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Atlantis Health Plan Member Handbook- POS
Benefit Coverage Timely payment of premiums is required in order to continue health care coverage and benefits. The Plan may terminate coverage and benefits based on non-payment of premiums as defined in the Subscriber Contract and/or Group Remittance Agreement. Coordination of Benefits for Group Members If you are covered under any other health insurance plan, tell your doctor and AHP. Any time more than one Group health insurance policy is effective for an individual, the insurance companies must coordinate their payments to ensure all covered services are paid, and that the combined payments do not exceed the charges for the services rendered. The rules that determine which insurance carrier is primary or secondary are standard in the insurance industry. However, all AHP procedures must be followed in order for AHP to assume payment, even if AHP coverage is not primary. Therefore, remember to see your Primary Care Provider for referrals to participating AHP providers. Should you have questions about Coordination of Benefits after carefully reading the information in your Subscriber Contract, please call the AHP Member Services Department at 1-866-747-8422. Termination of Coverage Your coverage and/or the coverage of your dependents may terminate for the following reasons:
Continuation of Group Coverage Should you or your dependents become ineligible for coverage through your current group, you may be able to continue the coverage if you qualify as required by the Federal Consolidated Omnibus Budget Reconciliation Act (COBRA) or the laws of the State of New York. Please contact your employer for further details of this and other applicable laws.
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