Frequently Asked Questions

For our major medical plans, regular AVMA members who reside in the United States, under the age of 65 and Student Chapter members attending a full schedule of classes, may apply to insure themselves and their eligible dependents. Please be sure to review the plan descriptions which outline the eligibility requirements for each coverage.

You may download the Enrollment forms and mail completed forms to:

P.O.Box 30475
Tampa, FL 33630-3475

or you may call the Trust office at 800-621-6360 and we will e-mail, fax or mail you an Enrollment form. Please be sure to complete all of the questions, sign the form and return it. Remember all questions must be complete You may also contact an agent. click here to find an agent in your area. 

No. You may choose whatever coverages fit your needs. In fact, the AVMA GHLIT Life & Disability coverages could be a nice compliment to other non-Trust coverages.

The AVMA GHLIT policies contain a provision that allows the surviving dependents to remain insured under the policies for the coverages which were in force on the day the insured member died, if the contribution is paid. The Trust office must receive an original copy of the death certificate to obtain the date of death and to process claim benefits for any Life Insurance in force. The Trust office must also be notified of which coverages the surviving spouse/domestic partner and/or child(ren) wish to retain.

In most states and on most plans, your child can remain a dependent under AVMA GHLIT coverage policy until he/she reaches the age of 26.

HIPAA stands for Health Insurance Portability and Accountability Act of 1996, P.L. 104-91. This law on access to medical coverage relates to underwriting, pre-existing limitations, guaranteed renewal, COBRA and certification requirements in the event someone terminates from the plan. Learn more about HIPAA at the Department of Labor's website. - Please note this may take a few minutes to appear.

Commonly known as the "Kennedy-Kassebaum Bill," HIPAA establishes new requirements for self-funded, fully-insured group plans (including church plans) and Individual Health policies. The purpose of the law is to:

•Improve portability and continuity of health insurance coverage in the group and individual markets
•To combat waste, fraud and abuse in health insurance and health care delivery
•To promote the use of medical savings accounts
•To improve access to long-term care services and coverage
•To simplify the administration of health insurance
Learn more about HIPAA at the Department of Labor's website. - Please note this may take a few minutes to appear.

Yes. Simply call the Trust office and request the appropriate New York Life form.

You may pay your premium by check, money order, monthly EFT or by VISA, Mastercard, or Discover credit card.

Yes, prescription drugs may be covered under the GHLIT Major Medical plans. If you are enrolled in a Traditional Indemnity Plan or the HSA- qualified plan, you pay the full preferred price upfront for each prescription and are reimbursed according to the Traditional Indemnity Plan or the HSA-qualified plans provisions. With all Traditional Indemnity Plans, except Plan E, and HSA-qualified plans, prescription drug charges are subject to the deductible and co-insurance. Plan E participants, please refer to your schedule of benefits.

If you are enrolled in a PPO or PPO Value Plan you are responsible for paying a co-payment as outlined in your schedule of benefits.

There are two ways to find out if your hospital or physicians are in the network. You can click on "Locate Providers" from the homepage and then select "UnitedHealthcare Options PPO Network", which will take you to the network site or you can call the toll free number at 1-800-621-6360.

Your I.D. card contains important information that your doctor will need: address to send claims; telephone number to call with questions; and your network logo which lets your doctor know what network your plan utilizes. It is important that you carry your I.D. card with you at all times.

No. You only need to call if you are going to be admitted to the hospital for an overnight stay.

Emergency admissions are everyone's greatest concern. We all worry about many details in an emergency situation. The least of your worries should be "Do I need to notify my insurance company?" If your injury or sudden illness requires you to stay in the hospital overnight, contact the Trust Office at 800-621-6360 and you will be connected to a UMR representative. Notification should be made immediately following admission or on the first business day following weekend or holiday admissions. If you are unable to notify the Trust Office, anyone may phone on your behalf-your spouse, a relative, your doctor, or the hospital.

Anyone of the following: Patient, patient's family, treating physician, or hospital may contact a UMR representative, although it is ultimately the member's responsibility to make sure one of the above does contact UMR, Inc.

•Patient name, address and age
•Member name and certificate number
•Admitting physician and hospital name, address and phone number

Maternity admissions should be pre-certified. Please call UMR as soon as your due date is known, within the first three months. At that time United Healthcare Options UMR will evaluate your pregnancy to help determine risk factors and offer support and education according to your needs.

Representatives of UMR, Inc., a company specializing in health care coordination and management, evalute all acute care medical admissions, and all admissions for the treatment of mental health and substance abuse, to help determine that your proposed in-patient treatment is necessary.  This process will enable you to spend as much time as required in a health care facility but no longer than is necessary to allow you to get back to your family, work and personal responsibilites as quickly as possible.

Life insurance claims ONLY should be mailed to:
AVMA-GHLIT
P.O.Box 30481
Tampa, FL 33630-3481

All other claims should be mailed to:
AVMA GHLIT
P.O.Box 909720
Chicago, IL 60690-9720

It's simple...to file a claim, answer each question on the Insured's Statement portion of the claim form and have your health care provider complete the Attending Physician portion. Then just mail the form and itemized bill to:

All medical claims:

AVMA-GHLIT
P.O.Box 909720
Chicago, IL 60690-9720

All disability claims:

AVMA GHLIT
P.O. Box 8015
Wausau, WI  54402-8015

All Iife insurance claims:

AVMA GHLIT
P.O. Box 30481
Tampa, FL 33603-3481

Claims are administered by UMR, Inc.

The charges are applied based on the order in which they are received and adjudicated.

Payment will be sent directly to your health care provider if you assigned benefits at the health care provider's office, or on the AVMA GHLIT claim form that was submitted to the Trust office.

The AVMA plan coordinates benefits with other insurance plans which help keep claims costs down and assures that no one is reimbursed more than the charges incurred.

If your health care provider uses government standardized form (UB92 for hospital; HCFA1500 for all others), you do not need to fill out a claim form. If your health care provider does not use standardized forms, you must submit one completed claim form per calendar year for each family member incurring claims.

Hospitals and physicians in all areas of the United States participate in the United HealthCare Options PPO Network. To locate a hospital or physician near your home, office, or anywhere in the United States, use the UnitedHealthcare Options site or call 1-800-621-6360.

You can use any of several tools available to you to locate a provider or determine whether your doctor is in the UnitedHealthcare Options PPO Network. Call 1-800-621-6360, and a UnitedHealthcare Options customer service representative will assist you in locating the electronic directory on the AVMA GHLIT website to look up providers who participate in the network.

The UnitedHealthcare Options clinical management staff answers the phone from 7:00 AM - 7:00 PM CT, Monday through Friday.

The UnitedHealthcare Options trained clinical management staff.

Yes, on November 30, 2012 NYL, the underwriter of the GHLIT medical coverages, informed the Trust that it will be unable to continue offereing major medical coverage in the bona fide association market beginning 1/1/2014.

Yes, NYL informed the Trust that it has concluded that, beginning in 2014, it would be unable to offer the Trust a medical insurance product that would be competitive in the evolving medical insurance marketplace that would continue to bring the additional value of the current medical insurance for AVMA members. The burden of complying with varying coverage and rate requirements on a state by state basis was cited by NYL as a significant factor in its decision. This determination was made based on NYL’s belief that evolving market conditions and the regulatory environment created by the Patient Protection and Affordable Care Act (“PPACA”) will ultimately prevent them from offering competitive medical insurance for association plans such as the GHLIT’s.

Yes, in early 2012, the GHLIT hired the services of a firm in Washington, DC who is well versed in the health care reform law. With their assistance, and that of the AVMA Governmental Relations Division and AVMA members, lawmakers were contacted in an effort to preserve the rules/guidelines of bona fide association health plans. Unfortunately, even with this effort, NYL determined that the burden of complying with varying coverage and rate requirements on a state by state basis would preclude them for continuing to offer association health plans.

Yes, the Trust will provide GHLIT members with the resources needed to ease this transition and to help in finding a plan that meets their needs. The Trustees and their business partners are investigating alternative arrangements that will aid AVMA members in securing comparable medical insurance.

Yes, in conjunction with our business partners, we will be establishing a program to help assist members in transitioning to other medical insurance options effective 1/1/2014.

Yes, this change only impacts our medical insurance policies effective 1/1/2014. Current medical insurance will continue throughout 2013, provided the applicable premium is paid in a timely manner.

No, any life, disability income or other non-medical coverage through the GHLIT will remain unchanged and in effect.

Yes, we will provide GHLIT members with the resources needed to ease this transition and to help in finding a plan that meets their needs. In order to do this, we are committed to keeping GHLIT members informed every step of the way. They will be receiving regular communications in the coming months with updated information to assist you and your family. We will include the AVMA Executive Board on appropriate communication pieces.

Yes, the extension of medical insurance coverage through 2013 by NYL should ensure that any insured member under the AVMA GHLIT does not face a gap in their insurance coverage until the PPACA Exchange coverage becomes effective on January 1, 2014.

No, the burden of complying with varying coverage and rate requirements on a state by state basis was cited by NYL as a significant factor in its decision. This determination was made based on NYL’s belief that evolving market conditions and the regulatory environment created by the Patient Protection and Affordable Care Act (“PPACA”) will ultimately prevent them from offering competitive medical insurance for association plans such as the GHLIT’s. The Trust has been investigating alternative underwriting arrangements but has been unable to identify any other insurance carrier that will offer medical coverage to a bona fide association plan that would continue to provide the value of the current GHLIT major medical coverages for members.

Yes, we will provide GHLIT members with the resources needed to ease this transition and to help them find a plan that meets their needs. In order to do this, we are committed to keeping GHLIT members informed every step of the way. They will be receiving regular communications in the coming months with updated information to assist the member and their family.

Yes, in conjunction with our business partners, we will establish a program to assist you in transitioning to another medical insurance policy effective 1/1/2014.

Yes, the decision by NYL only impacts the GHLIT medical insurance policies. Any life, disability income or other non-medical coverage through the GHLIT will remain unchanged and in effect.

Yes, in order to maintain your GHLIT medical coverage through 2013, you will need to make timely payments of all premiums due.