Section 5420.EXHIBIT A   Description of Coverage – Cover Page

The Managed Care Reform and Patient Rights Act of 1999 established rights for enrollees in health care plans.  These rights cover the following:

            What emergency room visits will be paid for by your health care plan.

            How specialists (both in and out of network) can be accessed.

            How to file complaints and appeal health care plan decisions (including external independent reviews).

            How to obtain information about your health care plan, including general information about its financial arrangements with providers.

You are encouraged to review and familiarize yourself with these subjects and the other benefit information in the attached Description of Coverage Worksheet.  SINCE THE DESCRIPTION OF COVERAGE IS NOT A LEGAL DOCUMENT, for full benefit information please refer to  your contract or certificate, or contact your health care plan at the toll free number on the next page.  In the event of any inconsistency between your Description of Coverage and contract or certificate, the terms of the contract or certificate will control.

For general assistance and information, please contact the Illinois Department of Insurance Office of Consumer Health Insurance at _________________________.  (Please be aware that the Office of Consumer Health Insurance will not be able to provide specific plan information.  For this type of information you should contact your health care plan directly.)