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Plan Description
Cigna > Cancer Insurance

Note: This page contains a brief summary of coverage. It does not state all provisions and limitations of the plan. The terms and provisions of each plan, as outlined in the plan document, will determine coverage and eligibility.

Broker Name:	Cigna
Policy Number:	34512435
Original Plan Effective Date:	12/11/2002
Rate Guarantee Expiration Date:	12/11/2002
Plan Anniversary Date:	12/11/2202
Division:	All Divisions
Location:	California
Employee Classes:	Full Time Manager Officer

Additional Highlights
Preventive Care	Actual charges up to $60 per calendar year
Hospital Confinement	$100 per day for the first 75 days
Drugs & Medicine	Actual charges up to $250 per confinement
Surgical	Actual charges up to $3000 per operation
Reconstructive	Actual charges up to $620 per operation
Anesthesia	Actual charges up to 25% of the scheduled amount for the surgical procedure performed
Skin Cancer	Actual charges up to $240 per operation
Special Nursing	Actual charges up to $75 per day for private duty nursing while Hospital confined
Ambulance	Actual charges
Extended Care	Actual charges up to $50 per day
Waiver of Premium	Premium waived after 90 days of disability

Waiting Period Information
Eligible employees are eligible as of the 1st of the month following the employee's hire date.

Termination of Coverage Information
When a plan participant is terminated from the company, the plan coverage ends on the last day of the month following the employee's termination date.

(per month)

View Plan Cost Structure File

http://www.colonial.com

Member Services

- Summary Plan Description

- Claim Form