Medical & Prescription

As a retiree of the Robert Wood Johnson Foundation, you are eligible for medical, prescription, vision, and dental coverage.

The Foundation's current medical plan is an Open Access Plus Plan (OAP), and along with the vision plan, is administered by Cigna HealthCare. The medical plan includes prescription drug coverage.

When you turn 65, Medicare becomes your primary medical coverage and Cigna becomes your secondary medical insurance coverage. 

When your covered dependent (spouse/civil union/domestic partner) turns 65, Medicare becomes their primary medical insurance coverage and Cigna becomes their secondary medical insurance coverage, regardless of your age and your enrollment status in Medicare. 

You can find Cigna's retiree summary of benefits and coverage by visiting  the Forms and Document tab.

Our retiree medical premium collection and Medicare Part B reimbursements are administered by Alliant Insurance Services Administrators, Inc. (AIS). AIS is a third-party administrator specializing in employee benefits matters.

• The minimum arrangement for remitting your medical premium payment is on a monthly basis. Premium remittance on a quarterly or annual basis is optional. 

• Past due premium payments will be addressed according to the Foundation's Retiree Premium Collection Administrative Procedure. 

• You will send premium payments directly to AIS (not the Foundation) at the address below.

Robert Wood Johnson Foundation
c/o AIS Administrators
PO Box 12009
Cheshire, CT 06410

If you have questions related to submitting your medical premium payment, you can contact AIS directly at (800) 458-9594 or questions@aisadmin.com. 

This is a three-tier prescription plan which means there are three co-pay levels that are determined by the prescription drug you need. See the table below for details. 

*Preferred brand - These are brand-name drugs that may not be available in generic form, but are chosen for their cost effectiveness compared to alternatives.

*Non-preferred brand - These are brand-name drugs that are not included on Cigna's list of preferred prescription drugs. 

• When you fill your long-term prescriptions through Cigna's Home Delivery Pharmacy, you pay at least 50% less than you would at your local participating pharmacy. 

• It’s a secure, economical way to get your maintenance medications.

• For new prescriptions, ask your doctor for a 90-day prescription and mail it to Cigna's Home Delivery Pharmacy, along with a check for the co-payment or credit card information on the order form.

• Within 14 days, your medication will be shipped free to you, along with a receipt and usage instructions.

• Log into your mycigna.com account and complete the online order form OR

• Call Cigna's Home Delivery Pharmacy at (800) 835-3784. Be sure to have your member ID and Rx number(s) handy when you call.

Retirees can submit medical and behavioral health claims online at myCigna.com. Follow the steps below. 

1. Click on the word Claims in the top menu bar.

2. Select Forms Center and then select Submit a Claim Online.

3. Select the service type.

5. Read "Here's What you'll need to Submit a Claim Online."

4. Click Start.

5. Complete prompted questions.

6. Upload supporting documents.

7. Review claim details and authorize payment.

8. Check the Certification box.

9. Click Submit.

10. Receive Confirmation Page to verify claim was accepted.
 

The Cigna medical claim form is located under the Forms and Document tab.  

To submit a medical claim form for reimbursement of fees paid to an out-of-network medical provider or to a non-participating pharmacy: 

1. Complete a Cigna claim form. Be sure to follow all the instructions on the reverse side of the form.

 

2. Attach an itemized receipt, which must include your name, the patient’s name, type of service, provider name, provider address, provider tax ID number, date of service, diagnosis, and charge for service.

 

3. Mail the form and receipt to the address shown on the form. Important: For the claim to be considered, the envelope must be postmarked within one year of the date of service. Be sure to keep a copy for your records.

You do not need to submit a Cigna claim if you go to an in-network provider. 

Cigna is moving to digital ID cards for Foundation members.  The current cards will continue to work since there were no plan changes, but if you have plan changes to coverage tiers or elect medical benefits, you will be able to access your digital ID card or request a physical card by contacting Cigna through myCigna.com and the myCigna app, or by calling Cigna Customer Service at 1.800.997.1654.