Medical

Keep yourself and your loved ones healthy with our medical plans and wellness offerings.

You have three medical plan options to choose from. All three options offer the same comprehensive medical and prescription drug coverage. The difference is in how you pay for care.

Compare Your Medical Plans.     

View the guide     See the chart

 

Deductible

In CDHP 20, the entire family deductible must be satisfied — either by one covered family member or by any combination of covered family members — before any family member moves to coinsurance. 

In CDHP 30, if you cover any family members, each covered member will have an in-network deductible of $6,850. When an individual reaches this deductible, that individual will start paying coinsurance when receiving care from an in-network provider. When the family deductible is satisfied — either by one covered family member or by any combination of covered family members — all family members will start paying coinsurance. 

Out-of-pocket Maximum

The out-of-pocket maximum is a limit on how much you will pay toward the cost of covered, in-network care during the plan year. If you reach this limit, the plan pays all of the costs of covered, in-network care for the rest of the plan year.

In CDHP 20 and CDHP 30, if you cover any family members, each covered member of the family will have their own, individual out-of-pocket maximum. This “embedded” maximum amount is lower than the total family out-of-pocket maximum.

Once a covered family member hits their individual limit, the plan will pay 100% of that person’s covered, in-network expenses for the rest of the plan year.

Once any combination of family members reaches the total family out-of-pocket maximum, the plan will pay 100% of covered, in-network expenses for all covered family members.

 

Note: To the extent summary information in People Link conflicts with the terms of the underlying legal plan documents, the terms of the legal plan documents shall prevail.

 

 

PPO

CDHP 20

CDHP 30

In-Network

Out-of-Network

In-Network

Out-of-Network

In-Network

Out-of-Network

Annual plan deductible (individual/family)

$800/
$2,400

$1,600/
$4,800

$1,500/
$3,000

$3,000/
$6,000

$3,500/
$7,000*

$7,000/
$14,000

Annual out-of-pocket maximum

 

      Individual

$3,300

$6,600

$4,500

$9,000

$6,500

$13,000

      Individual     in a family

$3,300

$6,600

$6,850

$18,000

$6,850

$26,000

      Family

$9,900

$19,800

$9,000

$18,000

$13,000

$26,000

Coinsurance
(you pay)

20% after deductible

40% after deductible

20% after deductible

40% after deductible

30% after deductible

50% after deductible

Preventive care

$0

No coverage

$0

No coverage

$0

No coverage

Primary care physician

$30 copay

40% after deductible

20% after deductible

40% after deductible

30% after deductible

50% after deductible

MDLIVE telemedicine visits
 

Amwell telemedicine visits

$30 copay

 

$30 copay

$45 per visit before deductible; 20% after deductible

$49 per visit before deductible; 20% after deductible

$45 per visit before deductible; 30% after deductible

$49 per visit before deductible; 30% after deductible

Specialty care physician

$45 copay

40% after deductible

20% after deductible

40% after deductible

30% after deductible

50% after deductible

Urgent care

$50 copay

20% after deductible

30% after deductible

Emergency care

$200 copay

20% after deductible

30% after deductible

 

* In CDHP 30, each covered family member will have an individual, in-network deductible of $6,850. When an individual reaches this deductible, that individual will start paying coinsurance. When the family deductible is satisfied, all family members will start paying coinsurance.

Prescription drug coverage is included with the medical plan you choose.

You can use your coverage to purchase your prescriptions at local participating pharmacies and you can purchase certain medications through the mail-order service.

Compare Your Medical Plans.

View the guide     See the chart

 

Coverage Levels

Your Equifax medical plan covers your prescription medications at three levels. The amount you pay will depend on the type of medication your doctor selects.

$ Generic medications will cost you less. These drugs have the same active ingredients, safety, quality, and strength as their brand-name counterparts.

$$ Preferred brand-name medications will cost you more. These are drugs for which generic equivalents are not available. While they typically cost more than generics, they usually cost less than non-preferred brand-name drugs.

$$$ Non-preferred brand-name medications will cost you the most. Generally, these are drugs that have generic alternatives and/or one or more preferred brand-name options within the same drug class.

If a physician prescribes you a non-preferred brand-name prescription when a generic option is available:

  • You must pay the difference in cost.
  • The difference you pay will not count toward your deductible, if you are in the PPO.
  • This difference you pay will not count toward your out-of-pocket maximum.

Step Therapy (ST)

On the drug list, certain high-cost brand-name medications have an ST next to them. ST stands for Step Therapy.

Step Therapy medications aren’t covered by your plan unless your doctor requests and receives approval from Cigna.

The Step Therapy program encourages the use of lower-cost, clinically appropriate medications to treat your condition. These are typically generics or preferred brands. You have to try these medications first before your plan covers more expensive brand-name medications.

For more information, read the Step Therapy Flyer.

 

PPO

CDHP 20

CDHP 30

In-Network

Out-of-Network

In-Network

Out-of-Network

In-Network

Out-of-Network

30-day prescription drug cost (retail)

Generic

$10 copay

No coverage

20% after deductible

No coverage

30% after deductible

No coverage

Preferred brand-name

30% up to $30 maximum

No coverage

Non-preferred brand-name

50% up to $70 maximum

No coverage

90-day prescription drug cost (mail-order or retail)

Generic

$25 copay

No coverage

20% after deductible

No coverage

30% after deductible

No coverage

Preferred brand-name

30% up to $75 maximum

No coverage

Non-preferred brand-name

50% up to $175 maximum

No coverage

Note: To the extent summary information on this site conflicts with the terms of the underlying legal plan documents, the terms of the legal plan documents shall prevail.

Contact Information

laptop

Log in to your personal online Cigna account to learn more.

phone

Call 800-244-6224 to speak with a Cigna representative.

paper

View the 2019 Cigna Value Prescription Drug List for a full list of covered generic and brand-name medications.