Page 17 - 2022 Clarins Benefit Guide
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YOUR BENEFITS GUIDE 2022
Regulatory Notices
Women’s Health and Cancer Rights Act Reasonable Alternative Standard Notice
If you have had or are going to have a mastectomy, Your health plan is committed to helping you achieve
you may be entitled to certain benefits under the your best health. Rewards for participating in a
Women’s Health and Cancer Rights Act of 1998 wellness program are available to all employees. If you
(WHCRA). For individuals receiving mastectomy- think you might be unable to meet a standard for a
related benefits, coverage will be provided in a reward under this wellness program, you might qualify
manner determined in consultation with the for an opportunity to earn the same reward by different
attending physician and the patient, for: means. Contact Frans Saint Louis, Benefits Manager
at 845-680-6317 and we will work with you (and, if you
• All stages of reconstruction of the breast on wish, with your doctor) to find a wellness program with
which the mastectomy was performed; the same reward that is right for you in light of your
• Surgery and reconstruction of the other breast to health status.
produce a symmetrical appearance;
• Prostheses; and HIPAA Privacy Notice
• Treatment of physical complications of the This Notice describes how you may obtain a copy of
mastectomy, including lymphedema. the Plan’s Notice of Privacy Practices, which describes
the ways that the plan uses and discloses your
These benefits will be provided subject to the same protected health information.
deductibles and coinsurance applicable to other
medical and surgical benefits provided under this We understand that keeping your personal health
plan. Therefore, the following deductibles and information private is important to you. Therefore, we
coinsurance apply: strive to be diligent about protecting information that
Clarins has access to that pertains to your health.
In-Network Out-of-Network
Open 80% after deductible 60% after
Access Plus deductible • Your rights to access your personal information
Plan • Choices you can make about how and when
In-Network 70% after deductible N/A Clarins can share your personal information
Only Open
Access Plus • When and how Clarins may use your personal
Plan information
HSA Plan 80% after deductible 60% after • Clarins’ responsibilities regarding your personal
deductible information.
A copy of the Notice of Privacy Practices is
If you would like more information on WHCRA available for viewing and printing on the Clarins self-
benefits, call Frans Saint Louis, Benefits Manager at service site. If you would like to request a paper
845-680-6317. copy of the notice, contact Frans Saint Louis,
Benefits Manager at 845-680-6317.
Patient Protection
CIGNA allows the designation of a primary care HIPAA Special Enrollment
provider (and pediatrician as the primary care provider If you are declining enrollment for yourself or your
for your children). You have the right to designate any dependents (including your spouse) because of
primary care provider who participates in our network other health insurance or group health plan
and who is available to accept you or your family coverage, you may be able to enroll yourself or your
members. For information on how to select a primary dependents in this plan if you or your dependents
care provider, and for a list of the participating primary lose eligibility for that other coverage (or if the
care providers, contact CIGNA. employer stops contributing towards your or your
dependents’ other coverage).
16 Clarins USA, Inc.
