Medical insurance
Select from three medical optionsthrough Cigna.
All plans cover in-network preventive care at 100%, prescription drugs, and include an annual limit on your expenses. The differences are: what you payfor the plan , what you pay when you getcare , how out-of-network care is covered, and your annual maximumcost for care (out-of-pocket maximum).
HSA
HMO
PPO
HSA/HRA Contribution
$500/$1,000
$2,000/$4,000
$2,000/$4,000 $2,000 Individual
Annual Deductible
$1,650 Individual
$2,500 Individual
$3,300 Family
$5,000 Family
$4,000 Family
Out-of-pocket maximum
$3,300 Individual $8,000 Family Plan pays 100%
$6,350 Individual $12,700 Family
$3,000 Individual $7,500 Family
Coinsurance
Plan pays 100%
Plan pays 100%
Preventive care Primary care visit
100% covered
100% covered
100% covered
Deductible Deductible Deductible Deductible Deductible Deductible
$15copay $30copay $15copay $30copay $100copay
$15copay $30copay $15copay $30copay $100copay
Specialist visit
Virtual visit
Urgent care
Emergency room
Inpatient hospital care
$250/admission
$250/admission
Prescription drugs
(30 days | 90 days)
(30 days | 90 days)
(30 days | 90 days) ($50/100 deductible) $10 copay|$20copay
Generic
Ded then $10copay|$20 copay Ded then $25copay|$50 copay Ded then $45copay|$90 copay
$10 copay | $20 copay
Preferred brand
$25 copay | $50 copay
$25 copay|$50copay
Non-preferred brand
$45 copay | $90 copay
$45 copay|$90copay
Balance billing applies
Balance billing applies
Balance billing applies
Out-of-network care
$3,300/$6,600
N/A
$4,000 / $8,000
Annual deductible
Plan pays 80%
N/A
Plan pays 70%
Coinsurance
$3,300/$8,000
N/A
$4,000 / $8,000
Out-of-pocket maximum
The information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final rates are dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract, and other notices contained in this document, applications, and other corresponding communications for additional information.
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