Medical
Medical coverage provides healthcare protection for you and your family. You can visit any provider, but in-network doctors offer the highest level of benefits and lower out-of-pocket costs by charging reduced, contracted rates. Out-of-network providers set their own fees, so you may be responsible for charges above the Reasonable and Customary (R&C) limits. Preventive care—such as physical exams, flu shots, and screenings—is covered at 100% when you use in-network providers. The main differences between plan options are how much you pay per paycheck and what you pay when you receive care.
Each plan has different:
- Annual deductible amounts – the amount you pay each year for eligible in-network and out-of-network charges before the plan begins to pay.
- Out-of-pocket maximums– the most you will pay each year for eligible network services and/or prescriptions. After you reach your out-of-pocket maximum, the plan picks up the full cost of covered medical care for the remainder of the year.
- Copays – A copay is a fixed amount you pay for a health care service. Copays do not count toward your deductible but do count toward your annual out-of-pocket maximum.
- Coinsurance – Once you’ve met your deductible, you and the plan share the cost of care, which is called coinsurance. For example, you pay 20% for services and the plan will pay 80% of the cost until you have reached your out-of-pocket maximum.
Cigna HDHP
Benefit Highlights
In-Network
Deductible (Individual/Family)
$1,650/$3,300
Out-of-Pocket Max (Individual/Family)
$2,500/$5,000
Urgent Care
10% after deductible
Emergency Room
10% after deductible
Retail RX (Up to 30-Day Supply)
Generic
$10 copay
Preferred Brand
$30 copay
Non-Preferred Brand
$50 copay
Specialty
30% coinsurance up to $300 maximum payment per prescription
Mail-Order RX (Up to 90-Day Supply)
Generic
$20 copay
Preferred Brand
$60 copay
Non-Preferred Brand
$100 copay
Specialty
30% coinsurance up to $300 maximum payment per prescription (maximum 30 day supply)
Out-of-Network
Deductible (Individual/Family)
$1,650/$3,300
Out-of-Pocket Max (Individual/Family)
$5,000/$10,000
Urgent Care
30% after deductible
Emergency Room
10% after deductible
Retail RX (Up to 30-Day Supply)
Generic
Not Covered
Preferred Brand
Not Covered
Non-Preferred Brand
Not Covered
Specialty
Not Covered
Mail-Order RX (Up to 30-Day Supply)
Generic
Not Covered
Preferred Brand
Not Covered
Non-Preferred Brand
Not Covered
Specialty
Not Covered
Monthly Plan Cost
Employee Only: $240.00
Employee and Spouse: $522.00
Employee and Child(ren): $431.00
Employee and Family: $735.00
Cigna OAP
Benefit Highlights
In-Network
Deductible (Individual/Family)
$250/$750
Out-of-Pocket Max (Individual/Family)
$3,000/$6,000
Primary Care Visit
$20 copay
Specialist Visit
$20 copay
Urgent Care
$50 copay
Emergency Room
$100 copay
Retail RX (Up to 30-Day Supply)
Generic
$10 copay
Preferred Brand
$25 copay
Non-Preferred Brand
$40 copay
Mail-Order RX (Up to 90-Day Supply)
Generic
$20 copay
Preferred Brand
$50 copay
Non-Preferred Brand
$80 copay
Out-of-Network
Deductible (Individual/Family)
$750/$2,250
Out-of-Pocket Max (Individual/Family)
$6,000/$12,000
Primary Care Visit
40% after deductible
Urgent Care
40% after deductible
Emergency Room
$100 copay
Generic
50% coinsurance (deductible waived)
Preferred Brand
50% coinsurance (deductible waived)
Non-Preferred Brand
Specialty
50% coinsurance (deductible waived)
Mail-Order RX (Up to 90-Day Supply)
Generic
Not Covered
Preferred Brand
Not covered
Non-Preferred Brand
Not covered
Specialty
Not covered
Monthly Plan Cost
Employee Only: $287.00
Employee and Spouse: $628.00
Employee and Child(ren): $517.00
Employee and Family: $885.00
Cigna OAPIN
Benefit Highlights
In-Network
Deductible (Individual/Family)
None
Out-of-Pocket Max (Individual/Family)
$1,500/$3,000
Preventive Care
$0 copay
Primary Care Visit
$20 copay
Specialist Visit
$20 copay
Urgent Care
$40 copay
Emergency Room
$100 copay (waived if admitted)
Retail RX (Up to 30-Day Supply)
Generic
$10 copay
Preferred Brand
$25 copay
Non-Preferred Brand
$40 copay
Mail-Order RX (Up to 90-Day Supply)
Generic
$20 copay
Preferred Brand
$50 copay
Non-Preferred Brand
$80 copay
Monthly Plan Cost
Employee Only: $319.00
Employee and Spouse: $698.00
Employee and Child(ren): $573.00
Employee and Family: $982.00
Kaiser HMO (California Employees Only)
Benefit Highlights
In-Network
Deductible (Individual/Family)
None
Out-of-Pocket Max (Individual/Family)
$2,500/$5,000
Primary Care Visit
$20 copay
Specialist Visit
$20 copay
Urgent Care
$20 copay
Emergency Room
$100 copay (waived if admitted)
Retail RX (Up to 30-Day Supply)
Generic
$10 copay
Preferred Brand
$30 copay
Specialty
$30 copay
Mail-Order RX (Up to 100-Day Supply)
Generic
$20 copay
Preferred Brand
$60 copay
Specialty
$60 copay; Availability for mail order varies by item
Monthly Plan Cost
Employee Only
| <30 | $115.80 |
| 30-39 | $128.00 |
| 40-49 | $165.00 |
| 50-54 | $214.80 |
| 55-59 | $271.60 |
| 60-64 | $335.00 |
| 65+ | $379.80 |
Employee and Spouse
| <30 | $323.60 |
| 30-39 | $347.80 |
| 40-49 | $379.80 |
| 50-54 | $446.60 |
| 55-59 | $570.20 |
| 60-64 | $636.20 |
| 65+ | $820.80 |
Employee and Child(ren)
| <30 | $318.20 |
| 30-39 | $327.20 |
| 40-49 | $313.60 |
| 50-54 | $354.20 |
| 55-59 | $406.00 |
| 60-64 | $448.00 |
| 65+ | $571.00 |
Employee and Family
| <30 | $450.20 |
| 30-39 | $497.80 |
| 40-49 | $501.20 |
| 50-54 | $570.80 |
| 55-59 | $655.80 |
| 60-64 | $742.60 |
| 65+ | $902.40 |
Retail RX (Up to 30-Day Supply)