Page 10 - Your New Medical Plans with Centivo
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OPTIONS           2     3    MBA HSA High and MBA HSA Low                                                                  OPTIONS           2     3     MBA HSA High and MBA HSA Low







               MBA HSA High and Low Plan Options

                                                                                                                                          Getting started with                                         P.O. Box 755
                                                                                                                                                                                                       Buffalo, NY 14225
                                                                                                                                                                                                       Forwarding Service Requested  Your Health Plan
               The MBA HSA High Plan and MBA HSA Low Plan are similar to                                                                  the MBA HSA High and                                         Penelope Jacobs   Identification Card
                                                                                                                                                                                                                         is here.
                                                                                                                                                                                                       120 Old Orchard Road
                                                                                                                                                                                                       Anytown, US 01234
               the HDHP/HSA plan options offered in previous years. These                                                                 Low Plans
               plans are administered by Centivo and use the Cigna national                                                               You’ll get an ID card mailer at the                          December 15, 2020
                                                                                                                                                                                                       Dear Penelope,
                                                                                                                                                                                                       Welcome to your health plan, administered by Centivo. Here is your member ID card.
                                                                                                                                                                                                       You can start using your card on January 1, 2021. Have questions about your benefits?
                                                                                                                                                                                                       Call the Conceirge Team at 844-599-0604.
               provider network.                                                                                                          beginning of the plan year with key                          Sincerely,
                                                                                                                                                                                                       The Centivo Team
                                                                                                                                          details on how to use your plan,                How to access more information
                                                                                                                                          such as how to access the Centivo               about your benefits
                                                                                                                                                                                                                  ID card placed here
                                                                                                                                          app and member portal, where to                        Centivo App and Member Portal:
                                                                                                                                                                                                 Text “DOWNLOAD” to 65021 or visit my.centivo.com
                                                                                                                                          view your prescription benefits,                       You can access the Centivo app and member portal 24 hours a day. Download the
                                                                                                                                                                                                 Centivo app by texting “DOWNLOAD” to 65021 or visiting your app store. Or go to
                                                                                                                                                                                                 my.centivo.com*. Here you can access your plan details, view cost information and
               The MBA HSA High Plan offers higher                                                                                        and key contact information.                           Explanation of Benefits statements (EOBs) for any healthcare you receive, view or print
                                                                                                                                                                                                 your electronic ID card, send a message to the Centivo Concierge Team, and more.
                                                                                                                                                                                                 You will need to create an account the first time you visit the site using your Centivo
                                                                                                                                                                                                 member ID, which can be found on the front of your Centivo member ID card.
               coverage for any care you receive as
                                                                                                                                                                                                 Finding a network provider:
               compared to the Low Plan, with a smaller                                                                                                                                          Visit mycigna.com
                                                                                                                                                                                                 Your plan utilizes the Cigna PPO provider network. Visit mycigna.com and create an
                                                                                                                                                                                                 account using your Centivo member ID to search for an in-network provider. Or if
               annual deductible and 20% coinsurance                                                                                                                                             you’re logged into the Centivo app or member portal, follow the link to mycigna.com
                                                                                                                                                                                                 from the “Home” and “Find Care” pages.
               (your share of the costs for any care                                                                                                                                             Centivo Concierge Team:
                                                                                                                                                                                                 844-599-0604
                                                                                                                                                                                                 Call the Centivo Concierge Team with any questions throughout the year, available
               received) - in exchange for a higher                                                                                                                                              Monday through Friday from 8 am to 8 pm Eastern Time at 844-599-0604.
               payroll deduction.                                                                                                                                                                Pharmacy Information:
                                                                                                                                                                                                 You can view a list of participating pharmacies, as well as the list of covered
                                                                                                                                                                                                 medications under your pharmacy plan, by visiting the [provider] member portal at
                                                                                                                                                                                                 [members.provider.com]. You will need to create an account the first time you visit the
                                                                                                                                                                                                 site using your Centivo member ID, which can be found on the front of your Centivo
               Conversely, the MBA HSA Low Plan                                                                                                                                                  member ID card.
               offers lower coverage for any care you                        Both plans allow you to use                                                                                   © 2020 Centivo.  * You can access my.centivo.com using the following browsers: Apple Safari, Firefox, Google Chrome, or Microsoft Edge.
                                                                                                                                                                                                 Internet Explorer is not a supported browser.
               receive, with a bigger annual deductible                      out-of-network providers –
               and 30% coinsurance - in exchange for                         but out-of-network care will
               a lower payroll deduction.                                    cost you more out-of-pocket.
                                                                                                                                          The MBA HSA High and
                                                                                                                                          Low Plan Network

                                                                                                                                          Both plans use the Cigna PPO
                                                                                                                                          network, which offers access
                                                                                                                                          to healthcare providers across
               The MBA HSA High Plan and MBA HSA Low Plans are                                                                            the US. You can view the
               HSA-qualified, meaning you are allowed to make tax-free                                                                    Cigna provider network at
               contributions into a health savings account (HSA) to help                                                                  https://hcpdirectory.cigna.com/
               pay for your current and future medical expenses.
                                                                                                                                          (when asked to login/register,
               If you enroll in either of these plan options,                                                                             choose “Continue as guest”, and
               MB Aerospace will contribute money into your HSA:                                                                          when asked to select a plan,
               $500 for employee-only coverage, $750 for employee                                                                         choose “PPO”).
               + 1 coverage, or $1,000 for family coverage.
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