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Retiree Medical, Prescription Drug and Mental Health and Substance Abuse Programs - RR Donnelley   
How the Retiree Group Health Program Works
General Information
The Retiree Group Health Program offers the following Medical Program options through CIGNA:
 | The CIGNA Open Access Plus option covers you and your spouse who are under age 65 (or not Medicare-eligible) and who live in a CIGNA network area.
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| The CIGNA Indemnity option covers you and your spouse who are under age 65 (or not Medicare-eligible) and who do not live in a CIGNA network area.
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| The CIGNA Post-65 Medicare option covers you and your spouse who are age 65 or older or who are otherwise eligible for Medicare due to disability. |
Your home ZIP code and Medicare eligibility determine which coverage options are available to you and your spouse.
If either you or your spouse is age 65 or older (or otherwise Medicare-eligible due to disability) and the other is under age 65 (and not Medicare-eligible), you will be covered by different plans. In this case, the not Medicare-eligible individual will be eligible for the CIGNA Open Access Plus option if the home ZIP code falls within the CIGNA network. If the not Medicare-eligible individual does not live in a CIGNA network area, he or she will be eligible for the CIGNA Indemnity option. The individual who is age 65 (or otherwise Medicare-eligible due to disability) is eligible only for the CIGNA Post-65 Medicare option. When filing claims for your spouse, your spouse’s Social Security number or CIGNA Alternate Medical Identifier Number should be used.
You receive information regarding the Medical Program coverage options available to you and your spouse when you are first eligible for coverage under the Program and during each Annual Enrollment period thereafter.
Once you and your spouse are enrolled in a Medical Program, you and your spouse automatically are enrolled in the Mental Health and Substance Abuse Program and Prescription Drug Program.
The Retiree Group Health Program covers most charges for illness and injury (up to the maximum reimbursable charge), provided the claims administrator considers the expense to be a covered expense.
The amount the Retiree Group Health Program pays is based on medical and mental health and substance abuse covered expenses incurred by you and your spouse in a calendar year.
Once you and your spouse meet the annual “deductible” requirement, the Retiree Group Health Program generally pays a percentage of covered expenses for the remainder of the calendar year, up to the “annual out-of-pocket limit.” Then, once the deductible and coinsurance amounts paid by you and your spouse reach the applicable annual out-of-pocket limit, the Program pays 100% of additional covered expenses for the remainder of that calendar year.
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