Page 1

Medical Insurance City of Sunny Isles Beach is offering two medical plans options to choose from with Cigna. During this time, you have the opportunity to enroll if you have previously declined coverage. You may also add any legal dependent that previously were not insured.

LOW OPTION Plan Coverage Calendar Year Deductible (CYD) Individual / Family Coinsurance Provider Services Primary Office Visit Specialist Office Visit Adult Wellness (Includes Preventive Lab)

HIGH OPTION

In-Network Only

In-Network

Out-of-Network

$1,000 / $2,000

$250 / $500

$1,000 / $2,000

100%

100%

60% / 40%

Open Access $15 $30

Open Access $15 $30

40% After CYD 40% After CYD

$0

$0

40% After CYD

Hospital Services In-Patient Hospital

0% After CYD

$250

40% After CYD + $500

In-Patient Physician Services

0% After CYD

0% After CYD

40% After CYD

Out-Patient Surgery-Hospital

0% After CYD $250

Emergency Room Preventive Services Ambulatory Surgery Center

0% After CYD + $200 40% After CYD + $500 $250

$250

0% After CYD

0% After CYD + $200

40% After CYD

Lab / X- Ray

$0

$0

40% After CYD

Major Diagnostic (MRI, CAT, CT, PET)

$0

$100

40% After CYD

Urgent Care Facility

$30

$30

40% After CYD

Yes $2,000 / $4,000

Yes $1,000 / $2,000

Yes $2,000 / $4,000

Unlimited

Unlimited

Unlimited

No $5 / $25 / $50 / 20% up to $150 2.5 x copay

No $5 / $25 / $50 / 20% up to $150 2.5 x copay

No 50% + In-Network Copay

Annual Out-of-Pocket Maximum Includes Deductible (Yes / No) Individual / Family Lifetime Maximum Prescription Drugs – Included in Max OOP Generic / Brand / Non-Preferred Level 4 Mail Order (90 Day Supply)

For detailed information on medical benefits see certificate of coverage. 15

compare-high-and-low-option-coverage  
compare-high-and-low-option-coverage  
Advertisement