Page 6 - 2021 Marcolin Benefit Guide

Your Health

Care Coverage

Your health care coverage includes medical, dental and
vision plans. Detailed information about each plan is in
this section. If you have questions, please contact
Human Resources.

YOUR MEDICAL PLAN
You have two medical plan options:

• Cigna HSA Plan with employer funding OUT-OF-POCKET MAXIMUMS
• Cigna PPO plan Out-of-pocket maximums apply to all the plans. This is

IN/OUT-OF-NETWORK COVERAGE the maximum amount you will pay for health care costs
during a plan year. Once you have reached the out-of-
The CIGNA medical plans feature in- and out-of-network pocket maximum, the plan will fully cover eligible
coverage; individual and family deductibles; copays; medical expenses for the rest of the benefits plan year.
coinsurance; and out-of-pocket maximums. The HSA If you see an out of network provider, you may be
plan offers a lower monthly cost, a higher deductible and responsible for out-of-pocket costs that are considered
lower coinsurance amounts, while the PPO plan cost
more each month but offers a lower deductible and above the “reasonable and customary” fees.

higher levels of coinsurance. If you don’t understand
some of these terms, please refer to the Glossary on You decide which medical plan will work best for you
page 16. and your family based on the monthly cost of coverage,

You may use in- or out-of-network providers if you are the annual deductible, and the out-of-pocket
maximum.
enrolled in both CIGNA options. You will always pay less
if you see a doctor or receive services within the How to Find an In-Network Provider
provider network because the plan pays more for “in-
network services.” Go to www.cigna.com and select “Find a Doctor”
(located at the top of the screen). Click “Employer or
DEDUCTIBLE School”. Fill in the information needed and then choose
You must meet an annual deductible before the medical Open Access Plus (OAP) as the network – without carelink.
plan begins to cover a portion of your costs. Once the
deductible is met, the medical plan begins to pay for a
percentage of covered expenses (this is called
coinsurance). Note: All services apply to the deductible
on the HSA plan but not on the PPO (copays apply for
doctor visits, emergency room, urgent care and
prescriptions on the PPO plan option).

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