The Company offers three medical plan options through Cigna so you can choose the plan that best meets your and your family’s needs.
Your 3 Medical Plans
AMSURG offers three medical plans through Cigna:
• PPO Plan
• HSA Primary Plan
• HSA Base Plan
PPO Plan
The PPO plan offers lower deductibles and lower potential out-of-pocket costs in exchange for higher payroll deductions. You’ll pay set copays for certain services, such as office visits, prescription drugs and urgent care, which can make your healthcare costs more predictable.
HSA Primary and HSA Base Plans
The HSA Primary and HSA Base plans are high-deductible health plans (HDHPs). They offer lower payroll deductions, but higher deductibles and potential out-of-pocket costs when you receive care beyond preventive services.
These plans are eligible for a Health Savings Account (HSA), which includes a company match when you contribute. Unlike the PPO, the HSA plans do not have copays. You generally pay the full negotiated cost of covered services until you meet the deductible, after which the plan pays a percentage of covered expenses.
Connect to Your Benefits Tip:
To get the most from an HSA plan, consider establishing and contributing to your HSA. Contributions can help you pay for eligible healthcare expenses today, while unused funds can remain in the account and grow for future healthcare needs.
| Cigna PPO | HSA Primary | HSA Base | |
| In-Network | |||
| Deductible | $2,700 individual $5,400 family | $4,200 individual $8,400 family | $5,700 individual $11,400 family |
| Out-of-Pocket Maximum1 | $6,400 individual $12,800 family | $6,400 individual $12,800 family | $7,250 individual $14,500 family |
| HSA Contribution2 | N/A | $750 individual $1,000 family | $550 individual $750 family |
| Coinsurance | 80% | 80% | 80% |
| Preventive Care | $0 | $0 | $0 |
| PCP/Specialist visit & Urgent Care | $30/$60 | 80% after deductible | 80% after deductible |
| Emergency Room | 80% after deductible | 80% after deductible | 80% after deductible |
1 Deductibles, coinsurance and copays (where applicable) accumulate toward the medical out-of-pocket maximum.
2 The Company HSA contribution is available to all teammates who contribute to the plan.
| Cigna PPO | HSA Primary | HSA Base | |
| Deductible | In-Network: $2,500 individual $5,000 family Out-of-Network: $5,000 individual $10,000 family (embedded) | In-Network: $4,000 individual $8,000 family Out-of-Network: $8,000 individual $16,000 family (embedded) | In-Network: $5,500 individual $11,000 family Out-of-Network: $10,000 individual $20,000 family (embedded) |
| Coinsurance (Plan Pays) | In-Network: 80% Out-of-Network: 50% | In-Network: 80% Out-of-Network: 50% | In-Network: 80% Out-of-Network: 50% |
| Out-of-Pocket Maximum1 | In-Network: $6,000 individual $12,000 family Out-of-Network: $15,000 individual $30,000 family | In-Network: $6,000 individual $12,000 family Out-of-Network: $15,000 individual $30,000 family | In-Network: $6,850 individual $13,700 family Out-of-Network: $20,550 individual $41,100 family |
| HSA Contribution2 | N/A | $750 individual $1,000 family | $500 individual $750 family |
| Office Visit (PCP/Specialist) | In-Network: $30 PCP / $60 SPC (deductible waived) Out-of-Network: 50% | In-Network: 80% Out-of-Network: 50% | In-Network: 80% Out-of-Network: 50% |
| Telemedicine: MDLIVE | In-Network: $30 copay | In-Network: 80% | In-Network: 80% |
| Inpatient Hospital | In-Network: 80% Out-of-Network: 50% | In-Network: 80% Out-of-Network: 50% | In-Network: 80% Out-of-Network: 50% |
| Outpatient Surgery | In-Network: 100% Out-of-Network: 50% | In-Network: 100% Out-of-Network: 50% | In-Network: 100% Out-of-Network: 50% |
| Emergency Room | In-Network: 80% Out-of-Network: 50% | In-Network: 80% Out-of-Network: 50% | In-Network: 80% Out-of-Network: 50% |
| Urgent Care | In-Network: $60 copay (deductible waived) Out-of-Network: 50% | In-Network: 80% Out-of-Network: 50% | In-Network: 80% Out-of-Network: 50% |
| Mental Health/Substance Abuse Inpatient | In-Network: 80% Out-of-Network: 50% | In-Network: 80% Out-of-Network: 50% | In-Network: 80% Out-of-Network: 50% |
| Mental Health/Substance Abuse Outpatient | In-Network: $30 copay (deductible waived) Out-of-Network: 50% | In-Network: 80% Out-of-Network: 50% | In-Network: 80% Out-of-Network: 50% |
1 Deductibles, coinsurance and copays (where applicable) accumulate toward the medical out-of-pocket maximum.
2 The Company HSA contribution is available to all teammates who contribute to the plan.
Summaries of Benefits and Coverage
In accordance with the Patient Protection and Affordable Care Act, the Company and your insurance carrier have created a Summary of Benefits and Coverage (SBC), which provides additional information about your Company medical/prescription drug plan. You can find the SBC for each of the Company’s plans by viewing our Documents page.
If you would like paper copies, please contact the Benefits Center at 1-888-305-7027.
Company-Paid Critical Illness Coverage to Supplement HSA Medical Plan Coverage
If you are in salary band I (less than $100K) and enroll in an HSA medical plan, you will receive $3,000 of company-paid critical illness coverage from MetLife at no cost. This coverage is separate from your medical coverage and gives you a lump-sum payment for a covered serious illness that is yours to spend any way you choose. Company-paid coverage will be at the Teammate-Only level. You can purchase additional coverage for yourself and other family members.
Key Features
- Your out-of-pocket costs will be lower if you receive care from in-network providers. This is because the plans pay negotiated rates for in-network care. To locate a network provider in your area, visit myCigna.com or call member services at 1-800-244-6224. Note: myCigna.com is the website for teammates to use once they are active in Cigna’s system and then can register for an account. Newly eligible teammates that want to find a provider before they enroll should visit: https://hcpdirectory.cigna.com/web/public/consumer/directory. They can also call Cigna OneGuide’s pre-enrollment line at 1-888-806-5042.
- Eligible in-network preventive care is covered at 100%.
- In- and out-of-network deductibles and out-of-pocket limits do not cross-apply. If you choose in-network and out-of-network services, the deductibles and out-of-pocket amounts must be met separately to satisfy the out-of-pocket maximums.
- Any deductibles, coinsurance or copays accumulate toward the out-of-pocket maximum.
- All deductibles are calculated under the embedded model. This means that in a family covered group one covered person can meet the plan’s individual level deductible and move to co-insurance while the rest of the covered participants combined meet the remaining family deductible.
Understanding Medical Plan Deductibles
Embedded Deductibles
With an embedded deductible, there are two deductible amounts within one plan; single and family. The single deductible is embedded in the family deductible, so no one family member can contribute more than the single amount toward the family deductible.
Once the member meets their single deductible, they will start paying coinsurance toward the out-of-pocket maximum. If any combination of enrolled family members meet the family deductible, the entire family will move to coinsurance.
For example, if you have a $4,000/8,000 (single/family) embedded deductible, this is how it would work:
Since the subscriber met his deductible, he was able to move on to his copays/ coinsurance. The spouse will continue to pay toward the deductible until it is met.
Once the deductible is met, you will pay coinsurance when you receive covered services.
Prescription Drugs
When you enroll in medical coverage, you’re automatically covered for prescription drug benefits through Cigna.
Pharmacy benefits are provided by Cigna and are only available if you are enrolled in a Company-sponsored Medical Plan.
Your Cigna medical ID card will include information about your prescription drug benefits and you should present this card at the pharmacy.
Benefits are available for generic, preferred brand-name, non-preferred brand-name and specialty drugs.
Generic drugs are typically your best value. If you choose a multisource brand-name drug when a generic equivalent is available, you will pay the generic copay plus the difference in cost between the generic and brand-name drug.
- The PPO Plan provides benefits before the deductible applies. Your out-of-pocket costs apply toward satisfying the annual out-of-pocket maximum. However, coupons and discounts do not apply.
- The HSA Primary and HSA Base Plans provide benefits for non-preventive drugs after the deductible. Please refer to the chart below for preventive medication benefits where the deductible is waived.
- Your out-of-pocket costs apply toward satisfying the annual out-of-pocket maximum. However, coupons and discounts do not apply.
| Prescription Drug Coverage | |||
| Preventive Prescriptions | 100% Covered | 100% Covered | 100% Covered |
| Generic – Retail | $30 copay | 30% coinsurance after deductible | 30% coinsurance after deductible |
| Preferred Brand – Retail | $60 copay | 30% coinsurance after deductible | 30% coinsurance after deductible |
| Non-Preferred – Retail | $100 copay | 30% coinsurance after deductible | 30% coinsurance after deductible |
| Specialty | $100 copay | 30% coinsurance after deductible | 30% coinsurance after deductible |
| Prescription Drug Coverage | |||
| Preventive Prescriptions | 100% Covered | 100% Covered | 100% Covered |
| Generic – Retail | $20 copay | 20% coinsurance after deductible | 20% coinsurance after deductible |
| Preferred Brand – Retail | $50 copay | 20% coinsurance after deductible | 20% coinsurance after deductible |
| Non-Preferred – Retail | $70 copay | 20% coinsurance after deductible | 20% coinsurance after deductible |
| Specialty | 0% coinsurance (Not subject to deductible but expenses paid by you count toward your plan’s annual out-of-pocket maximum.) | 20% coinsurance after deductible | 20% coinsurance after deductible |
Choose what works best for you: 30-day or 90-day supply
- If you choose to fill your prescription in a 30-day supply, you can use any retail pharmacy in your plan’s network.
- If you choose to fill your prescription in a 90-day supply, you must use a 90-day retail pharmacy in your plan’s network or the Cigna Home Delivery Pharmacy. Visit Cigna.com/Rx90network.
The Plan follows Cigna’s formulary of prescription drugs, which may change without notice. If you have any questions about how this may affect you, please contact Cigna at 1-800-244-6224. The cost you pay for prescription drugs may vary between vendors. For example, your cost for a 90-day supply may cost less when purchasing via the mail order program versus purchasing it at a retail pharmacy.
Prefer to have your medications delivered to your door?
You can use the Cigna mail order program, which allows you to get three months of your medication at two and a half times the applicable copay amount, delivered to your home address. Call customer service at 1-800-244-6224 or visit myCigna.com/choosehomedelivery.
Contact
Cigna does not issue physical ID cards, but you can download a digital card at myCigna.com or request that an ID card be mailed to you by calling Cigna at 1-800-244-6224 and providing Group #3345800.
Not registered on myCigna yet? It’s quick and easy – just scan the QR Code to download the myCigna App and follow the prompts to register.
