If the claimant wishes to contest Our decision, He must contact the Appeals Department and inform Us, orally or in writing, that He wishes to contest Our decision. If the decision is upheld, the claimant has the right to a second level appeal review. The Appeals Department contact information is:
Cigna Supplemental Health Solutions PO Box 22000 Chattanooga, TN 37421-9702 Cigna-Supplemental-benefit-appeals@cigna.com Fax: 866-304-4326
Appeal determination will be made in writing no later than 30 calendar days after Our receipt of the written request unless We need more time to obtain additional information to make a determination. If more time is needed to obtain the additional information, We may extend Our response time an additional 30 days. However, this response time may be suspended while We are waiting for additional information requested from the claimant as permitted under Our grievance procedures. We will keep the claimant regularly advised of the status of Our response to the complaint.
Throughout this procedure and at any time during this procedure the claimant may, by written request, appoint another person to act as His agent or representative.
11) Under the Administrative Provisions section, the following changes are made:
a) The Change in Premium Rates provision is revised so that the first two sentences read as follows:
No change in rates will be made until 24 months after the Effective Date. The premium rates may be changed by Us with at least 31 days advance written notice. Item # 5 our right to change premium under the events during a rate guarantee period if "Other changes occur in the nature of the risk that would affect our original risk assessment" is removed.
b) A refund of Unearned Premium is added:
Refund of Unearned Premium If the Policyholder cancels this Policy for any reason, We shall refund the pro rata portion of the Unused Collected Premium to the beginning of the next monthly billing cycle. “Unused Collected Premium” as used herein means that portion of any premium collected which is not used, on a pro rata basis to the beginning of the next monthly billing cycle at the time of cancellation, by Us to insure against loss as there is no risk of loss from Covered Persons, or that portion of any collected premium which would have not been collected had the premium been paid monthly.
c) The Grace Period provision is revised as follows:
Policy A Policy Grace Period of 31 days will be granted for payment of required premiums under this Policy. This Policy will be in force during the Policy Grace Period. The Policyholder is liable to Us for any unpaid premium for the time this Policy was in force. If the premium is not paid before the grace period ends, the coverage provided by this policy will terminate as of the last day of the grace period. Covered Person A Grace Period of 31 days will be granted for payment of required premiums under this Policy. A Covered Person’s coverage under this Policy will remain in force during the Grace Period. If the premium is not paid before the grace period ends, the coverage provided by this policy will terminate as of the last day of the grace period.
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