Page 21 - Enrollment guide 2024-25 - v3

Required Notices Key Contacts

Women’s Health and Cancer Rights Your Employer or Human Resources Office For:
Act (WHCRA) • Change of mailing or email address

• Add or drop coverage for you or a dependent (must be within 30 days of qualifying event)
If you have had or are going to have a mastectomy, • Questions about your cost
you may be entitled to certain benefits under the • SchoolCare Enrollment/Change Form
Women’s Health and Cancer Rights Act of 1998 • FSA enrollment form, if applicable
(WHCRA). For individuals receiving mastectomy-
related benefits, coverage will be provided in
a manner determined in consultation with the
attending physician and the patient, for:
Cigna Member Services: 800-244-6224, 24/7/365 For:
• All stages of reconstruction of the breast on
which the mastectomy was performed; • Benefit questions, including access to mental health or employee assistance program benefits
• Surgery and reconstruction of the other breast • Concerns with provider(s) or to appeal a Cigna coverage decision
produce a symmetrical appearance; • Assistance with mail order prescriptions
• Prostheses; and dependents might be eligible for these programs, • Guidance with completing your health assessment on myCigna
• Treatment of physical complications of the contact your State Medicaid or CHIP office or dial • Questions about the Good For You! Well-Being Program
mastectomy, including lymphedema. 877-KIDS NOW or insurekidsnow.gov to find out
how to apply. If you qualify, ask your state if it has a Cigna Technical Support: 800-284-8346, 24/7/365 For:
These benefits will be provided subject to the same program that might help you pay the premiums for
deductible and coinsurance applicable to other an employer-sponsored plan.
medical and surgical benefits provided under the • Technical assistance with myCigna.com or the myCigna app
plan. If you would like more information on WHCRA If you or your dependents are eligible for premium
benefits, call Cigna at 800-244-6224. assistance under Medicaid or CHIP, as well as eligible
under your employer plan, your employer must SchoolCare :
SchoolCare: 603-836-5031
Premium Assistance Under Medicaid allow you to enroll in your employer plan if you Monday through Friday 8:30 a.m. - 4:30 p.m.
aren’t already enrolled. This is called a “special
and the Children's Health Insurance enrollment” opportunity, and you must request
Program (CHIP) coverage within 60 days of being determined eligible Member Care: Press 1
for premium assistance. If you have questions
If you or your children are eligible for Medicaid or about enrolling in your employer plan, contact the • General eligibility inquiries
CHIP and you’re eligible for health coverage from Department of Labor at askebsa.dol.gov or call 866- • Questions regarding enrollment information
your employer, your state may have a premium 444-EBSA (3272). • COBRA and Retiree billing questions
assistance program that can help pay for coverage, • Email membercare@schoolcare.org
using funds from their Medicaid or CHIP programs. To see if your state has a premium assistance
If you or your children aren’t eligible for Medicaid program, or for more information on special Group Relations: Press 3 or Jeff Kantorowski at NEA-NH 603-715-9315
or CHIP, you won’t be eligible for these premium enrollment rights, contact either: • Benefit questions
assistance programs but you may be able to buy • Questions/issues that haven't been resolved by
individual insurance coverage through the Health • U.S. Department of Labor Cigna Member Services
Insurance Marketplace. For more information, visit Employee Benefits Security Administration • Request assistance for appealing a Cigna coverage decision
healthcare.gov. dol.gov/agencies/ebsa • Health benefit options for retirees
866-444-EBSA (3272) • Email grouprelations@schoolcare.org
If you or your dependents are already enrolled in
Medicaid or CHIP, contact your State Medicaid or • U.S. Department of Health and Human Services Accounting: Press 4
CHIP office.
Centers for Medicare & Medicaid Services • COBRA and Retiree payment questions
If you or your dependents are NOT currently enrolled cms.hhs.gov • Email accounting@schoolcare.org
in Medicaid or CHIP, and you think you or any of your 877-267-2323, Menu Option 4, Ext. 61565

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