Page 5 - 2015 New Hire Guide
P. 5
Fontbonne University
Medical
Coverage, choice, cost and convenience are factors each of us
considers important in selecting a medical plan. You may choose from
two different medical plans—whichever one best meets your needs—
or you may choose to waive coverage. While the available plans both
cover the same types of medical services, each provides coverage at a
different level (copay or deductible and coinsurance) and requires you
to contribute a different amount per pay period toward the premium.
Please refer to the Medical Plan Summary pages of this Guidebook for
speciic information about your plan options.
Plan Overviews and Options
In-Network Benefits
When you obtain services “in the network”, Cigna pays for eligible
expenses. Cigna reimburses both your Primary Care Physician and
participating Specialists at the allowances identiied in your plan
summaries on a fee-for-service basis. You receive the highest level of
beneits when using in-network services and you do not have to ile
claims (however, you are responsible for all copays, deductibles, and
coinsurance).
Out-of-Network Benefits
When you obtain services “out of the network” for the PPO plan,
Cigna does pay for eligible services. However, you will be responsible
for paying a greater share of the cost when you obtain out-of-network
services. Non-network providers are reimbursed up to the applicable
allowance. A higher annual deductible and a coinsurance payment
applies to all eligible medical and most supplemental services.
On both the premium and HSA plans, once you reach your out-of-
pocket maximum, the plan pays 100% of the appropriate allowance for
eligible services for the rest of the year.
NOTE—Deductions for medical premiums are taken on a
pre-tax basis .
5
Medical
Coverage, choice, cost and convenience are factors each of us
considers important in selecting a medical plan. You may choose from
two different medical plans—whichever one best meets your needs—
or you may choose to waive coverage. While the available plans both
cover the same types of medical services, each provides coverage at a
different level (copay or deductible and coinsurance) and requires you
to contribute a different amount per pay period toward the premium.
Please refer to the Medical Plan Summary pages of this Guidebook for
speciic information about your plan options.
Plan Overviews and Options
In-Network Benefits
When you obtain services “in the network”, Cigna pays for eligible
expenses. Cigna reimburses both your Primary Care Physician and
participating Specialists at the allowances identiied in your plan
summaries on a fee-for-service basis. You receive the highest level of
beneits when using in-network services and you do not have to ile
claims (however, you are responsible for all copays, deductibles, and
coinsurance).
Out-of-Network Benefits
When you obtain services “out of the network” for the PPO plan,
Cigna does pay for eligible services. However, you will be responsible
for paying a greater share of the cost when you obtain out-of-network
services. Non-network providers are reimbursed up to the applicable
allowance. A higher annual deductible and a coinsurance payment
applies to all eligible medical and most supplemental services.
On both the premium and HSA plans, once you reach your out-of-
pocket maximum, the plan pays 100% of the appropriate allowance for
eligible services for the rest of the year.
NOTE—Deductions for medical premiums are taken on a
pre-tax basis .
5
