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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
Prior Authorization
Certain drugs require the claims administrator’s authorization before they are covered under the Prescription Drug Program. Please contact your claims administrator to confirm whether your drug requires prior authorization.
If your prescription requires prior authorization, begin the prior authorization process by taking your prescription to a participating retail pharmacy or submitting it to the claims administrator’s mail service pharmacy. The claims administrator then works with the pharmacist and your physician to obtain the necessary information to make an appropriate coverage decision. This process can take up to two business days to complete. Once the claims administrator makes a decision, the claims administrator processes your mail service prescription or contacts the retail pharmacy to communicate whether or not the coverage was approved. If your medication is not approved, you can appeal by calling the claims administrator at the phone number listed on your prescription drug ID card.
