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You or a Family Member Is Ill or Injured
When you face a serious illness or injury, it is important that you or a family member review your benefits to ensure that you get the most from your coverage. You may be surprised by how many of the Corporation's benefit plans can assist you. Also, it is important to be aware of special procedures, especially precertification, required by some medical coverage options.
If you need to talk to someone—for instance, if you are worried about a family member or if you are concerned about how to meet your medical expenses—consider calling the Employee Assistance Program (EAP), a free, confidential counseling service at 1-800-544-8320.
Please note that you may be eligible for an unpaid leave under the Family and Medical Leave Act (FMLA) to attend to your own or a family member's serious health condition. For information on FMLA leaves, see the Human Resources Guide to Working at The McGraw-Hill Companies.
For Surgery and Hospital Admissions
Make sure that the surgical procedure and/or admission is covered under your medical or dental plan.
Once you know there is coverage, follow the precertification procedures necessary to ensure that you get the maximum level of benefits from your coverage. Generally, some form of advance approval or coordination by your healthcare provider is required to precertify surgery or hospital admissions.
For procedures and hospitalizations covered through the medical options, call UnitedHealthcare so they can enroll you in the CustomCare Coordination program and provide you with extra assistance through the duration of your treatment and recovery.
Things to Do
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Review the provisions of your medical option to understand the benefits provided for the treatment or procedure you need.
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Check with UnitedHealthcare to see if you need to precertify your benefits. Precertification tells you how much the plan will pay and sometimes can suggest alternate methods of treatment. There may be substantial penalties if you do not precertify your benefits within the required time period.
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If you are covered under more than one medical plan, review the coordination of benefits features of each plan to see if you can submit your medical expenses to more than one plan for payment.
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For procedures and hospitalizations covered through the medical options, call UnitedHealthcare so they can enroll you in the CustomCare Coordination program and provide you with extra assistance through the duration of your treatment and recovery.
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Determine if you will need to take an FMLA or Optional Leave to care for a family member who is ill.
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If you are injured at work, contact your Human Resources representative to find out about Worker's Compensation benefits you may be eligible to receive.
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If you are injured while traveling for business, call the Human Resources Service Center at 1-888-THE-HRSC to file a Travel Accident Insurance claim.
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Submit claims to your Healthcare FSA for expenses not covered by your medical option.
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If you become aware that you will be unable to work for more than five consecutive days because of your own serious illness, or you will be absent due to an accident or hospitalization and you are under a physician's care, you should report this absence to the Corporation's disability insurance carrier, Liberty Mutual (1-800-853-7109), to see if you qualify for STD benefits.
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Review your coverage under the supplemental life insurance plan and the Retirement Program to understand the financial resources that may be available to you and your family.
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In case of terminal illness, consider a living needs benefit. See "How This Event Affects…" in the following chart.
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You may be eligible for a hardship withdrawal or hardship loan from the 401(k) Savings and Profit Sharing Plan to help cover extra ordinary medical expenses.
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If a family member is in need of on-going care:
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Call ValueOptions at 1-800-544-8320 and ask about CareSolutions, a comprehensive adult care support system that offers six hours of Corporation paid case management services.
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Backup dependent care is available to assist when your regular adult or elder care arrangements fall through. Visit the Work/Life page of the Human Resources Portal on the Intranet for more details
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Consider speaking to one of the counselors at the Employee Assistance Program, to address financial or emotional concerns.
How This Event Affects…
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If you are enrolled in the DMO Dental Plan, remember that the plan covers care received from a DMO dentist only. No coverage is available outside the network.
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If you are enrolled in The McGraw-Hill Companies Dental Plan, you may want to obtain a pretreatment estimate, which will allow you to estimate your out-of-pocket expenses.
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Your medical option may provide benefits for some dental procedures not covered by your dental plan.
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Employee Life and Accident Insurance
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In case of a terminal illness, supplemental life insurance offers a living needs benefit, which can provide you with 50% of your supplemental life insurance—up to $50,000.
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If you are in an accident and suffer a serious injury, you may be eligible for AD&D benefits, if you enrolled for coverage. Additional travel accident benefits may be available if you were injured while traveling on business for the Corporation.
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Dependent Life and Accident Insurance
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If you participate in the 401(k) Savings and Profit Sharing Plan and you have substantial medical expenses that are not paid by insurance or any other employer-provided benefit plan, you may be able to request a hardship withdrawal or hardship loan.
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If you, your spouse's, or domestic partner's income changes due to a disability, you may want to adjust your 401(k) savings contribution rate.
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