City of Pasadena

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1 point

For City of Pasadena, the benefit period is a calendar year.

True

False

1 point

A power wheel chair costing $2,500 will require a pre-treatment review.

True

False

1 point

Failure to notify the Benefits Administrator before incurring expenses for any of the services that requires a pre-treatment review will result in a penalty.

True

False

1 point

Family counseling is a benefit under this plan.

True

False

1 point

If a claim is denied in whole or in part, the covered person must appeal by submitting in writing a request for review within 180 days after the denial.

True

False

1 point

How many days does Allegiance have to response to all appeals and reviews for this group?

15 days

2 days

3 days

180 days

1 point

Routine mammogram for under age 40 does not require a review of medical necessity.

True

False

1 point

Once claims paid have exceeded $500, Allegiance will send an Accident Claim Form for injury or illness as part of normal procedures.

True

False

1 point

Morbid obesity applies to the out-of-pocket.

True

False

10.

1 point

Except for diabetic shoes for individuals diagnosed with diabetes, shoe inserts are considered an exclusion on this plan.

True

False

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