Page 7 - Fontbonne New Hire
P. 7
Fontbonne University
Wellness Program Wellness Resources
Employees have the opportunity to complete various wellness-related Cigna provides numerous online
tasks and receive a reduction in their medical premiums each year. resources to encourage, support, and
assist you in identifying and reaching
In order to be eligible for the program, employees must complete an your personal health goals. These
annual biometric screening. The biometric screening allows you to keep resources are available at no cost to
track of all your important health information such as blood pressure, you!
BMI, cholesterol levels, etc. Wellness program participants must also
complete the online health assessment, found at myCigna.com. Both the
biometric screening and the health risk assessment are required once a
year (in January) to be eligible for the wellness premium.
For more information on Fontbonne’s wellness program, visit
myCigna.com or contact Human Resources.
Medical Contributions—Monthly
Premium Plan HSA Plan
Wellness Non-Wellness Wellness Non-Wellness
Employee only $160 $187 $49 $82
Employee + spouse $854 $890 $462 $504
Employee + child(ren) $764 $791 $421 $451
Family $973 $1,007 $544 $590
Medical Benefits
Premium Plan HSA Plan
Cigna Open Access Plus
In-Network Out-of-Network In-Network Out-of-Network
Deductible
Individual $750 $1,500 $1,500 $3,000
Family $1,500 $3,000 $3,000 $6,000
Coinsurance 10% 30% 10% 30%
Out-of-Pocket Maximum
Individual $2,500* $7,500 $3,500 $5,900
Family $5,000* $15,000 $7,000* $11,800
Ofice visit copay $20** 30% after deductible 10% after deductible** 30% after deductible
Specialist copay $20 30% after deductible 10% after deductible 30% after deductible
Urgent care copay $50 $50 10% after deductible 30% after deductible
ER copay $150 $150 10% after deductible 10% after deductible
Inpatient/outpatient services 10% after deductible 30% after deductible 10% after deductible 30% after deductible
* Embedded structure (see page 7 for more information on embedded versus non-embedded plan designs)
** Routine preventive services covered at 100%
Please refer to the Summary Plan Description for detailed information on covered beneits
7
Wellness Program Wellness Resources
Employees have the opportunity to complete various wellness-related Cigna provides numerous online
tasks and receive a reduction in their medical premiums each year. resources to encourage, support, and
assist you in identifying and reaching
In order to be eligible for the program, employees must complete an your personal health goals. These
annual biometric screening. The biometric screening allows you to keep resources are available at no cost to
track of all your important health information such as blood pressure, you!
BMI, cholesterol levels, etc. Wellness program participants must also
complete the online health assessment, found at myCigna.com. Both the
biometric screening and the health risk assessment are required once a
year (in January) to be eligible for the wellness premium.
For more information on Fontbonne’s wellness program, visit
myCigna.com or contact Human Resources.
Medical Contributions—Monthly
Premium Plan HSA Plan
Wellness Non-Wellness Wellness Non-Wellness
Employee only $160 $187 $49 $82
Employee + spouse $854 $890 $462 $504
Employee + child(ren) $764 $791 $421 $451
Family $973 $1,007 $544 $590
Medical Benefits
Premium Plan HSA Plan
Cigna Open Access Plus
In-Network Out-of-Network In-Network Out-of-Network
Deductible
Individual $750 $1,500 $1,500 $3,000
Family $1,500 $3,000 $3,000 $6,000
Coinsurance 10% 30% 10% 30%
Out-of-Pocket Maximum
Individual $2,500* $7,500 $3,500 $5,900
Family $5,000* $15,000 $7,000* $11,800
Ofice visit copay $20** 30% after deductible 10% after deductible** 30% after deductible
Specialist copay $20 30% after deductible 10% after deductible 30% after deductible
Urgent care copay $50 $50 10% after deductible 30% after deductible
ER copay $150 $150 10% after deductible 10% after deductible
Inpatient/outpatient services 10% after deductible 30% after deductible 10% after deductible 30% after deductible
* Embedded structure (see page 7 for more information on embedded versus non-embedded plan designs)
** Routine preventive services covered at 100%
Please refer to the Summary Plan Description for detailed information on covered beneits
7
