Termination of Benefits Medicare Enrollment VHP may terminate or cancel your membership or the membership of your Dependent(s) if you or your spouse/ partner who is/are eligible to be covered by Medicare fails to enroll in Medicare as required by your employer. This requirement may not apply if you or your spouse/partner is age 65 or older and still working. If you or your Dependent(s) are eligible for Medicare please call VHP to discuss your termination and/or your options for continuation of coverage.
Enlistment in Uniformed Services VHP may terminate your membership or the membership of your Dependent(s) if you or your Dependent(s) enter full-time service in any branch of the armed forces (enlistment). If you are called to active duty in the uniformed services, you may be able to continue your Coverage under this EOC for a limited time after you would otherwise lose eligibility, if required by the federal Uniformed Services Employment and Reemployment Rights Act (USERRA) law. Contact your Group if you want to know how to elect USERRA coverage and how much you must pay your Group. If you or your Dependent(s) enlist, please call your Employer to discuss your termination and/or your options for continuation of coverage.
State Review of Termination If you believe your membership was terminated because of your ill health or your need for health care, you may request a review by the California Department of Managed Health Care by calling 1.888.466.2219 (toll-free). For additional information, telephone numbers, or e-mail address, please refer to the “Member Services Assistance” section under “DMHC Consumer Help-Line.”
Cessation of Coverage VHP will not cover any services or supplies provided after the effective date of termination regardless of whether you were seeing a physician or other provider for a condition or course of treatment. The only exceptions are when you may be eligible for continuation coverage or Individual Conversion, where applicable, and: • you are or your Dependent is a registered bed patient in a Plan Hospital at the date of termination of the Agreement by VHP. You or your Dependent may receive all the Benefits of your VHP coverage for the condition confining you to the hospital, subject to your payment of the premium and applicable co-payments, until those Benefits expire or you are discharged from the facility, whichever occurs first; • you are or your Dependent is receiving inpatient obstetrical care in a Plan Facility at the date of termination, and there has been no default in premiums. You will continue to receive Coverage of inpatient obstetrical care only through discharge; • you or your Dependent is Totally Disabled, as determined by VHP, by a condition for which you or your Dependent was receiving services before your employer terminated. You will continue to receive Coverage only for services related to the disabling condition, subject to all limitations and restrictions, including applicable co-payments and premiums. Coverage will end: • 12 months after the termination date; 85 V A L L E Y H E A L T H P L A N E V I D E N C E O F C O V E R A G E A N D D I S C L O S U R E F O R M
