CIGNA HealthCare

CIGNA Medical Plans
 

CIGNA Healthcare is the administrator for Pace University's medical plan options. Participants have access to the CIGNA Open Access Plus network, which is a national network. Annual deductibles, plan maximums, etc. are based upon a calendar year.

Highlights of the CIGNA plans:

  • No referrals to see specialists in or outside of the network
  • No requirement to select a Primary Care Physician (although it is recommended for coordination of care)
  • In-network preventive care exams are covered at 100%
  • Emergency care is covered 24 hours a day, no matter where the member receives such services (for the CIGNA In-Net 20, CIGNA 90/70, and CIGNA 100/70 plans, the ER co-payment is waived if you or a covered dependent are admitted to the hospital)
  • Access to discounted programs and products to promote a healthy lifestyle through CIGNA Healthy Rewards
  • Pharmacy program (including mail order) is managed by CIGNA Tel-Drug
  • Vision program is managed by CIGNA Vision

2013-2014 Medical Benefits

  • The Medical Plan Cost Calculator was developed to assist you in determining which plan option may be best for you and your family, financially. This calculator will provide you with an estimate of total cost of each of the available plans. We encourage you to utilize this tool to ensure that you are making the most appropriate choice (based upon cost) for you and your family.
  • The CIGNA In-Net 50 Plan is no longer available to new enrollees as of July 1, 2013. Those currently enrolled may continue to participate in this plan; however, once a current participant changes to a different plan option, he/she may not re-enroll in the CIGNA In-Net 50 Plan at a later date.
  • A new plan, the CIGNA HDHP/HSA (High Deductible Health Plan with a Health Savings Account) is available, as of July 1, 2013, to active employees who are not enrolled in another health plan, including Medicare Part A and/or Part B.
  • CIGNA has made some changes to its processing of in-network lab coverage. In most instances, you should not experience any issues, as your physician automatically sends your lab work to the correct CIGNA-participating lab. However, if the in-network provider sends your lab work to a non-participating vendor, the claim will be processed at the out-of-network level or will not be covered at all (if you are enrolled in an in-network only plan). As such, we strongly recommend that you notify your provider of the participating labs whenever you utilize these services. The following offers some guidance on how to best handle these services:

What you need to do when lab work is warranted:

  • Find network labs by going to www.myCIGNA.com or calling the number on your CIGNA ID card.
  • Inform your doctor that you want to use a CIGNA Open Access Plus network lab.
  • If your doctor takes a sample in the office, advise him/her that it must be sent to a CIGNA network lab.
  • Bring a print-out of participating labs to your appointment.
  • Make sure that the lab is an in-network lab. Just because a lab accepts your CIGNA ID card, it doesn’t necessarily mean that it’s part of the CIGNA Open Access Plus network.

If an in-network doctor does not send your lab work to a participating provider and your claim is processed at the out-of-network level (or not covered if you are in the CIGNA In-Net 50 or CIGNA In-Net 20 plans), you do have the right to appeal the decision. This can be done by contacting CIGNA’s customer service department at the number listed on your ID card.


 

CIGNA In-Net 50 Plan  (for those enrolled in this plan prior to July 1, 2013 only)

CIGNA In-Net 20 Plan

CIGNA 90/70 Plan

CIGNA 100/70 Plan

CIGNA HDHP/HSA Plan

Side By Side Comparison of the CIGNA Plan Options

 

Per Paycheck Premiums (July 1, 2013 through June 30, 2014)