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Home My WebLink AboutCIGNA CORPORATION - INSURANCE CERTIFICATE (2)AGO OR ® DAr 06 a2020 CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOESNOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED; subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu -of such endorsement(s). PRODUCER -- CONTACT NAME:.. _ AOn Risk .Services Central, Inc. P (866) 283-7122 FAX (800) 363-0105 Philadelphia PA office Wc. No. EsU: AUC. No.: One Liberty Place E-MAIL 1650 Market Street ADDRESS: Suite 1000 INSURERS) AFFORDING COVERAGE NAIC # Philadelphia_ PA 19103 USA INSURED INSURER A: _ ACE American Insurance Company 22667 Cigna corporation Et Al INSUR_ERB: LeXington Insurance Company 19437 900 Cottage Grove Road Bloomfield Cr 06002 USA I INSURER C: INSURER D: INSURER F. C-f ^O1 ACCA1r] THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW -HAVE;BEEN:ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY RE_ OUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICHTHIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE. POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested LTR TYPE OF INSURANCE - - INSD WVD POLICY NUMBER MM/DD MM1D UNITS - X COMMERCIAL GENERAL LIABILITY HDOG71Z3Zb70 EACH OCCURRENCE S1, 000, 000 CLAIMS -MADE ❑X OCCUR PREMISES fra occurrence $1,000,000 MED EXP (Any one person) $ 5 , 000 PERSONALBADV INJURY $19000io00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000, 000 PRODUCTS - COMP/OP AGG S L; 000-; 000 X POLICY ❑ JET LOC OTHER: - AUTOMOBRE LIABILrry - COMBINED SINGLE LIMIT Me =Identl BODILY INJURY ( Per person) ANYAUTO BODILY INJURY (Per aciident) OWNED SCHEDULED AUTOS ONLY AUTOS HIRED AUTOS NON -OWNED ONLY .AUTOSS ONLY PROPERTY DAMAGE Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE AGGREGATE EXCESS LIAR CLAIMS -MADE _ _ - DED RETENTION WORKERSCOMPENSATIONAND - PER STATUTE OTH- EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/ PARTNER / EXECUTIVE E.L. EACH ACCIDENT E.L. DISEASE -EA EMPLOYEE OFFICERIMEMBER EXCLUDED? ❑ (Mandatory In NIB N/A E.L: DISEASE -POLICY LIMIT If yes, describe under .DESCRIPTION OF OPERATIONS below - DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORO 101, AddlUohal The Cityof Fort Collins, its officers, agents and provisions of the General Liibility and Automobile Remarks Schedule; may be attached If rtoreapace is required) employees are included as Additional Insured in accordance with the policy yy Liability policies. Products Liability policy #35407110 is a claims made policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City Of Fort Collins-AUTHORQED REPRESENTATIVE 215 North mason Street Fort Collins Co 80524 USA S' e m 0 O Z d O It C3 ®19W2M ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 10042023 LOC #: A ®_ ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY NAMED INSURED Aon Risk services central, Inc. Cigna Corporation Et Al POLICY NUMBER See Certificate Number: 570082466412 CARRIER - - - NAIC CODE see Certificate Number: 570082466412 EFFECTIVE DATE: REMARKS FORM IS A SCHEDULE TO AC ACORD 25 FORM TITLE: Certificate of INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR LTR TYPEOFINSURANCE ADDL INSD SUER WVD POLICY NUMBER POLICY EFFECTIVE DATE (MWDD/YYYY). POLICY EXPIRATION DATE (MM/DDIYYYY) LMHTS OTHER - - - B Products Liab 35407110 Express Scripts Only 07/01/2020 07/01/2021 Comp/op Agg` $4,000,000 I ACORD 101 (200 101) - ® 2006 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Additi Allegiance Benefit Plan Management, Inc. Allegiance Cobra Services, Inc. Bravo Health Mid -Atlantic, Inc. Brighter Inc. Cigna Behavioral Health, Inc. Cigna Corporate Services, LLC Cigna Dental Health of California, Inc! Cigna Dental Health of Delaware, Inc. Cigna Dental Health of Florida, Inc. Cigna Dental Health of Kentucky, Inc. Cigna Dental Health of Maryland, Inc. Cigna Dental Health of New Jersey, Inc. Cigna Dental Health of North Carolina, Inc. Cigna Dental Health of Ohio, Inc. Cigna Dental Health of Pennsylvania, Inc. Cigna Dental Health of Texas, Inc. Cigna Dental Health of Virginia, Inc. Cigna Dental Health Plan of Arizona, Inc. Cigna Dental Health, Inc. Cigna Health and Life Insurance Company Cigna Health Management, Inc. Cigna Healthcare of Arizona, Inc. Cigna Healthcare of California, Inc.. Cigna Healthcare of Georgia, Inc. Cigna Healthcare of North Carolina, Inc. Cigna Healthcare of Tennessee, Inc. Cigna Healthcare of Utah, Inc. Cigna Healthcare, Inc. Cigna Life Insurance Company of New York Cigna Onsite Health, LLC Connecticut General Life Insurance Con Express Scripts Holding Company Gulfquest, LP Healthspring We & Health Insurance Com Healthspring of Florida, Inc. Healthspring USA, LLC Healthspring, Inc. Home Physicians Management, LLC Life Insurance Company of North America Newquest Management Northeast, LLC Newquest Management of Alabama, LLC Newquest, LLC Qualcare Alliance Networks, Inc. Qualcare, Inc. Scibal Associates, Inc. Tel -Drug of Pennsylvania, L.L.C. �I Named Insureds (1 of 2) Tel -Drug, Inc. Verity Solutions Group, Inc. Accredo Health Group, Inc. Accredo Health, Incorporated AHG of New York, Inc. Airport Holdings, LLC Biopartners in Care, Inc. Care Continuum, Inc. CareCore National Group, LLC CareCore National Intermediate Holdings, LLC CareCore National, LLC CareCore NJ, LLC CareNext Managed Care, LLC CareNext Post -Acute, LLC Chiro Alliance Corporation CuraScript, Inc. Diversified NY IPA, Inc. Diversified Pharmaceutical Services, Inc. EcondiscContracting Solutions, LLC ESI Canada ESI GP Canada ULC E51 GP Holdings, Inc.; ESI GP2 Canada ULC ESI Mail Order Processing, Inc. E51 Mail Pharmacy Service, Inc. ESI Partnership ESI Resources, Inc. eviCore healthcare MSI, LLC Express Reinsurance Company Express Scripts Administrators LLC / Express Scripts Canada Co. Express Scripts Canada Holding Co. -Express Scripts.Canada-Holding,.LLC ny, Inc. Express Scripts Canada Services Express Scripts Canada Wholesale Express Scripts Holding Company, Inc. Express Scripts Pharmaceutical Procurement, LLC Express Scripts Pharmacy Atlantic, Ltd.. Express Scripts Pharmacy Central, Ltd. Express Scripts Pharmacy Ontario, Ltd. Express Scripts Pharmacy West, Ltd. Express Scripts Pharmacy, Inc. Express Scripts Sales Operations, Inc. Express Scripts.Senior Care Holdings, Inc. Express Scripts Senior Care, Inc. Express Scripts Services Co. io/2a/i9 ft Additional Named Insureds (2 of 2) Express Scripts Specialty Distribution Services, Inc. Express Scripts Strategic Development, Inc. Express Scripts Utilization Management Company Express Scripts, Inc. Freco, Inc. Freedom Service Company, LLC Healthbridge Reimbursement & Product Support, Inc. Healthbridge, Inc. Innovative Product Alignment, LLC Inside RX, LLC Lynnfield Compounding Center, Inc. Lynnfield Drug, Inc. MAH Pharmacy, LLC Matrix GPO, LLC Matrix Healthcare Services, Inc. Medco Containment Insurance Company of NY Medco Containment Life Insurance Company Medco Health Services, Inc. Medco Health Solutions, Inc. MedSolutions Holdings, Inc. MedSolutions of Texas, Inc. MHS Holdings, CV MSI Health Organization of Texas, Inc. MyM Technology Services, LLC rriyMatrixx Holdings, LLC myMatrixx-B, LLC Palladian Health of Florida, LLC Palladian Independent Practice Association, LLC Priority Healthcare Corporation Priority Healthcare Distribution, Inc. QPID Health, LLC Specialty Products Acquisitions, LLC SpectraCare Health Care Ventures, Inc. SpectraCare, Inc. 10/24/19