Page 6 - Fontbonne New Hire
P. 6
In-Network vs. Out- Medical
of-Network Coverage As an employee of Fontbonne, you have the option of choosing between
In-Network Benefits two plans—the Premium Plan and the HSA Plan. While both plans cover
When you obtain services “in the the same types of medical services, each provides coverage at a different
network,” you cost-share with Cigna level (copay or deductible and coinsurance) and requires you to contribute
to pay for eligible expenses; Cigna a different amount per pay period toward the premium. You are
reimburses both your primary care encouraged to weigh these considerations when choosing the plan which
physician and participating specialists best meets your needs. Please refer to the medical plan summary pages of
at the allowances identiied in your
plan summaries on a fee-for-service this guidebook for speciic information about your plan options.
basis. In-network treatment is
encouraged whenever possible to take Features of Both Plans
advantage of the deepest discounts X Access to the Cigna network (medical and pharmacy)
and highest beneit levels.
X Coverage for routine preventive care at 100%
Out-of-Network Benefits
When you obtain services “out-of-the- Premium Plan—Traditional PPO Plan Features
network,” Cigna still shares the cost X Higher per-paycheck premiums with lower deductibles and out-of-
for eligible services, but you as the pocket maximums
member will be responsible for paying
a greater share of the cost. Non- X Flat dollar copays for prescription drugs
network providers are only reimbursed X Flat dollar copays for doctor’s ofice visits
up to the applicable allowance. Also
note a higher annual deductible X Eligible to participate in the lexible spending account (FSA)
and a higher coinsurance payment
applies to all eligible medical and most HSA Plan—QHDHP Features
supplemental services out-of-network.
X Lower per-paycheck premiums with higher deductibles and out-of-
On both the premium and HSA plans, pocket maximums, which allow you to pay for care when you need it
once you reach your out-of-pocket X
maximum, the plan pays 100% of Flat dollar copays for prescription drugs after the deductible has been
the appropriate allowance for eligible met
services for the rest of the year. X Certain preventive medications are covered at 100%—no cost to you
Note—deductions for X Eligible to participate in the health savings account (HSA)
medical premiums are
taken on a pre-tax basis.
6 2018 New Hire Enrollment
of-Network Coverage As an employee of Fontbonne, you have the option of choosing between
In-Network Benefits two plans—the Premium Plan and the HSA Plan. While both plans cover
When you obtain services “in the the same types of medical services, each provides coverage at a different
network,” you cost-share with Cigna level (copay or deductible and coinsurance) and requires you to contribute
to pay for eligible expenses; Cigna a different amount per pay period toward the premium. You are
reimburses both your primary care encouraged to weigh these considerations when choosing the plan which
physician and participating specialists best meets your needs. Please refer to the medical plan summary pages of
at the allowances identiied in your
plan summaries on a fee-for-service this guidebook for speciic information about your plan options.
basis. In-network treatment is
encouraged whenever possible to take Features of Both Plans
advantage of the deepest discounts X Access to the Cigna network (medical and pharmacy)
and highest beneit levels.
X Coverage for routine preventive care at 100%
Out-of-Network Benefits
When you obtain services “out-of-the- Premium Plan—Traditional PPO Plan Features
network,” Cigna still shares the cost X Higher per-paycheck premiums with lower deductibles and out-of-
for eligible services, but you as the pocket maximums
member will be responsible for paying
a greater share of the cost. Non- X Flat dollar copays for prescription drugs
network providers are only reimbursed X Flat dollar copays for doctor’s ofice visits
up to the applicable allowance. Also
note a higher annual deductible X Eligible to participate in the lexible spending account (FSA)
and a higher coinsurance payment
applies to all eligible medical and most HSA Plan—QHDHP Features
supplemental services out-of-network.
X Lower per-paycheck premiums with higher deductibles and out-of-
On both the premium and HSA plans, pocket maximums, which allow you to pay for care when you need it
once you reach your out-of-pocket X
maximum, the plan pays 100% of Flat dollar copays for prescription drugs after the deductible has been
the appropriate allowance for eligible met
services for the rest of the year. X Certain preventive medications are covered at 100%—no cost to you
Note—deductions for X Eligible to participate in the health savings account (HSA)
medical premiums are
taken on a pre-tax basis.
6 2018 New Hire Enrollment
