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Medical, Mental Health and Substance Abuse, Prescription Drug, Vision Care and HMO Programs Coverage Highlights Table of Contents
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Detailed Table of Contents
Index

Introduction

Who Is Eligible

Enrolling for Coverage

Your Rights and Responsibilities

How the Program Works

How the CIGNA Group Health Program Medical Program Options Work

How the UHC Group Health Program Medical Program Options Work

How the Blue Cross and Blue Shield (BCBS) Group Health Program Medical Program Option Works

How the Health Maintenance Organization (HMO) Program Works

The Prescription Drug Program

How to File a Claim

When Coverage Ends

Special Extensions of Coverage

Your Legal Right to Continuation Coverage Under COBRA

Coordinating Benefits With Other Programs

Claims and Appeals Procedures

Situations Affecting Your Benefits

Administrative and Contact Information

Your ERISA Rights

Medical, Prescription Drug, Mental Health and Substance Abuse, and HMO Programs

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Your Rights and Responsibilities

Your Rights

Statement of Rights Under the Newborns’ and Mothers’ Health Protection Act

Under federal law, the Program generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a delivery by cesarean section. However, federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable).

In any case, the Program may not, under federal law, require that a provider obtain authorization from the Program for prescribing a length of stay not in excess of 48 hours (or 96 hours). However, to use certain providers or facilities, or to reduce your out-of-pocket costs, you may be required to obtain certification. For information on certification, contact the claims administrator.

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