Benefits for 2025
Medical
Cigna HDHP/HSA Plan
In Network (National)
What you pay
Out of Network
Preventive Care
No Charge
30% after Deductible
Office Visit: PCP / Specialist
10% after Deductible
30% after Deductible
Emergency Room
10% after Deductible
Urgent Care
10% after Deductible
30% after Deductible
Complex Imaging (Outpatient)
10% after Deductible
30% after Deductible
Lab & X-Ray (Outpatient)
10% after Deductible
30% after Deductible
Inpatient Hospital
10% after Deductible
30% after Deductible
Outpatient Surgery
10% after Deductible
30% after Deductible
$2,000 / $4,000 Individual in a Family Max: $3,300
$6,000 / $12,000 Individual in a Family Max: $6,000
Deductible (Individual / Family)
Out-of-Pocket Max (Individual / Family)
$4,000 / $8,000
$11,000 / $22,000
Rx Copays (Retail or Mail Order Supply)- After Deductible
$10 / $40 / $60
Not Covered
Notes: Plan offers access to Cigna’s Open Access Plus National Network of doctors/hospitals All in-network services on this plan will first apply towards the in-network deductible Gersh will make an employer contribution of $750/$1,500 into a separate HSA account for any employee that elects this plan All copays, deductibles, & coinsurance apply towards the out-of-pocket max Out-of-Network services are paid based on allowable charges. Member may be responsible for paying the balance of the billed amount above that rate (commonly known as “balance billing”)
Employee Cost Per Pay Period (26)
HDHP/HSA Plan
Employee Only
$85.00
Employee + 1
$253.00
Employee + Family
$374.00
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.
2025 Employee Benefit Guide
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