Dental and Vision
“Customer Name, I will be happy to connect you with an Unum Dental & Vision Specialist. Please have your policy number, DOB, and zip code available in order to access your dental information. If you do not have your policy number available, I’ll be glad to provide it for you."
Call connection script for unum dental and vision
We will pay this benefit for the initial (first) diagnosis of internal (not skin) cancer. The benefit will be paid for each month this rider has been in force after the waiting period and before the diagnosis of cancer is made. Stop accruing benefit on the 65th birthday.
Progressive Payment Rider
Alternative Form of Payment (AFP) program that is processed at enrollment via Harmony
FPS
Life policy surrendered for cash value
Cash Surrender
If we have denied a claim (REJTD or GCCLO) and the customer advises they have additional information to submit that we have not yet reviewed
Reconsideration
If the red DENTAL is not on the Group’s profile detail screen in Client View, we are not the dental carrier, and the caller would need to be referred back to their HR department to determine which company is their dental carrier.
HPS
A doctor who is licensed to practice medicine and who is also licensed to practice pathologic anatomy by the American Board of Pathology. A pathologist also means an Osteopathic Pathologist who is certified by the Osteopathic Board of Pathology.
Pathologist
60 Calendar days processing time.
Appeal processing time for Non disability claims and life claims.
Connected to the assigned Financial Services Representative (FSR) to make the payment.
When customers have an outstanding claims overpayment balance, they have the option to make a payment over the phone as well as via mailed check. When a customer calls in to request to make a payment, they must be connected to the assigned Financial Services Representative (FSR) to make the payment.
Extends the right to appeal a claim decision to policyholders
ERISA
• Eyeglasses
• Sunglasses
• Sports glasses
• Spare pairs of glasses
• Contact lenses
Covered Vision Correction Materials
Having no symptoms and no signs that can be identified to indicate the presence of invasive or non-invasive cancer.
Complete Remission
Processing time for letter translations
10bd
5BD
Any appeal that does not fall under the ERISA guidelines
NON-ERISA Appeal
Product Type: Dental/Vision
Primary Reason: Connect Transfer
Primary Detail: Other
Transfer connect to unum dental and vision
Initial Diagnosis, Progressive payment and Specified Disease.
Optional Riders
Send an email to PHSSeniors@coloniallife.com including the name of the customer, the claim number, date of the letter, and the language they want the letter translated into.
Requests for a translated declination letter on a disability claim.
When a policy specifically excludes pre-existing conditions during the first 12 months
Pre existing conditions
180 days
Time limit to submits and appeal or reconsideration from the date of the letter.
A list of the dental benefits and covered amounts (not in CV, insured may access online.
Fee Schedule
C11000 Policy with coronary bypass benefit.
Benefit: 1000
Units purchased: 35
Diagnosis of Stroke on 08/25/2024
Coronary bypass: 06/22/2025
Coronary bypass:03/02/2025
Heart attack: 08/24/2025
What's the benefit to be paid?
35000 for first diagnosis of stroke- Policy will terminate and no additional benefits payable. Policy does not have recurring benefits.
A written request for review of the final claim decision is submitted by an individual other than the claimant or his/her attorney
The person submitting the request should be advised that we require a written Authorization from the claimant or his/her representative.
Special arrangements can be made on a group account that will provide exceptions for group customers who were covered by a different carrier’s policy, prior to their policy becoming effective with us
Credit for Time Insured (CFTI)
Erisa period to submit appeals for Erisa disability
60 Days