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Cigna Medical Plans

MainVue Homes offers two medical insurance plan options through Cigna. Please take the time to understand the features and differences of each plan so that you choose the coverage that is best for you and your family. Each medical plan includes in- and out-of-network benefits, which means you can choose any provider that you would like. However, you will pay less out of your pocket when you choose an in-network provider. Locate a network provider at www.MyCigna.com.

The table below summarizes the key in-network features of the medical plans. The coinsurance amounts listed reflect the amount you pay for services. Please refer to the official plan documents for additional information on coverage, out-of-network coverage and exclusions.

CIGNA HEALTHCARE HSA $1600 PPO $1000
Deductable
(Individual/Family)		 $1,650 / $3,300
(see note regarding family deductable)		 $1,000 / $2,000
Out-of-pocket Maximum
(Individual / Family)		 $4,000 /$8,000 $4,500 /$9,000
Preventive Care Covered in Full Covered in Full
Physician Services
Primary and Specialist		 20% Coinsurance $25 Copay*
Virtual Care
Primary and Urgent Care		 20% Coinsurance $15 Copay*
Emergency Room 20% Coinsurance 20% Coinsurance
Urgent Care 20% Coinsurance $25 Copay*
Lab/X-Ray 20% Coinsurance Basic: 20% Coinsurance*
Complex: 20% Coinsurance
Mental Health 20% Coinsurance
Inpatient Hospital 20% Coinsurance 20% Coinsurance
Outpatient Hospital 20% Coinsurance 20% Coinsurance
Outpatient Rehabilitation
(20 visits per year**)		 20% Coinsurance $25 Copay*
Spinal Manipulation 20% Coinsurance 20% Coinsurance

Pharmacy Coverage

This plan requires the use of appropriate generic drugs. When available, a generic drug will be dispensed in place of a brand name drug. If a generic equivalent isn’t manufactured, the applicable brand name copay or coinsurance will apply. You or the prescriber may request a brand name drug instead of a generic, but if a generic equivalent is available, you’ll be required to pay the difference in price between the brand name drug and the generic equivalent, in addition to paying the applicable brand name drug copay or coinsurance.

Unless your doctor requires the use of a brand name drug, your prescription may automatically be filled with a generic equivalent (when available). If you request a brand name drug when a generic equivalent is available, you may be required to pay the difference in cost.

  • Notice regarding Medicare Part D: Our medical plans offer what is called “creditable coverage,” which means a Medicare-eligible person will not have to buy a Medicare Part D supplement for prescription drugs and will not be subject to the 1% per month late enrollment charge assessed by Medicare for purchasing Part D at a later date. If you have questions about your options, please contact Human Resources.
  • There is no coverage for prescriptions from a pharmacy not in the network.
CIGNA HSA $1,650 PPO $1,000
Retail(30-day supply) | Mail Order(90-day supply) Retail(30-day supply) | Mail Order(90-day supply)
Deductable Subject to Medical Deductible No Deductable
Generics 20% Coinsurance $10 Copay | $30 Copay
Preferred Brand 20% Coinsurance $25 Copay | $75 Copay
Non-Preferred Brand 20% Coinsurance $45 Copay | $135 Copay