CIGNA INTERNATIONAL MEDICAL BENEFITS ABROAD PROGRAM

Transcription

1 Medical Benefits Abroad The Cigna International Medical Benefits Abroad Program gives you access to medical coverage for emergencies, urgent care and other health-related services for unexpected illnesses or injuries that may occur while traveling internationally on approved Company business. CIGNA INTERNATIONAL MEDICAL BENEFITS ABROAD PROGRAM The Cigna International Medical Benefits Abroad Program supplements your existing Macy s, Inc. (or non-macy s, Inc.) medical plan coverage and provides primary medical and accidental death and dismemberment coverage for illness and injuries that you may incur when traveling internationally on approved Company business. Although Macy s, Inc. medical plans currently provide medical benefits that cover emergency and/or urgent care services you may need while travelling outside of the country for business or pleasure, obtaining and paying for those benefits can often be inconvenient. Emergency and urgent care services you receive outside of the country are generally covered as in-network benefits under the terms of your medical plan and you are responsible for any emergency room or urgent care copayments or deductible/coinsurance. Unfortunately, many foreign doctors and hospitals are considered out-of-network under your medical plan and may require you to pay for your medical expenses upfront with cash or a credit card, which then requires you to wait and file a claim for reimbursement with your medical plan carrier when you return home. This can be inconvenient if you do not have access to enough funds to cover your medical expenses. In addition, any non-emergency follow-up care that you need before you return home will generally be covered only as out-of-network benefits under your medical plan. The new Cigna International Medical Benefits Abroad Program provides the convenience of primary medical coverage that will pay in-network benefits directly to foreign health care providers for your medical expenses and claims incurred while traveling internationally on Company business. COORDINATION OF BENEFITS For medical claims you incur while travelling abroad, the Cigna International Medical Benefits Abroad Program will be primary and pay benefits first, allowing you to focus on your care, not paying for it. Your primary medical coverage will pay secondary, if applicable, after the Cigna International Medical Benefits Abroad Program has paid its benefits. The Cigna International Medical Benefits Abroad Program does not coordinate its benefits with other medical coverage you have.

2 ELIGIBILITY You are automatically covered by the Cigna International Medical Benefits Abroad Program if you are a full-time active associate traveling on the business of, or at the expense of, the Company, outside your country of residence or permanent assignment. Spouses, domestic partners or children are not covered under this policy. Coverage begins when you leave your place of employment or residence to begin a business trip outside the country, and ends when you return from that international business trip. FEATURES THAT WORK FOR YOU These features of the Cigna International Medical Benefits Abroad Program may offer you peace of mind: You can report medical claims to Cigna from anywhere in the world, giving you a convenient, single point of contact for travel assistance and processing of medical expenses and claims that arise while you are traveling on business. Cigna can make claim payments on your behalf directly to international doctors in over 200 countries and in more than 100 currencies. Emergency travel services are available to you through Cigna Secure Travel. Cigna also helps you plan ahead through its dedicated website CignaEnvoy.com, which you can access before and during your trip to view valuable, practical information to help you locate doctors and hospitals from Cigna s global directory of pre-screened health care professionals even before you need care. MEDICAL BENEFITS The following medical benefits are covered under the Cigna International Medical Benefits Abroad Program: Calendar Year Medical $300,000 Benefit Maximum Calendar Year Deductible $0 Coinsurance (paid by 100% Cigna) Out-of-Pocket Coinsurance None Maximum Prescription Drug 100% of covered expenses, when medically necessary while on an approved international business trip. This benefit includes replacement of medicine for lost prescriptions that are medically necessary during an international trip. Calendar Year Emergency $1,000 Dental Maximum (includes dental accident & alleviation of sudden unexpected pain) Personal Deviation 7 days, when taken in conjunction with an approved business trip (Sojourn) Room and Board Inside Average Semi-Private Room Rate the U.S. Room and Board Outside $1,000 the U.S. Pre-Existing Condition None, subject to the calendar year maximum Medical Evacuation & $100,000 Repatriation 2 MBA_Highlights_7.17

3 ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS Listed below are the payment amounts for the loss of use of various parts of your body due to an accident: Amount of Principal Sum $100,000 War Risk Not covered Aggregate Limit of Liability $500,000 for all covered persons. The Program will not pay more than the Policy (This includes forms of Aggregate Maximum specified above for all covered losses for all covered transportation such as air, persons as the result of any one covered accident. If this amount does not allow bus, train and boat) all covered persons to be paid the amounts the Program otherwise would Loss of Life or two or more of the following (hand, foot or eye) Loss of speech and hearing Loss of speech or hearing Loss of one of the following (hand, foot or eye) Thumb and index finger provide, the amount paid for each Loss bears to the Aggregate Limit of Liability. 100% of the Principal Sum 100% of the Principal Sum 50% of the Principal Sum 50% of the Principal Sum 25% of the Principal Sum from the same hand If more than one loss above applies, only the largest applicable amount will be payable for all losses resulting from one accident. OFFSET FOR OTHER BENEFITS Any benefits for which you may be eligible under the Cigna International Medical Benefits Abroad Program may be offset by other benefits for which you may be eligible. These could include workers compensation, employer liability insurance or any other program as described in the Summary Plan Description. The Cigna International Medical Benefits Abroad Program may also recover any benefits paid to you if a third-party is determined to be liable for your injuries. COST OF COVERAGE The Company pays for 100% of the cost of the Cigna International Medical Benefits Abroad Plan. No associate contributions are required. 3 MBA_Highlights_7.17

4 Frequently Asked Questions Medical Benefits Abroad (MBA) Business Travel Medical Plan offered through Cigna International 1. How does an associate enroll in this program? A: There is no need for associates to enroll in the program. Associates are automatically covered when they are traveling outside their country of citizenship or outside their country of permanent assignment. Macy s, Inc. encourages associates to register on Cigna Envoy, prior to the associate s business travel outside of the country. 2. How does an associate login to register on Cigna Envoy? A: 1) Go to 2) Select I am an international business traveler from the list under I am a customer 3) Login using the username and password (provided by the HR Manager). If the HR Manager does not have this information, please Macy s, Inc. Benefits Department at benefits.communication@macys.com. 4) Click the Go button 3. What materials will the business travelers receive? A: Eligible associates will receive a Medical Benefits Abroad (MBA) Business Travel Medical Plan Welcome Kit from their HR Manager, which includes: Associate Communication MBA ID Card MBA Claim Form MBA Verification Form Certificate of Coverage Cigna also has a self-service, secure website CignaEnvoy.com, which provides a wealth of information exclusively for Macy s, Inc. associates. Associates can use CignaEnvoy.com to check the status of their claims and update personal information. In addition, Macy s, Inc. associates have access to Cigna s Country Guides and Provider Directories. 4. Will an associate receive an MBA ID card? If so, when? A: Yes. Before a Macy s, Inc. associate travels outside his or her country of residence or permanent assignment, MBA ID cards will be sent in an electronic Welcome Kit. 5. How is the MBA plan different from other Macy s, Inc. health care plan options? A: The MBA plan supplements any other applicable Macy s, Inc. health care plan coverage by serving as the primary (fully-insured) illness, accident and emergency coverage for medical, dental and prescription drug benefits for Macy s, Inc. associates while traveling on an approved business trip outside their country of residence or permanent assignment. These benefits are fully transportable, providing coverage for associates anywhere in the world. The My Choice Plans medical plan options offered through the Macy s, Inc. health care plan provide emergency medical coverage to both associates and any enrolled dependents if they have an accident or become ill while traveling outside of the country. However, it is important to note that the only coverage available while traveling is for emergent services, such as an illness or accidental injury. 4 MBA_Highlights_7-17

5 6. When does the MBA plan coverage begin and end? A: The MBA plan coverage begins when an eligible full-time Macy s, Inc. associate leaves his/her country of residence or permanent assignment to travel on Company business and ends upon return to the associate s country of residence or permanent assignment (not to exceed a continuous duration of six (6) or more months outside the associate s country of residence or permanent assignment). 7. Can an associate be covered under the MBA plan if the associate is not enrolled in a medical plan if they aren t enrolled in a Company-sponsored medical plan or any other medical coverage? A: No. The MBA plan is intended to supplement an associate s existing medical coverage. Associates for whom coverage is prohibited under applicable law or who are not covered by comprehensive medical insurance which complies with legal and regulatory requirements in their country of permanent assignment will not be considered eligible for the MBA plan. 8. Is the MBA plan a business travel accident plan? A: No. The MBA plan is a business travel medical plan that supplements an associate s existing health care coverage by providing primary (fully-insured) illness, accident and emergency coverage for medical, dental and prescription drug benefits to the associate while traveling on an approved business trip outside the covered associate s country of residence or permanent assignment. The MBA plan also provides concierge level services, as well as medical evacuation and repatriation services. However, the Macy s, Inc. MBA plan also does provide Accidental Death and Dismemberment coverage of up to $100,000 per associate, per year. 9. Will an associate s medical insurance ID card for Cigna work with the MBA plan? A: No. The MBA plan is for illness, accident and emergency coverage for medical, dental and prescription drug benefits while traveling on an approved business trip outside the covered associate s country of residence or permanent assignment. The MBA plan also provides concierge level services, as well as medical evacuation, but does not work in conjunction with an associate s other Cigna medical coverage. 10. Will the MBA plan provide coverage to an associate who wants to extend their travel for personal time? A: Yes. Macy s, Inc. associates who schedule personal or sojourn travel for up to a total of 7 days in advance of or after an approved international business trip (i.e. 7 days of personal travel that is taken in conjunction with an approved business trip) will be covered by the Macy s, Inc. MBA plan during the personal portion of their trip. 11. Does the MBA plan provide coverage to an associate on a personal vacation outside of the country with no associated business travel? A: No. The MBA plan only provides emergency coverage when traveling on an approved business trip outside the covered associate s country of residence or permanent assignment. If an associate is on a personal vacation traveling outside of the country with no associated business travel, he/she should contact their medical carrier to determine what coverage is available. 12. Will the MBA plan cover a spouse/domestic partner and/or dependents that accompany an associate during his or her business travel? A: No. The Macy s, Inc. MBA plan covers only eligible active full-time associates who are travelling on approved Company business outside their country of residence or permanent assignment. 5 MBA_Highlights_7-17

6 13. Who does a Macy s, Inc. associate notify if something were to happen? A: Macy s, Inc. and Cigna highly-recommend that a Macy s, Inc. associate, or someone acting on the associate s behalf if the associate cannot, contact Cigna immediately using the call collect contact number provided on the back of the MBA ID card (all charges will be accepted by Cigna on the associate s behalf). 14. Does the MBA plan provide any additional services? A: The MBA plan provides concierge services that include many additional benefits such as assistance with lost luggage, translation services and legal referrals, among others. 15. Does the Macy s, Inc. MBA plan provide coverage for international business travelers to the U.S.? A: Yes. The Macy s, Inc. MBA plan will cover international business travelers to the U.S. 16. Are there any caps on the amount of benefits a person can receive? A: Yes. Certain annual medical benefit maximum limits apply. Please see the medical benefit summary on page Are there any pre-existing exclusions? A: No. There are no pre-existing exclusions. 18. Are there any countries where Cigna cannot and/or will not provide coverage? A: No. Cigna has the ability to offer coverage to all full-time Macy s, Inc. associates traveling on an approved business trip outside their country of residence or permanent assignment. Cigna currently covers members in approximately 205 countries and jurisdictions and can provide coverage in most countries in accordance with applicable laws and regulations, making Cigna s MBA plan coverage truly global. 19. If a medical evacuation is needed, is this covered? A: Yes. A medical evacuation is the transfer of an associate from an inadequate medical facility to another that is better suited to give the most appropriate care for emergency medical treatment. If the covered associate suffers a life-threatening/limb-threatening medical condition, and Cigna, and/or its designee, determines that adequate medical facilities are not available locally, Cigna, or its designee, will arrange for an emergency evacuation to the nearest facility capable of providing adequate medical care. The covered associate, or someone acting on his/her behalf if the covered associate is unable to, must contact Cigna at the phone number indicated on their MBA ID card (ATT Access Code or ) to begin this process. In making their determinations, Cigna and/or its designee will consider the nature of the emergency, the associate s condition and ability to travel, as well as other relevant circumstances including airport availability, weather conditions and distance to the nearest adequate medical facility. 20. How is eligibility confirmed for an associate that is utilizing the MBA plan benefits? A: Eligibility information for the MBA plan is confirmed after receipt of a claim. The welcome kit each eligible Macy s, Inc. associate receives contains an MBA ID card with Cigna s contact information along with an MBA claim form. When an associate submits a claim, coverage is verified with Macy s, Inc. prior to the claim being processed. 6 MBA_Highlights_7-17

7 21. How are U.S. and Non-U.S. claims processed? A: All MBA claims, whether incurred in the U.S. or outside the U.S., are processed by Cigna s Senior Claims Associates as follows: Claims are received via CignaEnvoy.com, fax, mail/courier or /electronically Mail is opened, counted, and sorted into batches and date stamped Claims are scanned, indexed and given a unique identifier MBA claims are delivered to Cigna s Eligibility Team after the membership has been loaded International claims are delivered directly to the Cigna Claims Team Domestic claims are priced to take advantage of PPO discounts sent to Cigna in an electronic format for processing Cigna Claims Associates, working in date received order, process all claims Reimbursement checks in US Dollars are produced for mailing the next business day after processing is complete; local currency checks may take an additional two business days to process and mail Reimbursements and related documentation are generally mailed by Cigna s International Mail Operations Center staff 22. Is Cigna able to reimburse claim payments in local currency? If so, is the conversion rate based on date of service or date of processing the claim? A: Yes. Cigna specializes in reimbursing international claims in many languages and currencies with no additional charges applied by the carrier. Upon receipt of a foreign claim, Cigna converts the foreign currency into U.S. dollars using the date of service. This ensures that Macy s, Inc. associates will not have to assume the risk of currency fluctuation. 23. Are there any plan exclusions? A: Yes. Some of the exclusions to covered expenses will be charges for routine physical examinations; eyeglasses; hearing aids; routine dental care; routine cosmetic treatment or surgery; nervous or mental disorders of any kind; confinement or care in any government hospital or institution; expenses incurred during personal travel (unless expressly covered by the plan); expenses incurred as the result of loss or injuries arising out of employment which would be covered by Workers Compensation or a similar plan; and any expenses covered by any other employer or government-sponsored plan for which, and to the extent that the insured is eligible for reimbursement. 24. If an associate has additional questions who should they contact? A: If associates have additional questions, they should contact Cigna directly at the phone number indicated on their MBA ID card (ATT Access Code or ) 25. Is Cigna's customer service available 24 hours a day? A: Yes. Cigna members (including Macy s, Inc. associates) are able to reach a live Contact Center specialist 24 hours a day, seven days a week. Cigna offers toll-free (or collect) telephone access to the centers, as well as toll-free fax service and service for inquiries. Cigna s multilingual associates are able to verify coverage and link members to medical providers anywhere in the world. 7 MBA_Highlights_7-17