Page 6 - TriStar Energy-2023-Benefit Guide-V26(WLP)-LRI

Medical and Pharmacy Plan Overview

We offer the choice of two Consumer Driven Health Plans (CDHP) and a Buy-up PPO Plan through
Cigna. All of the medical options include coverage for prescription drugs through Cigna. To select the
plan that best suits your family, 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 • When you reach your out-of-pocket
medical and pharmacy expenses, the plan share the cost of covered maximum, the plan pays 100% of
except those with a copay, until you medical and pharmacy expenses. covered medical and pharmacy
reach the deductible. The plan will pay a percentage of expenses for the rest of the
• If you are enrolled in the CDHP, each eligible expense, and you will plan year. Your deductible and
you can pay for these expenses from pay the rest. coinsurance apply toward the
your Health Savings Account (HSA). out-of-pocket maximum.

Embedded deductibles and out-of-pocket maximums
With 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.)

Making the most of your plan
Getting the most out of your plan also depends on how well you understand it. Keep these important tips in mind when
you use your plan.
• In-network providers and pharmacies: You will always pay less if you see a provider within the medical and
pharmacy network.
• Preventive care: In-network preventive care is covered at 100% (no cost to you). Preventive care is often received during
an annual physical exam and includes immunizations, lab tests, screenings and other services intended to prevent
illness or detect problems before you notice any symptoms.

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