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mycigna.com

Medical Plan Options Open Access Plus Plan (PPO)

We are pleased to provide comprehensive medical coverage through Cigna. You may choose from three This plan provides both in-network and out-of-network coverage. Some services have co-pays and some apply
plans based on the health care needs of you and your family. coinsurance after members meet their annual deductible.
How the deductible works: If you enroll in employee-only coverage, the individual deductible of $500 applies. If you
If you have access to another health plan or are currently enrolled in one and choose to waive medical enroll with one or more dependents, the family deductible of $1,000 can be met in one of two ways:
coverage with Plymouth Rock, you are eligible to receive a one-time $3,000 bonus after 90 days of • After an eligible family member meets his or her individual deductible, covered medical expenses for that
employment provided you are still waiving coverage at that time. family member will be paid based on the coinsurance level specified by the medical plan

• Or, after the family deductible has been met, covered medical expenses for each eligible family member will be

Features in All Medical Plans paid based on the coinsurance level specified by the plan
• All in-network preventive care is covered at 100% Taking these steps can help save money and lower health care costs
• Not required to designate a primary care physician Receive Care in the Most Appropriate Setting
PHYSICAL WELL-BEING Services included in All Medical Plans Consider these lower-cost settings for minor illnesses and injuries: PHYSICAL WELL-BEING
• No referral needed to see a specialist
Costs can vary greatly depending on the type of care you need and where you receive it. Emergency rooms are high-cost
settings and sometimes those visits are not required.
• Prior authorization is only required for in-patient services
• Preventive eye exam covered once every 24 months
• Doctor’s office
• Urgent Care facility
• Convenience Care Clinic (CVS MinuteClinic, Walgreens Take Care Clinic)
• Virtual Health
• 24/7 Customer Service
• 24/7 Nurse Line
• 24/7 Nurse Line
• Virtual Health through MDLIVE for access to board certified doctors via phone or video chat Visit Lower-Cost Facilities with High-Quality Ratings
• mycigna.com - Register to obtain access to claims, your HSA and additional programs and resources It is less expensive when you use LabCorp or Quest Diagnostics for your lab work. On average, these labs cost 75% less
than doctor’s office labs or hospital labs and they are of equal quality. This is a way to control rising health care costs
• Health Coaching for disease and condition management for you and all employees.
• 8-Week Lifestyle Management Programs for tobacco cessation, stress reduction and weight loss Maximize In-Network Benefits
• Reimbursement for childbirth class Going to an in-network provider or facility gives you the benefit of Cigna’s discounted rate.

• Cigna Healthy Pregnancies, Healthy Babies® Program supports you in managing
your pregnancy and keeping you and your baby healthy Open Access Plus In-Network Plan (EPO)
• Cigna Healthy Rewards® Discount Program for up to 60% off on wellness services
including alternative medicine, massages and weight loss programs
This plan only covers services that are received by in-network providers and facilities. Out-of-network services are not
covered under this plan unless in the case of an emergency. In-network services have co-pays.
Visit mycigna.com to take advantage of these programs

Following these guidelines can help you get the best value for this plan
Make Sure You Stay in the Network of Doctors and Specialists: All providers you see must be in Cigna’s CareLink
network. A referred doctor may not be in the network.
To find a doctor in Cigna’s network, visit cigna.com and select the “Open Access Plus,
OA Plus, Choice Fund OA Plus WITH CareLink” medical plan option. Facilities: If you visit a facility for an outpatient service including lab work, scans or surgery, make sure they participate
in Cigna’s CareLink network.
Labs and Radiologists: If your in-network doctor sends your labs or scans that were performed in their office to a non-
participating location you will be responsible for the full cost. Remind your doctor to make sure they only send these

Campton, NH to other Cigna network providers.
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