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Know Your Benefits - March 8, 2011
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Know Your Benefits - March 8, 2011

As part of our ongoing efforts to help members understand their benefits, the R&I Committee and ALPA National have produced the following document for FedEx MEC LTD Plan participants.  Please keep a copy of this procedure with your policy or refer to the R&I page of the FedEx MEC website.

Know Your Benefits - March 8, 2011

As part of our ongoing efforts to help members understand their benefits, the R&I Committee and ALPA National have produced the following document for FedEx MEC LTD Plan participants.  Please keep a copy of this procedure with your policy or refer to the R&I page of the FedEx MEC website.

Filing A FedEx MEC LTD Plan Claim

  1. When a FedEx pilot, insured under the FedEx MEC-sponsored LTD plan, becomes sick or injured, s/he should contact ALPA’s Member Insurance staff as soon as practical. Do NOT wait until sick leave is exhausted. It is helpful to begin the process early and there is no disadvantage to doing so. Contact:

Patricia Morse
ALPA Member Insurance
535 Herndon Parkway
Herndon, VA  20170
Ph:  800/746-2572 (746-ALPA)
Patricia.morse@alpa.org

  1. ALPA’s Member Insurance staff will return to the new claimant a set of four forms, provided to ALPA by agreement with Aetna, which should be completed and returned to ALPA at the address above, as soon as completed.
  2. At the same time, once notified, ALPA will send an Aetna-formatted form to Aetna’s FedEx MEC LTD plan claims staff, advising of the new claim.
  3. Once the initial four forms are returned to ALPA, they will be sent on to the same Aetna claims office.  Once received, the forms will serve to initiate a formal request from Aetna for additional information that they will require in order to fully examine the claim.
  4. When all preliminary, initial and follow-up materials are received at Aetna, then within 45 days of receipt of all materials Aetna will issue a decision:
     
    1. If the benefit eligibility date is more than 90 days into the future, Aetna will confirm the conditions for benefit eligibility and will notify you that if you continue to satisfy those conditions at the end of your elimination period, you will be eligible for benefits to begin at the end of that period.
    2. If the benefit eligibility date is less than 90 days into the future, Aetna will provide a benefit approval or denial to the claimant.

                                                             i. If benefits are approved, checks will be issued (or direct-deposited) at the end of each month.

                                                            ii. If benefits are denied, the claimant will be provided with a 180-day window to appeal the denial according to instructions provided by Aetna.


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