Page 6 - Interior Architects-2022-23-Benefit Guide

Medical and Pharmacy Plan Overview

We offer a variety of medical plan options through Cigna and Kaiser of California. All of the
medical options include coverage for prescription drugs. To select the plan that best suits
your family, you should consider the key differences between the plans, the cost of coverage
(including payroll deductions), and how the plan covers services throughout the year.

Understanding how your plan works

1. Your deductible 2. Your coverage 3. Your out-of-pocket maximum
You pay out-of-pocket for most Once your deductible is met, you and the When you reach your out-of-pocket
medical and pharmacy expenses, plan share the cost of covered medical maximum, the plan pays 100% of
except those with a copay, until you and pharmacy expenses. The plan covered medical and pharmacy
reach the deductible. will pay a percentage of each eligible expenses for the rest of the calendar
You can pay for these expenses expense, and you will pay the rest. year. Your deductible and coinsurance
using your FSA or HSA. apply toward the out-of-pocket
maximum.

Embedded deductibles and out-of-pocket maximums
΅ The Cigna PPO and HDHP plans include embedded deductible and out-of-pocket maximums. Under an embedded approach,
each person only needs to meet the individual deductible and out-of-pocket maximum before the plan begins paying its share
for that individual. (And, once two or more family members meet the family limits, the plan begins paying its share for all covered
family members.)

Cigna LocalPlus Network Plans
In select zip codes, we offer Cigna LocalPlus medical Is your Doctor in the LocalPlus Network?
plans to give you cost-efficient access to quality doctors, 1. Go to Cigna.com
specialist and hospitals – right where you live. The LocalPlus 2. Click on “Find a Doctor, Dentist or Facility.”
network is smaller than Cigna’s national Open Access Plus 3. Under “How are you Covered?” click on
(OAP) Network. In this plan, you have access to in-network “Employer or School”
benefits only from the health care professionals and facilities
in the LocalPlus Network when in a LocalPlus Network 4. Under “Find a Doctor,” type in your location
service area. In your local area, or when in any LocalPlus and search criteria.
Network area, you must receive care from a health care 5. Login using your myCigna username and
professional or facility in this network to receive in-network password or select “Continue as Guest”
coverage. If you’re away from home and need care, look for 6. From the drop-down list, select “LocalPlus”
a participating LocalPlus doctor in the area or if outside the and then click “Choose.”
LocalPlus service area, you can use doctors or hospitals in 7. Select “LocalPlus” Network
Cigna’s Away From Home Care feature. If you choose to go
outside the LocalPlus Network when one is available – or
outside the Away From Home Care feature when LocalPlus
isn’t available – your care will not be covered by the plan
(except in an emergency).

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