NEA Retiree Health Program: Additional Provisions

Contribution Amount Information
Your cost can be changed only if done so for members of the same class insured under your Plan who reside in your state. Plan costs are reviewed for possible changes each year. The rate schedules currently being used are guaranteed through December 31, 2015.

Read Your Plan Description Very Carefully
This is only an outline describing your Program’s most important features. The Certificate of Coverage is your coverage contract. You must read the Certificate of Coverage itself to understand all of the rights and duties of both you and United American Insurance Company. You will receive your Certificate of Coverage and personalized ID card when you enroll, after which you have 30 days to change your mind.

Right To Return Your Plan Description
If you find you are not satisfied with your coverage, you may return your Certificate of Coverage to United American Insurance Company, 3800 S. Stonebridge Drive, McKinney, TX 75070. If you send it back within 30 days after your receive it—without claim—it will be treated as if it had never been issued and all of your payments will be returned.

Coverage Replacement
If you are replacing another health insurance policy, do NOT cancel it until you have actually received your new Certificate of Coverage and are sure you want to keep it.

Notice
This insurance may not fully cover all of your medical costs.

United American Insurance Company is not connected with Medicare.

This outline of coverage does not give all the details of Medicare coverage. Contact your Social Security office or consult “Medicare & You” for more details.

What This Program Does Not Cover
Coverage is not provided for any expenses which are not Medicare-approved, except as otherwise specified.

Pre-Existing Conditions
Loss due to injury or sickness for which medical advice was received or treatment was recommended or given by a physician within 3 months prior to the effective date is not covered unless the loss is incurred more than 60 days after the certificate effective date, subject to the terms and conditions of the Certificate of Coverage.

If this coverage replaces currently in force Medicare Supplement or primary hospital and medical reimbursement insurance coverage, then this pre-existing conditions limitation will be waived to the extent it was satisfied under the replaced coverage.

Your Certificate of Coverage is guaranteed renewable for as long as you remain an NEA or NEA-Retired member, make your payments when due, and NEA maintains the program.

Plan details can be found in the Certificate of Coverage issued to each insured.

This Program is not connected with or endorsed by the U.S. Federal Government or Federal Medicare Program.

NEA Retiree Health Program
c/o United American Insurance Company
3800 S. Stonebridge Drive
McKinney, TX 75070

If you have any questions, please call United American Insurance Company toll-free at 1-800-367-7572 (Mon-Fri 7:00 a.m. to 5:00 p.m. CT).