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| Table of Contents | |
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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
Your Rights and Responsibilities
Your Responsibilities
All covered individuals are responsible for learning how the Program works by carefully studying and referring to the SPD.
You have a responsibility:
 | To fully understand the benefit communication materials you receive. |
| To present your ID card before receiving services. |
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| To select a provider or primary care physician (if applicable). |
| To keep scheduled appointments and notify the provider’s office promptly if you will be delayed or unable to keep the appointment. |
| To follow the advice of your provider or primary care physician (if applicable) and consider the likely consequences when you refuse to comply with his or her advice. |
| To make the lifestyle changes recommended by your physician (if applicable). |
| To provide honest and complete information to your provider or primary care physician. |
| To know what medications you and your covered spouse take, why you are taking them, and the proper way to take them. |
| To express your opinions, concerns, or complaints in a constructive manner to the appropriate people. |
| To pay all applicable fees at the time service is rendered (if applicable), plus any additional payments due, in a timely manner. |
