Depending on where you live, you may enroll for coverage under one of the two point-of-service medical plans – the CIGNA Point-of Service Plan or the CIGNA Open Access Plan). If there is no point-of-service network available, you may be eligible for coverage under the CIGNA Indemnity Plan group contract. Prescription drugs and vision benefits are different for the CIGNA Point-of-Service Plan than the CIGNA Open Access and the CIGNA Indemnity Plan. You are automatically covered for prescription drug benefits and vision benefits when you enroll in a medical plan.
Medco administers the self-funded prescription plan which covers members in the CIGNA Open Access and CIGNA Indemnity Plan. The CIGNA Point-of-Service Plan offers prescription benefits through the CIGNA Pharmacy Plan.
Vision Service Plan (VSP) provides vision benefits under each medical plan. The vision benefits are different for the Point-of-Service Plan. See the Summary of Benefits for a summary of the copayments, deductibles, coinsurance, and related limits under each plan.
Highlights
Your Medical Benefits ... |
... Offer Coverage Under One of the Point-of-Service Plans for Most Employees
If you have access to the CIGNA point-of-service network, you can enroll in one of the two Point-of-Service Plans under the group contract. The network for the CIGNA Point-of-Service and the CIGNA Open Access Plans is available across the state of Tennessee. If you temporarily reside outside of Tennessee and CIGNA has a local point-of-service network available, you may be provided use of that network, and receive in-network benefits. CIGNA has discretion to determine network availability.
... Provide Coverage Under the CIGNA Indemnity Plan Group Contract for Employees who do not Have Access to a Point-of-Service Network
If you live in an area where a CIGNA network is not available, you may be covered under the CIGNA Indemnity Plan.
... Let You Waive Coverage
You may also choose to waive coverage. If you initially waive coverage, you may enroll during the next Open Enrollment period or when you experience a Qualifying Life Event, as described within the "About Your Benefits" section.
... Provide Protection for Your Family
You may enroll your Eligible Dependents for coverage under the same plan in which you are enrolled.
There may be state legislative requirements regarding group insurance plans covering individuals in the state. If so, CIGNA will comply with those requirements – which may create situations where a benefit is considered differently than as stated in this summary of benefits. Whenever there is a conflict between the summary in this book and the applicable Certificate of Insurance, the Certificate governs. You may request a copy of the Certificate by following the steps outlined under the “Administrative Information” section of this book. |
What happens to your benefits when ...
For more information about what happens to your medical, prescription drug, and vision coverage when certain changes or events occur, see “How Changes Affect Your Benefits” in the “About Your Benefits” section. |
Your Prescription Drug Benefits ... |
… Allow You the Flexibility to Use a Network Pharmacy or any Pharmacy You Choose
While benefits are higher when you use a network pharmacy, you can go to any pharmacy you choose and still receive prescription benefits.
- For the CIGNA Open Access and CIGNA Indemnity plans, call Medco at 1-800-685-8869 for assistance with locating a network pharmacy. This number is listed on your Medco ID card.
- For the CIGNA Point-of-Service Plan, call CIGNA at 1-800-CIGNA24 (1-800-244-6224) for assistance with locating a network pharmacy. This number is listed on your CIGNA ID card.
- No claim form is required when you use a network pharmacy. When you fill a prescription at a non-network pharmacy or file a direct claim, you pay the deductible and then you pay 50% for Medco prescriptions and 20% for CIGNA prescriptions of the eligible cost for up to a 30-day supply of most prescription drugs.
… Offer a Convenient Home Delivery Option
The home delivery option, designed for maintenance drugs, provides up to a 90-day supply of a drug. You will pay the required copayment. New prescriptions can be ordered by mail. Complete an order form and mail it with your prescription.
For Medco (CIGNA Open Access and CIGNA Indemnity Plans)
- Mail: Medco
PO Box 2201
Pittsburg, PA 15230-2201
- Fax: Your doctor may fax your prescription to Medco. Have your doctor call 1-888-327-9791 for information on how to fax to Medco.
- Internet Refills: www.medco.com
- Telephone Refills: 1-800-473-3455.
Have your ID card and your refill bottle with the prescription information ready.
For Tel-Drug (CIGNA Point-of-Service Plan)
- Mail: Tel-Drug, Inc.
PO Box 5101
Sioux Falls, SD 57117-9660
- Internet Refills: www.teldrug.com or you may also access through www.mycigna.com
- Telephone Refills: 1-800-Tel-Drug (1-800-835-3784) or 1-800-285-4812.
Have your ID card and your refill bottle with the prescription information ready.
|
The Vision Service Plan (VSP) offers increased benefits when you see an in-network provider. A list of VSP in-network providers is available on the provider directories link on the Internet at www.vsp.com or by calling VSP at 1-800-877-7195.
Home
