Benefits for 2026
Medical
SUMMARY OF COVERAGE
Plan Features
Cigna HSA $3500
Cigna OAP
IN NETWORK
Deductibles (Indiv / Family) Coinsurance
$3,500/ $6,000
$1,500 / $3,000
You Pay 20%
You Pay 10%
Out-of-Pocket Max (Indiv / Family)
$6,000 / $12,000
$3,000 / $6,000
Preventive Care
No Charge
No Charge
PCP & Referrals Required
No
No
Primary Care Visit Specialist Visit Diagnostic Exam
Ded. & 20% Coins. Ded. & 20% Coins. Ded. & 20% Coins. Ded. & 20% Coins.
$30Copay $50 Copay
100% 100%
X-Rays
Outpatient Procedure
Ded. & 20% Coins.
Ded. &10% Coins.
Inpatient Hospital Emergency Room
Ded. & 20% Coins. Ded. & 20% Coins. Ded. & 20% Coins.
Ded. &10% Coins.
$150 Copay $75 Copay
Urgent Care
Pharmacy / RX Retail (30 Day Supply) Mail Order (90 Day Supply)
Ded. then $10 / $40 / $70
$10 / $40 / $70
2.5x Retail
2.5x Retail
OUT OF NETWORK
Deductibles (Indiv / Family)
$5,000 / $10,000
$3,000 / $6,000
Coinsurance
You Pay 50%
You Pay 50%
Out-of-Pocket Max (Indiv / Family) Preventive Care Primary Care Visit Specialist Visit Diagnostic Exam
$10,000 / $20,000
$6,000 / $12,000
Ded. & 50% Coins. Ded. & 50% Coins. Ded. & 50% Coins. Ded. & 50% Coins. Ded. & 50% Coins.
Ded. & 50% Coins. Ded. & 50% Coins. Ded. & 50% Coins. Ded. & 50% Coins. Ded. & 50% Coins.
X-Rays
Cigna provider finder link, https://hcpdirectory.cigna.com/web/public/consumer/directory/search
Outpatient Procedure
Ded. & 50% Coins.
Ded. & 50% Coins.
Inpatient Visit
Ded. & 50% Coins. Ded. & 20% Coins. Ded. & 50% Coins.
Ded. & 50% Coins.
Emergency Room
$150
Urgent Care
Ded. & 50% Coins.
* Member may be responsible for any amount over the allowed amount
This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations, and exclusions set forth in each insurance carrier or provider’s contract.
2026 Employee Benefit Guide
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