March 25, 2008

Clarification:

New Personal Health Application (PHA) for The Hartford

We recently sent you a letter regarding the new Personal Health Application (PHA) required for The Hartford. Many employers have called to ask if and/or why they need to complete the form at this time.

The following should help clarify the intent of the original letter you received and eliminate any confusion about this new form.

Most employers will not need to do anything with this form today; we are simply notifying you that the form has changed. You should retain this form with your CBIA Administration materials.

• This new PHA is only required when underwriting or Evidence of Insurability (EOI) is required. Underwriting or EOI is only required in the following scenarios:

  1. Late Applicant / Late Entrant. When an employee elects Life or Disability coverage after they are first eligible for the coverage, they are considered a Late Applicant or Late Entrant. Coverage would be determined or approved only after the PHA is reviewed by The Hartford’s Underwriting Department.

  2. Benefit requested exceeds the Guarantee Issue Limit. When a group is requesting a Life or Disability benefit in excess of what is normally guaranteed, The Hartford will assess the risk (through data provided on the PHA) and will determine whether that higher amount can be provided.

• The Personal Health Application (PHA) replaces the CBIA Family Health Statement for Life and Disability “underwriting” purposes only. In the past The Hartford allowed CBIA enrollees to use the CBIA Family Health Statement for the above scenarios. This is no longer the case. From now on, when Evidence of Insurability is required, you will use this new form as opposed to the CBIA Family Health Statement. Note: The CBIA Family Health Statement is still required for new enrollees for MEDICAL coverage.

Please contact your Insurance Agent if you have any questions about whether The Hartford PHA pertains to any employees of your company at this time.