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Detailed Table of Contents |
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| Index | |
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Introduction
Who Is Eligible
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Enrolling for Coverage
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Program Premium Cost
| Determining an Annual Premium for You and Your Spouse/Domestic Partner |
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Your Rights and Responsibilities
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How the Retiree Group Health Program Works
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| 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 |
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| What Is an Expense That May Be a Covered Expense – Medical Program |
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| 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
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| 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 |
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| How to Fill Your Prescriptions through the Mail Service Pharmacy |
Your Legal Right to Continuation Coverage
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Coordinating Benefits With Other Programs
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How to File a Claim
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ERISA Claims and Appeals Procedures
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Situations Affecting Your Benefits
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| Right to Reimbursement, Assignment of Rights, and Duty to Notify |
Administrative and Contact Information
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Special Rules for Certain Participants
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| Wallace, Litho, Nielsen Retiree Group (retired on or after January 1, 2004) |
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| Skilled Nursing Facility/Inpatient Rehabilitation Facility Services |
| Spinal Treatment, Chiropractic, and Osteopathic Manipulative Therapy |
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| Experimental or Investigational Services or Unproven Services |
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Your ERISA Rights
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Retiree Medical, Prescription Drug and Mental Health and Substance Abuse Programs - Moore Wallace
How the Prescription Drug Program Works
How to Fill Your Prescriptions at a Retail Pharmacy
The claims administrator selects a network of retail pharmacies that offer reduced prices to covered individuals. You are not required to file a claim, provided you or your spouse/domestic partner receives benefits from a participating retail pharmacy, you or your spouse/domestic partner shows your prescription drug ID card, or the claims administrator verifies your eligibility at the point at which you or your spouse/domestic partner fills a prescription for you or your spouse/domestic partner. Your prescription drug ID card is generally separate from your medical ID card.
You or your spouse/domestic partner can obtain a list of participating retail pharmacies by calling the claims administrator at the phone number listed on your prescription drug ID card or by visiting the claims administrator’s website.
You or your spouse/domestic partner also can purchase prescription drugs at a non-participating pharmacy. However, you or your spouse/domestic partner is required to pay the prescription’s full cost at the time of your purchase, and you or your spouse/domestic partner must submit a claim form to the claims administrator for reimbursement.
