Page 22 | 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. New York Life Group Benefit Solutions & Health Advocacy Services Support when you need it – NYL & Health Advocate What is New York Life Group Benefit Solutions (NYL GBS) Health Advocacy Services? NYL GBS Health Advocacy Services provides access to expert assistance with a wide range of healthcare and health insurance challenges. Included with your NYL GBS offering are valuable health advocacy services to help you and your family members (including spouse, dependent children, parents and parents-in-law) resolve many of the healthcare, health insurance or medical bill challenges they may face. Health advocacy services link you with clinicians and insurance professionals who are experienced in a range of clinical, health benefits and administrative issues. Personal Health Advocates know the “ins and outs” of the healthcare and health insurance worlds and are supported by medical directors and other clinical and benefits specialists. These services are available anywhere in the United States. Clinical services Personal Health Advocates provide clinical and administrative support for many types of healthcare, benefits or medical bill issues. The Personal Health Advocate may: • Answer questions and provide information and resources about medical terms, tests, medications and treatments. • Help members identify primary and specialist physicians, hospitals, dentists and related healthcare providers (first focus is on network relationships to help customers use their benefits to their best advantage). • Locate doctors for second opinions and help arrange appointments and research questions about diagnoses, treatments and available support systems. • Help customers with rare or complex medical conditions identify top medical institutions and specialized medical programs across the country and help schedule appointments and research transportation and lodging where necessary. • Facilitate the transfer of medical records, X-rays and lab results prior to a scheduled appointment with a new physician. • Coordinate and help schedule diagnostic tests. • Arrange evaluation for and participation in clinical trials. • Assist with all types of prescription drug issues including formulary and benefit questions, information on generics, obtaining mail order, or locating lower-cost sources for prescription drugs that are not covered by the customer’s health care plan. • Arrange for home care, home equipment, etc. following discharge from the hospital. • Coordinate hospice, home care and other services for terminally ill individuals. • Identify and coordinate a range of services including acupuncture, chiropractic care, massage therapy, cosmetic practitioners, etc. Any money paid by the participant are backed by a six-month money- back guarantee if the coaching does not save them more money than they have paid. If at any time within the first six months of paid membership, the participant had at least three consultations with a My Secure Advantage (MSA) Health Coach and finds that the program has not produced more financial value than the cost of the program, the participant is entitled to a full refund of fees paid. 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 above.
Duncan Supply Company Benefit Guide 2025 Page 21 Page 23