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.

	In-Network
Deductible (Individual/Family)	$5,000/ $10,000
Out-of-Pocket Max (Individual/Family)	$6,500/ $13,000
Member Coinsurance	20%
Preventive Care	No Charge
Primary Care Visit	$40 Copay
Specialist Visit	$40 Copay
Inpatient Surgery	Deductible then 20%
Outpatient Surgery	Deductible then 20%
Urgent Care	$45 Copay, then 100%
Emergency Room	$100 Copay + 20%

Prescriptions
Retail Drugs (30 days)
Tier 1	$15
Tier 2	$50
Tier 3	$100
Mail Order Drugs (90 days)
Tier 1	$38
Tier 2	$125
Tier 3	$250

	Per Bi-Weekly 26 Pay Periods Cost
Employee Only	$0.00
Employee + Spouse	$213.10
Employee + Child(ren)	$180.57
Employee + Family	$319.66

Downloads

Summary of Benefits

Benefit Summary

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.

	In-Network
Deductible (Individual/Family)	$4,000/ $8,000
Out-of-Pocket Max (Individual/Family)	$5,500/ $11,000
Member Coinsurance	20%
Preventive Care	No Charge
Primary Care Visit	Deductible then 20%
Specialist Visit	Deductible then 20%
Inpatient Surgery	Deductible then 20%
Outpatient Surgery	Deductible then 20%
Urgent Care	Deductible then 20%
Emergency Room	Deductible then 20%

Prescriptions
Retail Drugs (30 days)
Tier 1	Deductible then 20%
Tier 2	Deductible then 20%
Tier 3	Deductible then 20%
Mail Order Drugs (90 days)
Tier 1	Deductible then 20%
Tier 2	Deductible then 20%
Tier 3	Deductible then 20%

	Per Bi-Weekly 26 Pay Periods Cost
Employee Only	$0.00
Employee + Spouse	$188.92
Employee + Child(ren)	$160.08
Employee + Family	$283.38

Downloads

Summary of Benefits

Benefit Summary

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.

	In-Network
Deductible (Individual/Family)	$3,500/ $7,000
Out-of-Pocket Max (Individual/Family)	$3,500/ $7,000
Member Coinsurance	0%
Preventive Care	$0
Primary Care Visit	Deductible
Specialist Visit	Deductible
Inpatient Surgery	Deductible
Outpatient Surgery	Deductible
Urgent Care	Deductible
Emergency Room	Deductible