UNICEF MIP

MEDICAL INSURANCE PLAN

January 2017
 Please note that the insurance contract is the only authentic text.

CONTENT
This document contains a general description of the medical cover provided by UNICEF through its
Medical Insurance Plan (MIP) for local staff outside U.S.A. Should you have any questions about an
item that is not listed below or want additional information, please contact Cigna or consult your
personal web pages which are accessible through www.cignahealthbenefits.com.

Our services.....................................................................................................................3
Your coverage .................................................................................................................5
1. In general............................................................................................................................................................. 6

2. Summary of benefits ........................................................................................................................................... 8

2.1. In the hospital .................................................................................................................................... 8

2.2. Ambulance and transportation expenses ......................................................................................... 9

2.3. At the General Pr actitioner’s ........................................................................................................... 10

2.4. At the specialist’s ............................................................................................................................. 12

2.5. At the licensed qualified health care prov ider’s (other than doctor) .............................................. 12

2.6. At the optician’s ............................................................................................................................ 14

2.7. At the dentist’s ................................................................................................................................... 15

2.8. At the phar macist’s .......................................................................................................................... 15

2.9. At the specialised supplier ’s office .................................................................................................. 16

2.10. In the laboratory/medical imaging facility ........................................................................................ 16

2.11. Pregnancy and childbirth................................................................................................................. 17

3. Special situations .............................................................................................................................................. 18

3.1. Countries w ith extremely poor medical facilities ...................................................................................... 18

3.2. Official Duty Travel ( DT) ............................................................................................................................ 19

3.3. Medical Evacuation Travel ( MET) ............................................................................................................. 19

3.4. Stop Loss Clause....................................................................................................................................... 19

3.5. Hardship ..................................................................................................................................................... 20

4. Exclusions ......................................................................................................................................................... 20

5. Access to forms................................................................................................................................................. 20

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OUR SERVICES
24/7 Availability
You can reach us anytime, anywhere in your preferred language. If you want to know how to submit a
claim or in case of emergency, you can contact us by phone, e-mail, fax or postal service. Our contact
details are mentioned on your membership card and on your personal webpages.

Tip: Keep your membership card in your wallet or purse so you have our contact information at
hand in case of emergency!

Our contact details

You can reach us 24 hours a day, 7 days a week, 365 days a year. In case of emergency or if you
simply have a question, you can contact our multilingual staff in several ways. Our contact details are
also mentioned on your personal webpages and on your membership card.

Antwerp office Kuala Lumpur office Miami office

www.cignahealthbenefits.com

unicef.mip@cigna.com

+32 3 217 65 72 +60 3 2032 53 33 +1 305 908 91 70

Cigna Cigna Cigna

P.O. Box 69 P.O. Box 10612 P.O. Box 260790
2140 Antwerpen 50718 Kuala Lumpur Miami, FL 33126-0790
Belgium Malaysia USA

Claims
For the regions EAPRO and ROSA, claims should be sent to Cigna Kuala Lumpur. For the region
TACRO, claims should be sent to Cigna Miami. For the other regions, our office in Antwerp will handle
the claims. Please send these claims to Cigna Antwerp.

Reimbursement
For the following countries, Cigna effects the payments directly to the insured:
Bangladesh, Bulgaria, Denmark, Egypt, Guinea, India, Indonesia, Jordan, Kenya, Mali, Nepal,
Philippines, Rwanda, Sri Lanka, Turkey.

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Toll-free numbers
Wherever feasible, you can call us for free through a toll-free number. If there is no toll-free number
available for your country of stay, you can use the dedicated phone number, which is also mentioned
on your membership card. You can find the full list of available toll-free numbers per country on your
personal webpages.

Your personal webpages – Access to online information and services

All information regarding your plan is gathered on your personal webpages. Basically, everything you
need to know is easily available in one place that is accessible at any time from anywhere in the world.
Here you can also access our online services: you can search our worldwide health care provider
network for a particular provider, download fillable forms and consult your settlement details.

Tip: We master all major languages in-house, so there is no need for you to translate any of the
documents you wish to send us.

Access to quality health care at preferential rates

Wherever you are, you have access to our worldwide network of health care providers. We make sure
you benefit from health care services at preferential rates. To find a provider that best suits your needs,
search our provider list by location, type of facility and/or specialty on your personal webpages.

Free choice of health care provider

You have free choice of medical service provider, worldwide, but if you seek medical treatment in a
country which is not the country of your duty station, reimbursement will be limited to the reasonable
and customary expenses level applicable to the country of your duty station (see note below).
Consulting a provider from our network is beneficial to you, as we have negotiated advantageous rates
with most of our providers. This will also have an impact on your co-payment.

Important note:
Reasonable and Customary expenses refer to the prevailing pattern of charges for professional and
other health services at the duty station where the service is provided (staff member’s duty station).
This applies to services within the country of the staff member’s duty station.

For services provided outside the insured member’s duty station only the local prevailing pattern of
charges are going to be accepted. Only in case of emergencies during official travel (DT) and
approved medical evacuation travel (MET) reimbursement is considered up to the limits of the
country where the care is given. To avoid unpleasant surprises it is hence recommended to apply
for approval beforehand.

See also: 3.2. Official Duty Travel (DT)

3.3. Medical Evacuation Travel (MET)

Let us pay your medical bills

By simply showing your membership card upon admission to a hospital, you do not have to advance
your medical expenses first and submit a claim for reimbursement afterwards. You will only have to pay
your patient share (co-payment).

Prior approval: no surprises by notifying us in advance

For all non-emergency hospitalisations you must request prior approval by our medical consultant. By
contacting us before a planned admission, you will benefit from our direct payment service and pre-

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negotiated prices. This means a lower patient share (co-payment) and no unpleasant surprises when
you receive your medical bill.

Information on chronic diseases and possibility to contact our medical

consultant
We help raise awareness about the risk of developing serious or chronic diseases like diabetes,
cardiovascular disorders or cancer. If you would like personal advice, feel free to contact our medical
consultant through your personal web pages.

Swift processing of your medical claims

As we have claims processing offices in three time zones (Antwerp, Miami and Kuala Lumpur), we can
quickly process your claims and handle your queries. Thanks to our high-quality services, we have a
customer satisfaction rate of 98%.

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YOUR COVERAGE
1. In general

Benefits Description

Aim The UNICEF Medical Insurance Plan (MIP) is a health insurance

scheme for the benefit of locally-recruited active and former staff
members (and their eligible family members) serving or residing
at designated duty stations away from the headquarters location.
Eligibility Automatic for
- Staff members holding appointment of three (3) months or
more
Optional for:
- Eligible family members of staff members
- After-service health insurance (ASHI) protection for former
staff members and their eligible family members
Reasonable and customary Reasonable and Customary expenses refer to the prevailing
pattern of charges for professional and other health services at
the duty station where the service is provided (staff member’s
duty station). This applies to services within the country of the
staff member’s duty station.

For services provided outside the insured member’s duty station

only the local prevailing pattern of charges are going to be
accepted. Only in case of emergencies during official travel (DT)
and approved medical evacuation travel (MET) reimbursement is
considered up to the limits of the country where the care is given.
To avoid unpleasant surprises it is hence recommended to
request approval beforehand.

Currency of reimbursement By default, claims will be reimbursed in the currency of the

Validity of prescriptions
Claim submission deadline
subscriber’s salary/pension.
One year
For continuous medication, the physician has to indicate that the
drug is required for a longer period, and specify that period.
All claims must reach Cigna within 12 months after the date on
which the expenses were incurred.

Outpatient treatment/outpatient Treatment given on an outpatient basis, where the date of

surgery/day case admission is the same as the date of discharge.
Inpatient treatment/hospitalisation Treatment given on an inpatient basis, where the date of
admission differs from the date of discharge (minimum one
overnight stay).
Insurance year An insurance year is equal to a calendar year.

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Prior approval Prior approval from Cigna’s medical consultant is required for all
non-emergency hospitalisations.
Prior approval means that reimbursement is guaranteed only in
cases where our medical consultant grants his explicit approval
for the treatment, on the basis of the medical justification, as well
as a cost estimate furnished by the beneficiary at least one week
prior to the planned admission. In case of a medical emergency,
approval can be obtained post factum, on the basis of the same
medical criteria.

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2. Summary of benefits
For elements that are not listed below, we kindly refer you to the UNICEF list of reimbursable and non-
reimbursable items, which you can find on your personal webpages.

2.1. In the hospital

GENERAL RULE

Insurance coverage is worldwide, but if you seek medical treatment in a country which is not
the country of your duty station, reimbursement will be limited to the reasonable and
customary expenses level applicable the country of your duty station
You are covered for all generally accepted medical and surgical procedures (reasonable and
customary), including the latest medical technologies. Your Group Insurance Plan offers a
free choice of physician and care provider. You are therefore entitled to be treated by the
physician of your choice and in the establishment of your choice.

Item Remarks

Prior approval from Cigna’s medical consultant is required for all non-emergency
hospitalisations. Notification of such hospitalisations should be given at least 1 week prior to
the admission date.

Bed and board Private room: 70% of private room rate, OR

100% of semi-private room rate
(whichever is greater)
Semi-private room: 100%
General ward: 100%
ICU: 100%

Doctor’s fees during a hospitalisation 100%

(i.e. including an overnight stay)

Outpatient consultations in hospital 80%

Other hospital expenses 100%

Emergencies 100%

Accompanying person Not covered

Personal expenses Not covered

Home for the elderly / nursing home Not covered

Cures Not covered

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Item Remarks

Drug and alcohol abuse Inpatient: see Hospitalisation

Maximum 90 days per person per calendar year,
provided it is carried out at facility certified for
detoxification and rehab
Outpatient:
80% up to limit for psychotherapy of 1 month MIP
reference salary per calendar year (per patient), up to
50 visits per person per calendar year

Outpatient surgery Doctor’s fees: 100%

Other hospital expenses: 100%

Outpatient chemotherapy, radiotherapy, 100%

Outpatient haemodialysis 80%

Second surgical opinion 100%

2.2. Ambulance and transportation expenses

GENERAL RULE

All treatments and medicines must be prescribed by a qualified and registered medical
doctor. Transportation from the place where you fell ill or got injured by an accident to the
nearest hospital.

Item Remarks

General transportation costs Not covered

Ambulance - surface 80%

Transportation from the place where you fell ill or got
injured by an accident to the nearest hospital.
If you have to be transferred to another hospital it has
to be for medical reasons, not practical.
Ambulance – air Not covered
See CF/AI/2009-008.
Evacuation Not covered
See CF/AI/2009-008.
- Active staff: via HR duty station
- Retired staff: not foreseen
Repatriation of deceased person Not covered

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2.3. At the General Practitioner’s

GENERAL RULE

All treatments and medicines must be prescribed by a qualified and registered medical
doctor.

Item Remarks

Consultation 80%

Annual subscription fees 80%

Complete check-up Not covered

Routine examinations children until 19 100%

Well child care · New-born: 1 routine examination at birth, in the
hospital
· 0- 1 year old: 6 routine visits per year
· 1-2 years old: 2 routine visits per year
· 3-19 years old: 1 routine visit per year

Routine physical examinations for adults For children up to 19 years old: see Well-child care

For adults from 20 years old: 80% with a maximum of 1

exam per person per calendar year:
· Blood analysis:
o Haematology;
o Sedimentation rate;
o Blood sugar;
o Creatinine, urea;
o SGPT, SGOT, Gamma – GT, bilirubin;
o Cholesterol – Total, LDL, HDL, triglyceride.
· Urine analysis:
o Microscopic evaluation;
o Glucose;
o Albumin.
o Stool/faecal analysis: occult blood.
o Hepatitis B: once a year from 21 years old.
· Chest x-rays:
o Once every two years.
o Once every year if a smoker or 45 years of
age or older
· Static and exercise electro cardiogram (ECG):
o Once every two years;

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Item Remarks

o Once every year if 45 years of age or older.

· Colonoscopy:
o Women between the ages of 50 and 75:
once every 5 to 10 years;
o Men between the ages of 45 and 75: once
every 5 to 10 years.
· For women:
o Pap smear: once a year;
o Mammography: once a year if 40 years of
age or older;
o Bone Mineral Density (BMD) test: once a
year if 60 years of age or older.
· For men:
o Urological examination: once every 2 years
if 55 years of age or older;
o Prostate specific antigen (PSA): once a
year if 50 years of age or older;
o Abdominal ultrasound for aortic aneurysm:
once a year if 60 years of age or older.

HIV test & counselling 100%

2 voluntary blood tests per year without prescription

Vaccinations / preventive medication / For adults

immunisations 100% for Immunisations for adults recommended by
both the local health authorities and the World Health
Organization

Immunisations for official duty travel (DT) should be

charged to the same funding source covering the travel
costs and not claimed under the MIP.

For children (well child care): the MIP will cover

immunisations as determined by the Health Authorities
of the country in which the subscriber resides.
Seasonal flu vaccinations 100%

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2.4. At the specialist’s

GENERAL RULE

All treatments and medicines must be prescribed by a qualified and registered medical
doctor.

Item Remarks

Consultation 80%

Routine examination for women (PAP 80%

smear, mammography, gynaecology)
1 PAP smear and 1 mammography per calendar year

Routine urological examination for men 80%

(PSA-test)
1 PSA-test per calendar year

Consultation 80%

2.5. At the licensed qualified health care provider’s (other than doctor)

GENERAL RULE
A doctor’s prescription is required for care given by a person holding a paramedical degree
(e.g. nurse, physiotherapist).
A renewal of the prescription is required for treatments taking longer than 3 months unless
specified differently.

Item Remarks

A doctor’s prescription is required for care given by a person holding a paramedical degree
(e.g. nurse, physiotherapist).

Psychiatrist - psychotherapy 80% up to limit of 1 month MIP Reference Salary per

calendar year (per patient)
Physiotherapy 80% if to improve or restore bodily functions
Not covered if preventive

· If the duration of the treatment exceeds 6 months,

the attending physician must reassess the treatment
and issue a new prescription;
· Treatments requiring more than 60 sessions per
calendar year are subject to Cigna’s prior
authorisation

Osteopathic treatment 80% if to improve or restore bodily functions

Not covered if preventive

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Item Remarks

Chiropractic treatment 80%, in case of chronic pain syndrome treatment on

condition, AND:
- Treatment recognised as valid by competent
health authorities of the country
- Treatment given by qualified medical doctor or
licensed chiropractor
Acupuncture 80%, if:
- Treatment recognised as valid by competent
health authorities of the country
- Treatment given by qualified medical doctor or
licensed chiropractor

Private home duty nurse 80%, if medical acts (wound dressing, injections, etc.)
and rendered by qualified nurse

Home health care 80%, if prescribed as medically necessary and as an

alternative to either hospitalisation, or a stay in a skilled
nursing facility
Alternative medicine In general: not covered
For example: applied kinesiology, therapeutic
aromatherapy, Ayurveda, bionergetic therapy,
biofeedback therapy, Chinese medicine, craniosacral
therapy, enzyme therapy, gemstone, crystal, chakra
therapy, heating pads, iridology, karate, magnetic field
therapy, massage therapy, meditation therapy,
mind/body therapy, music therapy, naturophatic
therapy, orthomolecular therapy, reflexology, shiatsu,
Tai Chai, therapeutic touch, yoga.
Chinese medicine is accepted for members assigned to
duty station China.
Ayurveda is accepted for insured members assigned to
duty country India and if the treatment is given in India.
Some treatments are covered at 80% (see List of
reimbursable and non-reimbursable items), under the
following conditions:
- There is a medical condition that requires
treatment, AND
- The treatment is rendered by a qualified medical
doctor, AND
- The treatment is recognised as a valid treatment
modality by the competent health authorities of the
country.

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Speech therapy 80% if to improve or restore speech functions

Not covered if preventive

Homeopathy 80%, under the following conditions:

- There is a medical condition that requires
treatment, AND
- The treatment is rendered by a qualified medical
doctor, AND
- The treatment is recognised as a valid treatment
modality by the competent health authorities of the
country.

2.6. At the optician’s

GENERAL RULE
See General rule for outpatient care (2.3.), unless indicated differently.

Item Remarks

Eye test to determine dioptre by 80% up to a ceiling of 100 USD per year
ophthalmologist

Lenses 80%, up to maximum 75 USD/lens and maximum 2

lenses in a period of 12 months (date of 1st purchase
determines period of 12 months)
A waiting period of 12 months participation in the MIP is
required.

Contact lenses See Lenses

Fluid for contact lenses Not covered

Disposable lenses See Lenses

Maximum 150 USD in a period of 12 months

Frames 80% up to a maximum of 50 USD per frame and

Sunglasses (with or without dioptre)
maximum one (1) frame in a period of 24 months (date
of 1st purchase determines period of 24 months)
A waiting period of 12 months participation in the MIP is
required.
Not covered

Lasik/keratotomy and other procedures to 80% subject to a maximum equivalent to twice the
change the dioptre ceiling for optical so maximum of 150 USD per eye
A waiting period of 12 months participation in the MIP is
required.

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2.7. At the dentist’s

GENERAL RULE
All dental treatments, dental surgery included, are covered under dental care.

Item Remarks

Ordinary dental care 80%

Maximum 50% of MIP Reference Salary per person per
calendar year

Orthodontics (e.g. braces, dento-facial 80% subject to the limit for ‘Ordinary dental care’, only if
orthodontics) the treatment was started before the age of 15
Maximum treatment period: 4 years

Dental surgery 80% subject to the limit above

Some oral surgeries are not subject to the maximum
dental care limit (see UNICEF MIP List of reimbursable
and non-reimbursable items)

Dental care after an accident 80% up to a maximum of one MIP Reference Salary
per person per calendar year

2.8. At the pharmacist’s

GENERAL RULE

All medicines must be prescribed by a qualified and registered medical doctor.

Item Remarks

General 80%
Prescribed, medically justified and containing
pharmaceutical components to treat a specified
diagnosis

Medication for emergency care and for use 100%

in hospital
Contraceptive devices and medication 80%
Condoms are not reimbursable.

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2.9. At the specialised supplier’s office

GENERAL RULE

Normally reimbursable at 80% if prescribed by attending physician as medically necessary.

Item Remarks

Orthopaedic devices 80% for rental

(purchase acceptable if this is cheaper or if the
equipment cannot be rented.)

Hearing aids 80%

Maximum 300 USD per apparatus, including the related
exam and batteries
Maximum 1 apparatus per ear per 36 months

Batteries hearing aids 80%, falling under the maximum for hearing aids

Adaptations to house (shower, elevator, Not covered

lavatory, etc.)

Orthopaedic shoes/insoles 80%

2.10. In the laboratory/medical imaging facility

GENERAL RULE
In general, tests and medical imaging are done on outpatient basis.

Test and imaging done during a hospitalisation are covered at 100% (see Hospitalisation).

Item Remarks

Diagnostic medical imaging Outpatient: 80%

Inpatient: 100%

Lab tests Outpatient: 80%

Inpatient: 100%

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2.11. Pregnancy and childbirth

GENERAL RULE
Outpatient: reimbursable at 80%. Inpatient: reimbursable at 100%

Item Remarks

Delivery in hospital See Hospitalisation

Outpatient delivery See Outpatient surgery

Home delivery 80%

Visits midwife 80%

Pre- and postnatal exercises 80%

Sterilisation See Outpatient surgery

Reversal of sterilisation Not covered

Abortus provocatus Not covered

Hormonal treatment to stimulate fertility 80% if to stimulate natural fertility

IVF (In-Vitro Fertilisation) Not covered

ICSI (intra-cellular sperm injection) Not covered

AI (artificial insemination) Not covered

MESA (microchirurgical epididymal sperm- Not covered

aspiration)

TESE (testicular sperm-extraction) Not covered

Cryoconservation Not covered

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3. Special situations
3.1. Countries with extremely poor medical facilities

As from 1st January 2011, the UNICEF MIP will reimburse members working and living in countries with
extremely poor medical facilities, who are treated in neighbouring countries offering reliable facilities,
following the reasonable and customary limits of the so-called “regional care” country. This is not
considered a medical evacuation (MET) and concerns non-urgent medical care only. For medical
evacuations, the current procedures remain in place.

Duty station Regional care

Afghanistan Pakistan and India
Bhutan India
Cambodia Thailand
Central African Republic Cameroon
Democratic Republic of Congo Burundi, Rwanda and Uganda (for staff and family
members located near the Eastern borders of Congo)
East Timor Australia (Darwin)
Guinea Bissau Senegal
Haiti Dominican Republic
Iraq Jordan
Kosovo Albania, Bosnia, Croatia, Macedonia, Montenegro,
Serbia, Slovenia
Laos Thailand (Nong Khai and Udon Thani provinces)
Lesotho South Africa
Liberia Ghana
Mali Senegal
Myanmar Thailand
Claims involving Bumrungrad Hospital will be strictly
reimbursed based on R&C for Thailand; staff members
are cautioned that they will be responsible for all costs
exceeding the R&C.
Sierra Leone Ghana
Somalia Kenya
South Sudan Uganda
Kenya, only if referred by doctor from Uganda
Sudan Egypt

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Duty station Regional care

Swaziland South Africa
Zimbabwe South Africa

The list above will be reviewed on a yearly basis.

3.2. Official Duty Travel (DT)

Expenses for emergency treatment will be reimbursed based on the prevailing pattern of charges for
professional and other health services in the country where the expenses are incurred. Expenses for
non-emergency treatments will be reimbursed based on the prevailing pattern in the country of the staff
member’s duty station. DT is not available for retirees/ASHI.

3.3. Medical Evacuation Travel (MET)

Expenses will be reimbursed based on the prevailing pattern of charges for professional and other
health services to where MET is authorised. MET is not available for retirees/ASHI.

3.4. Stop Loss Clause

For all covered reasonable and customary expenses, once the out-of-pocket expenses reach a limit
(see specifications below), the MIP will start reimbursing an additional 80% of the out-of-pocket portion.
The out-of-pocket refers to the total sum of co-payments of the expenses incurred by all family
members in a calendar year.

• Active staff
50% of his or her monthly net base salary (i.e. gross salary less staff assessment

• Retired staff
50% of the remuneration basis for calculating his or her contribution (i.e., 25 per cent of the monthly
net base salary at the date of separation adjusted by the global cost-of-living increases declared by
the UNJSPF.

The stop loss clause will not be considered as long as the total non-reimbursed portion of medical and
hospital expenses incurred by the subscriber have not exceeded the limits above in a single calendar
year.

The non-reimbursed portions in respect to dental care, outpatient mental and nervous care, eyeglasses
and hearing aids are not taken into account in determining the out-of-pocket expenses. Neither are
non-recognised medical and hospital expenses (e.g. difference between semi-private and private
accommodation in the hospital would not be taken into account).

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3.5. Hardship

The maximum level of reimbursement of medical expenses per individual person (not per family) in a
single calendar year is established at six (6) times the MIP Reference Salary.
MIP Reference Salaries are updated on a yearly basis.
For expenses incurred beyond this limit, the MIP participant is expected to meet these expenses.

In the event of a life-threatening illness with major medical expenses, the MIP participant could be
faced with expenses which are so significantly over and above the normal limits payable under the MIP
that they would cause undue financial hardship. Under such very exceptional circumstances, amounts
in excess of the regular limit of six (6) times the MIP Reference Salary may be reimbursed.

These cases will be considered by Cigna and UNICEF DHR. It is important to note that these cases will
never be considered for hardship as long as the total non-reimbursed medical and hospital expenses
incurred by the MIP subscriber and enrolled family members (for reasonable and customary care) have
not exceeded the stop loss limits as mentioned above under 3.4.

4. Exclusions

The coverage shall, amongst other items, not extend to:

- Alternative medicine
- Cosmetic and plastic surgery
- Spa cures
- Food and dietary products
- Fertility/Infertility treatment

This is a non-limitative list. In case the treatment you are considering to undergo is not listed in this
overview or the List of Reimbursable and Non Reimbursable items, you are advised to contact us to
seek prior approval.

5. Access to forms

On your personal web pages you can download the claim form and the cost estimate form mentioned
in this document in the ‘Useful documents’ section. You can access your personal webpages as
follows:

- Go to www.cignahealthbenefits.com and click on Plan members;

- Fill in your personal reference number, which you can find on your membership card (270/xxxxx);
- Fill in your password.

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Chief editor: Wouter Reggers • Cigna International Health Services BVBA • Plantin en Moretuslei 299
2140 Antwerpen • Belgium • RPR Antwerpen VAT BE 0414 783 183 • FSMA 13799 A-R
‘Cigna’ refers to Cigna Corporation and/or its subsidiaries and affiliates. Cigna International and Cigna Global Health Benefits
refer to these subsidiaries and affiliates. Products and services are provided by these subsidiaries, affiliates and other
contracted companies and not by Cigna Corporation. ‘Cigna’ is a registered service mark.
This material is provided for informational purposes only. It is believed accurate as of the date of publication and is subject to
change. Such material should not be relied upon as legal, medical, or tax advice. As always, we recommend that you consult
with your independent legal, medical, and/or tax advisors. Products and services may not be available in all jurisdictions and
are expressly excluded where prohibited by applicable law.
Copyright 2015 Cigna Corporation

The following companies provide the insurance cover in Europe:

Cigna Life Insurance Company of Europe S.A.-N.V., registered in Belgium with limited liability, Avenue de Cortenbergh 52,
1000 Brussels, Belgium. Insurance company authorised in Belgium under licence number 938.
Cigna Europe Insurance Company SA-NV., registered in Belgium with limited liability, Avenue de Cortenbergh 52, 1000
Brussels, Belgium. Insurance company authorised in Belgium under licence number 2176.
Cigna Life Insurance Company of Europe SA-NV and Cigna Europe Insurance Company SA-NV., are subject to the prudential
supervision of the National Bank of Belgium, Boulevard de Berlaimont 14, 1000 Brussels (Belgium) and to the supervision of
the Financial Services and Markets Authority (FSMA), Rue du Congrès 12-14, 1000 Brussels (Belgium), in the field of
consumer protection .

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