Each of the four Cigna medical plans provides comprehensive benefits and a nationwide network of providers. For the highest level of benefits, under the Gold PPO Plan, Silver PPO Plan, and Consumer HDHP with a HSA, use a Tier 1 provider. Tier 1 providers are identified as physicians who have earned top designation in the Cigna network for quality care and outcomes, all while minimizing claims cost. As an incentive to use Tier 1 doctors, your office visit copay will be less than if you use a non-Tier 1 network provider. Please refer to the benefit summaries for more information.
Your premiums for medical coverage are based on the plan selected and the dependents you choose to cover. Please note that there is a premium surcharge if you elect to cover a spouse who has access to coverage elsewhere, including Medicare. See the enrollment site at Ceridian for rate details.
Your premium contributions will be reduced if you successfully participate in the Spark360 Wellbeing Incentive Program and if you are nicotine-free. Please refer to the Spark 360 Wellbeing section of this site for more information about earning points toward your incentive requirement.
Gold PPO Plan
The Gold plan has the richest benefits, and your out-of-pocket expenses will be less than if you are on one of the other medical plans. Please refer to the benefit tables for out-of-network benefit levels.
HOW THE PLAN WORKS
Plan Type: PPO
Network Preventive Care Visit: The plan pays 100% for in-network preventive care visits.
Network Annual Deductible: The annual deductible is $1,000 for Individual coverage and $2,000 for Family coverage. The deductible applies to services such as inpatient hospital stays, diagnostic labs and some prescription drugs. Once your deductible is met, the Plan will begin to pay benefits.
Network Copays: Some services are not subject to the Plan deductible and have set copay amounts instead. Examples are office visits and generic drugs.
Network Coinsurance: Once you have met the deductible the Plan begins to pay benefits at 80% and you will be responsible for the remainder, which is called your coinsurance. Your coinsurance amount is 20%.
Network Out-of-Pocket Maximum: This is the most that you will have to pay for covered services in a plan year. All of your eligible deductible, coinsurance and copay amounts accumulate towards the annual out-of-pocket maximum. Once you meet the out-of-pocket maximum, the plan pays 100% of your eligible expenses for the remainder of the year.
Telehealth MDLive: Telehealth or Virtual Visit services are available from MDLive. MDLive lets you get the care you need virtually – including most prescriptions (when appropriate) – for a wide range of minor conditions. You can connect with a board-certified provider via video chat or phone, when, where and how it works best for you. MDLive visits have a $10 copay. Refer to the Telehealth page for additional information.
Resources
| Services | In-Network | Out-of-Network |
| Deductible Individual/ Family | $1,000 / $2,000 | $2,000/ $4,000 |
| Annual Out-of-Pocket Maximum | $7,350 / $14,700 | $11,550 / $23,100 |
| Coinsurance | 20% after Deductible | 40% after Deductible |
| Primary Care Visits / MDLive Visit |
$10 copay – Tier 1
$25 copay – Non-Tier 1
$10 copay MDLive
|
40% after Deductible |
| Preventive Care | Covered in Full | 40% after Deductible |
| Specialist Visit | $20 copay – Tier 1 $40 copay – Non-Tier 1 $20 copay MDLive |
40% after Deductible |
| Inpatient Visit | 20% after Deductible | 40% after Deductible |
| Outpatient Visit | 20% after Deductible | 40% after Deductible |
| Emergency Room | $250 copay then 20% | $250 copay then 20% |
| Urgent Care | $75 copay | 40% after Deductible |
| Rx Retail (30 Day Supply) | ||
| Generic |
$10 copay
|
$10 Copay |
| Preferred Brand |
25% to $100 max
|
25% to $100 max |
| Non-Preferred Brand |
50% to $200 max
|
50% to $200 max |
| Specialty |
50% to $200 max
|
50% to $200 max |
| Rx Mail Order (90 Day Supply) | ||
| Generic |
$10 copay
|
$10 Copay |
| Preferred Brand |
25% to $100 max
|
25% to $100 max |
| Non-Preferred Brand |
50% to $200 max
|
50% to $200 max |
| Specialty |
50% to $200 max
|
50% to $200 max |
Silver PPO Plan
HOW THE PLAN WORKS
Plan Type: PPO
Network Preventive Care Visit: The plan pays 100% for in-network preventive care visits.
Network Annual Deductible: The annual deductible is $2,500 for Individual coverage and $5,000 for Family coverage. The deductible applies to services such as inpatient hospital stays, diagnostic labs and some prescription drugs. Once your deductible is met, the Plan will begin to pay benefits.
Network Copays: Some services are not subject to the Plan deductible and have set copay amounts instead. Examples are office visits and generic drugs.
Network Coinsurance: Once you have met the deductible the Plan begins to pay benefits at 80% and you will be responsible for the remainder, which is called your coinsurance. Your coinsurance amount is 20%.
Network Out-of-Pocket Maximum: This is the most that you will have to pay for covered services in a plan year. All of your eligible deductible, coinsurance and copay amounts accumulate towards the annual out-of-pocket maximum. Once you meet the out-of-pocket maximum, the plan pays 100% of your eligible expenses for the remainder of the year.
Telehealth MDLive: Telehealth or Virtual Visit services are available from MDLive. MDLive lets you get the care you need virtually – including most prescriptions (when appropriate) – for a wide range of minor conditions. You can connect with a board-certified provider via video chat or phone, when, where and how it works best for you. MDLive visits have a $10 copay. Refer to the Telehealth page for additional information.
Resources
| Services | In-Network | Out-of-Network |
| Deductible Individual/ Family | $2,500 / $5,000 | $5,000/ $10,000 |
| Annual Out-of-Pocket Maximum | $8,350 / $16,700 | $16,700 / $33,400 |
| Coinsurance | 20% after Deductible | 40% after Deductible |
| Primary Care Visits / MDLive Visit |
$15 copay – Tier 1
$30 copay – Non-Tier 1
$15 copay MDLive
|
40% after Deductible |
| Preventive Care | Covered in Full | 40% after Deductible |
| Specialist Visit | $40 copay – Tier 1 $60 copay – Non-Tier 1 $40 copay MDLive |
40% after Deductible |
| Inpatient Visit | 20% after Deductible | 40% after Deductible |
| Outpatient Visit | 20% after Deductible | 40% after Deductible |
| Emergency Room | $250 copay then 20% | $250 copay then 20% |
| Urgent Care | $75 copay | 40% after Deductible |
| Rx Retail (30 Day Supply) | ||
| Generic |
$10 copay
|
$10 Copay |
| Preferred Brand |
25% to $100 max
|
25% to $100 max |
| Non-Preferred Brand |
50% to $200 max
|
50% to $200 max |
| Specialty |
50% to $200 max
|
50% to $200 max |
| Rx Mail Order (90 Day Supply) | ||
| Generic |
$10 copay
|
$10 Copay |
| Preferred Brand |
25% to $100 max
|
25% to $100 max |
| Non-Preferred Brand |
50% to $200 max
|
50% to $200 max |
| Specialty |
50% to $200 max
|
50% to $200 max |
Bronze PPO Plan
HOW THE PLAN WORKS
Plan Type: PPO
Network Preventive Care Visit: The plan pays 100% for in-network preventive care visits.
Network Annual Deductible: The annual deductible is $5,000 for Individual coverage and $10,000 for Family coverage. The deductible applies to services such as inpatient hospital stays, diagnostic labs and prescription drugs. Once your deductible is met, the Plan will begin to pay benefits.
Network Copays: Unlike the other plans, there are no copays since all services go towards your deductible.
Network Coinsurance: Once you have met the deductible, the Plan begins to pay benefits at 70% and you will be responsible for the remainder, which is called your coinsurance. Your coinsurance amount is 30%.
Network Out-of-Pocket Maximum: This is the most that you will have to pay for covered services in a plan year. All of your eligible deductible and coinsurance amounts accumulate towards the annual out-of-pocket maximum. Once you meet the out-of-pocket maximum, the plan pays 100% of your eligible expenses for the remainder of the year.
Resources
| Services | In-Network | Out-of-Network |
| Deductible Individual/ Family | $5,000 / $10,000 | $10,000/ $20,000 |
| Annual Out-of-Pocket Maximum | $8,300 / $16,600 | $16,600 / $33,200 |
| Coinsurance | 30% after Deductible | 50% after Deductible |
| Primary Care Visits / MDLive Visit |
30% after Deductible
|
50% after Deductible |
| Preventive Care | Covered in Full | 50% after Deductible |
| Specialist Visit | 30% after Deductible | 50% after Deductible |
| Inpatient Visit | 30% after Deductible | 50% after Deductible |
| Outpatient Visit | 30% after Deductible | 50% after Deductible |
| Emergency Room | 30% after Deductible | 50% after Deductible |
| Urgent Care | 30% after Deductible | 50% after Deductible |
| Rx Retail and Mail Ord | ||
| Generic |
30% after Deductible
|
50% after Deductible |
| Preferred Brand |
30% after Deductible
|
50% after Deductible |
| Non-Preferred Brand |
30% after Deductible
|
50% after Deductible |
| Specialty |
30% after Deductible
|
50% after Deductible |
Consumer High Deductible Health Plan (HDHP) with a Health Savings Account (HSA)
With the Consumer Choice HDHP with a HSA, you must meet the plan deductible before copays will apply. This plan allows you to minimize the premium you pay from your paycheck while saving for the future with pre-tax contributions to a personal Health Savings Account.
-
- If you enroll in the Consumer HDHP and meet the Spark360 Wellbeing wellness program requirement, State Industrial will make a deposit to your Health Savings Account (HSA). The amount deposited will be $500 for Employee Only coverage and $1,000 for Employee & Spouse, Employee & Children and Family coverages.
-
- If you are age 65 or older or are otherwise Medicare eligible, please consult your tax advisor before enrolling in the Consumer HDHP with HSA.
HOW THE PLAN WORKS
Plan Type: High Deductible Health Plan
Network Preventive Care Visit: The plan pays 100% for in-network preventive care visits.
Network Annual Deductible: The annual deductible is $3,300 for Individual coverage and $6,600 for Family coverage. The deductible applies to all services such as inpatient hospital stays, diagnostic labs, office visits and prescription drugs.
Network Coinsurance and Copays: Once your deductible is met, copays and/or coinsurance will apply as stated in the plan documents. Some services such as office visits will have a copay while other services such as inpatient hospital services will be paid at 100%.
Network Out-of-Pocket Maximum: This is the most that you will have to pay for covered services in a plan year. All of your eligible deductible, coinsurance and copay amounts accumulate towards the annual out-of-pocket maximum. Once you meet the out-of-pocket maximum, the plan pays 100% of your eligible expenses for the remainder of the year.
Resources
The Consumer HDHP medical plans allows for:
- You pay lower medical plan premiums compared to the Silver and Gold PPO plans
- Preventive services covered at 100%
- The ability to open and make tax-free contributions into a Health Savings Account (HSA) through HSA Bank, a Cigna partner
Here are the advantages of opening an HSA account:
- You contribute tax free to the account through payroll deductions, lowering your taxable income
- You can use the funds to pay for qualified current and future health care expenses
- The account is yours for life whether you change jobs, health plans or retire. You own the account.
- No “use it or lose it” rules – the balance rolls over from year to year
- Receive contributions from State Industrial if you meet the wellness incentive requirements
- Contribute up to $4,300 for employee only or $8,550 for employee and family in 2025
Once you have enrolled in the Consumer Plan, your HSA account with HSA Bank will be automatically opened. HSA Bank may reach out to you if more information is needed to validate the opening of the account. If you do not respond within 90 days, the account will be closed. Please refer to the HSA Bank Customer Website Guide in the resource box for more information. Please note, if you earn the wellness incentive deposit from State Industrial but do not have an open account, State will not be able to contribute to your account and you may forfeit the deposit.
Refer to the Telehealth page for additional information.
| Services | In-Network | Out-of-Network |
| Deductible Individual/ Family | $3,300 / $6,600 | $6,400/ $12,800 |
| Annual Out-of-Pocket Maximum | $6,000 / $12,000 | $12,000 / $24,000 |
| Coinsurance | 0% after Deductible | 0% after Deductible |
| Primary Care Visits / MDLive Visit |
$15 copay – Tier 1
$30 copay – Non-Tier 1
$15 copay MDLive
|
30% after Deductible |
| Preventive Care | Covered in Full | 30% after Deductible |
| Specialist Visit | $40 copay – Tier 1 $60 copay – Non-Tier 1 $40 copay MDLive |
30% after Deductible |
| Inpatient Visit | 0% after Deductible | 30% after Deductible |
| Outpatient Visit | 0% after Deductible | 30% after Deductible |
| Emergency Room | $250 copay then 20% | $250 copay then 20% |
| Urgent Care | $60 copay | 30% after Deductible |
| Rx Retail: after meeting your medical deductible the below copays will apply | ||
| Generic |
Deductible then $10 copay
|
Deductible then $10 Copay |
| Preferred Brand |
Deductible then 25% coinsurance
|
Deductible then 25% coinsurance |
| Non-Preferred Brand |
Deductible then 50% coinsurance
|
Deductible then 50% coinsurance |
| Specialty |
Deductible then 50% coinsurance
|
Deductible then 50% coinsurance |
| Rx Mail Order: after meeting your medical deductible the below copays will apply | ||
| Generic |
Deductible then $10 copay
|
Deductible then $10 Copay |
| Preferred Brand |
Deductible then 25% coinsurance
|
Deductible then 25% coinsurance |
| Non-Preferred Brand |
Deductible then 50% coinsurance
|
Deductible then 50% coinsurance |
| Specialty |
Deductible then 50% coinsurance
|
Deductible then 50% coinsurance |
*All services except Preventive Care vists are subject deductible before copays and coinsurance are applied. When an individual’s single deductible is met plan benefits begin to pay for that individual.
Medical Plan Tools
myCigna
Nothing is more important than your good health. That’s why there’s the myCigna® website – your online home for assessment tools, plan management, medical updates and much more.
On myCigna.com you can:
- Find in-network doctors and medical services
- View ID card information
- Review your coverage
- See how much your medication will cost you at the different pharmacies in your network
- Manage and track claims
Cigna Healthy Rewards
Get discounts on the health products and programs you use every day for:
- Weight management and nutrition
- Fitness clubs and equipment
- Mind/body programs and equipment
- Vision and hearing care
- Alternative medicine
- Health and wellness products
Just use your Cigna ID card when you pay and let the savings begin.
You can use Cigna Virtual Care for 24/7 care
Cigna Cigna Virtual Care) Connection lets you get the care you need – including most prescriptions (when appropriate) – for a wide range of minor conditions. You can connect with a board-certified provider via video chat or phone, when, where and how it works best for you.
Choose when: 24/7/365. Day or night, weekdays, weekends and holidays.
Choose where: Home, work or on the go.
Choose how: Phone or video chat.
Cigna Lifestyle Management programs
If weight, tobacco or stress is affecting your health or your ability to live an active life, it may be time to make some changes. A health coach can provide you with personalized support to help you:
- Learn to manage your weight using a non-diet approach that helps you build confidence, change habits, eat healthier and become more active
- Develop a personal quit plan to become and remain tobacco-free
- Understand the sources of your stress, and learn to use coping techniques to better manage stress both on and off the job
You can use an online or telephone coaching program– or both – for the support you need. To learn more about the Lifestyle Management programs call the member services number on the back of your Cigna ID card.
Resources
Cigna One Guide
The Cigna One Guide® service can help you make smarter, informed choices and get health-related recommendations based on what matters most to you. It’s our highest level of support that combines the ease of a powerful app with the personal touch of live service. One Guide personal support, tools and reminders can help you stay healthy and save money.
Understand your plan
- Know your coverage and how it works
- Get answers to all your health care or plan questions
Get care
- Find an in-network doctor, lab or urgent care center
- Connect to health coaches, pharmacists and more
- Stay on track with appointments and preventive care
- Take advantage of dedicated one-on-one support for complex health situations
Save and earn
- Maximize your benefits and earn incentives (if provided by your employer)
- Get cost estimates and service comparisons to avoid surprises
- Check account balances and claim activity to manage expenses
Once you have enrolled, start using the Cigna One Guide support service by downloading the enhanced my Cigna App, click to chat or by phone.
Preventive care
Overall good health is important. That’s why your Cigna medical plans include coverage for eligible preventive care services at no additional cost to you, when you receive them from a doctor who participates in your plan’s network. This means no money taken from your account and no out-of-pocket costs to you. Covered preventive care services can include, but are not limited to:
- Blood pressure screenings
- Cholesterol screenings
- Diabetes screenings
- Testing for colon/rectal cancer
- Clinical breast exams
- Pap tests
- Mammograms
Cigna Healthy Pregnancies, Healthy Babies
Each woman’s journey to motherhood is unique. Enrolling in the Cigna Health Pregnancies, Healthy Babies® program is a healthy place to start.
To support you along your journey, you’ll get:
- Helpful guidance and support on everything from infertility and preconception planning to post-delivery information.
- A workbook to help you learn about pregnancy and babies, including topics like prenatal care, exercise, stress, depression and more.
- 24/7 live telephone support from a case manager, who has nursing experience and can help you with everything from tips on how to handle your discomfort during pregnancy to birthing classes and maternity benefits.
- Access to an audio library of health topics.
- Incentives for participating in the program, if offered by your employer
You’ll also have easy access to a wealth of information on the myCigna® website from trusted sources like WebMD and Healthwise. You’ll learn how to make a plan for a healthy pregnancy, monitor your pregnancy week by week, prepare for labor and delivery, care for your baby and more.
Cigna Veteran Support Line
This free hotline is available 24/7/365 to all veterans, their families and caregivers. No need to be a Cigna customer. Cigna stands ready to connect you with:
- Pain management resources
- Substance use counseling
- Financial support
- Food, clothing, housing
- Legal assistance
- Parenting and child care
- Aging services
- Weekly Mindfulness for Vets sessions by phone and more. Call 855.244.6211
