Medical Benefits

Your employer offers medical insurance to protect the health of you and your family. It covers medical expenses such as visits to the doctor’s office, emergency care, and prescription drugs. It’s important to have a medical plan that meets your needs and the needs of your family. Keep in mind that your out-of-pocket costs will be lower if you receive care from an in-network doctor and facility. To find an in-network doctor, please visit www.cigna.com.

Cigna OAP Network	In-Network
Deductible (Individual/Family)	$1,000 / $2,000
Out-of-Pocket Max (Individual/Family)	$3,700 / $7,400
Member Coinsurance	10%
Office Visits
Routine Preventive	Covered at 100%
Primary Care	$30 Copay
Specialist	$40 Copay
Telehealth (Virtual Care)	$30 Copay
Hospital Services
Inpatient Care (Facility/Physician)	Deductible + Coinsurance
Urgent Care	$30 Copay
Emergency Room	$100 Copay + Deductible + Coinsurance

Prescription Drugs
Retail Prescriptions
Tier 1 / Tier 2 / Tier 3	$10 / 50% up to $50 / 70% up to $75
Mail Order Prescriptions
Tier 1 / Tier 2 / Tier 3	$20 / 50% up to $100 / 70% up to $150
Out-of-Network
Deductible (Individual/Family)	$3,000 / $6,000
Out-of-Pocket Max (Individual/Family)	$7,400 / $14,800
Member Coinsurance	40%

	Per Pay Period Cost
Employee Only	$111.88
Employee + Spouse	$336.90
Employee + Child(ren)	$303.29
Employee + Family	$583.72

Downloads

Summary of Benefits

Benefit Summary

Accessing Digital ID Cards

Know Before You Go

Cigna Virtual Care Flyer

Specialty Medications

Preventative Medication Program

GoodRx Flyer

RecoveryOne Flyer

Cigna OAP Network	In-Network
Deductible (Individual/Family)	$1,650 / $3,300
Out-of-Pocket Max (Individual/Family)	$3,000 / $6,000
Member Coinsurance	10%
Office Visits
Routine Preventive	Covered at 100%
Primary Care	Deductible + Coinsurance
Specialist	Deductible + Coinsurance
Telehealth (Virtual Care)	Deductible + Coinsurance
Hospital Services
Inpatient Care (Facility/Physician)	Deductible + Coinsurance
Urgent Care	Deductible + Coinsurance
Emergency Room	Deductible + Coinsurance

Prescription Drugs
Retail Prescriptions
Tier 1	Deductible + Coinsurance
Mail Order Prescriptions
Tier 1	Deductible + Coinsurance
Out-of-Network
Deductible (Individual/Family)	$3,000 / $8,000
Out-of-Pocket Max (Individual/Family)	$6,000 / $12,000
Member Coinsurance	$6,000 / $12,000