hr buzz dekalb county 2012 health plan options chart
TRANSCRIPT
DeKalb County 2012 Health Plan OptionsKaiser HMO
Premiums & Cost Sharing- Lower monthly premiums than Cigna Open Access
Plans
- $15 doctor co-pay/$25 specialist co-pay
- No co-pay for preventive care visits
- No deductible for doctor/specialist visits
- Co-pay for Outpatient Procedure
($100 Employee/$200 Family)
- Co-pay for Inpatient Procedure
($200 Employee/$400 Family)
- Emergency Room $75
- No co-insurance (80/20 split)
Plan Usage
- Must use in-network doctors at Kaiser facilities
- Must use Kaiser pharmacy, lab, and specialists
Cigna Open Access Plus In-Network (formerly known as Cigna HMO)
Premiums & Cost Sharing
- Highest monthly premiums
- $25 doctor co-pay/$40 specialist co-pay
- No co-pay for preventive care visits
- No deductible for doctor/specialist visits
- Co-pay for Outpatient Procedure
($100 Employee/$200 Family)
- Co-pay for Inpatient Procedure
($200 Employee/$400 Family)
- Emergency Room $150
- No co-insurance (80/20 split)
Plan Usage
- Must use in-network doctors & specialists for lowest rates
- Wider range of doctors than Kaiser
- May use out-of-network doctors at higher cost- Caremark pharmacy plan
Cigna Open Access Plus(formerly known as Cigna PPO High)
Premiums & Cost Sharing
- Monthly premium less than Cigna OA Plus In-network but higher than Kaiser and Cigna Choice Fund
- $300 Employee/$600 Family Deductible In-network
- $500 Employee/$1000 Family Deductible Out-of-network
- Emergency Room $150 co-pay plus 20% co-insurance
- 20% In-Network co-insurance (after deductible is met)
- 40% Out-of-network co-insurance (after deductible met)
- Max out-of-pocket cost: $1500 Employee/$3000 Family
- $10 (Generic)/$25 (Brand)/$50 (Specialty) pharmacy co-pays
Plan Usage
- No deductible for preventive care visits
- No deductible for pharmacy; Caremark pharmacy plan
- Employee pays 100% of cost up to deductible then 20% of cost after deductible is met
- Must use in-network doctors/specialists for lowest rates
- Wider range of doctors than Kaiser- May use out-of-network doctors at higher cost
Cigna Choice Fund (A new option also referred to as a Consumer Driven Health Plan,High Deductible Plan) with Health Savings Account (HSA))
Premiums & Cost Sharing
- Lowest monthly premium but very high deductible
- $1500 Employee/$3000 Family Deductible (County provides $750 toward Employee deductible and $1500
toward Family deductible)
- 20% In-Network co-insurance (after deductible is met)
- 40% Out-of-network co-insurance (after deductible is met)
- Max out-of-pocket cost: $3000 Employee/$6000 Family
Plan Usage
- No deductible for preventive care visits
- Employee pays 100% of cost up to deductible then 20% of cost after deductible is met (medical & pharmacy)
- Must use in-network doctors & specialists for lowest rates
- Wider range of doctors than Kaiser
- May use out-of-network doctors at higher cost
- Cigna pharmacy plan
- Employee pharmacy co-pays apply to deductible - With HSA, unused end-of-year balances roll over to next year or may be transferred to another qualified health savings plan
* This is intended for information purposes only and not to be construed as the official plan document.HR 10/12/11