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Company Address:
1350 Hayes St,BENICIA,CA,USA
ZIP Code: Postal Code:
94510-2945
Telephone Number:
8188433489 (+1-818-843-3489)
Fax Number:
7077455559 (+1-707-745-5559)
Website:
www. calbrokermag. com
Email:
USA SIC Code(Standard Industrial Classification Code):
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Policy and Procedure - premierlife. com this Policy, Premier Access Insurance Company and Access Dental Plan shall be collectively referred to as “Premier Access” Purpose To ensure timely access to and availability of dental services for all Members, including Members in rural areas, Members
Definitions Procedure - premierlife. com This policy applies for operations under Premier Access Insurance Company and Access Dental Plan For the purposes of this Policy, Premier Access Insurance Company and Access Dental Plan shall be collectively referred to as “Premier Access”
EMPLOYER APPLICATION - premierlife. com PREMIER ACCESS INSURANCE COMPANY, P O BOX 659010, SACRAMENTO, CA 95865-9010 COBRA The Applicant is subject Federal COBRA (more than 20 employees) Does the Applicant currently have COBRA enrollees- ? Yes No (If yes, please attach a list including name(s) and original effective date(s) of COBRA coverage and a copy of COBRA election statement )
FORMULARIO DE QUEJA O RECLAMACIÓN POR AGRAVIO La Compañía de Seguros Access Dental (el plan “Premier”) toma muy en serio los problemas que tienen sus Personas Afiliadas, y se esfuerza para lograr soluciones aceptables para todas las partes involucradas
| Preferred Provider Organization (PPO)Premier Access Insurance One of the most common dental plan designs, Preferred Provider Organizations (PPOs) give members the freedom to go to the provider of their choice! Like every dental carrier, Premier Access
Policy and Procedure - premierlife. com This policy applies for operations under Premier Access Insurance Company and Access Dental Plan For the purposes of this Policy, Premier Access Insurance Company and Access Dental Plan shall be collectively referred to as “Premier Access” Purpose
AUTORIZACIÓN PARA UTILIZAR Y REVELAR INFORMACIÓN MÉDICA Autorizo a la Premier Access Insurance Company, para que utilice y revele una copia de la información médica y dental específica, que se describe a continuación Información que consiste de: (Marque todo lo que sea pertinente )
Nondiscrimination and Language Availability Statements If you believe that Premier Access Insurance Company has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Jennifer Felice, Grievance Coordinator