Wellness Benefit – Claims Checklist & FAQ

Equip yourself with helpful information and documentation before you get started.

Claims Checklist & FAQ Wellness Bene昀椀t Ready to 昀椀le a claim? Equip yourself with helpful information and documentation before you get started. Information you’ll need: Questions you’ll answer: ☐ Employer or Group name ☐ Date of visit ☐ Group number (optional, but speeds up ☐ Type of screening test the process) ☐ Name of medical provider ☐ Employee name No documentation or forms are generally needed ☐ Employee birthdate for this type of claim. Go the Voya Claims Center and ☐ Employee Social Security number complete the online claim form. ☐ If the claim is for a spouse and/or child, you’ll also need: ☐ Spouse/child’s name ☐ Spouse/child’s birthdate ☐ Spouse/child’s Social Security number What kinds of health screening tests are covered? The Wellness Bene昀椀t provides an annual bene昀椀t payment if you complete a health screening test, whether or not there is any out-of-pocket cost to you. You only need to complete one health screening test, and may only receive a bene昀椀t payment once per year, even if you complete multiple health screening tests. You may also receive a bene昀椀t payment for your spouse and/or children if they are covered for the Wellness Bene昀椀t and complete a health screening test. For a complete description of your available bene昀椀ts, exclusions and limitations, see your certi昀椀cate of coverage and any riders. Health screening tests covered by the Wellness Bene昀椀t include, but are not limited to: • Immunizations • Routine eye exams • Annual physical exams (adults) • Mammography • Routine dental exams • Biometric screenings • Colonoscopy • Bone density screenings • And more ReliaStar LIfe Insurance Company (Minneapolis, MN) and ReliaStar Life Insurance Company of New York (Woodbury, NY), members of the Voya® family of companies 213330_250007584_03.indd 1213330_250007584_03.indd 1 21/04/2021 17:3521/04/2021 17:35

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