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Brevard Public SchoolsMedical Plan Options & Resources

Plan Year:

1/1/2018 – 12/31/2018

862431 a 04/14 Offered by: Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company, or their affiliates.

2

Cigna Pre- Enrollment Line

Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna

Phone Number: 1-800-564-7642

• A Cigna Pre-Enrollment hotline will be available to all enrolling

BPS employees and dependents

• Enrollees can call and speak with a knowledgeable Enrollment

Specialist for: Information on their specific plan options

Help finding participating doctors and other health care

professionals.

Help to get comparisons of all Cigna products and resources

available to them

• The specialists can provide contracted rates for services and

prescriptions• The hotline is staffed 24 / 7 / 365

• It will remain open throughout the year for new hires

BPS Health Plan 2018


• Employee payroll deductions for

medical coverage remain the same

Changes for telehealth services• Copay will be reduced to just $10!

• An additional provider – Amwell – will join

MDLive to offer telehealth services

Wellness Incentive Activities

1. Biometric Screenings

2. Health Risk Assessments

4Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna

• What are they?

• Cholesterol / HDL /Weight / Height /Body Mass Index

(BMI) / Blood Pressure / Waist Measurement

• Where and When Do They Take Place?

• Beginning in September at Schools and Work sites

• Year-round at Labs/ Physician offices /BPS Well-

Care Centers

• What is it?

• A Health Questionnaire

• How do I do it?

• Log on to mycigna.com

Wellness Incentive Reward

838559 e 04/14 Offered by: Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company, or their affiliates.

IF both the Biometric Screening and Health Risk

Assessment are completed, the In-network BPS Health

plan deductible will be:

• $500 / Individual

• $1,000 / Two or more

If both activities are not completed, the In-network BPS

Health plan deductible will be:

• $1,500 / Individual

• $3,000 / Two or more

BPS Incentive Rewards Program January 2018

*PPACA alternatives availableConfidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna

Activity Milestone Award Points

Health AssessmentRequired for reduced medical plan In-network

deductible Required for reduced medical plan deductible.

Biometric Screening (onsite or PCP)

Required for reduced medical plan In-network deductible

Annual Physical Get an annual physical 100 points

BMI Achieve/Maintain a healthy Body Mass Index of less than 30

75 points

Blood PressureAchieve/Maintain a healthy blood pressure of less

than or equal to 139/8975 points

Waist CircumferenceAchieve/Maintain a healthy waist circumference of

less than 35 for women and 40 for men75points

Dental Cleaning (Self-Reported)

Dental Preventive Exams up to 2 per year2 x 50 points for each cleaning = 100

points

Telephonic Coaching Make progress towards personal health goal 75 points

Online Coaching Program Complete one online health coachingprogram 50 points

Flu Shot Get a flu shot 25 points

Earn 450 points and your name will be put in a drawing to earn a prize (ex: Gift Card)*

2018 BPS Health Plan


BPS Health Plan

w/ Wellness BPS Health Plan

Your Costs Your Costs

Wellness Incentive

(Received if an ACTIVE

EE and both activities

are completed)

In-Network Deductible:$500 EE / $1,000 Two or more Not Applicable

Network National OAP Network National OAP Network

Individual Deductible $500 $1,500

Family Deductible $1,000 $3,000

DeductibleApplication Medical Medical

Coinsurance (Plan/Member) Plan 80% / You 20% Plan 80% / You 20%

Individual In-network

Out of Pocket Maximum

(includes deductible)

$4,000 $4,000

Non-collective Family In-

network Out-of-Pocket

Maximum (includes

deductible)

$8,000 $8,000



BPS Health Plan

w/ WellnessBPS Health Plan

Your Costs Your Costs

Preventive Services 100% covered 100% covered

Primary Care Physician $30 copay $30 copay

Specialist $50 copay $50 copay

Preferred Health Centers $15 copay $15 copay

Urgent Care $45 copay (waived if admitted) $45 copay (waived if admitted)

Emergency Room20%^ + $250 copay (waived if admitted) 20%^ + $250 copay (waived if

admitted)

Inpatient Hospital$600 copay per admit + 20%^coinsurance

$600 copay per admit + 20%^ coinsurance

Outpatient Services 20%^ 20%^

^Cost share after deductible is met



Place of Service: Your Plan Pays Based on Where You Receive Services

Note: Services where plan deductible applies are noted with a caret (^).

These Benefits apply to both the BPS Plan With & Without WellnessThe only difference is the amount of the deductible ($500 / $1,000) ($1,500 / $3,000)

BenefitPhysician’sOffice

(Your Cost)

Independent Lab(Your Cost)

Emergency Room & Urgent Care Facility

(Your Cost)

Outpatient Facility(Your Cost)

In-Network

Out-of-Network

In-Network

Out-of-Network

In-Network

Out-of-Network

In-Network

Out-of-Network

Lab $0 40%^ $0 40%^ER: 20%^ UC: $0

$0 40%^

X-ray 20%^ 40%^ N/A 40%^ER: 20%^ UC: $0

20%^ 40%^

AdvancedRadiologyImaging

N/A 40%^ N/A N/AER: 20%^ UC: 20%^

20%^ 40%^

Advanced Radiology Imaging (ARI) includes MRI, MRA, CAT Scan, PET Scan etc.Note: All lab and x-ray services including ARI provided at Inpatient Hospital are covered under Inpatient Hospital Benefit. Note: X-Rays will be covered 100% only if completed at Urgent Care Facility.

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2018 Pharmacy Benefits


BPS Plan

w/ WellnessBPS Plan

In-Network

Only

Retail

(30-day

supply)

Home

Delivery

(90-day

supply)

Retail 90

(90 days

from a Retail

Pharmacy)*

Retail

(30-day

supply)

Home

Delivery

(90-day

supply)

Retail 90

(90 days

from a

Retail

Pharmacy)*

Preventive

MedicationsCopaysApply

Copays

Apply

Copays

Apply

Copays

apply

Copays

apply

Copays

Apply

Generic You pay $20 You pay $40 You pay $60 You pay $20 You pay $40 You pay $60

Cigna-

Preferred

Brand

You pay $50 You pay $100 You pay $150 You pay $50You pay

$100

You pay

$150

Specialty Rx

Cigna Home

Delivery is

Exclusive

Provider

You pay $125 You pay $250 You pay $375You pay

$125

You pay

$250

You pay

$375

Prescription Drug List: Standard Rx Program subject to Refill-too-soon and Prior Authorization,

Step Therapy, Quantity Limits etc. See Certificate of Coverage for details.

*Retail 90 available at select Pharmacies.

11

Review the

covered drug list

on Cigna.com,

myCigna.com or

the myCigna

Mobile App to

know which drugs

are generic or

preferred and

cost less

GETTING THE MOST OUT OF THE CIGNA PHARMACY BENEFITS PLAN:

Prescription Drug

Quote Tool on

myCigna.com and

the myCigna

Mobile App shows

what drugs cost, or

compare prices at

over 62,000 retail

pharmacies and

Cigna Home

Delivery Pharmacy

Medications

delivered right to

your door at no

additional cost –

there may even be

a cost savings

TheraCare®

provides education

and support for

customers who

have complex

conditions and

may use injectable

medications

24/7/365 access to

claim history,

benefit details,

drug and

pharmacy

comparison tools

and a pharmacist

to answer your

questions

1 3 4

Learn what

drugs are

covered

Use Cigna

Home

Delivery

Pharmacy

Talk to a

pharmacist

any time

5

Use

myCigna.com

or myCigna

MobileApp

2

Compare

prices


12

Open Access Plus Network

National Network

699,600 doctors andspecialists

5,800 hospitals and facilities

No referrals needed

No designated PCP needed

Same network as last year

National Labs – LabCorp and Quest:

With national labs Quest Diagnostics® or Laboratory Corporation of

America® (LabCorp), members can save up to 84%.

There are hundreds of locations nationwide, so Quest Diagnostics

and LabCorp make it easy to get lab services at a lower cost.

Other labs are part of the Cigna network, (for example those

associated with a doctor’s office or on site at a hospital), but

customers will likely get even bigger savings when they go to

Quest Diagnostics or LabCorp.


13

Finding In-Network Doctors & Facilities

During Open Enrollment:

Current non-Cigna members can log onto Cigna.com to find

in-network providers and facilities ~ be sure you are in the

OAP Network


14

Current Cigna Customers: myCigna.com – Find A Doctor or Service

Cost Savings Opportunities

15

1.List is not all-inclusive.

2.“America's Emergency Care Environment, A State-by-State Report

Card - 2014", American College of Emergency Physicians (ACEP)

The information provided here is for informational purposes only. You should consult your doctor

for medical advice or services, including seeking advice prior to receiving care. During a medical

emergency, go to the nearest hospital or call 911.


16

Provides “condition appropriate” care at alternative

network locations.

Secure, virtual “Skype-like” consultations.

Get health related services via telephone, smartphone

and computer.

Now just $10.00 per session!

General Health

Acne

Allergies

Bronchitis Cold & flu

Fever Gout

Headache

Infections

Pediatric Care

Cold & flu

Constipation

Ear infection

Fever

Nausea & vomiting

Pink eye

Joint aches & pains

Nausea & vomiting

Pink eye

Rashes

Sinus infection

Sore throat

Sunburn

Urinary tract infection

Conditions

Treated By

MDLIVE

Doctors


MDLIVE provides immediate, on-demand 24/7/365 access to affordable, quality

non-urgent care through a national network of licensed,

board-certified U.S.-based doctors, including pediatricians.

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Online video

consultations

Phone

consultations

Email communication,

post consultation

Prescription services

(sent directly to a pharmacy)

A Doctor Is

Always In

Health care services are delivered by MDLIVE participating doctors and not by Cigna.


19

Link to

come from

vendor

Look for the MD Live

link on your mycigna

home page.

Register Right Away! Register BEFORE you

need to use MDLIVE and it will be ready for you

when you DO need it!


Registration

What’s available on myCigna for members?

myCigna.com

• Print forms or print/order ID cards

• Check your coverage and explanation of benefits

• Track claims, payments and deductibles

• Sign up for online coaching programs

• Keep track of your health history and records with an

online personal health record

• Find in-network doctors, specialists, hospitals and labs

• Learn about common health problems and treatment

options

• Compare treatment and procedure costs

• Find cost and quality ratings for doctors and hospitals

• Switch a prescription to Cigna Home Delivery Pharmacy

with one easy phone call, and have your medications

delivered to your door

20

No claim forms

needed in-network

Talk with a health

specialist when you

can’t reach your

doctor – day or night


Cigna is OPEN 24/7/365

By phone – 1.800.Cigna24

• Call us anytime day or night – live, 24/7 customer service, 365 days a year

• Ask for a Spanish-speaking representative or speak with us in your preferred language

– interpreter service is available in over 150 languages

Online and on the go – myCigna.com and myCigna Mobile App

• Award-winning* directory of doctors, hospitals, facilities with cost and quality ratings

• Coverage details (copays, deductibles, out-of-pocket maximums, etc.)

• Claim activity and history

• Temporary ID cards or info on how to order new ones (myCigna.com only)

• A wealth of health information and resources (myCigna.com only)

• Compare drug prices with our Prescription Drug Price Quote tool

• You could save money when you order through Cigna Home Delivery Pharmacy

(myCigna.com only)


*. myCigna.com health care cost and quality capabilities named one of the top ten innovations of 2012 by Information Week.

Questions? If you still have questions about your

benefits and Cigna Resources, please

call 1-800-Cigna-24 (800-244-6224) or

see your Benefits Department for

additional information.

Rates will vary by plan design including the amount of plan deductibles, coinsurance, and out-of-pocket and lifetimemaximums.

All health insurance policies and health benefit plans have exclusions and limitations. For costs and details of coverage, see your

enrollment materials. The information in this presentation summarizes the highlights of your plan. For a complete list of both covered and

not covered services, including benefits required by your state, see your employer’s group insurance certificate, summary plan

description or group service agreement – the official plan documents. If there are any differences between the information in this

presentation and the plan documents, the information in the plan documents takesprecedence.

“Cigna,” the “Tree of Life” logo, “GO YOU,” “TheraCare” and “Healthy Rewards” are registered service marks, and “Cigna Home Delivery Pharmacy” is a

service mark, of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All products and services are provided

by or through such operating subsidiaries and not by Cigna Corporation. Such operating subsidiaries include Connecticut General Life Insurance Company,

Cigna Health and Life Insurance Company, Tel- Drug, Inc., Tel-Drug of Pennsylvania, L.L.C., Cigna Onsite Health, LLC, Cigna Behavioral Health, Inc., Cigna

Health Management, Inc., and HMO or service company subsidiaries of Cigna Health Corporation, including Cigna HealthCare of Arizona, Inc., Cigna

HealthCare of California, Inc., Cigna HealthCare of Colorado, Inc., Cigna HealthCare of Connecticut, Inc., Cigna HealthCare of Florida, Inc., Cigna HealthCare

of Georgia, Inc., Cigna HealthCare of Illinois, Inc. (IL & IN), Cigna HealthCare of Indiana, Inc., Cigna HealthCare of St. Louis, Inc. (MO, KS & IL), Cigna

HealthCare of North Carolina, Inc., Cigna HealthCare of New Jersey, Inc., Cigna HealthCare of South Carolina, Inc., Cigna HealthCare of Tennessee, Inc. (TN

& MS), and Cigna HealthCare of Texas, Inc. “Cigna Home Delivery Pharmacy” refers to Tel-Drug, Inc. and Tel-Drug of Pennsylvania, L.L.C. In Texas, Open

Access Plus and LocalPlus plans are considered Preferred Provider plans with certain managed care features and Open Access Plus IN and LocalPlus IN

plans are considered Exclusive Provider plans with certain managed care features. All models are used for illustrative purposes only.

862431 a 04/14 © 2014 Cigna. Some content provided underlicense.

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