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Medical
Dental
Pharmacy
Vision
FSA
2022 Plan Options |
Medical 750 |
Medical 1500 |
Bind |
Spousal Plan |
 |
|
 |
 |
|
|
Cigna Open Access Plus, OA Plus, Choice Fund OA Plus |
Cigna Open Access Plus, OA Plus, Choice Fund OA Plus |
Options PPO Network, Choice Plus Network |
Other Insurance |
|
|
Deductible |
$750 / $1,500 |
$1,500 / $3,000 |
$0 |
$0 |
|
Out-of-Pocket Maximum |
$4,000 / $8,000 |
$4,000 / $8,000 |
$5,500 / $11,000 |
$0 |
| Out-of-Pocket Maximum (Out-of-Network) | $4,000 / $8,000 | $4,000 / $8,000 | $11,000 / $22,000 | $0 |
|
Preventive Care |
100% Coverage |
100% Coverage |
100% Coverage |
$0 |
|
Co-payment |
Emergency Room Only |
Emergency Room Only |
Refer to Plan Details |
$0 |
|
Co-insurance In-Network |
85% /15% |
85% / 15% |
$0 |
$0 |
|
Co-insurance Out-of-Network |
65% / 35% |
65% / 35% |
Refer to Plan Details |
$0 |
|
Employee Employee + 1 Family |
$100 $203 $293 |
$35 $62 $90 |
$42 $89 $128 |
$107 $193 $268 |
A surcharge will be added to the regular monthly premiums for those that choose to not participate with the PHP annually and/or for those that use tobacco.
Personal Health Profile (PHP)
- Will be required for employee and spouse (if enrolled on ARUP insurance) to avoid surcharge
- If spouse does not complete their PHP and the employee does, they are still subject to the surcharge
Tobacco Premium Surcharge
- Those using tobacco will pay a higher premium for medical insurance
- Smoking cessation supplies are available at no cost through the Family Health Clinic
- Be sure to select the tobacco or non-tobacco rates when enrolling
- By selecting non-tobacco, you are committing to not using tobacco the full year
