Page 30 - PetVet 2022 Master Benefits Guide_Final

Compliance Notices

WOMEN’S HEALTH & CANCER RIGHTS ACT OF 1998

The Women’s Health and Cancer Rights Act (WHCRA) requires group health plans to provide participants
with notices of their rights under WHCRA, to provide certain benefits in connection with a mastectomy, and to
provide other protections for participants undergoing mastectomies.

If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the
Women’s Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related
benefits, coverage will be provided in a manner determined in consultation with the attending physician and
the patient, for:

• All stages of reconstruction of the breast on which the mastectomy was performed;
• Surgery and reconstruction of the other breast to produce a symmetrical appearance;
• Prostheses; and
• Treatment of physical complications of the mastectomy, including lymphedema.

These benefits will be provided subject to the same deductibles and coinsurance amounts applicable to other
medical and surgical benefits provided under the health plan offered by your employer.

Please keep this information with your other group health plan documents. If you have any questions about
the Plan’s coverage of mastectomies and reconstructive surgeries, please contact the Human Resources
Department.

PREMIUM ASSISTANCE UNDER MEDICAID AND CHIP

If you or your children are eligible for Medicaid or CHIP and you are eligible for health coverage from your
employer, your State may have a premium assistance program that can help pay for coverage. These States
use funds from their Medicaid or CHIP programs to help people who are eligible for these programs, but also
have access to health insurance through their employer. If you or your children are not eligible for Medicaid
or CHIP, you will not be eligible for these premium assistance programs. Please refer to separate CHIP
Notice.

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