Microsoft Word - 2022 - FT Employee Benefits Enrollment Guid

Commonwealth Emergency Physicians

What’s new for 2022 Health Insurance - Medical We are offering the same 2 medical and prescription drug benefits for the upcoming plan year through Cigna: The Open Access Plus 500 and the Open Access Plus HSA plans. The following chart shows a brief comparison of the benefit choices available; however, please reference carrier plan summaries for detailed benefit structure.

OAP PLUS 500

OAP PLUS HSA

Services

In Network

Out-of-Network

In-Network

Out-of-Network

Physician Visit Copay (Primary/Specialist)

$25/$50

Deductible + 60%

Deductible + Coins

Deductible + Coins

$3,000/$6,000

$6,000/$12,000

CEP will fund $200 monthly into the HSA for full-time employees

CEP will fund $200 monthly into the HSA for full-time employees

Deductible (Individual/Family)

$500/$1,000

$750/$1,500

Inpatient-facility

Deductible + 20% Deductible + 60% Deductible + Coins

Deductible + Coins

Urgent Care Copay

$50

Deductible + 60% Deductible + Coins

Deductible + Coins

80%

60%

100%

80%

Coinsurance

Emergency Room Copay Out-of-pocket Maximum (Individual/Family) Prescription Drugs Deductible Copay

Deductible + 20%

Deductible + 20%

Deductible + Coins

Deductible + Coins

$4,000/$8,000

$5,500/$11,000

$4,000/$8,000

$10,000/$20,000

N/A $10/$40/$60

N/A 40%/60%

Combined w/Medical $10/$40/$60

Combined w/Medical 20%/80%

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