2025 Benefit Guide Cal Final Gersh (corrected)

Benefits for 2025

Medical

NEW Cigna PPO Plan

In Network (National)

What you pay

Out of Network

Preventive Care

No Charge

50% after deductible

Coinsurance

Plan pays 70%

Plan pays 50%

Office Visit: PCP / Specialist

$30 Copay / $50 Copay 50% after deductible

$350 Copay then 30% after Deductible (Copay waived if admitted)

Emergency Room

Urgent Care

$50 Copay

50% after Deductible

Complex Imaging (Outpatient)

30% after Deductible

50% after Deductible

Lab & X-Ray (Outpatient)

30% after Deductible

50% after Deductible

Inpatient Hospital

30% after Deductible

50% after Deductible

Outpatient Surgery

30% after Deductible

50% after Deductible

Deductible (Individual / Family)

$2,500 / $5,000

$3,000 / $6,000

Out-of-Pocket Max (Individual / Family)

$5,000 / $10,000

$15,000 / $30,000

Rx Copays (Retail or Mail Order Supply)

$15 / $35 / $70

Not Covered

Notes: Plan offers access to Cigna’s Open Access Plus National Network of doctors/hospitals 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)

New PPO Plan

Employee Only

$123.40

Employee + 1

$431.36

Employee + Family

$577.56

* 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.

2025 Employee Benefit Guide

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