GROUP MAJOR MEDICAL

*For hospitalizations, call UMR Care Management for plan required notification
seven days prior to admission or within two working days after an emergency
admission. You or your health care provider must call the 800 number listed
below. Failure to call for notification may result in benefits being reduced.
GROUP MAJOR MEDICAL
American Veterinary Medical Association
Group Health and Life Insurance Trust
Group Policy Number: G-14884
HOSPITAL NOTIFICATION REQUIRED
SEE OTHER SIDE
Underwritten by: New York Life Insurance Company, N.Y., N.Y.
FOLD
To locate a network provider, please call the GHLIT at 800-621-6360
or visit www.avmaghlit.org, where you may access the Provider
Directory.
MAIL ALL MEDICAL CLAIMS TO:
AVMA GROUP HEALTH AND LIFE INSURANCE TRUST
P.O. Box 909720
Chicago, IL 60690-9720
800-621-6360
SEND ELECTRONIC CLAIMS TO PAYOR ID: 95266
Failure to use a PPO provider may result in a reduction of plan benefits.
Before receiving treatment, please call the GHLIT at 800-621-6360 to locate a
Provider.
This card and notification do not guarantee coverage.
All benefits are subject to verification of eligibility and plan limitations.