Medical Benefits Summary
Where do you go to get fast, accurate information about your claims? How do you locate a doctor in your network? Where do you go to get information about a medical condition of concern to you? At www.humana.com, you'll find fast, personal, secure answers.
Your link to smart choices -- www.humana.com
Enjoy access to MyHumana -- your quick connection to special online tools, information and resources on the Humana website.
As a Humana member, you can access MyHumana to:
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Check the status of medical and prescription claims
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Find participating physicians and pharmacies using Physician Finder Plus
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Review plan benefits
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Take health assessments and research conditions and treatments
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Receive secured messages from Humana about issues affecting your health
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And much more!
For additional information, visit www.humana.com.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandates that if an employee or dependent can provide a Certificate of Coverage from a prior insurance plan showing continuous coverage with a break (s) of no more than 63 days, that employee or dependent shall be credited for the period of continuous coverage and may not have to re-qualify for coverage for his/her pre-existing condition( s).
Exclusions and limitations -- Some services and supplies are not covered. For a complete list of the exclusions and limitations, please refer to the Summary Plan Description. Copays apply per visit, treatment, confinement, purchase, or rental unless otherwise stated.
Once you or your dependents are no longer an active member of the Del Valle ISD group health policy, you may obtain a Certificate of Credible Coverage by calling Humana HealthCare at 1-800-448-6262.
Enrollment Details
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Your Benefit Coordinator will schedule a benefits meeting with you.
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Coverage begins on the first of the month following the employee's start date.
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Benefits are only available to full-time employees (full-time is 20+ hours/week).
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Your first 30 days as a regular employee are called your window of eligibility. You may only enroll you and / or your dependents during your window of eligibility, or during open enrollment, unless you have a qualified change in family status. Qualifying events are: marriage, divorce, birth/adoption, death, change in employment or a significant change in your spouse’s benefit plan. If you have any questions, contact Del Valle ISD. Late entry is not allowed unless it is due to a qualifying event.
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If you are a new hire enrolling on a PPO plan or enrolling your dependents due to a qualifying event, you must provide a Certificate of Credible Coverage from your previous employer, if applicable.
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New babies and/or new spouses must be enrolled within 30 days of the birth/marriage date.
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When / if you leave your job at Del Valle ISD, you may be eligible for COBRA. If for any reason you or your family members are in a position that loss of health care coverage may occur, please contact Del Valle ISD to discuss options that may be available.
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Coverage for unmarried children: They will be eligible until they reach the age of 25.
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You will also receive a medical/prescription drug ID card (to be used at your physician's office and at hospitals). On the back of the card are phone numbers for Pre-Certification, Mental/Nervous Pre-Certification, Customer Service, and Verification of Benefit Services. If you lose your ID card, call Humana Customer Service at 800-448-6262 to order a new one.
01/18/2008
In compliance with House Bill 2724, which amends Section 22.004 of the Education Code please be aware:
- Del Valle ISD makes health care coverage available to its employees that is comparable to HealthSelect that is offered through TRS. To compare coverage [click here]
- The medical coverage offered by Del Valle ISD is through Humana. Humana is licensed to do business in the state of Texas .
- Del Valle ISD has complied with the requirements of Section 22.004 of the Education Code.
