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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 Prescription Drug Program Works
What Is an Expense That May Be a Covered Expense – Prescription Drug Program
Outpatient prescription drugs (including injectables) that are approved for use by the Food and Drug Administration (FDA), prescribed by a properly licensed physician, and dispensed by a licensed pharmacy may qualify as a covered expense provided the drug is not excluded from coverage.
The claims administrator makes a determination as to whether a benefit will be provided.
For a complete listing of the current-year Primary/Preferred Drug List, and to confirm whether a drug listed on the Primary/Preferred Drug List is covered by the Prescription Drug Program, contact the claims administrator online or at the phone number listed on your prescription drug ID card. Refer to the “What Expense Is Excluded From Being a Covered Expense – Prescription Drug Program” section for specific information about medications that may be listed on the formulary provided by the claims administrator but that are not covered under the Prescription Drug Program.
