Cigna Health and Life Insurance Company 900 Cottage Grove Road Bloomfield, Connecticut 06002
WELLNESS TREATMENT, HEALTH SCREENING TEST AND PREVENTIVE CARE BENEFIT RIDER This Rider is attached to and made a part of your group insurance Policy. It is subject to the terms, conditions, limitations and exclusions contained in the Policy as well as those set forth in this Rider. Rider Effective Date: January 01, 2024 THIS RIDER DOES NOT CONTAIN COMPREHENSIVE ADULT WELLNESS BENEFITS AS DEFINED BY WYOMING LAW. BENEFITS The following provisions explain the benefits available under this Rider. Please see the Schedule of Benefits for the applicability of these benefits on a class level. We will pay the per day benefit shown in the Schedule of Benefits, if a Covered Person undergoes or receives Wellness Treatment, Health Screening Test, and/or Preventive Care examination, immunization, or testing as set forth below, under direction of a Physician while coverage under this Rider is in force. Benefits are subject to any applicable Benefit Waiting Period and Elimination Period. BENEFIT WAITING PERIOD The Benefit Waiting Period shown in the Schedule of Benefits applies to this Rider. WELLNESS TREATMENT Well Child Care – Office Treatment, Labs and Immunizations; Osteoporosis screenings; Routine gynecological exams; Routine prostate exams; General health exams; Colorectal cancer screening; Lead poisoning screening; Cancer screenings; Adult immunizations; Annual routine preventative dental exam; Annual routine ophthalmological exam including refraction
HEALTH SCREENING TEST
Mammography;
Pap Smear for women over Age 18;
Flexible Sigmoidoscopy; Hemoccult Stool Specimen;
Colonoscopy;
Prostate Specific Antigen (for prostate cancer); Stress test on a bicycle or treadmill; Fasting blood glucose test; Blood test for triglycerides; Serum cholesterol test to determine levels of HDL and LDL; Bone marrow testing;
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