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There are some issues common to most patients, which require some forms or form letters. This section provides related forms and form letters needed for patients.
1. Basal Body Temperature Chart This form is needed for infertility treatments. Please follow the ACMA instructions on its use.
1. Sample Summary Plan Description Letter Recently, some patients reported to ACMA that they have never received insurance policy from their insurance company BlueCross BlueShield of Illinois. To clarify this issue, ACMA contacted the state and federal insurance regulatory agencies. Both agencies told ACMA that it is illegal for insurance company to withhold insurance policy. The laws require insurance companies to disclose insurance policy to all patients. The U.S. Department of Labor Employee Benefits Security Administration provides ACMA with this form letter for patients to use in case you have difficulty in obtaining your insurance policy. If you have further questions on this issue, please contact the U.S. Department of Labor Employee Benefits Security Administration at 866-275-7922.
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