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.

office or a utilization review program (see the PAC/CSR section of your certificate) may refer an individual for Case Management. The Review Organization assesses each case to determine whether Case Management is appropriate. You or your Dependent is contacted by an assigned Case Manager who explains in detail how the program works.

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