What does the eligibility disclaimer mean?
If a members plan is fully insured, as described in the Member Handbook, eligibility is binding for five business days and quoted benefits are binding for 30 business days from the date of authorization. For all plans, services are subject to eligibility and plan provisions, including pre-existing condition limitations in effect at the time services are rendered. ODS will guarantee member eligibility for five business days following the date the authorization is approved. Eligibility must be in effect for services performed after this five day period. ODS also guarantees benefits for 30 days from the date the authorization is approved. Services after this 30-day period are subject to benefits that are in place at the time the services are rendered.
