| Navigation Options | |
 |
|
| Table of Contents | |
|
|
|
Detailed Table of Contents |
|
|
| Index | |
|
|
Introduction
Who Is Eligible
 |
|
 |
|
|
|
|
|
Enrolling for Coverage
|
|
|
Program Premium Cost
| Determining an Annual Premium for You and Your Spouse/Domestic Partner |
|
|
|
|
Your Rights and Responsibilities
|
|
How the Retiree Group Health Program Works
|
|
|
|
|
|
|
|
|
|
|
| Retiree Group Health Program Design – Mental Health and Substance Abuse Program |
| A Summary Chart of the Retiree Group Health Program – CIGNA Open Access Plus |
| A Summary Chart of the Retiree Group Health Program – CIGNA Indemnity |
| A Summary Chart of the Retiree Group Health Program – CIGNA Post-65 Medicare |
|
|
|
|
|
|
|
|
|
|
| What Is an Expense That May Be a Covered Expense – Medical Program |
|
|
|
|
|
| What Expense is Excluded From Being a Covered Expense – Medical Program |
| What Is an Expense That May Be a Covered Expense – Mental Health and Substance Abuse Program |
| What Expense is Excluded From Being a Covered Expense – Mental Health and Substance Abuse Program |
How the Prescription Drug Program Works
|
|
|
|
| What Is an Expense That May Be a Covered Expense – Prescription Drug Program |
| What Expense Is Excluded From Being a Covered Expense – Prescription Drug Program |
|
|
| How to Fill Your Prescriptions through the Mail Service Pharmacy |
Your Legal Right to Continuation Coverage
|
|
|
|
|
|
Coordinating Benefits With Other Programs
|
|
|
How to File a Claim
|
|
ERISA Claims and Appeals Procedures
|
|
Situations Affecting Your Benefits
|
|
| Right to Reimbursement, Assignment of Rights, and Duty to Notify |
Administrative and Contact Information
|
Special Rules for Certain Participants
|
|
|
|
|
|
|
| Wallace, Litho, Nielsen Retiree Group (retired on or after January 1, 2004) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| Skilled Nursing Facility/Inpatient Rehabilitation Facility Services |
| Spinal Treatment, Chiropractic, and Osteopathic Manipulative Therapy |
|
|
|
|
|
|
|
|
| Experimental or Investigational Services or Unproven Services |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Your ERISA Rights
|
|
|
|
|
|
Retiree Medical, Prescription Drug and Mental Health and Substance Abuse Programs - Moore Wallace
Program Premium Cost
Determining an Annual Premium for You and Your Spouse/Domestic Partner
Total Cost of Coverage
Each calendar year, the Plan’s actuaries determine the total cost of coverage for the Program based on each Medical Program in which a retiree and his or her spouse/domestic partner are enrolled. The “total cost of coverage” includes the Plan’s cost of all medical, mental health and substance abuse, and prescription drug benefits; administrative and operating expenses; and other liabilities without regard to premiums paid by retirees or their spouse/domestic partners or subsidies paid by Moore Wallace or any of its subsidiaries.
How much you and your spouse/domestic partner must pay to the Plan to be enrolled for coverage (called your “premium”) will depend upon:
 | Which Medical Program you and your spouse/domestic partner are enrolled in; and |
| Whether you and your spouse/domestic partner are eligible for an annual subsidy cap amount described in the section “Special Rules for Certain Participants,” described below, from your former employer, and if so, how much. |
You and your spouse/domestic partner will know the premium for the next calendar year when you and your spouse/domestic partner receive your enrollment materials.
