Spear PT - 2026 Benefit Guide

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

11

Made with FlippingBook - Online catalogs