HUMANA DENTAL INSURANCE

Dental Insurance Enrollment Procedures for the Employees of

DHHS

1) Employee must complete the application and payroll form and return both to your Benefit Representative’s office.

2) Benefit Representative must then forward the application to Advisors Financial Group and forward the payroll form to their payroll center for processing.

Eligibility Requirements

· New Employee (has 30 days from date of hire to enroll)

· Qualifying Events (some examples are loss of coverage from a spouse’s coverage, marriage, birth of a child, etc. 30 days from the date of event to enroll.

· Open Enrollment Period (for current active employees)

Policy Changes

ADDITIONS TO AN EXISTING POLICY- Another application must be completed marking change box at the top. Mail it with a payroll change form. Then it must be routed to your Benefit Representative. Additions can ONLY be done during open enrollment, or a Qualifying event.

REMOVAL OF DEPENDENTS – The employee must complete a Policy Service Request form and turn it into their Benefit Representative. Removals can be done anytime.

CANCELLATION OF POLICY – The employee must first stop his payroll deduction, Humana cannot do this for them. Next, the employee needs to complete a Policy Service Request form and turn it into their Benefit Representative. Cancellations can be done at anytime.

Important Contact Information

For questions concerning enrollment or policy information contact the agent, Advisors Financial Group at 1-800-334-1217.

For Policy Holder Service questions, contact Humana Insurance Company at 1-800-635-4252.

For questions concerning dental claims the EMPLOYEE must contact Humana at 1-800-635-4252. Due to changes in HIPPA laws only the employee will be able to get information on claims.

Important Contact Information

Advisors Financial Group

8364 Six Forks Rd., Suite 200

Raleigh, NC 27615

919-844-1777