Request an ODA Wellness Trust Quote for a New Office
- Complete and sign the Health Plan Participation Request.
- Goups must meet the minimum participation criteria for group coverage:
a) Legal entity and member in good standing with the ODA
b) Engaged in full –time practice where an employer/employee relationship exists
c) Participation requirements are based on the number of employees enrolled versus the number of employees eligible
d) A minimum of two participants per group
- Eligible employees not requesting a quote must complete and sign the waiver table.
- Submit the application and Personal Health Questionnaires to ODAWT via fax to (614) 340-9444. If you utilize a secure email system, please feel free to reply by email to email@example.com. We will submit the office to underwriters for a rate quote and rates will be provided to each office as soon as possible.
Request an ODA Wellness Trust Quote for a Newly Eligible Employee
- Employers currently enrolled in the ODA Wellness Trust and have newly eligible employees or an employee having a qualifying event may request the employees complete a Personal Health Questionnaire to receive a quote.
- Employers complete the Add Employee Form.
- Provide proof that the new eligibility or qualifying event has occurred within the last 60 days.
- Return completed forms to the ODA Wellness Trust via fax to (614) 340-9444. If you utilize a secure email system, please feel free to reply by email to firstname.lastname@example.org. We will submit the information to underwriters for a rate quote and rates will be provided for the newly eligible employee(s) as soon as possible.
How to Enroll:
- Select an ODA Wellness Trust plan that works best for you from the rate information provided to you.
- If a new group, the employer must sign a Health Plan Participation Contract.
- Complete a Confirmation of Coverage Selection form signed by employer.
- Return it to the ODA Wellness Trust via fax to (614) 340-9444. If you utilize a secure email system, please feel free to reply by email to email@example.com
- Employees declining coverage need to sign and submit a waiver. Please note this will require the office quote to be re-evaluated when more than one application has been reviewed.
- Offices that would like to enroll in automatic monthly payments can fill out the Electronic Funds Transfer form.
ODA Wellness Trust representatives are available via phone at (800) 282-1526 and email at firstname.lastname@example.org to answer any questions you have about the health benefit plans and how to obtain a quote.
ODASC understands that your practice day is busy. Representatives will work to answer calls in the order received and return your call quickly however we may not always be available when you are. Please consider submitting your questions via email to email@example.com as a more convenient way to receive a response without interruption.
An email will be generated to confirm receipt of all faxes submitted to ODAWT (614) 340-9444 within one business day. Please include with your fax an email address the fax receipt confirmation should be sent. If you do not receive a confirmation of fax receipt (please check your junk/spam file), the ODAWT has not received your fax.
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