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  • Uha Authorized Representative Form 2017

Get Uha Authorized Representative Form 2017-2025

Lease return the completed form to the Appeals Coordinator at the address below, and keep a copy for your records. Member Name Phone Number Address Member Number Name and address of the authorized representative that will appeal on your behalf Name: Address: Relationship to Member: Your authorized representative will have access to all medical information of any sort relevant to the appeal as described in Section 9: If you Disagree with our Decision in your Medical Benefits Guide. Check her.

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UHA's healthcare network is within the state of Hawaii only. You will pay substantially more for services you receive on the Mainland if the service can be done in Hawaii.

UHA 600 (Bundle) No annual deductible and UHA covers 90% of the cost of physician services.

UHA offers a Preferred Provider Organization (PPO) plan that provides the state's top comprehensive medical benefits, paying at 90% of the eligible charge for most services rendered by a participating provider.

There are three ways to submit medical claims electronically. You may connect either directly to UHA, submit your claims through a clearinghouse that has a connection with UHA, or through the Hawaii Xchange online service.

UHA 3000 – Focused on Keeping You Well. UHA offers Hawaii's first health insurance plan to offer full, complete, 100% coverage for wellness and preventive medicine. Our plans provide services that help keep you healthy, detect diseases early, and prevent chronic disease at no cost to you.

UHA offers a Preferred Provider Organization (PPO) plan that provides the state's top comprehensive medical benefits, paying at 90% of the eligible charge for most services rendered by a participating provider.

In 1996, a group of physician teachers at the University of Hawaii John A. Burns School of Medicine decided to make a difference. They created the University Health Alliance to bring a simpler, more caring approach to employee health insurance. Since then, UHA has grown to offer the largest physician network in Hawaii.

UHA will cover all eligible dependent children up until their 26th birthday. If an employee's dependent is certified as disabled, the dependent may continue coverage after UHA has reviewed and approved enrollment of a completed Disability Certification Form.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232