expatriates in the U.S.

The documents listed below are called a summary of material modification (SMM). An SMM explains recent updates to your plan that are not yet captured or updated in your summary plan description (SPD) since the last publication date. Be sure to review the SMM for an understanding of important plan updates.

Prescription Drug Program Changes
For prescription drugs obtained inside the U.S. or mail-order in the U.S.

• Coverage for COVID-19 at-home test kits (January 15, 2022)
• New coverage for weight loss class of prescription drugs (January 1, 2022)
• Flu Shots, COVID-19, other immunization coverage: Established coverage from a pharmacy (February 15, 2021)
• New coverage for continuous glucose monitoring systems (January 1, 2021) 
• Rare Conditions Value Program (January 1, 2021)
• Flu shots: Temporary coverage when received at a network pharmacy (September 15 - December 31, 2020)
• Managed prior authorization for Xyrem (January 1, 2020)
• Advanced Opioid Management Program (January 1, 2019)
• Condition-specific prescription drug programs (January 1, 2018) 

Other General Plan Changes

• "Other dependent" legal guardian administrative clarification (January 1, 2021)
• New address for benefits correspondence (June 1, 2020)
• New dependent verification requirement (January 1, 2019) | Learn more
• New qualifying life event (January 1, 2019)
• Employee after-tax contributions eliminated (January 1, 2019)
• New fee for insufficient funds (January 1, 2019)

Review the benefit summary and highlights to understand basic information about your dental plan, such as benefits, copayments, deductibles, coinsurance and plan contact information.

• 2023 Cigna Benefit Summary and Highlights

Review the Certificate of Insurance to understand what is covered under the plan. You can contact Cigna to request a current Certificate of Insurance.

• 2023 Cigna Certificate of Coverage (Expatriates in the US)

Prescription Drug Program 
For prescription drugs obtained inside the U.S. or mail-order in the U.S.

• 2024 Prescription Drug Program Formulary | 2024 List of Exclusions
• Express Scripts Price a Prescription tool
• Prescription Drug administrative changes due to COVID-19

Chevron is legally required to provide certain notices to plan participants. These notices are posted on this website for your reference.

After you enroll, there are two opportunities to change your coverage ongoing:

Open Enrollment

Open enrollment is your annual opportunity to review and make changes to your coverage for the next plan year.  Any changes you make to your benefits coverage during open enrollment become effective January 1 of the new year. If you miss the open enrollment deadline, you must wait until the next open enrollment period or if you experience a qualifying life event. You'll receive information each year about the dates of the open enrollment period and instructions for reviewing your coverage and making any desired changes.

Life Event

If you get married, have a baby, move or experience some other qualifying life event, you have 31 days to make changes to your benefits, if permitted by the event. If you miss this deadline, you'll have to wait until the next open enrollment period to change your benefits. To report a life event and understand what changes you may be eligible to make:

• Go to the BenefitConnect website and click the Report a Life Event link just under the main banner on the home page.
• Call the HR Service Center. Choose the option for Benefits, then Health coverage.

You are required to verify the eligibility of any new dependents you enroll in your Chevron health plans. You have up to 60 days to obtain and submit requested documentation that verifies your dependent(s) are eligible to participate in Chevron’s health benefits. If you don’t provide acceptable documentation by the deadline, your dependent(s) will be disenrolled from coverage. Learn more about this process.

All medical services are insured by Cigna — whether inside or outside the United States. Your Global Choice Plan is a PPO plan, which means you can use any doctor you want — network or out-of-the-network. 

What is a Network?
A network is a group of independent health care providers in the U.S. – doctors, hospitals, pharmacies – that have agreed with your health plan to charge discounted rates for services provided to plan members. Network providers save you money directly by reducing your out-of-pocket costs.

How to Use Your Medical Coverage in the U.S.
While your medical plan allows you to visit any provider you choose, it’s important to understand that if you receive medical services inside the U.S., there are different levels of benefits for network providers and out-of-network providers.

• When you use a network provider in the U.S., the plan will pay 100 percent of the cost for covered medical services.
• If you use an out-of-network provider in the U.S., that’s your choice, but the plan will pay only 70 percent of the cost for most covered medical services for an out-of-network provider, and you will pay the remainder. Chevron will not reimburse you for this expense.

Here are some important things to remember about using your medical coverage in the U.S.:

• The Global Choice Plan uses the Cigna Open Access Plus (OA Plus) network. See the How-To-At-A-Glance section later on this page to learn more about networks and how to locate a network provider.
• Show your Cigna member ID card to your provider for medical services. If they have questions about your coverage they should contact Cigna at the phone number listed on your ID card. If you need to obtain a prescription when you are inside the U.S., use your Express Scripts ID card.
• If you visit a network provider in the United States, you do not need to submit a claim form for reimbursement. You’ll pay out of your own pocket for your portion of the medical service, if any, when you receive it. Your provider will work directly with Cigna.
• If you visit an out-of-network medical provider in the United States, you will generally need to pay for the service when you receive it, out of your own pocket. Be sure to give your provider a Cigna claim form, then you’ll return the claim form with the required copies of receipts and bills to Cigna for reimbursement to you.

As a reminder, health plans only pay for services, treatment and prescription drugs that they have agreed to cover. If a service or treatment is excluded from your plan’s coverage, you’ll be required to pay the full amount. You can call your plan to ask about what services are covered and what are excluded.

Express Scripts administers your prescriptions obtained in the United States or by mail-order within the United States. Similar to medical services, your prescription drugs are covered at different levels depending on where and how they are purchased.

• If you use a U.S. network retail pharmacy or the mail order pharmacy, the plan pays 100 percent of eligible expenses.
• If you use an out-of-network pharmacy in the U.S., the plan will only pay 70 percent of eligible expenses.

To make sure your drugs are covered at 100 percent, remember:

• Some drugs are covered only if they’re prescribed for certain uses or only up to quantity levels. These must be approved in advance before the plan will cover them. If you don’t get approval from the plan, you’ll pay the full cost.
• High-cost specialty maintenance medications must be purchased through the mail order specialty pharmacy. You can get your first fill of a specialty drug at a network retail pharmacy for no cost, but after that, you’ll pay the full cost if you continue to purchase it at a retail pharmacy.

Here are some important things to remember about using your prescription drug coverage in the U.S.:

• If you need to obtain a prescription when you are inside the United States, use your Express Scripts ID card. Your Cigna ID card is only for medical services or when you purchase a prescription drug outside the U.S.
• Mail-order is only available through Express Scripts and only applies to addresses within the United States because medications cannot be shipped overseas. In addition, medications cannot be shipped through Chevron pouch mail.

As a reminder, health plans only pay for services, treatment and prescription drugs that they have agreed to cover. If a service or treatment is excluded from your plan’s coverage, you’ll be required to pay the full amount. You can call your plan to ask about what services are covered and what are excluded.

All medical services are insured by Cigna - whether inside or outside the U.S.

• There are no Cigna networks outside the United States, unless your home country is in the CignaLinks network. Cigna has more than 185,000 doctors and hospitals with either direct settlement or who are a part of CignaLinks. Cigna has partnerships with local providers through the CignaLinks program that may provide additional cost savings. Contact Cigna for more information about CignaLinks. (See contact information at the bottom of the page.)
• Individual providers (such as a doctor), pharmacies and outpatient hospital facilities will generally require payment at the time services are delivered. If you have access to a CignaLinks provider, you’ll pay out of your own pocket for your portion of the medical service, if any, when you receive it. Your provider will work directly with Cigna for reimbursement of the rest of the service. 
• If you don’t have access to a CignaLinks provider, you will generally need to pay for the service when you receive it, out of your own pocket. Be sure to give your provider a Cigna claim form, and then you’ll return the claim form with the required copies of receipts and bills to Cigna. Cigna will reimburse you directly.
• Cigna does have a direct settlement agreement with many international providers (physician and hospitals). This means that if you use one of these providers, Cigna can settle your charges directly. Be sure to provide your member ID card when you visit. If Cigna does not have a direct settlement agreement in place, they can, in many cases, arrange for a Guarantee of Payment. You or the provider should contact the 24-hour member services unit at the number on your ID card to make arrangements. Regardless of the direct settlement agreement, you should always obtain a copy of the bill for services rendered and retain it for your records. Contact Cigna for more information about direct settlement providers. (See contact information at the bottom of the page.)

As a reminder, health plans only pay for services, treatment and prescription drugs that they have agreed to cover. If a service or treatment is excluded from your plan’s coverage, you’ll be required to pay the full amount. You can call your plan to ask about what services are covered and what are excluded.

Prescription drugs obtained outside the United States are insured by Cigna.

• There are no networks outside the U.S. When you obtain prescription drugs outside the U.S., you do not need to use a network provider; the plan will pay 100 percent of billed charges for prescription drugs.
• If you need to obtain a prescription when you are outside the United States, Cigna can help you locate a physician. Cigna can also verify if a prescription is available or help you determine the drug equivalency in other countries for your prescription medications.
• If you need to obtain a prescription when you are outside the United States, use your Cigna ID card.
• Some drugs are covered only if they’re prescribed for certain uses or only up to quantity levels. These must be approved in advance before the plan will cover them. If you don’t get approval from the plan, you’ll pay the full cost.
• Mail-order is only available through Express Scripts and only applies to addresses within the United States because medications cannot be shipped overseas. In addition, medications cannot be shipped through Chevron pouch mail.

You will receive the ID cards listed below. You may also receive a new ID card periodically; always destroy your old card and be sure to present your new card to your provider at your next visit.  

• You will receive an ID card in the mail from Cigna for worldwide medical services and prescription drugs outside the U.S. You can also download a digital ID card from your account on the CignaEnvoy website.
• If you are in a work location with the CignaLinks partnership, you may receive a second ID card along with the standard Cigna ID card that all other participants receive. The additional ID card will be issued automatically if applicable in your situation. Just be sure to always carry both cards, but only show your CignaLinks card when you receive medical services from a CignaLinks provider outside the United States.
• You will receive an ID card in the mail from Express Scripts for prescription drugs. You must present this ID card for retail pharmacy benefits in the U.S. You can also download a digital ID card from your account on the Express Scripts website or the mobile app.
• You will not receive an ID card from VSP for basic vision coverage. You do not need an ID card to receive care, simply tell your provider that you have coverage under VSP. 

Tip: When you enroll in health benefits on the BenefitConnect website or through the HR Service Center, know that your election is not immediate with each of the claims administrators. You must wait until your coverage is activated with the claims administrators before ID cards can be generated and for your coverage to display in the plan administrator's system.

• If you enroll during open enrollment, your ID cards will be generated in December, and your coverage fully activated on January 1 of the new year.
• If you enroll mid-year as a new hire or due to a qualifying life event, please allow at least 7 business days for BenefitConnect/HR Service Center to process your enrollment election with the claims administrators. Know that this could take slightly less or slightly more days, depending on when you enrolled. If you have questions about your election, contact the HR Service Center. (Choose the option for Benefits, then Health coverage.)

A network is a group of independent medical providers that have agreed with your medical plan claims administrators to charge contracted fees for services provided to plan members. The Global Choice Plan is a preferred provider organization (PPO) health plan. 

For services inside the U.S., you can choose to see any provider you choose, network or out-of-network. There are different levels of benefits for network providers and out-of-network providers. Higher benefits are paid when you receive health care services from a network provider in the U.S. You always have the option of using an out-of-network provider, but plan benefits are lower if you do.  

There are no Cigna networks outside the United States; however Cigna does have a direct settlement agreement with many international providers (physician and hospitals). This means that if you use one of these providers, Cigna can settle your charges directly. Be sure to provide your member ID card when you visit. If Cigna does not have a direct settlement agreement in place, they can, in many cases, arrange for a Guarantee of Payment. You or the provider should contact the 24-hour member services unit at the number on your ID card to make arrangements. Regardless of the direct settlement agreement, you should always obtain a copy of the bill for services rendered and retain it for your records.

Cigna has more than 185,000 doctors and hospitals with either direct settlement or who are a part of CignaLinks. The CignaLinks partnership is an agreement with select, regional networks for additional cost savings and ease of access to health care. CignaLinks can also help you understand how health care works in your host country. Contact Cigna for more information about CignaLinks (see contact information at the bottom of this page).

What happens when I use an out-of-network provider in the U.S.? If you visit an out-of-network provider in the U.S., you may be responsible for paying the full amount and submitting a claim to the claims administrator after the visit. Your services will be subject to the out-of-network annual deductible and your coinsurance amounts will be higher, so your out-of-pocket costs will be higher. In addition, you may be subject to the maximum reimbursable charge (MRC) and out-of-network providers may balance bill you for the difference between the plan MRC and their usual fee for services. Learn more about going out-of-network.

What is the maximum reimbursable charge (MRC)? MRC is the maximum amount the Global Choice Plan will pay for covered out-of-network services. You will be responsible for paying any amount above the plan’s MRC for the service. Generally, your provider will bill you for this amount and you’ll pay the provider directly. Providers often refer to this as balance billing. These payments do not apply to your deductible or out-of-pocket maximum. And these payments are in addition to your coinsurance obligation for the service, if applicable.

how to find a network provider

Outside the U.S., individual providers (such as a doctor), pharmacies and outpatient hospital facilities will generally require payment at the time services are delivered. You’ll need to submit a claim directly to Cigna for reimbursement. However Cigna does have a direct settlement agreement with many international providers. This means that if you use one of these providers, Cigna can settle your charges directly. Be sure to provide your member ID card when you visit. If Cigna does not have a direct settlement agreement in place, they can, in many cases, arrange for a Guarantee of Payment. You or the provider should contact the 24-hour member services unit at the number on your ID card to make arrangements. Regardless of the  direct settlement agreement, you should always obtain a copy of the bill for services rendered and retain it for your records.

Should you need to submit a claim:

• Cigna claim form (medical services or prescription drugs outside the U.S.)
• You can submit claim forms and bills by mail, email or fax, or you can submit claims online at CignaEnvoy.com.
• Keep a copy of your completed claim form and receipts for your records. You can track the status of your claim on CignaEnvoy.com and you can contact Cigna if you have any questions. Cigna offers several options for reimbursement including international direct deposit, checks, electronic funds and wire transfers.

Inside the U.S., typically If you visit a network provider, your provider will usually handle all claims and paperwork for you. If you visit an out-of-network provider you may have to pay the cost out-of-pocket and/or be billed directly from the provider. To be reimbursed for covered services, you’ll have to file a claim form with the claims administrator. 

Out-of-Network Medical Services in the U.S.

• Cigna claim form (medical services or prescription drugs outside the U.S.)
• You can submit claim forms and bills by mail, email or fax, or you can submit claims online at CignaEnvoy.com.
• Keep a copy of your completed claim form and receipts for your records. You can track the status of your claim on CignaEnvoy.com and you can contact Cigna if you have any questions. Cigna offers several options for reimbursement including international direct deposit, checks, electronic funds and wire transfers.

Prescription Drugs Inside the U.S. with Express Scripts

• Express Scripts claim form
• You can also submit a claim online from the Express Scripts website or the mobile app.
• To ensure timely payment, you should file your claim as soon as you can. If you don’t file a claim within 365 days from the date on which you incur a covered charge, no plan benefits will be payable for that covered charge.   

Basic Vision with VSP

• VSP claim form
• To ensure timely payment, you should file your claim as soon as you can. Typically, June 30 of the following year is the normal deadline to submit claims for eligible expenses incurred from January 1 through December 31 of the plan year.

The Global Choice Plan is only available to employees on an expatriate assignment in the U.S. So, if you repatriate following the conclusion of your expatriate assignment, your Global Choice Plan coverage ends the last day of the month of the effective date of your repatriation.