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<br /> <br />Il'~ I-:(lS~ 1(1 lkc()nw ,I \lcmlwr <br />Once you review your enrollment materials: <br /> <br />· Completely fill out the enrollment form and sign where indicated. Be <br />sure to read both sides. <br /> <br />· Choose a PCP for yourself and each covered member of your family. <br /> <br />· Return the signed enrollment form to your employer by the <br />date specified. <br /> <br />CO\cl'age fur Out-of- \red Ikpell!lCl1lS <br />When you choose the Aetna U.S. Healthcare USAccess plan, you can <br />relax knowing that your covered dependents have the same quality <br />protection you do - even if they live away from home. <br /> <br />Eligible dependents who live within another Aetna U.S. Healthcare <br />USAccess service area can choose a participating PCP in their own <br />service area. Or, if they live in an area not serviced by an Aetna <br />U.S. Healthcare USAccess plan, they are eligible for coverage through <br />our Open Choice~ PPO plan (where available). <br /> <br />Female members <br />can take advantage <br />of our Women's Health <br />for Life programs. <br /> <br />" <br /> <br /> <br />Aracely Santiago-Justiniano <br /> <br />\1It'!" lOll Enroll <br />A USAccess plan 10 card will be sent to you after your enrollment <br />form is processed. Carry the card with you as proof of coverage. fJ.s of <br />your effective date, the member copy of your enrollment form may be <br />used as a temporary membership card until you receive your <br />permanent card. <br /> <br />You will also receive materials explaining how to use the plan. Refer <br />to these materials, as well as your plan documents, when you have <br />questions about your Aetna U.S. Healthcare benefits, limitations, <br />exclusions and other details. In the event of a problem with coverage <br />or for information on how to utilize the grievance procedure, call <br />Member Services at the toll-free number on your 10 card. <br /> <br />7 <br />