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Plan Description
Fortis Benefits > Spouse Life Plan
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Important Note: This plan is dependent on the existence of a
Voluntary Life Plan.
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Broker Name:
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Blue Cross Blue Shield of Georgia
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Policy Number:
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34512435
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Original Plan Effective Date:
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12/11/2002
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Rate Guarantee Expiration Date:
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12/11/2002
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Plan Anniversary Date:
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12/11/2202
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Billing Cut-off Day of the Month:
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25
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Retroactive Termination Limit:
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30
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Division:
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All Divisions
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Location:
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California
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Employee Classes:
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Full Time
Manager
Officer
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General Plan Information
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Base Plan Benefit
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$10,000
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Accelerated Benefit
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Included
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Waiver of Premium
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Included for employees up to age 60
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Conversion
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Included
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Portability
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Included
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Additional Highlights
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Field One
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Value one
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Waiting Period Information
Eligible employees are eligible as of the 1st of the month following the employee's hire date.
Termination of Coverage Information
When a plan participant is terminated from the company, the plan coverage ends on the last day of the month following the employee's termination date.
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(per month)
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Base Plan Rate:
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$0.15
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Base Plan Rate Type:
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Per $1,000 of benefit
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Base Plan Contribution:
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Employee contributes 0% per month.
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Plan Name HMO
http://www.bluesss.com
Member Services
John Carpet
600 Lafayette East
Detroit, MI 48226
(313) 225-5890
Fax (313) 225-3453
Claims Services
Jennifer Pattern
600 Lafayette East
Detroit, MI 48226
(313) 225-3445
Fax (313) 225-3435
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