Medical Plan Highlights and Changes Open Access Plus In-Network
Open Access Plus
(OAPIN)
(OAP)
Single
Deductible
The most you’ll pay next year out-of-pocket
Copays apply Copays apply
$5,000
$6,000
HRA contribution from employer Inpatient Hosp Outpatient Fac INN: In-Network OON: Out of Network
Family
n/a $200/day –max 4
15%
$200
15%
$10,000 $12,000
n/a
Single $500 INN/ $1,000 OON
Family $1,500 INN/ $3,000 OON
$10,000 $5,000 $5775 $11,550 INN/ INN/
CIGNA Choice Fund® with Health Reimbursement Arrangement (HRA)*
Single
Emp + Spouse
Family
$1,000 INN/ $3,000 OON
Emp + Child $2,000 INN/ $4,000 OON
$3,000 INN/ $6,000 OON
$3,000 INN/
$6,000 INN/
$9,000 INN/
$6,000
$12,000
$18,000
$10,000
$20,000
$11,550
$23,100
OON
OON
OON
OON
OON
n/a
n/a
$500
$1,000
$1,500
CYD 15% INN
CYD 15% INN CYD 15% INN CYD 15% INN CYD 15% INN
CYD 30% OON CYD 30% OON CYD: Calendar Year Deductible CCN: CIGNA Care Network
CYD 30% OON
CYD 30% OON
PCP: Primary Care Physician
No changes to Prescription Copays. Remember, you also have access to Convenience Clinics, for a PCP copay, located at many drug stores and pharmacies. Please refer to your Benefit Certificate booklet for a comprehensive view of your plan benefits.
CYD 30% OON