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 |
$1,000 / $2,000 |
$2,000 / $6,000 |
Out-of-Pocket Max |
$5,000 / $10,000 |
$12,000 / $36,000 |
Member Coinsurance |
20% |
50% |
Physician Visits |
||
Primary Care Visit |
$25 Copay |
Deductible + 50% |
Routine Preventive |
Fully Covered |
Deductible + 50% |
Specialist Visit |
$50 Copay |
Deductible + 50% |
Hospital Services |
||
Physician Services |
Deductible + 20% |
Deductible + 50% |
Inpatient Hospitalization |
Deductible + 20% |
Deductible + 50% |
Outpatient Surgery |
Deductible + 20% |
Deductible + 50% |
Basic Outpatient Diagnostics |
Deductible + 20% |
Deductible + 50% |
Urgent Care |
$75 Copay |
Deductible + 50% |
Emergency Room |
Deductible, then $300 Copay + 20% |
Deductible, then $300 Copay + 20% |
Retail Prescriptions |
||
Preferrred Generic |
Tier 1A: $3 |
In-Network Copay + 50% |
Preferred Brand |
$45 Copay |
In-Network Copay + 50% |
Non-Preferred |
$75 Copay |
In-Network Copay + 50% |
Specialty |
Preferred: 20% up to $250 |
In-Network Copay + 50% |
Mail Order Prescriptions |
||
Preferrred Generic |
Tier 1A: $6 |
N/A |
Preferred Brand |
$90 Copay |
N/A |
Non-Preferred |
$150 Copay |
N/A |
Specialty |
N/A |
N/A |
Monthly Cost |
|
|---|---|
Employee Only |
$167.73 |
Employee + Spouse |
$1,087.81 |
Employee + Child(ren) |
$659.63 |
Employee + Family |
$1,772.88 |
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 |
$10,500 / $31,500 |
Out-of-Pocket Max |
$7,500 / $15,000 |
$20,500 / $61,500 |
Member Coinsurance |
0% |
30% |
Physician Visits |
||
Primary Care Visit |
$25 Copay |
Deductible + 30% |
Routine Preventive |
Fully Covered |
Deductible + 30% |
Specialist Visit |
$50 Copay |
Deductible + 30% |
Hospital Services |
||
Physician Services |
Deductible |
Deductible + 30% |
Inpatient Hospitalization |
Deductible |
Deductible + 30% |
Outpatient Surgery |
Deductible, then $250 Copay |
Deductible + 30% |
Basic Outpatient Diagnostics |
Deductible |
Deductible + 30% |
Urgent Care |
$75 Copay |
Deductible + 30% |
Emergency Room |
Deductible, then $500 Copay |
Deductible, then $500 Copay |
Retail Prescriptions |
||
Preferrred Generic |
Tier 1A: $3 |
In-Network Copay + 50% |
Preferred Brand |
$50 Copay |
In-Network Copay + 50% |
Non-Preferred |
$80 Copay |
In-Network Copay + 50% |
Specialty |
Preferred: 20% up to $250 |
In-Network Copay + 50% |
Mail Order Prescriptions |
||
Preferrred Generic |
Tier 1A: $6 |
N/A |
Preferred Brand |
$100 Copay |
N/A |
Non-Preferred |
$160 Copay |
N/A |
Specialty |
N/A |
N/A |
Monthly Cost |
|
|---|---|
Employee Only |
$39.99 |
Employee + Spouse |
$807.38 |
Employee + Child(ren) |
$397.53 |
Employee + Family |
$1,326.05 |
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 |
$5,000 / $10,000 |
$15,000 / $45,000 |
Out-of-Pocket Max |
$8,150 / $16,300 |
$30,000 / $90,000 |
Member Coinsurance |
0% |
30% |
Physician Visits |
||
Primary Care Visit |
$25 Copay |
Deductible + 30% |
Routine Preventive |
Fully Covered |
Deductible + 30% |
Specialist Visit |
$50 Copay |
Deductible + 30% |
Hospital Services |
||
Physician Services |
Deductible |
Deductible + 30% |
Inpatient Hospitalization |
Deductible, then $250 Copay |
Deductible + 30% |
Outpatient Surgery |
Deductible |
Deductible + 30% |
Basic Outpatient Diagnostics |
Deductible |
Deductible + 30% |
Urgent Care |
$75 Copay |
Deductible + 30% |
Emergency Room |
Deductible, then $500 Copay |
Deductible, then $500 Copay |
Retail Prescriptions |
||
Preferrred Generic |
Tier 1A: $3 |
In-Network Copay + 50% |
Preferred Brand |
$50 Copay |
In-Network Copay + 50% |
Non-Preferred |
$80 Copay |
In-Network Copay + 50% |
Specialty |
Preferred: 20% up to $250 |
In-Network Copay + 50% |
Mail Order Prescriptions |
||
Preferrred Generic |
Tier 1A: $6 |
N/A |
Preferred Brand |
$100 Copay |
N/A |
Non-Preferred |
$160 Copay |
N/A |
Specialty |
N/A |
N/A |
Monthly Cost |
|
|---|---|
Employee Only |
$0.00 |
Employee + Spouse |
$722.15 |
Employee + Child(ren) |
$317.74 |
Employee + Family |
$1,191.51 |