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Medical Continuation Guide: Enrollment and Eligibility Instructions

This comprehensive guide provides step-by-step instructions for enrolling in the medical continuation program, including eligibility criteria, enrollment process, and detailed information for filling out forms. Ensure a seamless transition when terminating medical coverage.

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Medical Continuation Guide: Enrollment and Eligibility Instructions

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  1. TCC

  2. ELIGIBILITY • Participated in a medical plan for at least 90 days or more • Must be enrolled at the time of termination • Can’t be in arrears • Can’t be termed for cause • No TCC provisions for dental

  3. TCC ENROLLMENT • Fill out Medical Continuation form • EE must make decision within 60 days of termination • Must become effective on the day of termination (retro) • Employee pays 102% of premium • Different process for HMO TCC & Aetna TCC

  4. Filling out HMO TCC Form • Activity name and number at top of form • Prorated amount plus next full month if at the end of the 31 days then next full month • Section 1 g. Day of termination from employment • If for the dependent only then the dependent’s SSN# is imperative as the policy has to be under the dependent not the employee • Please verify premium according to chart. If going into the next premium year give the enrollee the new rate also

  5. Sending HMO TCC App/Pymt • Send termination to HMO’S and terminate in P/S. HQ will reinstate (terminate EE the day they terminate even they say they might take a Medical Continuation • Have EE sign, date and give EE a copy of the form • Send the check and Medical Continuation form to lock box • Fax a copy of check and Medical Continuation form to HQ by fax 703-432-0436 Attention: Mary Skinner

  6. Sending Aetna TCC App/ Pymt • Terminate in P/S. Aetna will reinstate (terminate EE the day they terminate even if they say they might take a Medical Continuation • Ensure that the designated employer information (Suffix, Account #, Plan, employer signature and etc.) are completed on the application • Employees responsibility to mail the application along with the payment to Aetna

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