More about New York Life Group Benefit Solutions (NYL GBS) Health Advocacy Services? Medical Bill Saver scope of services Once the Personal Health Advocate completes a bill investigation and determines the true customer out-of-pocket responsibility on non-covered medical bills over $400, Medical Bill Saver negotiation specialists work with health care professionals to negotiate a discount for customers, helping to reduce their out-of-pocket costs. Using fee benchmarking databases, critical pricing trend information, including provider specialty, procedure type and geographic region, the Personal Health Advocate will: •Negotiate with physicians, dentists, hospitals, surgery centers and other health service providers. •Provide a written summary of the outcome of the negotiation, and the applicable terms and conditions of payment to the provider. •Secure written provider sign-off on the terms and conditions negotiated on the customer’s behalf. •Provide customer education to clarify overall health plan and how to get the most out of their benefits and maximize savings by using in-network providers. Exclusions and limitations 1. Health advocacy services are not insurance, and this program does not provide reimbursement for financial losses. 2. Health advocacy services are not medical care, and neither NYL GBS nor Health Advocate, Inc. provide or recommend medical care or treatment. 3. Only covered employees and their family members (spouse/domestic partner, dependent children, parents and parents-in-law) are eligible for health advocacy services. 4. Neither Health Advocate, Inc. nor NYL GBS guarantees that Health Advocate’s intervention on behalf of the covered employee or family member will result in a particular outcome or that Health Advocate’s efforts on their behalf will lead to a result satisfactory to the covered employee or family member. 5. Health advocacy services are not performed on behalf of any health care plan, and neither NYL GBS nor Health Advocate, Inc., in connection with these services, acts as a business associate under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) or its regulations. 6. Health advocacy services are provided under a contract with Health Advocate, Inc. and will be provided while NYL GBS is providing life or disability insurance or services to you for your employees, and while the contract between NYL GBS and Health Advocate, Inc. is in effect. 7. NYL GBS and Health Advocate, Inc. reserve the right to make changes in the services provided to the extent necessary to comply with applicable laws or regulations. 8. Neither NYL GBS nor Health Advocate, Inc. will have any liability for delay or non-fulfillment of services resulting from acts not within either party’s control, including but not limited to acts of God, war, riots, civil disturbances, strikes, accident, fire, transportation conditions, labor and/or material shortages, governmental controls, regulations and permits, and/or embargoes. Personal Health Advocates are available Monday through Friday between 8:00 am and 12 midnight EST at a dedicated NYLGBS toll-free number: (866) 799-2725. Resources are available by phone 24/7 at the same toll-free number and a Personal Health Advocate will reach out to the caller the next business day. Services include but are not limited to those described on the pages above. Page 24 | Duncan Supply Company, Inc.| Plan Year 2025 Open Enrollment This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations, and exclusions set forth in each insurance carrier or provider’s contract.
