Medical
Medical coverage offers healthcare protection for you and your family. You may visit any medical provider you choose, but in-network providers offer the highest level of benefits and lower out-of-pocket costs. Network providers charge members reduced, contracted fees instead of their typical fees. Providers outside the plan’s network set their own rates, so you may be responsible for the difference if a provider’s fees are above the Reasonable and Customary (R&C) limits.
Preventive Care – like physical exams, flu shots, and screenings – is always covered 100% when you use in-network providers. The key difference between the plans is the amount of money you’ll pay each pay period and when you need care.
Each plan has different:
- Annual deductible amounts – the amount you pay each year for eligible in-network and out-of-network charges before the plan begins to pay.
- Out-of-pocket maximums – the most you will pay each year for eligible network services and/or prescriptions. After you reach your out-of-pocket maximum, the plan picks up the full cost of covered medical care for the remainder of the year.
- Copays – A copay is a fixed amount you pay for a health care service. Copays do not count toward your deductible but do count toward your annual out-of-pocket maximum.
- Coinsurance – Once you’ve met your deductible, you and the plan share the cost of care, which is called coinsurance. For example, you pay 20% for services and the plan will pay 80% of the cost until you have reached your out-of-pocket maximum.
Cigna CDHP
Plan Information
Plan Name: Cigna CDHP
Policy Number: 3345397
Effective Date: 01/01/2025
Network: Cigna
In-Network Benefit Highlights
Deductible (Individual/Family)
$XX/$XX
Out-of-Pocket Max (Individual/Family)
$XX/$XX
Preventive Care
$XX
Primary Care Visit
$XX
Specialist Visit
$XX
Urgent Care
$XX
Emergency Room
$XX
Benefit Highlights
In-Network
Deductible (Individual/Family)
$1,650/$3,300
Out-of-Pocket Max (Individual/Family)
$3,300/$6,600
Preventive Care
$0 (deductible waived)
Primary Care Visit
10% after deductible
Specialist Visit
10% after deductible
Urgent Care
10% after deductible
Emergency Room
10% after deductible
Retail Rx (Up to 30-Day Supply)
Generic
$5 copay
Preferred Brand
$40 copay
Non-Preferred Brand
$60 copay
Specialty
30% up to $250
Mail-Order Rx (Up to 90-Day Supply)
Generic
$15 copay
Preferred Brand
$120 copay
Non-Preferred Brand
$180 copay
Specialty
30% up to $250
Out-of-Network
Deductible (Individual/Family)
$4,500/$9,000
Out-of-Pocket Max (Individual/Family)
$9,000/$18,000
Preventive Care
30% after deductible
Primary Care Visit
30% after deductible
Specialist Visit
30% after deductible
Urgent Care
30% after deductible
Emergency Room
10% after deductible
Retail Rx (Up to 30-Day Supply)
Generic
Not covered
Preferred Brand
Not covered
Non-Preferred Brand
Not covered
Specialty
Not covered
Mail-Order Rx (Up to 90-Day Supply)
Generic
Not covered
Preferred Brand
Not covered
Non-Preferred Brand
Not covered
Specialty
Not covered
Plan Documents
Contact Information
Cigna PPO
Plan Information
Plan Name: Cigna PPO
Policy Number: 3345397
Effective Date: 01/01/2025
Network: Cigna
In-Network Benefit Highlights
Deductible (Individual/Family)
$XX/$XX
Out-of-Pocket Max (Individual/Family)
$XX/$XX
Preventive Care
$XX
Primary Care Visit
$XX
Specialist Visit
$XX
Urgent Care
$XX
Emergency Room
$XX
Benefit Highlights
In-Network
Deductible (Individual/Family)
$250/$750
Out-of-Pocket Max (Individual/Family)
$2,500/$5,000
Preventive Care
$0 (deductible waived)
Primary Care Visit
$20 copay (deductible waived)
Specialist Visit
$40 copay (deductible waived)
Urgent Care
$20 copay (deductible waived)
Emergency Room
$150 copay + 10% after deductible (copay waived if admitted)
Retail Rx (Up to 30-Day Supply)
Generic
$5 copay
Preferred Brand
$30 copay
Non-Preferred Brand
$50 copay
Specialty
30% up to $250
Mail-Order Rx (Up to 90-Day Supply)
Generic
$15 copay
Preferred Brand
$90 copay
Non-Preferred Brand
$150 copay
Specialty
30% up to $250
Out-of-Network
Deductible (Individual/Family)
$750/$2,250
Out-of-Pocket Max (Individual/Family)
$7,500/$15,000
Preventive Care
30% after deductible
Primary Care Visit
30% after deductible
Specialist Visit
30% after deductible
Urgent Care
30% after deductible
Emergency Room
$150 copay + 10% after deductible (copay waived if admitted)
Retail Rx (Up to 30-Day Supply)
Generic
Not covered
Preferred Brand
Not covered
Non-Preferred Brand
Not covered
Specialty
Not covered
Mail-Order Rx (Up to 90-Day Supply)
Generic
Not covered
Preferred Brand
Not covered
Non-Preferred Brand
Not covered
Specialty
Not covered
Plan Documents
Contact Information
Cigna EPO
Plan Information
Plan Name: Cigna EPO
Policy Number: 3345397
Effective Date: 01/01/2025
Network: Cigna
In-Network Benefit Highlights
Deductible (Individual/Family)
$XX/$XX
Out-of-Pocket Max (Individual/Family)
$XX/$XX
Preventive Care
$XX
Primary Care Visit
$XX
Specialist Visit
$XX
Urgent Care
$XX
Emergency Room
$XX
Benefit Highlights
In-Network Only
Deductible (Individual/Family)
$0
Out-of-Pocket Max (Individual/Family)
$2,500/$5,000
Preventive Care
$0
Primary Care Visit
$20 copay
Specialist Visit
$20 copay
Urgent Care
$20 copay
Emergency Room
$125 copay (waived if admitted)
Retail Rx (Up to 30-Day Supply)
Generic
$5 copay
Preferred Brand
$30 copay
Non-Preferred Brand
$50 copay
Specialty
30% up to $250
Mail-Order Rx (Up to 90-Day Supply)
Generic
$15 copay
Preferred Brand
$90 copay
Non-Preferred Brand
$150 copay
Specialty
30% up to $250
Plan Documents
Contact Information
Kaiser HMO (CA)
Plan Information
Plan Name: Kaiser HMO (CA)
Policy Number: 602550
Effective Date: 01/01/2025
Network: Kaiser CA
In-Network Benefit Highlights
Deductible (Individual/Family)
$XX/$XX
Out-of-Pocket Max (Individual/Family)
$XX/$XX
Preventive Care
$XX
Primary Care Visit
$XX
Specialist Visit
$XX
Urgent Care
$XX
Emergency Room
$XX
Benefit Highlights
In-Network Only
Deductible (Individual/Family)
$0
Out-of-Pocket Max (Individual/Family)
$1,500/$3,000
Preventive Care
$0
Primary Care Visit
$20 copay
Specialist Visit
$20 copay
Urgent Care
$20 copay
Emergency Room
$50 copay (waived if admitted)
Retail Rx (Up to 30-Day Supply)
Generic
$15 copay
Preferred Brand
$35 copay
Non-Preferred Brand
$35 copay (prior authorization required)
Specialty
$35 copay
Mail-Order Rx (Up to 100-Day Supply)
Generic
$30 copay
Preferred Brand
$70 copay
Non-Preferred Brand
$70 copay (prior authorization required)
Specialty
$35 copay
Plan Documents
Contact Information
Kaiser HMO (OR)
Plan Information
Plan Name: Kaiser HMO (OR)
Policy Number: 19880
Effective Date: 01/01/2025
Network: Kaiser OR
In-Network Benefit Highlights
Deductible (Individual/Family)
$XX/$XX
Out-of-Pocket Max (Individual/Family)
$XX/$XX
Preventive Care
$XX
Primary Care Visit
$XX
Specialist Visit
$XX
Urgent Care
$XX
Emergency Room
$XX
Benefit Highlights
In-Network Only
Deductible (Individual/Family)
$0
Out-of-Pocket Max (Individual/Family)
$1,500/$3,000
Preventive Care
$0
Primary Care Visit
$20 copay ($5 copay for first 3 visits)
Specialist Visit
$20 copay
Urgent Care
$20 copay
Emergency Room
$50 copay (waived if admitted)
Retail Rx (Up to 30-Day Supply)
Generic
$10 copay
Preferred Brand
$20 copay
Non-Preferred Brand
$40 copay
Specialty
Applicable generic, preferred brand and non-preferred brand drug costs shares apply
Mail-Order Rx (Up to 90-Day Supply)
Generic
$20 copay
Preferred Brand
$40 copay
Non-Preferred Brand
$80 copay
Specialty
Applicable generic, preferred brand and non-preferred brand drug costs shares apply
Plan Documents
Coming Soon!