This is NOT a guarantee that benefits will be paid. This patient is listed in our
computer system as a participant in UABT. However, we cannot guarantee that he/she
is covered because a loss of coverage may not have been reported to us or entered
into our system. In addition, if the participant or the participant's employer is
required to make a premium payment and fails to do so in the time allowed, there
will be no coverage. The information provided is as of this date, and we do not
assume any obligation to notify you of any changes in benefits or eligibility.
The complete Plan Document defines the benefits, limitations (including but not limited
to a pre-existing condition limitation), exclusions, and other provisions of this plan.
Payment of benefits can be limited or denied as a result of these limitations or
exclusions. As a courtesy, we are including a very brief schedule of the plan
benefits, but it does not describe every limitation, exclusion, or provision of
the Plan Document that could disallow your claim for benefits. If there is an error
or misunderstanding in the schedule, the Plan Document controls. A copy of the entire
Plan Document has been provided to the participant. Rather than rely on this schedule,
you may want to avoid this risk by obtaining a copy of the Plan Document from the
participant. Be aware that your claim, or a portion thereof, can also be denied if
benefits are exhausted before your claim is processed.
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