Claims Administrators Information for Lockheed Martin Corporation retirees
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- Agatha Adams
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1 Claims Administrators Information for Lockheed Martin Corporation retirees This notice constitutes a Summary of Material Modifications (SMM) and provides you with the names, addresses, member services telephone numbers, and Web site addresses for Lockheed Martin Corporation retiree claims administrators and insurance carriers. Please note that this information may change from time to time and is updated periodically. Please keep this notice with your Summary Plan Descriptions (SPDs). If you have any questions, please contact the Lockheed Martin Employee Service Center at: Toll-free calls in the U.S International callers Hearing impaired Customer service representatives are available Monday through Friday 8 a.m. to 8 p.m. Eastern time, except on holidays. LMC-GL7 G08CAI101
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3 MEDICAL The Lockheed Martin Total Health Plan (plan 069); Medicare Plus Plan (plan 075); Medicare Plus Catastrophic Plan (plan 076); Medicare Supplement Plan (plan 019); Medicare Eligible Retiree Medical Plan (plan 029); Medical Indemnity Plan (022); Preferred Provider Organization (PPO) (plans 099 and 399) These plans are Self Insured and may be available to non-represented and certain formerly represented employees. Aetna Member Services # Mailing Address P.O. Box 14586, Lexington, KY International Indemnity Plan (IIP) This plan is Self Insured and may be available to non-represented and certain formerly represented employees. CIGNA International Expatriate Benefits (plan 011) Member Services # or Mailing Address P.O. Box 15050, Wilmington, DE Mental Health and Substance Abuse Mental health and substance abuse benefits are Self Insured. The Health Plan Report (HPR) for a medical plan indicates whether CIGNA Behavioral is the claims administrator for mental health and substance abuse benefits. CIGNA Behavioral Health Member Services # Mailing Address P.O. Box 44639, Eden Prairie, MN Prescription Drugs The prescription drug benefit is Self Insured. The Health Plan Report (HPR) for a medical plan indicates whether Caremark is the claims administrator for prescription drug benefits. Caremark (formerly PharmaCare) Member Services # Mailing Address P.O. Box 2860, Pittsburgh, PA
4 Designated Provider Network (DPN) and Point of Service (POS) for formerly represented and certain non-represented retirees These plans are Self Insured. The Health Plan Report (HPR) for a medical plan indicates whether Caremark or CIGNA Behavioral Health is the claims administrator for prescription drugs or mental health and substance abuse benefits. Colorado CIGNA, Colorado (plan 102) Member Services # Mailing Address P.O. Box , Chattanooga, TN Connecticut Aetna, Connecticut (plan 147) Member Services # Mailing Address P.O. Box 14586, Lexington, KY District of Columbia CIGNA, Mid-Atlantic (plan 107) Member Services # Mailing Address P.O. Box , Chattanooga, TN Florida CIGNA, Florida (plan 103) Member Services # Mailing Address P.O. Box , Chattanooga, TN Louisiana Aetna, New Orleans (plan 231) Member Services # Mailing Address P.O. Box 14586, Lexington, KY CIGNA, New Orleans (plan 106) Member Services # Mailing Address P.O. Box , Chattanooga, TN
5 Maine CIGNA, Maine (plan 227) Member Services # Mailing Address P.O. Box , Chattanooga, TN Maryland CIGNA, Mid-Atlantic (plan 107) Member Services # Mailing Address P.O. Box , Chattanooga, TN Massachusetts Aetna, Boston (plan 148) Member Services # Mailing Address P.O. Box 14586, Lexington, KY Mississippi Aetna, Gulfport (plan 179) Member Services # Mailing Address P.O. Box 14586, Lexington, KY New Jersey/New York/Pennsylvania Aetna, New Jersey/New York/Pennsylvania (plan 146) Member Services # New York Aetna, New York (plan 214) Member Services # Mailing Address P.O. Box 14586, Lexington, KY
6 CDPHP (Capital District Physicians Health Plan, Inc.) (plan 145) Member Services # Mailing Address Patroon Creek Corporate Center, 1223 Washington Ave. Albany, NY Ohio Aetna, Northeast (plan 207) Member Services # Mailing Address P.O. Box 14586, Lexington, KY Aetna (plan 398) Member Services # Mailing Address P.O. Box 14586, Lexington, KY Rhode Island CIGNA, Rhode Island (plan 228) Member Services # Mailing Address P.O. Box , Chattanooga, TN Texas Aetna, TX (plans 143 & 144) Member Services # Mailing Address P.O. Box 14586, Lexington, KY Virginia CIGNA, Mid-Atlantic (plan 107) Member Services # Mailing Address P.O. Box , Chattanooga, TN
7 Health Maintenance Organizations (HMOs) and Managed Care Plans The HMO and Managed Care Plans are generally guaranteed under a contract or policy issued by the HMO, Senior HMO, or Managed Care Plan except as noted. These plans may be available to non-represented and represented retirees. Alabama Blue Cross Blue Shield, Alabama, PPO (plan 234) Member Services # Mailing Address P.O. Box 9907, Columbus, GA Arizona Aetna, Arizona, HMO (plan 250) (Self Insured) Member Services # Aetna, Arizona, Senior HMO (plan 724) CIGNA, Arizona, Senior HMO (plan 627) Member Services # Mailing Address P.O. Box 38639, Phoenix, AZ PacifiCare, Arizona, HMO (plan 379) Member Services # Mailing Address Customer Service Dept., P.O. Box 60125, Phoenix, AZ Secure Horizons, Arizona, Senior HMO (plan 801) Member Services # Mailing Address P.O. Box 52078, Phoenix, AZ Arkansas Health Advantage, HMO (plan 232) Member Services # Mailing Address P.O. Box 8069, Little Rock, AR
8 California Blue Cross of California, HMO (plan 307) Member Services # Mailing Address P.O. Box 60007, Los Angeles, CA Blue Cross of California, Senior HMO (plan 607) Member Services # Mailing Address P.O. Box 60007, Los Angeles, CA HealthNet, Northern California, HMO (plan 319) Member Services # Mailing Address P.O. Box 14702, Lexington, KY HealthNet, Southern California, HMO (plan 320) Member Services # Mailing Address P.O. Box 14702, Lexington, KY HealthNet, Northern & Southern California, Senior HMO (plans 719 & 720) Member Services # Mailing Address P.O. Box 10198, Van Nuys, CA Kaiser Permanente, Northern California, HMO (plan 259) Member Services # or Mailing Address Claims Dept., P.O. Box 12923, Oakland, CA Kaiser Permanente, Northern California, Senior HMO (plan 659) Member Services # or Mailing Address Claims Dept., P.O. Box 12923, Oakland, CA Kaiser, Permanente, Southern California, HMO (plan 258) Member Services # Mailing Address Claims Administration, P.O. Box 7004, Downey, CA Kaiser, Permanente, Southern California, Senior HMO (plan 658) Member Services # or Mailing Address Claims Administration, P.O. Box 7004, Downey, CA
9 PacifiCare Signature Value, Central Coast, HMO (plan 375) Member Services # Mailing Address Customer Service Dept., P.O. Box 6006, Cypress, CA PacifiCare Signature Value Advantage, HMO (plan 355) Member Services # Mailing Address Customer Service Dept., P.O. Box 6006, Cypress, CA Secure Horizons, Southern California, Senior HMO (plan 755) Member Services # Mailing Address P.O. Box 489 M/S CY48-117, Cypress, CA Colorado HMO Blue Advantage (plan 242) Member Services # Mailing Address P.O. Box 60007, Los Angeles, CA Kaiser Permanente, Colorado, HMO (plan 252) Member Services # or Mailing Address P.O. Box , Denver, CO Kaiser Permanente, Colorado, Senior HMO (plan 652) Member Services # Mailing Address Kaiser Permanente, Claims Dept., P.O. Box , Denver, CO PacifiCare, Colorado, HMO (plan 286) Member Services # Mailing Address Customer Service Dept., P.O. Box 4266, Greenwood Village, CO Secure Horizons, Colorado Springs, Denver, Northern & Pueblo Colorado, Senior HMO (plans 686, 802, 804 & 805) Member Services # Mailing Address P.O. Box 6770, Englewood, CO
10 District of Columbia Aetna, District of Columbia, Senior HMO (plan 718) Aetna, Mid-Atlantic, HMO (plan 309) (Self Insured) Member Services # Kaiser Permanente, Mid-Atlantic, HMO (plan 254) Member Services # or Mailing Address P.O. Box 6233, Rockville, MD Kaiser Permanente, Mid-Atlantic, Senior HMO (plan 654) Member Services # or Mailing Address P.O. Box 6233, Rockville, MD Optimum Choice, Mid-Atlantic, HMO (plan 340) Member Services # or Mailing Address 800 Oak Street, Frederick, MD Florida Aetna, Florida, HMO (plan 273) Member Services # or Mailing Address P.O. Box 14089, Lexington, KY Aetna, Florida, Senior HMO (plan 705) Blue Cross Blue Shield, Florida Panhandle, PPO (plan 236) Member Services # Mailing Address P.O. Box 9907, Columbus, GA
11 United Healthcare, Florida, EPO (plan 255) Member Services # Mailing Address P.O. Box 30555, Salt Lake City, UT Georgia Aetna, Georgia, HMO (plan 397) (Self Insured) Member Services # Web address Aetna, Georgia, Senior HMO (plan 708) Web address Aetna, Georgia, Golden Choice Senior PPO (plan 706) Web address Blue Cross Blue Shield (Blue Choice), Southern Georgia, PPO (plan 235) Member Services # Mailing Address P.O. Box 9907, Columbus, GA Blue Cross Blue Shield, Georgia, HMO (plan 303) Member Services # Mailing Address P.O. Box 9907, Columbus, GA CIGNA Healthcare, Georgia, HMO (plan 300) (Self Insured) Member Services # Mailing Address P.O. Box , Chattanooga, TN Kaiser Foundation Health Plan of Georgia, Inc., HMO (plan 233) Member Services # or Mailing Address Kaiser Permanente Claims Administration, P.O. Box , Atlanta, GA
12 Kaiser Senior Advantage, Georgia, Inc., HMO (plan 603) Member Services # or Mailing Address Kaiser Permanente Claims Administration, P.O. Box , Atlanta, GA Hawaii Hawaii Medical Services, PPO (plan 312) Member Services # or Mailing Address 818 Keeumoku Street, Honolulu, HI Kaiser Permanente, Hawaii, HMO (plan 253) Member Services # or ; (Oahu) Mailing Address 80 Mahalani St., Wailuku, HI Kaiser Permanente, Hawaii, Senior HMO (plan 653) Member Services # (Oahu) or (Neighbor Islands) Mailing Address 80 Mahalani St., Attn: Affiliate Care, Wailuku, HI Louisiana Humana, Louisiana, HMO (plan 350) Member Services # Mailing Address Humana Claims, P.O. Box 14610, Lexington, KY Humana, Louisiana, Senior HMO (plan 750) Member Services # (claims) or (other) Mailing Address P.O. Box 14601, Lexington, KY Maine Harvard Pilgrim HealthCare, HMO (plan 311) Member Services # Mailing Address P.O. Box , Quincy, MA
13 Maryland Aetna, Maryland, Senior HMO (plan 716) Aetna, Mid-Atlantic, HMO (plan 309) (Self Insured) Member Services # Aetna Golden Choice, Maryland, Senior HMO (plan 644) Kaiser Permanente, Mid-Atlantic, HMO (plan 254) Member Services # or Mailing Address P.O. Box 6233, Rockville, MD Kaiser Permanente, Mid-Atlantic, Senior HMO (plan 654) Member Services # or Mailing Address P.O. Box 6233, Rockville, MD Optimum Choice, Mid-Atlantic, HMO (plan 340) Member Services # or Mailing Address 800 Oak Street, Frederick, MD Massachusetts Harvard Pilgrim HealthCare, HMO (plan 311) Member Services # Mailing Address P.O. Box , Quincy, MA Minnesota HealthPartners, Minnesota, HMO (plan 323) (Self Insured) Member Services # or Mailing Address P.O. Box 1309, Minneapolis, MN
14 HealthPartners Freedom Group, Minnesota, Senior HMO (plan 723) Member Services # or Mailing Address P.O. Box 9463, Minneapolis, MN Mississippi United Healthcare, Mississippi, HMO (plan 289) Member Services # Mailing Address P.O. Box , Atlanta, GA Nevada Secure Horizons, Nevada, Senior HMO (plan 803) Member Services # Mailing Address P.O. Box 98319, Las Vegas, NV New Hampshire Harvard Pilgrim HealthCare, HMO (plan 311) Member Services # Mailing Address P.O. Box , Quincy, MA New Jersey Aetna, New Jersey, HMO (plan 265) (Self Insured) Member Services # Aetna, Northern & Southern, New Jersey, Senior PPO (plan 694) Aetna Golden Choice, Northern & Southern, New Jersey, Senior PPO (plans 647 & 673) CIGNA, New Jersey, HMO (plan 337) (Self Insured) Member Services # Mailing Address P.O. Box , Chattanooga, TN
15 New Mexico CIGNA, New Mexico, HMO (plan 280) (Self Insured) Member Services # Mailing Address P.O. Box , Chattanooga, TN New York CDPHP (Capital District Physicians Health Plan, Inc.), New York, HMO (plan 293) (Self Insured) Member Services # or Mailing Address 500 Patroon Creek Blvd., Albany, NY Empire HealthNet, Downstate New York, HMO (plans 328) Member Services # Mailing Address P.O. Box 1407, Church Street Station, New York, NY Independent Health, New York, Encompass HMO (plan 308) Member Services # Mailing Address 511 Farber Lakes Drive, Buffalo, NY MVP Health Plan, New York, HMO (plan 341) (Self Insured) Member Services # Mailing Address P.O. Box 1434, Schenectady, NY Ohio Anthem, Ohio Blue Preferred, HMO (plan 243) Member Services # Mailing Address P.O. Box 37180, Louisville, KY Kaiser Permanente, Ohio, HMO (plan 262) Member Services # Mailing Address Claims Dept., P.O. Box 5316, Cleveland, OH Kaiser Permanente, Ohio, Senior HMO (plan 662) Member Services # Mailing Address Claims Dept., P.O. Box 5316, Cleveland, OH
16 Oregon Kaiser Permanente, Oregon, HMO (plan 263) Member Services # or Mailing Address 500 N.E. Multnomah, Suite 100, Portland, OR Kaiser Permanente, Oregon, HMO (plan 663) Member Services # or Mailing Address 500 N.E. Multnomah, Suite 100, Portland, OR Pennsylvania Aetna, Pennsylvania, HMO (plan 326) (Self Insured) Member Services # Aetna, Pittsburgh/Western & Southeast Pennsylvania, Senior HMO (plans 697 & 698) Aetna Golden Choice, Pittsburgh/Western & Southeast Pennsylvania, Senior PPO (plans 645 & 661) Geisinger Health Plan, Pennsylvania, HMO (plan 238) Member Services # Mailing Address 100 North Academy Ave, Danville, PA Geisinger Gold Classic, Pennsylvania, Senior HMO (plan 798) Member Services # Mailing Address 100 North Academy Ave, Danville, PA Keystone Health Plan, Pennsylvania, HMO (plan 378) Member Services # or Mailing Address 1901 Market Street, Philadelphia, PA
17 Keystone Health Plan, Pennsylvania, Senior HMO (plan 707) Member Services # or Mailing Address Independence Blue Cross, P.O. Box , Camp Hill, PA UPMC, Pennsylvania, HMO (plan 248) Member Services # Mailing Address P.O. Box 2999, Pittsburg, PA UPMC, Pennsylvania, Senior HMO (plan 681) Member Services # Mailing Address P.O. Box 2997, Pittsburg, PA Puerto Rico Triple-S, Puerto Rico, PPO (plan 035) Member Services # Mailing Address P.O. Box , San Juan, Perto Rico South Carolina Blue Choice, South Carolina, HMO (plan 376) Member Services # Mailing Address P.O. Box 6170, Columbia, SC Texas Aetna, Austin, HMO (plan 370) Member Services # or Aetna, Dallas/Fort Worth, HMO (plan 274) (Self Insured) Member Services # Aetna, Harlingen, PPO (plan 269) (In Network) Member Services # Mailing Address P.O. Box 14586, Lexington, KY
18 Aetna, Houston, HMO (plan 296) (Self Insured) Member Services # Aetna, San Antonio, HMO (plan 385) Member Services # or Aetna, Texas, Senior HMO (plan 682) Aetna Golden Choice, Texas, Senior PPO (plan 713) CIGNA, Texas, HMO (plan 240) (Self Insured) Member Services # Mailing Address P.O. Box , Chattanooga, TN PacifiCare, Texas, HMO (plan 310) Member Services # Mailing Address Claims Dept., P.O. Box 29217, San Antonio, TX Secure Horizons, Texas, Senior HMO (plan 807) Member Services # Mailing Address P.O. Box 29127, San Antonio, TX Utah Select Health, Utah, HMO (plan 241) Member Services # Mailing Address P.O. Box 30192, Salt Lake City, UT
19 Virginia Aetna, Mid-Atlantic, HMO (plan 309) (Self Insured) Member Services # Aetna, Mid-Atlantic, Senior HMO (plan 683) Aetna Golden Choice, Virginia, Senior PPO (plan 714) Kaiser Permanente, Mid-Atlantic, HMO (plan 254) Member Services # or Mailing Address P.O. Box 6233, Rockville, MD Kaiser Permanente, Mid-Atlantic, Senior HMO (plan 654) Member Services # or Mailing Address P.O. Box 6233, Rockville, MD Optimum Choice, Mid-Atlantic, HMO (plan 340) Member Services # or Mailing Address P.O. Box 948, Frederick, MD Washington Group Health Cooperative, Washington, HMO (plan 249) Member Services # or Mailing Address P.O. Box 34585, Seattle, WA Group Health Cooperative, Washington, Senior HMO (plan 664) Member Services # or Mailing Address P.O. Box 34585, Seattle, WA
20 DENTAL & VISION Regular Dental The dental plans below are Self Insured. Delta Comprehensive PPO Dental (435) Customer Services # Mailing Address P.O. Box , Sacramento, CA Vision The vision plans are Fully Insured. EyeMed Vision Care (plans 429 & 433) Customer Services # Mailing Address 4000 Luxottica Place, Mason, OH LIFE AND OTHER INSURANCES & BENEFITS Life Insurance Life insurance is generally guaranteed under a contract or policy issued by the insurance carrier. Prudential Life Insurance Company of America Customer Services # Mailing Address Group Life Claims Division, P.O. Box 8517, Philadelphia, PA Aetna Life Insurance Customer Services # Mailing Address Service Center, P.O. Box 14549, Lexington, KY Dependent Optional Team Life Insurance Dependent Optional Term Life Insurance is generally guaranteed under a contract or policy issued by the insurance carrier. Prudential Life Insurance Company of America Customer Services # Mailing Address Group Life Claims Division, P.O. Box 8517, Philadelphia, PA
21 COBRA Ceridian COBRA Continuation Services Customer Services # Mailing Address th Street South, St. Petersburg, FL
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