CLAIM REMINDERS • BE SURE TO USE YOUR MEMBER ID AND ACCOUNT/GROUP NUMBER WHEN YOU FILE CIGNA’S CLAIM FORMS, OR WHEN YOU CALL YOUR CIGNA CLAIM OFFICE. YOUR MEMBER ID IS THE ID SHOWN ON YOUR BENEFIT IDENTIFICATION CARD. YOUR ACCOUNT/GROUP NUMBER IS SHOWN ON YOUR BENEFIT IDENTIFICATION CARD. • BE SURE TO FOLLOW THE INSTRUCTIONS LISTED ON THE BACK OF THE CLAIM FORM CAREFULLY WHEN SUBMITTING A CLAIM TO CIGNA. Timely Filing of Out-of-Network Claims Cigna will consider claims for coverage under our plans when proof of loss (a claim) is submitted within 180 days for Out- of-Network benefits after services are rendered. If services are rendered on consecutive days, such as for a Hospital Confinement, the limit will be counted from the last date of service. If claims are not submitted within 180 days for Out- of-Network benefits, the claim will not be considered valid and will be denied. WARNING: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information; or conceals for the purpose of misleading, information concerning any material fact thereto, commits a fraudulent insurance act.
New Employee Group Waiting Period to become insured again unless you are rehired within 12 months and met the New Employee Group Waiting Period in your previous employment. If your insurance ceased because you were no longer employed in a Class of Eligible Employees, you are not required to satisfy the 30-day Waiting Period if you again become a member of a Class of Eligible Employees. You will become eligible for insurance on the first of the month on or after the date you become a member of a Class of Eligible Employees. Eligibility for Dependent Insurance You will become eligible for Dependent Insurance on the later of: • the day you become eligible for yourself; or • the day you acquire your first Dependent. Waiting Period First of the month on or after 30 days of Active Service. If you are a rehire and have met the applicable 30 day waiting period during your previous employment, the waiting period will be waived upon rehire and you will be eligible the first of the month on or after your rehire date if you are rehired within 12 months. Classes of Eligible Employees Each Employee as reported to the insurance company by your Employer. Effective Date of Employee Insurance You will become insured on the date you elect the insurance by completing the Employer’s specified enrollment process, but no earlier than the date you become eligible. You will become insured on your first day of eligibility, following your election, if you are in Active Service on that date, or if you are not in Active Service on that date due to your health status. Late Entrant - Employee You are a Late Entrant if: • you elect the insurance more than 31 days after you become eligible; or • you again elect it after you cancel your payroll deduction (if required). Dependent Insurance For your Dependents to be insured, you will have to pay the required contribution, if any, toward the cost of Dependent Insurance.
HC-CLM25
01-11 V11
Eligibility - Effective Date Employee Insurance This plan is offered to you as an Employee. Eligibility for Employee Insurance You will become eligible for insurance on the day you complete the waiting period if: • you are in a Class of Eligible Employees; and • you are an eligible, full-time Employee; and • you normally work at least 30 hours a week; and • you pay any required contribution. If you were previously insured and your insurance ceased because you were no longer employed, you must satisfy the
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