27 This standard will apply when the services you rec eive are not within your control. For example, when your participating hospital assigns you a non - participating anesthesiologist or Emergency Room Physician, or refers your lab tests or x - rays to a non - participating pathologist or radiologist for interpre tation. Opportunity to Select a Primary Care Physician Under the terms of the Plan, you are not required to select a Primary Care Physician (PCP), but may do so if you wish. You may use Cigna’s Open Access Plus network to select a Primary Care Physician fo r yourself, your Spouse, and/or your Eligible Dependent Child. The role of the PCP is to provide or arrange for medical care. Whether you select a PCP or not, you, your Spouse, and/or your Eligible Dependent child may exercise their choice of other health care providers without authorization from the PCP to provide the covered services they need, including Specialists. Each individual covered under the Plan has the right to select a PCP from Cigna’s list, and such PCP may be different for each covered indiv idual. Cigna’s Toll - Free Care Line Cigna’s toll - free care line allows you to talk to a health professional at any time, seven days a week, 24 hours a day, by calling the toll - free number shown on the back of your identification card at 800 - Cigna 24 (800 - 24 4 - 6224). The staff at Cigna’s toll - free care line can provide you with names of Open Access Plus participating providers. You, your Spouse, and/or your Eligible Dependent Child may call Cigna Health Care toll free number if you need medical care. The staff will assist you with the available options. Access to Cigna Participating Providers While on Travel If you, your Spouse, or your Eligible Dependent Children need medical care while away from home, including travel outside the U.S., you have access to a national network of participating providers through Cigna’s Away - From - Home Care feature. You can call Cigna Health Care toll free care line, 800 - Cigna 24, and the staff will provide you with names of Open Access Plus participating providers in other networ k areas. If you obtain the name of a participating provider from Cigna’s website or through the care line, Cigna recommends that you call the provider to confirm that the provider is currently participating in the Open Access Plus network before you make a n appointment. If You Have a Complaint about Cigna If you have any type of complaint about Cigna, you may contact Cigna member services. You should contact Cigna member services if you have any concerns regarding a Cigna employee, the quality of care prov ided by Cigna participating providers, or the processing of your claims (including claims for your covered family members). The toll - free number for Cigna member services is 800 - Cigna 24 (or 800 - 244 - 6224) as shown on the back of your Cigna identification c ard. You also will be able to find the Cigna number on any copy of your Explanation of Benefits (EOB) Cigna provides to you. You also have the option to express your concerns to Cigna in writing. Cigna will make every effort to resolve the concerns you rai se on your initial contact. However, Cigna may need more time to address your concerns. In this case, someone will get back to you as soon as possible, but no more than 30 days after your initial contact. The Fund Office also is available to you should yo u have any complaints about Cigna or any aspect of the administration of the Plan. You may contact the Fund Office at 202 - 785 - 8148 or toll free at 800 - 457 - 3481. Contacting Cigna member services or the Fund Office to make a complaint does not replace the r equirement that you file a written appeal if you are not satisfied with the results of a decision by Cigna on a claim you have submitted for benefits or services received under the Plan. If you do not agree with Cigna’s decision on any claim, you may conta ct Cigna member services or the Fund Office about your concerns. In addition, you must make a written request as set forth under the section governing appeals and as explained in the section “ Claims Filing and Appeal Procedures ” included in this SPD .
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