Employee Benefits FAQs

To find a doctor in your area go to myCigna.com. Click the tab that says “Find a Doctor”, this will lead you to another page where you will select that you are covered by an “Employer or School”. From there you can search for a doctor by type, doctor by name, or health facilities. Once you select the search variant you would like, you will need to enter in your zip code of your area. The next screen should show what plan you need to select, you should select the plan that says “Open Access Plus, OA plus, Choice Fund OA Plus” to find if your doctor is in-network. Once you are in the system, you will also have access to the Cigna app (myCigna) which can be found in the App Store or Google Play or go to myCigna.com to find out more about your coverage and doctors in your area.

In-network – services and providers that are contracted with the carrier and are covered at in-network cost. Services are applied to the in-network deductible and max out of pocket.

Out-of-network – services and providers are not contracted with the carrier and are covered at out-of-network cost. Services are applied to the out-of-network deductible and max out of pocket. *Not all plans have out-of-network benefits.

Cigna offers a Cigna One Guide service that can answer questions and clarify any plans you are considering selecting. By calling 1-888-806-5042, you will be able to speak directly with a Cigna representative that will help you understand the basics of health coverage, identify the types of health plans available to you, check to see if your doctors are in-network, and answer any questions you may have regarding provider networks or plans available to you. After enrollment, you will still have access to chatting or calling a Cigna One Guide service representative along with using the myCigna app or going to myCigna.com. When reaching out to a Cigna One Guide service representative, please inform them you are under the Concurrent HRO medical plan.

OAP Plan – This is a copay plan. Visits to primary doctors, specialty doctors, urgent care, Rx and other services (copay service) are at a copay rate. Copays are applied to the max out of pocket, not the deductible. Services such as hospital stays, ER visits, labs and testing, etc. are a co-insurance and are first applied to the deductible and then the max out of pocket.

HSA/HDHP – Member is responsible for 100% of any covered service. All services are at a rate that is negotiated between the carrier and the provider. Rates can vary based on service, area code, provider, etc. For estimated cost, call your provider. Typically, the deductible and max out of pocket are the same. Once the max out of pocket is met, the carrier will then pay 100% of any covered service.

HSA/HDHP medical plans do not have a copay. Rather, the cost per visit/service is negotiated between the provider and the carrier and varies based on zip code, provider, service, etc. Please call the provider for a cost estimate.

During the benefit open enrollment period you will have access to add your dependents in the concurrenthro.com portal. If any updates need to be made with dependent information, you will need to go to the “Benefit” tab in the portal and select “Dependents/Beneficiaries” to make the changes. If you are still having trouble, you can email [email protected] for further assistance.

Yes, please fill out this affidavit and have it notarized and emailed to [email protected].

Using myCigna.com you can review all medications that are covered. Additionally, using myCigna will allow you to use cost-comparison tools and purchase mail-order prescriptions. MyCigna will show the most affordable prescription for your medical needs. You can also download this document to find out more: Cigna Pharmacy Customer Transition of Care.

Here is the Rx List of prescriptions covered through Cigna.

Cigna offers virtual medical care for a variety of minor medical treatments, reducing the cost of going to the ER or doctor’s office. By going to myCigna.com you can use the feature, MDLive. This feature allows you the flexibility to virtually meet with an MDLive medical provider on-demand or schedule an appointment for your minor medical needs. Additionally, MDLive offers convenient and confidential behavioral/mental health virtual care. This care is similar to if you were to seek an in-office visit, from the convenience of your own home. You can schedule a visit for those services through myCigna.com. To find out more, please review this flyer: Cigna TeleDoc flyer.

The myCigna app gives you full access to electronic medical cards as well as access to find healthcare providers, care and costs, view claims, manage spending accounts, and update your profile. Logging into the myCigna app will be available on the start date of your benefits. If you renewed your Cigna medical coverage for the plan year with no changes in coverage, you will not receive a new card. Changes in coverage will receive a new physical medical card will be mailed before the start date of your benefits. If you do not receive your card in time for your medical appointment, please download the myCigna app or contact [email protected] for assistance.

First, make sure your coverage is updated with your provider so they can find you in the system and run claims. If the provider is not able to find you in the carrier system, make sure your information is accurate and up-to-date in their system. If your information is up-to-date and there are still issues, please contact [email protected]. Once the issue is resolved, the provider will need to re-run the claims. In order to update personal information with the carriers (i.e. date of birth/name/address), please reach out to [email protected].

A deductible is the amount of money the carrier requires you to pay/meet before the co-insurance will contribute.

An embedded deductible is a system that combines individual and family deductibles in a family health insurance policy. Each person has their own deductible but the family also has a maximum total deductible if multiple family members need medical care during the year.

The deductible is on calendar year term and resets at the first of the year.

The out of pocket max is the most that you will have to pay for the year before the carrier pays 100% for any covered service.

The premium is the amount you pay every month to have insurance coverage.

No. The premium is what you pay to have insurance coverage. The deductible goes towards the out of pocket max which is the most that you will pay for the year before the carrier pays 100% of any covered service.

Open Enrollment is the only time of year that changes to benefits can be made, outside of a qualifying event.

Due to IRS Section 125 regulations, once you have made your benefit elections for the plan year, you cannot change your benefits until the next annual open enrollment period. The only exception is if you have a qualified change in status. Election changes must be consistent with your status change and must be made within 30 days. Examples of these qualifying events include:

• Marriage, legal separation, divorce, declaration of common law marriage, civil union or domestic partnership
• Birth or adoption of a child
• Court-appointed responsibility
• Loss of other group or government-sponsored coverage
• Newly entitled to other group or government sponsored coverage
• Change in a dependent’s benefits status (example: a dependent child’s 26th birthday)
• Death of a dependent
• Spouse’s Open Enrollment

To change your benefits elections, notify [email protected] and submit change paperwork within 30 days of the change in status. You may be asked for proof of the change, such as a marriage certificate or birth certificate.

To make any changes to benefits, the IRS requires that we have proof of the Qualifying Event.

If coverage is lost from the employer, or if is dependent starting new coverage (i.e. loss of job, change of status, new job, etc.), please provide a letter on letterhead from the employer with the following information:

1. The members who were enrolled in coverage.
2. Coverage enrolled in (medical, dental, and/or vision).
3. Effective date for loss of coverage or effective date for start of new coverage.

If the Qualifying Event is due to the enrollment in:

1. Medicare, please provide proof of the Medicare card.
2. A marriage, please provide proof of the marriage certificate.
3. Birth of a new child, please provide the birth certificate.
4. Adoption of a child, please provide court appointed. documentation.
5. Death, please provide the death certificate.
6. A COBRA Letter.

All documentation necessary for the specific Qualifying Event needs to be sent to [email protected].

Please submit documentation to [email protected].

You can only terminate benefits during open enrollment, unless there is a qualifying event.