SAMPLE Cigna Open Access Plus Plan

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SAMPLE Cigna Open Access Plus Plan Important Information THIS IS A SAMPLE DOCUMENT. NO BENEFITS ARE GUARANTEED. NO COVERAGE REPRESENTATION IS CONSIDERED TO BE ACTUAL MEDICAL BENEFITS PROVIDED TO YOU BY Cigna . Table of Contents Important Information ........................................ ........................................ ..................................6 Special Plan Provisions ........................................ ........................................ ..................................8 Important Notices ........................................ ........................................ ........................................ ..9 How To File Your Claim ........................................ ........................................ .............................11 Eligibility - Effective Date ........................................ ........................................ ...........................11 Employee Insurance.

how to select a primary care provider, and for a list of the participating primary care providers, visit www.mycigna.com or contact customer service at the phone number listed on the back of your ID card. For children, you may designate a pediatrician as the primary care provider. HC-NOT5 01-11 Important Information

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