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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
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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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Your ERISA Rights
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Retiree Medical, Prescription Drug and Mental Health and Substance Abuse Programs - RR Donnelley
Program Premium Cost
Determining an Annual Premium for You and Your Spouse
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 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 spouses or subsidies paid by RR Donnelley or any of its subsidiaries.
How much you and your spouse must pay to the Plan to be enrolled for coverage (called your “premium”) will depend upon:
 | Which Medical Program you and your spouse are enrolled in; and |
| Whether you and your spouse are eligible for an annual subsidy cap amount, described below, from your former employer, and if so, how much. |
You and your spouse will know the premium for the next calendar year when you and your spouse receive your enrollment materials.
