MEDICAL & PRESCRIPTION DRUG PLAN INSURANCE
Administered by Cigna
Comprehensive and preventive healthcare coverage is important in protecting you and your family from the financial risks of unexpected illness or injury. A little prevention usually goes a long way, especially in healthcare. Routine exams and regular preventive care provide an inexpensive review of your health.
Small problems can potentially develop into large expenses. By identifying the problems early, often
they can be treated at little cost.
Comprehensive healthcare also provides peace of mind In case of an illness or injury, you and your family are covered with an excellent medical plan through Equity Administrative Services, Inc.
Cigna administers the Medical and Prescription insurance plans. Associates who are active in the medical plan have the opportunity to make changes to their coverage during open enrollment.
The Cigna Open Access Plus (health benefits plan allows you to choose your health care providers. No referrals required to see a specialist. You have coverage for out of network services, but you will have higher out of pocket costs, and you may need to file a claim.
Equity Administrative Services, Inc offers you a few medical plan options. Note there are no new enrollments in the Standard PPO Plan. The Standard PPO plan will no longer be an available medical plan option after the 2020 plan year. With the medical plan options available, you may select where you receive your medical services. If you use in network providers, your costs will be lower Locating a Cigna network provider is easy just visit www.mycigna.com.
For additional information, please review the Summary of Benefits and Coverage (SBC) for the Standard PPO and High Deductible Health plans posted to the HR For You folder and at https://equitybenefitsconnect com/
We have teamed up with Cigna to offer you the use of Cigna s Telehealth Connection and 90 Now prescription refill programs. These programs are available to all medical plan participants.
RESOURCES
CIGNA 90 NOW PRESCRIPTION REFILLS
With this maintenance medication program, you now have more choice in how, and where, you can fill your prescriptions. You choose what is best for you.
If you fill your prescription in a 90-day supply, you have to use a 90-day retail pharmacy in the plan network (includes CVS, Target, Giant Eagle, Walgreens, Walmart, Kroger’s and many more).
If you fill your prescription in a 30-day supply, you can use any pharmacy in the plan network.
Filling your prescriptions in a 90-day supply means that you will be less likely to miss a dose, and you will have to make fewer trips to the pharmacy to refill your medications.
If you use Cigna Home Delivery Pharmacy to fill your prescriptions, you can have your medications delivered to your home in a 90-day supply.
Please refer to the Cigna 90 Now Maintenance Drug List overview which provides more detailed information on the program. The overview is located in the HR For You folder.
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HIGH DEDUCTIBLE HEALTH PLAN 1 |
EMBEDDED DEDUCTIBLE HEALTH PLAN 2 |
AGGREGATE DEDUCTIBLE HEALTH PLAN 3 – HRA |
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| In-Network | Out-of-Network | In-Network | Out-of- Network | In-Network | Out-of-Network | |
| DEDUCTIBLES | Calendar Year Aggregate Deductible |
Calendar Year Embedded Deductible |
Calendar Year Embedded Deductible |
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| Individual | $2,000 | $4,000 | $4,000 | $8,000 | $2,000 | $4,000 |
| Family | $4,000 | $8,000 | $8,000 | $16,000 | $4,000 | $8,000 |
| COINSURANCE | ||||||
| Plan Pays | 80% | 60% | 100% | 60% | 80% | 60% |
| You Pay | 20% | 40% | 0% | 40% | 20% | 40% |
| OUT OF POCKET MAXIMUM | Deductible & Copays Included | Deductible & Copays Included | Deductible & Copays Included | |||
| Individual | $3,000 | $8,000 | $4,000 | $12,000 | $3,000 | $8,000 |
| Family | $6,000 | $16,000 | $8,000 | $20,000 | $6,000 | $16,000 |
| OFFICE VISITS | ||||||
| TeleMedicine | Fee based on service | Not Covered | Fee based on service | Not Covered | Fee based on service | Not Covered |
| Primary Care Physician | 20% coinsurance | 40% coinsurance | No Charge | 40% coinsurance | 20% coinsurance | 40% coinsurance |
| Specialist | 20% coinsurance | 40% coinsurance | No Charge | 40% coinsurance | 20% coinsurance | 40% coinsurance |
| Urgent Care | 20% coinsurance | 20% coinsurance | No Charge | No Charge | 20% coinsurance | 20% coinsurance |
| Emergency Room | 20% coinsurance | 20% coinsurance | No Charge | No Charge | 20% coinsurance | 20% coinsurance |
| Diagnostic Labs & X-Rays | 20% coinsurance | 40% coinsurance | No Charge | 40% coinsurance | 20% coinsurance | 40% coinsurance |
| Hospitalization | 20% coinsurance | 40% coinsurance | No Charge | 40% coinsurance | 20% coinsurance | 40% coinsurance |
| Mental Health Office Visit | 20% coinsurance | 40% coinsurance | No Charge | 40% coinsurance | 20% coinsurance | 40% coinsurance |
| Preventive Care Services | 100% coverage; No Deductible | 40% coinsurance; No Deductible | 100% coverage | 40% coinsurance | 100% coverage; No Deductible | 40% coinsurance; No Deductible |
| LIFETIME MAXIMUM | Unlimited | Unlimited | Unlimited | |||
| PRESCRIPTION DRUGS | HDHP 1 Retail & Mail Order |
HDHP 2 Retail & Mail Order |
HDHP 3 Retail & Mail Order |
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| Generic | Deductible, 20% coinsurance | Deductible, 0% coinsurance | Deductible, 20% coinsurance | |||
| Brand | ||||||
| Non-Preferred | ||||||
Preventative care is covered at 100% (in network). Preventative care includes your annual physical, well-woman, well-baby and well-child exams, mammography and colonoscopy screenings, blood pressure and cholesterol testing and intervention for alcohol or substance abuse.
Email Katie Plush ([email protected]) or Vicki Barone ([email protected]) if you have any questions about the benefits or online enrollment process.
