Citi Benefits Handbook
Plan Information
Item
Details
Plan Sponsor
Citigroup Inc.
750 Washington Boulevard, 9th Floor
Stamford, CT 06901
Employer Identification Number
52-1568099
Participating Employers
Citigroup Inc. and any of its U.S. subsidiaries in which at least an 80% interest is owned.
Plan Administrator
Plans Administration Committee of Citigroup Inc.
c/o Claims and Appeals Management Team
P.O. Box 1407
Lincolnshire, IL 60069-1407
Fax: 1 (847) 554-1653
Call 1 (800) 881-3938 (ConnectOne). See the For More Information section for detailed instructions, including TDD assistance.
From outside the United States, Puerto Rico, and Canada:
Call 1 (469) 220-9600. See the For More Information section for detailed instructions, including TDD assistance.
Type of Administration
The Plans are administered by the Plans Administration Committee of Citigroup Inc. through agreements entered into with the Claim Administrators. However, final decision on the payment of claims rest with the Claim Administrators.
Agent for Service of Legal Process
General Counsel
Citigroup Inc.
388 Greenwich Street
New York, NY 10013
Plan Year (for all Plans)
January 1 — December 31
Plan Names and Numbers
Medical Plans (self-funded ChoicePlan 500, High Deductible Health Plan, and Oxford PPO) including prescription drugs; and medical clinics
Citigroup Health Benefit Plan
Plan number 508
Dental Plans (fully-insured MetLife PDP and Cigna DHMO)
Citigroup Dental Benefit Plan
Plan number 505
Vision Plan (fully-insured Aetna Vision)
Citigroup Vision Benefit Plan
Plan number 533
Health Care Spending Account/Limited Purpose Health Care Spending Account
Citigroup Flexible Benefits Plan
Plan number 512
Be Well Program
Citigroup Be Well Program
Plan number 521
Dependent Day Care Spending Account (DCSA)
Not applicable (DCSA is not subject to ERISA)
Transportation Reimbursement Incentive Program (TRIP)
Not applicable (TRIP is not subject to ERISA)
Basic Life, Basic AD&D, GUL, and Supplemental AD&D insurance
Citigroup Life Insurance Benefits Plan
Plan number 506
Business Travel Accident/Medical insurance
Citigroup Business Travel Accident/Medical Plan
Plan number 510
Long-Term Care insurance
Citigroup Long-Term Care Insurance Plan
Plan number 535
Short-Term Disability and Long-Term Disability
Citigroup Disability Plan
Plan number 530
For fully insured HMOs
Call the Citi Benefits Center at ConnectOne at 1 (800) 881-3938. See the For More Information section for detailed instructions, including TDD and international assistance.
Plan number 508
Funding
  • Medical Plan
  • Dental Plan
The Medical Plan and Dental Plan are funded through insurance contracts, the general assets of Citigroup, or a trust qualified under Section 501(c)(9) of the Code on behalf of the Plans. The cost of medical and dental coverage is shared by Citigroup and the participant.
The following Plans are self-insured, and thus are not subject to state laws:
  • ChoicePlan 500 (administrated by Aetna and Anthem BlueCross BlueShield)
  • High Deductible Health Plan (administrated by Aetna and Anthem BlueCross BlueShield)
  • Oxford PPO
The following Plans are fully-insured and are subject to state laws:
  • Vision Plan
  • Be Well Program
  • Health Care Spending Account (HCSA)
  • Limited Purpose Health Care Spending Account (LPSA)
The cost of the Vision Plan and medical spending accounts is provided by employee contributions. Citigroup pays for the Be Well Program. The Vision Plan is funded through an insurance contract. The medical spending accounts and the Be Well Program are funded from the general assets of Citigroup.
  • Basic Life insurance
  • GUL insurance
  • Basic and Supplemental AD&D insurance
  • Business Travel Accident/Medical insurance
Basic Life, Basic AD&D, GUL, Supplemental AD&D, and Business Travel Accident/Medical insurance are fully-insured. Benefits are provided under insurance contracts between Citigroup and the Claims Administrator. The Claims Administrator, not Citigroup, is responsible for paying claims. Basic Life, Basic AD&D, and Business Travel Accident coverage is provided through employer contributions; GUL and Supplemental AD&D is provided through employee contributions.
  • Disability Plan
STD benefits are paid from the general assets of the Company. STD coverage is provided by Citigroup; no employee contributions are required.
A portion of the LTD benefits are fully insured and a portion of the benefits are paid from the general assets of the Company. The Claims Administrator, not Citigroup, is responsible for paying claims. LTD coverage is provided through both employer and employee contributions.
  • Long-Term Care insurance (LTC)
LTC benefits are fully insured. The cost of LTC coverage is provided by employee contributions.
Any refund, rebate, dividend adjustment, or other similar payment under any insurance contract entered into between Citigroup and any insurance provider shall be allocated, consistent with the fiduciary obligations imposed by ERISA, to reimburse Citigroup for premiums it has paid or to reduce Plan expenses.