This page contains answers to common questions handled by our
Board Members.
- How do I submit a medical bill for payment ?
- What is covered by the Relief Association ?
- What is not covered by the Relief Association ?
- What do I need to submit for proof of insurance ?
Send a copy of your medical bill along with the Explanation of Benefits form
to:
The Rockford Police Relief Association
Medical Bills
420 W. State St.
Rockford, IL 61101
The Association will pay covered medical, surgical ,dental ($500
limit on dental), and hospital bills incurred by its members
resulting from injury or illness of a member, subject to the following restrictions:
Any bills to be covered under this Section shall be bills incurred by members
for treatment of members residing within the United States. Written approval for any
treatment is to be secured from the Board of the Association for all members living
outside the United States before such treatment and the board may grant coverage at the
board's discretion.
The board may waive the notice provisions and the coverage provision regarding
residency in the case of emergency treatment by a member.
The maximum benefit allowed to any one member in one fiscal year (January to
December) or for one illness or injury shall be two thousand ($2,000.00) dollars total.
The Association will pay the above-listed benefit for one and only one course
of treatment or counseling directed by a physician or psychiatrist not to exceed two
thousand ($2,000.00) dollars for alcohol related or drug related programs physician during
the lifetime of a member. Payment will be made only upon completion of treatment and shall
not be made if the member voluntarily terminates treatment before the completion of
treatment or against medical or psychiatric advice.
The Association will pay the benefit for one course of treatment for mental
illness or related counseling not to exceed two thousand ($2,000.00) dollars during the
member's lifetime. This treatment shall be paid only for the services of a certified
psychiatrist or certified clinical psychologist; no other forms of counseling will be paid
for by the Association whether said counseling is ordered, prescribed or directed by a
physician or psychiatrist. All costs of treatment beyond the provisions of this Section
will be the sole responsibility of the member. Payment for such treatment or counseling
will be paid only upon completion of treatment.
No payment whatsoever shall be made for any bill incurred in the treatment of
any sexually transmitted disease or resulting from any illness or injuries brought on by
any sexually transmitted disease or aggravated by any sexually transmitted disease. No
payment shall be made for any bill incurred for an abortion or illness or injury
aggravated by an abortion. No payment shall be made for any bill resulting from any
intentional or self-inflicted injury, while sane or insane; no bill shall be paid because
of a suicide or attempted suicide, while sane or insane.
No bill for medication shall be paid unless such medication was administered by
a physician to a member while the member was confined in a hospital or said medication was
administered by a physician in the physician's office or clinic.
Bills that will not be paid for by the Association include but are not limited
to: Cosmetic surgery, elective surgery, dentures, crutches, braces, belts,
eyeglasses, eye examinations (unless by an ophthalmologist), hearing aids, contact lenses, RK surgery or other elective surgery of the eye. This provision does not apply to illness
or damage caused solely by injury that occurs while the party is a member in good standing
of the Rockford Police Relief Association.
The Association will not pay for any surgery to reverse the effects of a prior
vasectomy or tubal legation.
What do I need to submit for proof of insurance ?
If you have City Insurance you will need to send us a
copy of a pay stub from the previous year.
Please black out any informaton you do not want us
to see. The only thing we need to see is your name and how much is
deducted from your check for insurance.
If you have another form of insurance send in a copy of the
insurance bill. You must show what it cost to insure you if you are
covered by a spouses insurance.
If you are receiving Medicare include a copy of the Social
Security statement that show what is taken out for Medicare.
Mail this to:
The Rockford Police Relief Association
Insurance Remembusment
420 W. State St.
Rockford, IL 61101
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