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EMPLOYEE BENEFITS

The Benefits Section of Human Resources & Risk Management is a customer service and benefits processing operation. We handle the daily activities of managing your benefits, design communications to keep you apprised of changes, prepare you for retirement, conduct data analysis, provide training on our technology-based benefits and new employee orientation. Our staff continuously strives to provide comprehensive benefits to employees, dependents and retirees while maintaining reasonable costs and a high level of service.   
 
We recognize each employee has different needs and since time is of the essence, technology and convenience are the key factors in conducting business. Plan participants may log on to http://www.mycigna.com/
to check claims payment status, eligibility, order an ID card, get a Treatment Cost Estimate or Drug Cost Estimate, print your Explanation of Benefits (EOB) statements, check out the Clinical Payment and Reimbursement Policy, refill mail order prescriptions, monitor Flexible Spending Account (FSA) balances, query for medical information or just search for a provider anywhere in the country. Utilizing the Cigna tools enables you to get the most value out of your plan and saves time!

Those who prefer personal contact may call Cigna's Harris County dedicated customer service line at (888) 806-5042 or the Harris County Benefits staff at (713) 274-5500, toll free (866) 474-7475.

Benefits Comparison for Plan Year 3/1/17 – 2/28/18

                                 Cigna Open Access Plus Plan Highlights

 

BASE PLAN/HAMP
In-Network

BASE PLAN/HAMP
Out-of-Network

Annual Deductible
(per calendar year)

BASE:   $600/$1,800
HAMP:  $300/$900

$1,000 Individual
$3,000 Family

Maximum Out -of-Pocket-includes deductible, coinsurance, medical, and Rx copays

(Per Individual/Family Per Calendar Year)

BASE:   $7,150/$14,300 

HAMP:  $6,650/$13,300

$10,000 Individual 
$30,000 Family

Lifetime Maximum Benefit

Unlimited except where otherwise indicated

Unlimited except where otherwise indicated

Primary Care Physician Visit

BASE:   $30 copay
HAMP:  $25 copay
CCN:    $20 copay


50% after deductible

Specialist Office Visit

Participating CCN Providers

Non CCN Participating Providers

BASE: $40 copay; HAMP: $35 copay

BASE: $50 copay; HAMP: $45 copay

 

Preventive Care

100% coverage

50% after deductible

Allergy Services (includes testing, serum and injections)

100% after $40 copay

150 doses per calendar year

50% after deductible

Maternity Care (coverage includes voluntary sterilization)
 

Payable as any other covered expense

Payable as any other covered expense

Diagnostic Laboratory & Radiology Services

100% coverage

50% after deductible

Complex Imaging/High Tech Radiology

90% after deductible
100% Coverage at eviCore Facilities  

50% after deductiible

Rehabilitation, Speech, Occupational and Physical Therapy

100% after a $25 copay,
up to 60 visits per calendar year*

50% after deductible,
up to 60 visits per calendar year*

Convenience Care Clinic

BASE:   $30 copay
HAMP:  $25 copay

50% after deductible

Urgent Care Facility

100% after a $50 copay

50% after deductible

Emergency Room

$300 copay; waived if confined,
80% after deductible if admitted

$300 copay; waived if confined,
50% after deductible if admitted

Outpatient Surgery

80% after deductible

50% after deductible

Inpatient Services

80% after deductible

50% after deductible

Home Health Care

100 visits per calendar year

90% after deductible

50% after deductible
 

Mental Health
   Outpatient Visits
   Inpatient Services


100% after $30 copay
80% after deductible


50% after deductible
50% after deductible

Chemical Dependency
 
   Outpatient Visits
    Inpatient Services


100% after $30 copay
80% after deductible


50% after deductible
50% after deductible

 

PLUS PLAN/HAMP
In-Network

PLUS PLAN/HAMP
Out-of-Network

Annual Deductible
(per calendar year)

None

$1,000 Individual
$3,000 Family

Maximum Out -of-Pocket-includes deductible, coinsurance, medical, and Rx copays

(Per Individual/Family Per Calendar Year)

PLUS:   $6,150/$12,300 

HAMP:  $5,650/$11,300

$10,000 Individual

$30,000 Family

Lifetime Maximum Benefit

Unlimited except where otherwise indicated

Unlimited except where otherwise indicated

Primary Care Physician Visit

PLUS:   $25 copay
HAMP:  $20 copay
CCN:    $15 copay



50% after deductible

Preventive Care

100% coverage

50% after deductible

Allergy Services (includes testing, serum and injections)

100% after $40 copay

50% after deductible

Maternity Care (coverage includes voluntary sterilization)

Payable as any other covered expense

Payable as any other covered expense

Diagnostic Laboratory & Radiology Services

100% coverage

50% after deductible

Complex Imaging/High Tech Radiology

$100 copay 
100% Coverage at eviCore Facilities 

50% after deductiible

Rehabilitation, Speech, Occupational and Physical Therapy

100% after a $20 copay,
up to 60 visits per calendar year*

50% after deductible,
up to 60 visits per calendar year*

Convenience Care Clinic

PLUS:   $25 copay
HAMP:  $20 copay

50% after deductible

Urgent Care Facility

100% after a $50 copay

50% after deductible

Emergency Room

$300 copay; waived if confined

$300 copay; waived if confined,
50% after deductible if admitted

Outpatient Surgery

PLUS:   $400 copay
HAMP:  $200 copay

50% after deductible

Inpatient Services

PLUS:   $600 copay
HAMP:  $300 copay

50% after deductible

Home Health Care 

100 visits per calendar year*

 

100% coverage

50% after deductible

Mental Health
   Outpatient Visits
   Inpatient Services

 

$30 copay
PLUS:   $600 copay

HAMP:  $300 copay


50% after deductible
50% after deductible

Chemical Dependency
 
   Outpatient Visits
    Inpatient Services


$30 copay
PLUS:   $600 copay

HAMP:  $300 copay


50% after deductible
50% after deductible

* Maximums are a combined limit for in-network and out-of-network services.

 

PRESCRIPTION BENEFIT IN-NETWORK FOR ALL PLANS  

 

% You Pay

Minimum Copay

Maximum Copay

RETAIL (30 day supply)

Generic

25%

$5

$50

Brand

30%

$25

$150

Specialty

30%

$50

$300

CIGNA Rx 90 NETWORK or MAIL ORDER (61-90 days supply)

Generic

25%

$10

$100

Brand

30%

$50

$300

 

Go to http://www.hctx.net/HRRM/medicalplan.aspx for a description of your employee benefit plans and options.

 

 
 
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Contact Human Resources and Risk Management at hrrm_email@hctx.net.
Contact the ADA Coordinator at HCHRRMADACoordinator@bmd.hctx.net.
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