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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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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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How the UHC Group Health Program Medical Program Options Work

Special Services Available

Disease Management Services

If you are diagnosed with or at risk for developing certain chronic medical conditions, you may be eligible to participate in a disease management program at no cost. This program is designed to support conditions such as:

Heart failure;

Coronary artery disease;

Diabetes;

Asthma, and

Chronic obstruction pulmonary disease.

As a result, you can receive free educational information through the mail, and you can directly access a health advocate resource who can help you manage your condition.

The disease management program offers:

Education and guidance on how to manage your condition;

Information on healthy lifestyle options, including proper nutrition, medication management, exercise, and how to quit smoking;

One-on-one support via a toll-free number from a registered nurse 24 hours a day, seven days a week;

Speech recognition teaching modules;

An interactive website; and

Educational booklets.

Participation is completely voluntary and free. If you think you may be eligible to participate or would like additional information regarding the program, call the claims administrator at the phone number listed on your medical ID card.

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