Please read carefully as applications without the proper Proof of Insurance (POI) attached will not be considered.
It is the applicants responsibility to provide the appropriate required documentation.
If you have questions, please email, care@gaucherdisease.org, or call, 301-900-1053, prior to submitting your application.
Proof of Insurance is:
IF APPLYING FOR THE UPCOMING CALENDAR YEAR (i.e. in November of current
calendar year for a grant beginning January 1 of the upcoming calendar year):
FOR PRIVATELY PAID INSURANCE PLANS:
· A copy of your notification from your insurance carrier(s)
regarding your UPCOMING calendar year insurance premium cost AND policy
calendar year, i.e. January 1 - December 31 OR July 1 - June 30, etc.
FOR MEDICARE INSURANCE PLANS:
· A copy of your UPCOMING CALENDAR YEAR Medicare benefit rates. Medicare benefit
rates are often slow to be mailed. You can check online through the Social
Security Administration portal to obtain your deduction amounts.
FOR EMPLOYER SPONSORED PLANS:
·
A copy of your most current pay stub indicating
the cost of your insurance deductions AND
- A verifying document from HR, such as a benefit table with your selected
levels highlighted, as to your monthly group premium rates. Please
ensure this table accurately reflects the premium rates for the UPCOMING calendar year as well as an
indication of the policy calendar year dates, i.e. June 1 - May 30.
IF APPLYING AFTER JANUARY 1 FOR THE CURRENT CALENDAR YEAR:
FOR PRIVATELY PAID INSURANCE PLANS:
- A copy of your most current invoice from your insurance carrier(s) indicating your insurance premium cost AND policy calendar year, i.e. January 1 - December 31. This can be submitted as two separate documents if needed.
FOR MEDICARE INSURANCE PLANS:
- A copy of your current calendar year Medicare benefit rate(s) letter.
FOR EMPLOYER SPONSORED PLANS:
- A copy of your most current pay stub indicating the cost of your insurance
AND - A verifying document from HR, such as a benefit table with your selected levels highlighted, as to your monthly group premium rates as well as the policy calendar year dates, i.e. June 1 - May 31.
YOUR INSURANCE POLICY CALENDAR YEAR IS REQUIRED AS PART OF THE VERIFYING DOCUMENTATION
If you are completing the application prior to January 1 for the upcoming calendar year, it is your responsibility to ensure the proof of insurance you are providing accurately reflects the 2021 premium for each policy.
If your policy effective year is not January 1 - December 31, you must also provide documentation that verifies the policy calendar year, i.e. the letter last received by the health insurance carrier informing you of your premium rate as well as the effective date of the premium change.