2. What’s in the presentation?
Who is Cigna
NRS
Medical
Plan
What’s new
Out-patient
Money back
Who are covered
1958 – year Cigna was established as a global health service provider and insurance broker that provides international employee benefits
10 CG Centers have joined from 2007 to 2014
4,141 members in CG system as at December 2014
In-patient
What to do…
What are covered

3. myWellness.irri.org
NRS
Medical
Plan
Safety
at Work

4. Expert in international health insurance
Who is Cigna?
1958
Expert in international health insurance
60M
Customers worldwide 10
4,222
CG members
1958 – year Cigna was established as a global health service provider and insurance broker that provides international employee benefits
10 CG Centers have joined from 2007 to 2014
4,141 members in CG system as at December 2014
2011
IRRI
NRS-CO joined the plan

5. What’s new in the plan? NRS Medical Plan ≈ PhP 1.1M
Medical insurance coverage of a maximum $25,000 per calendar year;
100% reimbursement for medical ambulatory (not requiring hospitalization) and hospitalization ;
Reimbursement of expenses for dental (80%) and psychiatric (50%) treatment up to a maximum of $500 and $600, respectively, per person per calendar year;
Reimbursement of medical expenses related to the HIV virus. This includes the cost of medication, testing, vaccines, and consultation;
Emergency treatment is covered anywhere in the world.

6. Spouse or domestic partner
Who are covered?
NRS
Member &
Approved Dependants
Spouse or domestic partner
(over 65)
Children (below 21)

7. What medical services are covered?
Pharma products
Lab test
HIV test
Annual checkup
Outpatient
& Inpatient
Preventive screening
Dental care
Optical care
Physical med & rehab
Pregnancy & childbirth
Psych treatment

8. Outpatient services Chemo- therapy Radio- therapy Hemo- dialysis
Outpatient surgery /
day case

9. Inpatient services
Semi-private
room

10. Children’s care MMR Polio DPT Hepa B Chicken pox New- born
Birth to age 1
Age 1 to 2
Age 3 to 6
Age 7 to 19 1
6/2mos
3/6mos
4/yr
6/2yrs
Polio
MMR
DPT
Hepa B
Chicken pox

11. Women’s care
Physical
exam
Mammo-graphy
Papsmear
Once a year

12. Men’s care
Urological exam
PSA screening

13. Treatment by Psychiatrist
Psychiatric care
≈PhP26,000/ year
Treatment by Psychiatrist

14. Optical care 1 exam / 2 years ≈ PhP2,500 per lens / 2 years
Frames not covered

15. Dental care ≈PhP22,000 per member/ year Scaling Implants X-ray
Dentures
Ceiling of PHP22k
Surgical
treatment
Orthodontic

16. Paramedical fees Physio-therapy Speech therapy Wound dressing
Osteo-pathy
Chiro-practic

17. Pharmaceutical products
Medication treatment
General
Maintenance medicines

18. Diagnostic imaging MRI CT scan Ultra-sound X-rays CT scans
Nuclear medicine scans
MRI scans
Ultrasound
Ultra-sound

19. Laboratory test CBC Blood sugar Uric acid X-rays CT scans
Nuclear medicine scans
MRI scans
Ultrasound
Uric acid

20. Annual check up Blood analysis Urine test Stool test Chest x-ray ECG
X-rays
CT scans
Nuclear medicine scans
MRI scans
Ultrasound

21. With approval of Cigna consultant
HIV test
With approval of Cigna consultant
X-rays
CT scans
Nuclear medicine scans
MRI scans
Ultrasound

22. Pregnancy & childbirth
Pre- and post-natal care
Hospital care
Amniotic
fluid test
(with approval of medical consultant)
X-rays
CT scans
Nuclear medicine scans
MRI scans
Ultrasound

23. Life threatening situations
Ambulance
Life threatening situations
X-rays
CT scans
Nuclear medicine scans
MRI scans
Ultrasound

24. Some exclusions
“to name a few”
USA & Singapore

25. Where can I get more details?
myWellness.irri.org

26. Your CIGNA card 1 2 3 4 Cigna dedicated Web site that the
members can log in to for information related to the plan
The RESNO is your Cigna personal reference number
that needs to be mentioned in all correspondence with Cigna 1 2 3 4
Personal details of the plan member: name, gender, and date of birth
How to read your card
Front
1 – dedicated web site
2 – personal details – name, gender, birthdate
3 – personal reference number – 1 for every family
plan 288 – group identification
couples both working in IRRI – the one with the address is the principal member – RESNO of the principal member
if both have addresses – automatic husband is the principal member – husband’s RESNO
4 – Cigna contact details
Cigna’s phone number, fax number
dedicated address for plan 288 members
mailing address of Cigna’s office that caters to our area
Cigna contact details that the members can use to get in touch with Cigna

27. Your CIGNA card
Percentage of costs covered for outpatient treatment 5 5
Contact details to be used by health care providers

28. What to do: Inpatient (accredited)
Member
Care Provider
Cigna
Accomplish
cost estimate form
Present Cigna card
Provide guarantee
of payment
Provide treatment
Pay excess,
if any
Submit Philhealth
documents
Bill the patient for excess, if any,
then send final billing to Cigna

29. What to do: In/Outpatient
(non-accredited)
Member
Care Provider
Cigna
Go to hospital
Provide treatment
Pay bill
Submit Philhealth
File claim
Process claim
Receive reimbursement

30. What to do: Planned Outpatient
(accredited)
Member
Care Provider
Cigna
Accomplish
cost estimate form
Provide cost of procedure
Send cost
estimate form
Provide GOP
Get treatment
Submit Philhealth
Bill Cigna

31. How do I log in?

32. How do I log in?

33. How do I log in?

34. How do I log in?

35. How do I file a claim online?
Step 1
Scan all your documents (.pdf, .jpeg, .jpg, .tif, .tiff, and .gif).

36. How do I file a claim online?
Step 2
Log in to and click “Online”.

37. How do I file a claim online?
Step 3
Read the important reminders and click “Claim Online”.

38. How do I file a claim online?
Step 4
Fill out the claim form.

39. How do I file a claim online?
Step 5
Fill out the payment details.

40. How do I file a claim online?
Step 6
Attach the scanned documents, accept the terms and conditions, and click “Send”.

41. How do I file a claim online?
Your claim has been sent successfully.

42. Questions?

43. Who do I contact? Janet Lazarte Cheryll Mercado Kentjie Masaredo
Compensation, Benefits & Reporting Services
FF Hill Building
x2353
Janet Lazarte
Cheryll Mercado
Kentjie Masaredo