Questions & answers · Vision insurance
What events does Unum Insurance Company's filed vision insurance policy say it pays for?
AI-drafted from filed documents · reviewed: pendingwhether a specific event is coveredUnum Insurance Company
Unum Insurance Company's filed vision insurance policy in Colorado (CO) states that benefits are payable for Covered Services or Materials received from an In-Network Provider [2]. The policy specifies that when benefits are payable for such services or materials, Unum will pay the In-Network Provider directly, based on the In-Network Benefits shown in the Schedule of Benefits [2]. The Insured is responsible for any required Co-Pay and any cost that exceeds the Allowance, both of which are shown in the Schedule of Benefits [2]. The policy also notes that if a discount or other in-store offer is combined with a covered service, the provider may require the Insured to pay in full and submit a receipt for Out-of-Network reimbursement [2]. This does not appear in these excerpts — check the full policy for details on what specific services or materials are covered.
Information only — not legal advice. The insurer decides.
These answers quote forms insurers filed with state regulators. Your own policy, its endorsements and your state’s rules control. A filed form may not be the version sold to you.
Where this comes from (2)
[1] Unum Insurance Company · CO · SERFF UNUM-134172128 · form VI-2019-UIC · p. 1 · 4 · Colorado
Colorado [This Policy replaces previously issued [Unum] Policy Number [123456-000] which was effective [January 1, 2015].] This Policy is issued to the [Policyholder] in return for the payment of required premiums. The first premium payment is due on or before the Policy Effective Date. All subsequent premiums are due in accordance with the Premium Due Dates. We issue this Policy and Certificate of Coverage in agreement of the Policyholder's and Insured’s applications and enrollment forms. We will pay benefits to eligible Insured’s according to the terms and provisions outlined in this Policy and the certificate. This is a non-participating Policy. Please read this Policy carefully. This Policy is delivered in and is governed by laws of the governing jurisdiction[ and to the extent applicable, by the Employee Retirement Income Security Act of 1974 (ERISA) and any amendments]. There may be changes that impact an Insured’s benefits based on the Insured’s state of residence. Defined terms, provision titles, and sections heading have been capitalized. Signed for Unum on the Policy Effective Date.
[2] Unum Insurance Company · CO · SERFF UNUM-134172128 · form VI-2019CT-UIC-CO · p. 6 · 20 · Vision Details
Unum Insurance Company When benefits are payable for Covered Services or Materials received from an In-Network Provider, we will pay the In-Network Provider directly, based on the In-Network Benefits shown in the Schedule of Benefits. The Insured will be responsible for any required Co-Pay and any cost that exceeds the Allowance. The Co-Pay and the Allowance are both shown in the Schedule of Benefits You will generally incur lower cost by using an In-Network Provider. When benefits are payable for Covered Services or Materials received from an In-Network Provider and are combined with a discount, or other in-store offer, the provider may require that you pay in full and submit your receipt for the Out-of-Network reimbursement.
Drafted by a local AI model from the excerpts above, then checked by rules (citations, no rankings, no “not covered” claims from a partial excerpt). Question id Qab5c8e8a. Spotted an error? Tell us.