Claims For Benefits
A claim for benefits is a request for Plan benefits made in accordance with the Plan’s claims procedures. In order to
file a claim for benefits offered under this Plan, you must complete the claim form from the applicable claim administrator—
CIGNA, ComPsych or Caremark®.However, if you receive In-Network benefits from a participating provider (as described in the applicable sections of this
SPD), you will not have to submit a claim. All claims for benefits must have been filed prior to the end of the second
calendar year following the date the claim was incurred in order to be eligible for payment under the Plan.
In general, under the Plan’s rules, simple inquiries about the Plan’s provisions that are unrelated to any specific
benefit claim will not be treated as a claim for benefits.
