Medical Plans
We recognize that you have different needs when it comes to your medical coverage. Each plan provides a different level of affordability and flexibility, allowing you the opportunity to select the one that best fits your lifestyle and provides the protection you need.
We offer you a choice between three comprehensive medical plans:
- Kaiser High HMO
- Cigna OAPIN Plan
- Cigna OAP Plan
Kaiser High HMO Plan
This HMO plan allows you to use Kaiser Permanente facilities and doctors/providers for your medical and pharmacy needs. Services outside the Kaiser network are not covered, except for out-of-area emergency care. When you enroll, Kaiser will automatically assign a personal primary care provider (PCP) to you and your enrolled family members based on your zip code. However, you can change your doctor by contacting Kaiser Member Services.
Cigna OAP Plan
The OAP plan gives you the freedom to seek care from the provider of your choice. However, you will maximize your benefits and reduce your out-of-pocket costs if you choose an in-network provider who participates in the Cigna network. These providers have agreed to charge members reduced fees instead of their typical fees. Plus, in-network providers will submit claims for you, saving you time and the hassle of paperwork.
If you decide to go outside the network, your out-of-pocket costs will be higher and the plan will pay benefits only up to the “allowed amount” for a particular health care service. If your out-of-network provider charges more than the allowed amount, you will be responsible for paying those charges on your own. You generally will have to pay the full cost of the medical services up front and then submit a claim to Cigna to be reimbursed for the covered portion of the charges.
Medical Plan 1
| Medical Benefits | Carrier & Plan Name | |
|---|---|---|
| In-Network | Out-of-Network | |
| Deductible (Individual/Family) | $$$/$$$ | $$$/$$$ |
| Out-of-Pocket Maximum (Individual/Family) | $$$/$$$ | $$$/$$$ |
| Preventive Care | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| PCP Office Visit | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Specialist Office Visit | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Telehealth/Virtual Visit | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Basic Lab & Radiology | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Major Lab & Radiology (MRI/CT/PET) | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Ambulance | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Emergency Room | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Urgent Care | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Inpatient Hospital | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Outpatient Surgery | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Prescriptions (Generic/Brand/Non-Formulary) | ||
| Retail Prescription Drugs | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Mail Order Prescription Drugs | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
Medical Plan 2
| Medical Benefits | Carrier & Plan Name | |
|---|---|---|
| In-Network | Out-of-Network | |
| Deductible (Individual/Family) | $$$/$$$ | $$$/$$$ |
| Out-of-Pocket Maximum (Individual/Family) | $$$/$$$ | $$$/$$$ |
| Preventive Care | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| PCP Office Visit | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Specialist Office Visit | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Telehealth/Virtual Visit | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Basic Lab & Radiology | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Major Lab & Radiology (MRI/CT/PET) | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Ambulance | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Emergency Room | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Urgent Care | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Inpatient Hospital | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Outpatient Surgery | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Prescriptions (Generic/Brand/Non-Formulary) | ||
| Retail Prescription Drugs | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Mail Order Prescription Drugs | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
Medical Plan 3
| Medical Benefits | Carrier & Plan Name | |
|---|---|---|
| In-Network | Out-of-Network | |
| Deductible (Individual/Family) | $$$/$$$ | $$$/$$$ |
| Out-of-Pocket Maximum (Individual/Family) | $$$/$$$ | $$$/$$$ |
| Preventive Care | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| PCP Office Visit | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Specialist Office Visit | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Telehealth/Virtual Visit | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Basic Lab & Radiology | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Major Lab & Radiology (MRI/CT/PET) | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Ambulance | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Emergency Room | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Urgent Care | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Inpatient Hospital | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Outpatient Surgery | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Prescriptions (Generic/Brand/Non-Formulary) | ||
| Retail Prescription Drugs | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |
| Mail Order Prescription Drugs | $$$ copay / % after deductible is met | $$$ copay / % after deductible is met |