Cigna HMO/PPO and Kelsey Seybold
1. Benefit summary
Click each option to download a detailed list and descriptions of the benefits covered under the plan:
Open Access Plus Copay
Kelsey Care HMO
HMO Open Access
 
More complete descriptions of Benefits and the terms under which they are provided are contained in the Certificate of Coverage that you will receive upon enrolling in the plan.
 
2. Prescription Mail Order Form
Click here to download form. Upon filling out please mail to the following address:
 
Cigna Home Delivery Pharmacy
P. O. Box 1019
Harsham, PA 19044
 
3. Customer Service
1-800-244-6224
 
4. Providers
For a detailed list of providers in your network please click here.
 
5. Kelsey Seybold Locations
Click here for locations download.
 
Aetna
1. Benefit Summary
Please click here for a detailed list and description of your benefits and coverage.
 
2. Prescription Mail Order Form
Click here to download form. Upon filling out please mail to the following address:
 
Aetna Rx Home Delivery
P. O. Box 829518
Pembroke Pines, FL 33082-9518
 
3. Customer Service
1-888-267-2637
 
4. Providers
For a list of providers in your network please click here.
 
KelseyCare Advantage
1. Benefit Summary
Please click here for a detailed list and description of your benefits and coverage.
 
2. Claims and Customer Service
KelseyCare Advantage
P.O. Box 841649
Pearland, Texas 77584
 
Member service: 713-442-2273
Schedule appointments: 714-442-5178
 
3. Kelsey Seybold Locations
Click here for locations download.
 
On 3/14/22, we contacted you regarding the Machine Readable Files (MRFs) requirement of the Transparency in Coverage Rule. This communication outlines the next steps and key information needed by the 7/1/22 enforcement date.
As a reminder, under the Transparency in Coverage Rule, issued in 2020 by the U.S. Department of Health & Human Services, U.S. Department of Labor and U.S. Department of the Treasury and enforced beginning 7/1/22, health plans (which includes clients who sponsor employee benefit plans) and health insurance issuers must publish two separate MRFs.
 
https://link.edgepilot.com/s/6fd1de34/BPY7d4H_dka9JRUCluLOeQ?u=https://www.cigna.com/legal/compliance/machine-readable-files

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