Medical Benefits
Your employer offers medical insurance to protect the health of you and your family. It covers medical expenses such as visits to the doctor’s office, emergency care, and prescription drugs. It’s important to have a medical plan that meets your needs and the needs of your family.
Keep in mind that your out-of-pocket costs will be lower if you receive care from an in-network doctor and facility. To find an in-network doctor, please visit www.cigna.com.
In-Network |
Out-of-Network |
|
|---|---|---|
Deductible |
$3,500 / $7,000 |
$7,000 / $14,000 |
Out-of-Pocket Max |
$4,500 / $9,000 |
$9,000 / $18,000 |
Coinsurance (Plan pays/You pay) |
0% / 100% |
80% / 20% |
Physician Visits |
||
Primary Care |
Deductible then $30 Copay |
Deductible then 20% |
Routine Preventive |
Covered in Full |
Not Covered |
Specialist |
Deductible then $60 Copay |
Deductible then 20% |
Telehealth |
PCP-Deductilbe then $30 Copay |
Deductible then 20% |
Hospital Services |
||
Physician Services |
Deductible then 100% |
Deductible then 20% |
Inpatient Hospital |
Deductible then 100% |
Deductible then 20% |
Outpatient Surgery |
Deductible then 100% |
Deductible then 20% |
Basic Outpatient Diagnostics |
Deductible then 100% |
Deductible then 20% |
Urgent Care |
Deductible then $50 Copay |
Deductible then 20% |
Emergency Room |
$350 Copay |
Deductible then 20% |
Retail Prescriptions (per 30-day Supply) |
||
Tier 1 - Generic |
Deductible then $10 Copay |
Deductible then 50% coinsurance |
Tier 2 - Preferred Brand |
Deductible then $30 Copay |
Deductible then 50% coinsurance |
Tier 3 - Non-preferred Brand |
Deductible then $60 Copay |
Deductible then 50% coinsurance |
Mail Order Prescriptions (per 90-day Supply) |
||
Tier 1 - Generic |
Deductible then $30 Copay |
Deductible then 50% coinsurance |
Tier 2 - Preferred Brand |
Deductible then $90 Copay |
Deductible then 50% coinsurance |
Tier 3 - Non-preferred Brand |
Deductible then $180 Copay |
Deductible then 50% coinsurance |
Monthly Cost |
|
|---|---|
Employee Only |
$179.71 |
Employee + Spouse |
$394.74 |
Employee + Child(ren) |
$349.21 |
Employee + Family |
$625.84 |
Your employer offers medical insurance to protect the health of you and your family. It covers medical expenses such as visits to the doctor’s office, emergency care, and prescription drugs. It’s important to have a medical plan that meets your needs and the needs of your family.
Keep in mind that your out-of-pocket costs will be lower if you receive care from an in-network doctor and facility. To find an in-network doctor, please visit www.cigna.com.
In-Network |
Out-of-Network |
|
|---|---|---|
Deductible |
$1,500 / $3,000 |
Emergency Services Only |
Out-of-Pocket Max |
$5,500 / $11,000 |
Emergency Services Only |
Member Coinsurance (Plan pays/You pay) |
80% / 20% |
Emergency Services Only |
Physician Visits |
||
Primary Care |
$30 Copay |
Emergency Services Only |
Preventive Care |
Covered in Full |
Emergency Services Only |
Specialist |
$60 Copay |
Emergency Services Only |
Telehealth |
PCP-$30 Copay |
Emergency Services Only |
Hospital Services |
||
Physician Services |
Deductible then 20% |
Emergency Services Only |
Inpatient Hospital |
Deductible then 20% |
Emergency Services Only |
Outpatient Surgery |
Deductible then 20% |
Emergency Services Only |
Basic Outpatient Diagnostics |
Deductible then 20% |
Emergency Services Only |
Urgent Care |
Deductible then 20% |
Emergency Services Only |
Emergency Room |
Deductible then $350 Copay |
Emergency Services Only |
Retail Prescriptions (per 30-day Supply) |
||
Tier 1 - Generic |
$10 Copay |
Emergency Services Only |
Tier 2 - Preferred Brand |
$45 Copay |
Emergency Services Only |
Tier 3 - Non-preferred Brand |
$70 Copay |
Emergency Services Only |
Mail Order Prescriptions (per 90-day Supply) |
||
Tier 1 - Generic |
$30 Copay |
Emergency Services Only |
Tier 2 - Preferred Brand |
$135 Copay |
Emergency Services Only |
Tier 3 - Non-preferred Brand |
$210 Copay |
Emergency Services Only |
Monthly Cost |
|
|---|---|
Employee Only |
$262.28 |
Employee + Spouse |
$582.46 |
Employee + Child(ren) |
$525.64 |
Employee + Family |
$826.64 |