Page 11 - Volcom Benefit Summary 2019 National 1

MEDICAL

HSA PPO Medical Plan

The Health Savings Account (HSA) plan through Cigna combines a high
deductible PPO health plan (HDHP) with a special, tax-qualified savings
account. You may use your HSA funds to pay for current medical expenses
such as deductibles, copays and coinsurance or save toward future medical
expenses. This plan works like the PPO plan by allowing you the freedom
to go in and outside of the network for care. Volcom will contribute $750
to individual and $1,500 to family bank accounts to be used towards the
deductible. You have the opportunity to contribute a combined maximum
of $3,500 for the individual and $7,000 for the family in 2019, and $3,550
for the individual and $7,100 for the family in 2020.

PPO Buy-Up Medical Plan
With the Cigna Preferred Provider Organization (PPO) plan, you are not
limited to the physicians within the PPO network and you may self-refer to
specialists. If you receive care from a physician who is a member of the PPO
network, a greater percentage of the entire cost will be paid by the insurance
plan. You may also obtain services using a non‐network provider; however,
you will be responsible for the difference between the covered amount and
the actual charges and you may be responsible for filing claims.

EDUCATIONAL VIDEOS

Deductibles, Copays, Coinsurance, and
Out-of-Pocket Maximums
http://video.burnhambenefits.com/terms/

High Deductible Health Plans and Health
Savings Accounts
http://video.burnhambenefits.com/hdhp/

FINDING A MEDICAL PROVIDER:
Go to www.cigna.com or call (800) 244-6224.
• HSA PPO: Open Access Plus, OA Plus, Choice
Fund OA Plus plan
• PPO Buy-Up: Open Access Plus, OA Plus, Choice
Fund OA Plus plan

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