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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
How the Retiree Group Health Program Works
General Information
Lifetime Maximum Benefit
The Retiree Group Health Program applies a lifetime maximum benefit of $2 million for each covered person. Covered expenses paid under the Prescription Drug Program do not count toward the lifetime $2 million maximum benefit.
If you would like to know how your covered expenses are “tallying up” in regard to your lifetime maximum, you should be aware that:
 | You can contact CIGNA to find out your lifetime maximum. |
| The Explanation of Benefits (EOB) statement does not show the remaining balance of your lifetime maximum. |
| CIGNA combines the medical and mental health or substance abuse claims data once per plan year. This lifetime maximum integration generally occurs toward the end of the first quarter, and reflects medical and mental health and substance abuse claims paid through the end of the preceding calendar year. Keep this timing in mind when you inquire about the lifetime maximum. |
