This plan has incorporated into the coverage access to a network of medical professionals, including doctors and hospitals, known as the Preferred Provider Organization (PPO), offered through Cigna. While you are allowed to visit any provider of your choosing, if you use an in-network PPO doctor or facility, you will pay less money out-of-pocket.
Contact the provider prior to your visit to confirm their membership in the network.
Information about getting your medical bills paid
- Go to the nearest PPO doctor’s office, urgent care center, or hospital. While you may choose any doctor or hospital, using the providers available through the PPO network may greatly decrease your costs. For a full listing of PPO doctors or hospital facilities, visit www.cigna.com.
- If you go to a doctor’s office or to the hospital, be sure to show your identification card. If the doctor or hospital needs to verify your coverage, they may call Personal Insurance Administrators, Inc., at (877) 358-3727. Carry your insurance ID card with you at all times.
- After you receive treatment at a PPO provider, your provider will submit a claim to the insurance company. Providers should submit claims electronically to PAYER ID 62308, or mail to Cigna, P.O. Box 188061, Chattanooga, TN 37422-8061.
- In some circumstances, such as using a non-PPO provider, you may be asked to pay up front. In this case, submit a claim for reimbursement for the portion of the charges the company is responsible for paying by sending all itemized hospital and medical bills, along with either a copy of your health insurance ID card or a completed claim form (available below), to:
Personal Insurance Administrators, Inc.
P.O. Box 6040
Agoura Hills, CA 91376-6040
- If you have questions about the status of your claim after it has been submitted, please call Personal Insurance Administrators, Inc., at (877) 358-3727.
- The completed claim, including all hospital and medical bills, must be submitted for payment within 90 days after the date loss occurs, or as soon thereafter as is reasonably possible.
- Always keep a copy of all documents submitted for claims.
- You have the right to request an independent medical review if health care services have been improperly denied, modified, or delayed based on medical necessity.
If you would like to have confidential medical information from the claims administrator sent to an address other than the address on file with the College, you can download a Confidential Communication Request, fill out the form, and send it to the address listed. This form is available below.
The Pharmacy Benefit Manager for this plan is Express Scripts. Only prescriptions filled at Express Scripts pharmacies are covered. Walgreens, CVS, Target, Wal Mart, and many other retail stores are in the Express Scripts Network. For additional stores, call (800) 447-9638 or visit their website by clicking the link below.
Additionally, please see the Preferred Formulary list and a list of preferred drug exclusions related to this plan.
A mail order discount is available for maintenance medications (taken on a regular basis); pay two copays for each 90-day supply when using the mail order discount program. To sign up, go to the Express Scripts website (link below) and set up an online account. You can also download a mail order form through the link below that you can print out and mail in with a prescription.
Specialty medications are available only through Accredo, an Express Scripts Specialty Pharmacy. For more information, please view the Accredo Information Sheet below.
Get help while you are traveling
As a student participating in this Plan, you are automatically enrolled in the Scholastic Emergency Services (SES) coverage.
With travel an accepted—and expected—part of collegiate life these days, students are regularly venturing all over the world. SES ensures that wherever students find themselves, they will always be able to receive medical care of high standards. SES offers a full range of services to help students through any difficulty away from home.
Count on SES to handle any and all student medical emergencies during travel, but call on us as well to retrieve lost luggage or documents, provide counseling services, offer insightful pre-trip information, and more.
For additional information, please see your insurance brochure. To visit their website for more information, click the link below.
View a glossary of commonly-used insurance terms, provided by the Department of Health and Human Services.