MI STATE SPECIFIC REQUIREMENTS
- Sample Evolution SBC No Buy-Up
- Sample Evolution SBC With Buy-Up
- Sample HDHP Agg SBC
- Sample HDHP Emb SBC
- Michigan Department of Health and Human Resources' Nonopioid Directive Form
- MI Sample Large Group Evolution with Buy-Up Booklet Certificate 2023
- MI Sample Large Group HDHP Booklet Certificate 2023
- MI Providers: The link below is a resource providing downloadable overviews of how CMM/Surescripts supports ePA with process included:
https://www.caremark.com/wps/portal/HEALTH_PRO_PRIOR_AUTH_INFO
SAMPLE EMPLOYER-GROUP MEDICAL INSURANCE BOOKLET-CERTIFICATES
Nippon Life Insurance Company of America® is providing prospective policyholders, members and dependents the opportunity to view sample employer-group medical insurance Booklet-Certificates.
Please note that these Booklet-Certificates are only representative samples, and do not constitute an actual insurance policy or contract. Any Booklet-Certificates actually issued may significantly vary from the samples provided based upon final plan selection and other factors. If there is any conflict between the samples provided and your issued Booklet-Certificate, the issued Booklet-Certificate will control. Sample Booklet-Certificates are subject to change.
If you are already a member, please sign in or register to view your group-specific Booklet-Certificate.
IMPORTANT NOTE:
NOTHING HEREIN IS A GUARANTEE OF BENEFITS OR ELIGIBILITY. ALL TERMS, PROVISIONS, CONDITIONS, LIMITATIONS AND EXCLUSIONS SHOWN IN YOUR ISSUED NIPPON LIFE INSURANCE COMPANY OF AMERICA BOOKLET-CERTIFICATE AND MASTER POLICY WILL GOVERN.