Citi Benefits Handbook
Claims Administrators
Each of the Claims Administrators below has the discretion and authority to render benefit determinations in a manner consistent with the terms and conditions of its respective Plan — namely, those provisions of the Plan Documents that apply to the participant and are administered by that particular Claims Administrator. Since TRIP, DCSAs and HSAs are not subject to ERISA, neither the Claims Administrator listed below nor the Plans Administration Committee is a fiduciary under ERISA for these arrangements.
Plan
Administrator Contact Information
Medical Plan and Prescription Drug Coverage
ChoicePlan 500
Aetna
Citigroup Claims Division
PO Box 981106
El Paso, TX 79998-1106
1 (800) 545-5862
Anthem BlueCross BlueShield
PO Box 105187
Atlanta, GA 30348-5187
1 (855) 593-8123
Note: Anthem does not underwrite or assume any financial risk for claims liability.
High Deductible Health Plan
Aetna
Citigroup Claims Division
PO Box 981106
El Paso, TX 79998-1106
1 (800) 545-5862
Anthem BlueCross BlueShield
PO Box 105187
Atlanta, GA 30348-5187
1 (855) 593-8123
Health Savings Account (HSA) (not subject to ERISA)
ConnectYourCare
1 (800) 881-3938
www.connectyourcare.com
Oxford Health Plans PPO
1st and 2nd Level Standard General Administration and Clinical Appeals
(Submit claim forms to this address)
PO Box 30432
Salt Lake City, UT 84130-0432
1 (800) 444-6222
1 (800) 201-4911 (after 5 p.m.)
For fully insured HMOs
Call the HMO directly at the telephone number on your ID card.
Prescription Drug Program
Paper claims address
Express Scripts
ATTN: Commercial Claims
PO Box 14711
Lexington, KY 40512-4711
1 (800) 227-8338
Home delivery service
Express Scripts
Mail Pharmacy Service
PO Box 66566
St. Louis, MO 63166-6566
1 (800) 227-8338
Dental Plan
MetLife Preferred Dentist Program (PDP)
Metropolitan Life Insurance Co.
MetLife Dental Claims Unit
PO Box 981282
El Paso, TX 79998-1282
1 (888) 830-7380
To submit an appeal:
MetLife Group Claims Review
PO Box 14589
Lexington, KY 40512-4093
Cigna Dental HMO
Cigna Dental HMO / Member Services
1571 Sawgrass Corporate Parkway
Suite 140
Sunrise, FL 33323
1 (800) 244-6224
Vision
Aetna Vision Plan
Aetna Vision
Attn: OON Claims
PO Box 8504
Mason, OH 45040-7111
1 (877) 787-5354
Members: www.aetnavision.com
Spending Accounts
  • Health Care Spending Account
  • Limited Purpose Health Care Spending Account
  • Dependent Day Care Spending Account (not subject to ERISA)
  • Transportation Reimbursement Incentive Program (not subject to ERISA)
Contact ConnectYourCare through ConnectOne at 1 (800) 881-3938.
Other Insurance
Short-Term Disability (STD)
Long-Term Disability (LTD)
Metropolitan Life Insurance Co.
PO Box 14590
Lexington, KY 40511-4590
1 (888) 830-7380
Basic Life
Metropolitan Life Insurance Company — Group Life Claims
PO Box 61006100
Scranton, PA 18505-61006100
1 (800) 638-6420
Basic and Supplemental Accidental Death and Dismemberment (AD&D)
Metropolitan Life Insurance Company — Group Life Claims
PO Box 6100
Scranton, PA 18505-6100
1 (800) 638-6420
Business Travel Accident/Medical
ACE American Insurance Company
Accident & Health Claims
1 Beaver Valley Road
PO Box 15417
Wilmington, DE 19850
1 (800) 336-0627
Group Universal Life (GUL)
Metropolitan Life Insurance Company — Group Life Claims
PO Box 6100
Scranton, PA 18505-6100
1 (800) 638-6420
Long-Term Care
John Hancock Life Insurance Company (U.S.A.)
Group Long-Term Care, B-6
200 Berkeley St.
Boston, MA 02117
1 (800) 222-6814