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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 to File a Claim
Retiree Group Health Program Claims
Medicare Electronic Claim Submission (Medicare Crossover)
The claims administrator can accept Medicare Part B claims electronically from Medicare for dates of service in 2002 and beyond. However, the claims administrator must first receive your Medicare health insurance claim (HIC) number, which is listed on your Medicare EOB statement. You or your spouse will need to call the claims administrator’s member services number and provide your HIC number, or you or your spouse can submit your first Medicare Part B EOB statement along with a claim form to the claims administrator. When the claims administrator receives the Medicare EOB statement, it will record your HIC number in your member record so all future Medicare Part B claims can be sent to the claims administrator electronically by Medicare.
Medicare Part A claims must continue to be submitted manually with a claim form. In most cases, you or your spouse must complete a claim form to get reimbursed for covered expenses. After your claim has been processed, you or your spouse will receive an EOB statement from the claims administrator that explains the charges for anything that you may owe.
