Benefits Provided Bythe CISEL Travel Insurance Policy

BeginningFebruary 1, 2016, Cigna Insurance Services (Europe) Limited (CISEL1) customers in the United Kingdom will be able to purchase a travel insurance policy thatwill include emergency medical coverage in the United Statesutilizing Cigna’s national Preferred Provider Organization (PPO) network. Benefits will be administered byHealix International (Healix).

Benefits provided bythe CISEL travel insurance policy

When policyholders travel to the United States, they havethe following benefit coverage:

In-network benefit coverage.Individuals and their covered family members can access Cigna's national PPO networkof hospitals, physicians, and other health care providersat 100 percent coverage for approved, eligibleemergency medical, surgical, hospital, and ambulance services or supplies. There is no copayment or coinsurance, and health care providers are reimbursed at 100 percent of the PPO rate for covered services.There is an unlimited benefit plan maximum.

Out-of-network benefit coverage is not available, unless it is for amedical emergency (e.g., the customer has been in an accident, is unconscious, or has a life-threatening condition).

Prior notification*required for inpatient services

Before receiving medical care, the CISEL policyholder is required to call Healix.If the CISEL policyholdercannot callHealix due to a medical emergency, please notify Healix by calling 1.877.697.7857. Treatment will be covered in accordance with the policy requirements.

*Note that the back of the ID card states, “For US inpatient services pre-authorization is required.” In this instance, pre-authorization is referring to the prior notification requirement for customers to call Healix; there is not a separate pre-authorization requirement for providers.

Verification of eligibility and benefits

To verify eligibility and benefits, call Healix Customer Service at 1.877.697.7857. This phone numberand other important information are on thepatient’s Cigna ID card or the travel insurance policy document they may present.If a patient does not have an ID card but knows they are covered by Cigna, call 1.800.88Cigna (882.4462). Although only Healix can verify eligibility and benefits for CISEL customers, Cigna can provide you with their contact information.

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1About CISEL. Formerly FirstAssist Insurance Services, CISEL is one of the United Kingdom's leading providers of solutions across core areas of insurance expertise in travel, health, and accident protection, and legal protection plans.

ID cards

The sample ID card* images below will help you to identify our CISEL policyholders who haveemergency medical coverage in the United States.

FrontBack

*These cards are for illustrative purposes only

Key ID card information

The front of the card includes the:

-Plan type

-Patient name

-Customer ID number

-Unique identifier – “C” –above “Cigna Insurance Services Europe Limited,” indicating aCISEL customer

The back of the ID card includes the:

-Claim submission address

-HealixCustomer Service phone number

-Wording, “For US inpatient services pre-authorization required”

Claims submission and reimbursement

Mail your claims to Cigna Healthcare, P.O. Box 182223, Chattanooga, TN 37422-7223for reimbursement of approved covered services. You may also submit your claims electronically using payer ID 62308. Healix will pay all claims and sendexplanations of payment.

Additional information

If you or your patientshave questions about claim status, payment, eligibility, benefits, or prior notification requirements, please call Healix Customer Service at 1.877.697.7857.

“Cigna” and the “Tree of Life” logo are registered service marks, and “Together, all the way.” is a service mark, of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All products and services are provided by or through such operating subsidiaries and not by Cigna Corporation. Such operating subsidiaries include Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company, Cigna Behavioral Health, Inc., and HMO or service company subsidiaries of Cigna Health Corporation and Cigna Dental Health, Inc.