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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
Your Legal Right to Continuation Coverage
Notification
In the case of a proceeding in bankruptcy under Title 11 of the United States Code with respect to RR Donnelley or its subsidiaries (including Moore Wallace or its subsidiaries) from whose employment you retired, you or your spouse/domestic partner who is a continuation coverage beneficiary will automatically be advised of the right to continuation coverage within 14 days of the date the COBRA administrator is notified by the employer of the event. The employer has 30 days after the date of the qualifying event to notify the COBRA administrator.
Under the law, the former employee or spouse/domestic partner who is a continuation coverage beneficiary has the responsibility to inform the COBRA administrator of a divorce or legal separation within 60 days after the qualifying event occurs. Upon such notification, coverage will be terminated retroactive to the date of the qualifying event. Failure to provide this notification results in the loss of continuation coverage rights. When the COBRA administrator is notified that one of these qualifying events has happened, you and your spouse/domestic partner will in turn be notified within 14 days of the right to choose continuation coverage.
