Cigna High Deductible Health Plan with Health Savings Account
The HDHP with HSA plan is a medical insurance plan option for LCPS employees. This plan will have the lowest monthly premium of the 3 plans offered. Enrollment comes with a Prescription Plan, a Health Savings Account providing an annual contribution of $1,000 for employee only (Individual) and $2,000 for employee plus one or more dependent (Family) and a $5,000 Critical Insurance policy.
Note: Employees covered by Medicare, Tricare or another non-HDHP health plan such as a spouse's plan, are not eligible for an HSA and may opt for an HDHP without HSA by contacting Employee Health, Wellness and Benefits.
Deductible: $1,500 Individual/$3,000 Family
Employer Funded HSA: $1,000 Individual/$2,000 Family
Coinsurance: 10% after in-network deductible
Out of Pocket Maximum: $6,000 Individual/$12,000 Family
PCP/Specialist Office Visit: 10% after in-network deductible
Preventive Exams: Covered 100%
Emergency Room: 10% after in-network deductible
Urgent Care: 10% after in-network deductible
The table below illustrates the different phases of the HDHP plan:
Important Information about the High Deductible Plan with Health Savings Account
With an HDHP plan, there is an annual deductible that must first be met before the medical or prescription plan will pay a portion of the cost. Both medical and prescription costs go toward the annual deductible.
The exception to this is preventive medical care which is not subject to deductible and covered at 100% at in-network providers and preventive medications on the LCPS HDHP Preventive Medications List, which are assigned a copay and not subject to deductible.
The annual deductible for the HDHP is $1,500 for employee only (Individual) coverage and $3,000 for employee plus one or more dependent (Family).
To help offset this deductible, LCPS will contribute $1,000 (employee only coverage) or $2,000 (employee plus one or more dependent), into a Health Savings Account, in your name. This account is your account and the funds can be used to pay your out-of-pocket medical and prescription costs while you are in the deductible phase. You can also contribute additional money into your HSA, on a pre-tax basis, to save for any additional out-of-pocket expenses. All HSA funds can be used for qualifying medical and prescription expenses and also for qualifying dental and vision expenses.
The network for the HDHP is the same as the network for the current Cigna OAP plan. If you use a participating Cigna provider, you will receive the Cigna discounted rate on your services. The same applies for your prescriptions. Express Scripts (ESI) will be the prescription plan provider for the HDHP. When you fill your prescription at an ESI participating pharmacy or through the mail order program, you will get the ESI discounted price on the prescription. Coinsurance:
If you reach the annual deductible on the plan, you would then move into the coinsurance phase where the plan will pay a majority of the cost (90% for medical and 90%/80%/70% for prescriptions). You will continue to receive the plans negotiated discounted rate if you are visiting in-network providers and facilities.
There is an out-of-pocket maximum on this plan. If your medical and/or prescription deductible and coinsurance costs reachl the out-of-pocket maximum, your medical and/or prescription expenses will then be covered at 100% for the remainder of that plan year. The out-of-pocket maximum for an individual is $6,000 and the maximum for the family is $12,000.
Critical Illness Policy:
If you enroll in the HDHP plan, you are provided with a $5,000 Critical Illness (CI) Policy for yourself, paid for by LCPS. You can also choose to purchase a CI policy for your spouse and/or dependent children – or purchase up to $25,000 in additional coverage for yourself. Premiums for additional coverage will be paid for by you.