Open Access Plus, OA Plus, Choice Fund OA Plus
Links
- Allegiance Website
- Toll Free (855) 999-2279
Providers
is our national network, with providers located throughout the United States. This network is available if you have selected the Medical 750 Plan, Medical 1500 Plan and the HDHP.
Cigna Network
- Allegiance Website
- Toll Free (855) 999-2279
Forms
Medical Plans
2020 |
Medical 1500 | |||
---|---|---|---|---|
Type of Service |
Network Providers |
Non-Network Providers |
||
Calendar Year Deductible | $1500 Individual / $3000 Family | |||
Coinsurance | 85% Insurance / 15% Member |
65% Insurance / 35% Member |
||
Calendar Year Out of Pocket Maximum (Includes Deductible, Coinsurance, Copayments, and Pharmacy) |
$4,000 per Individual / $8,000 per Family |
|||
Lifetime Maximum | Unlimited | |||
Medical 1500 Plan |
Medical Rates
2020 |
Full Time 30+ Hours/Week |
Part Time 20-29 Hours/Week |
Penalty for No PHP | Penalty for Tobacco Use |
---|---|---|---|---|
Exclusive 750 Plan (Cost per month) |
||||
Employee | $55 | $100 | +$50 | +$60 |
Employee + 1 Child | $95 | $180 | +$50 | +$60 |
Employee + Spouse | $95 | $180 | +$100 | +$60 |
Employee + Children | $135 | $265 | +$50 | +$60 |
Employee + Family | $135 | $265 | +$100 | +$60 |
COBRA Rates
2020 |
COBRA |
---|---|
Medical 750 Plan (Cost per month) |
|
Employee | $433.50 |
Employee + 1 Child | $922.08 |
Employee + Spouse | $922.08 |
Employee + Children | $1,331.10 |
Employee + Family | $1,331.10 |
Employee Clinic |
|
Employee | $150 |
Employee + 1 Child | $300 |
Employee + Spouse | $300 |
Employee + Children | $450 |
Employee + Family | $450 |
Privacy Practices