the insurance company or agent to resolve your
problem.
Humana Insurance Company
1100 Employers Blvd
Green Bay, Wisconsin 54344
(866) 427-7478
You can also contact the OFFICE OF THE COMMISSIONER OF INSURANCE, a state
agency which enforces Wisconsin's insurance laws, and file a complaint. You can file a
complaint electronically with the OFFICE OF THE COMMISSIONER OF INSURANCE at
its website at http://oci.wi.gov/. or by contacting:
For Your Questions and Complaints:
To request a Complaint Form:
Office of the Commissioner of Insurance
Complaints Department
P.O. Box 7873
Madison, WI 53707-7873
(800) 236-8517 (outside of Madison)
(608) 266-0103 (in Madison)
