Issuer Name
Renaissance Life & Health Insurance Company of America
Blue Cross Blue Shield of Michigan Mutual Insurance Company
Guardian Life Insurance Company of America
Blue Cross and Blue Shield of South Carolina
BlueCross BlueShield Kansas Solutions, Inc.
Oregon Dental Service, DBA Delta Dental Plan of Oregon
SafeGuard Health Plans, Inc., a Florida Corporation
Highmark Blue Cross Blue Shield West Virginia
Rocky Mountain Hospital and Medical Service, Inc., dba Anthem Blue Cross and Blue Shield
Blue Cross and Blue Shield of Kansas City
Unity Health Plans Insurance Corporation
QualChoice Life & Health Insurance Company, Inc.
Premera Blue Cross Blue Shield of Alaska
UnitedHealthcare of the Mid-Atlantic Inc
Group Hospitalization and Medical Services Inc.
Educators Health Plans Life, Accident, and Health, Inc
University of Utah Health Insurance Plans
The Guardian Life Insurance Company of America
Humana Health Benefit Plan of Louisiana, Inc.
SafeGuard Health Plans, Inc., a Texas Corporation
Blue Cross Blue Shield Healthcare Plan of Georgia, Inc.
Blue Cross and Blue Shield of Arizona, Inc.
Blue Cross and Blue Shield of Georgia, Inc.
Cigna HealthCare of North Carolina, Inc.
MetLife Health Plans, Inc., a Delaware Corporation
Compcare Health Serv Ins Co(Anthem BCBS)
The Pennsylvania Dental Corporation dba Delta Dental of Pennsylvania
Aspirus Arise Health Plan of Wisconsin, Inc.
CommunityCare Life & Health Insurance Co
Delta Dental Plan of New Hampshire, Inc.
Kaiser Foundation Health Plan of Georgia
Educators Health Plans Life, Accident, and Health
Humana Employers Health Plan of Georgia, Inc.
Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.
Louisiana Health Service & Indemnity Company

Issuer Doing Business As (D/B/A) if Applicable
Florida Blue HMO (a BlueCross BlueShield FL company)
Ambetter from Arkansas Health and Wellness
Metropolitan Health Plans Inc. a Delaware Corp.
Horizon Blue Cross Blue Shield of New Jersey

URL Claims Payment Policies
http://www.mhc.coop/wp-content/uploads/2017/2017_MT_Individual_Access_Care_Policy.pdf**** http://www.mhc.coop/wp-content/uploads/2017/2017_MT_Individual_Access_Care_Catastrophic_Policy.pdf http://www.mhc.coop/wp-content/uploads/2017/2017_MT_Individual_Connected_Care_Policy.pdf http://www.mhc.coop/wp-content/uploads/2017/2017_MT_Group_Access_Care_Policy.pdf http://www.mhc.coop/wp-content/uploads/2017/2017_MT_Group_Connected_Care_Policy.pdf
https://www.healthtradition.com/members/member-information/filing-a-claim/ b. Enrollee claims submission : https://www.healthtradition.com/members/member-information/filing-a-claim/ c. Grace periods and claims pending policies during the grace period https://www.healthtradition.com/members/member-information/member-payments/ d. Retroactive denials: https://www.healthtradition.com/members/member-information/filing-a-claim/ e. Enrollee recoupment of overpayments: https://www.healthtradition.com/members/member-information/member-payments/ f. Medical necessity and prior authorization timeframes and enrollee responsibilities:: https://www.healthtradition.com/members/member-information/referrals-and-prior-authorization/ g. Drug exceptions timeframes and enrollee responsibilities: Employer Groups: https://www.healthtradition.com/members/health-plan/employer-group-members/prescription-drug-benefit/ Individuals and Families: https://www.healthtradition.com/members/health-plan/members/drugs-pharmacy/ h. Information on Explanations of Benefits (EOBs): https://www.healthtradition.com/health-insurance-101/how-to-get-answers-to-your-questions-about-a-bill/ i. Coordination of benefits (COB): https://www.healthtradition.com/members/member-information/coordination-of-benefits/:
https://www.mclaren.org/Uploads/Public/Documents/HealthPlan/documents/MHP%20Documents/97459-Individual-HMO-Member-Handbook-MHPC20131209.pdf "PDF: http://www.mclarenhealthplan.org/uploads/public/documents/healthplan/documents/Provider%20Directory/mhpCommunityphydirectory.pdf " "Searchable engine: http://www.mclarenhealthplan.org/community-member/find-a-provider-community.aspx "