Medical
Benefits Enrollment & Changes
You may enroll in benefits during your first 31 days of full-time employment. However, once elections have been submitted, you are unable to make changes even if you are still within your 31-day enrollment window. You may also make changes to current coverage within 31 days of the date you experience a qualified change in status or change coverage during the annual open enrollment period. Open Enrollment is typically held November 1 – 15 each year, and elections made during this period become effective January 1 of the next calendar year.
Sections
Provider Contact
Cigna
1.800.244.6224
PDFs
Medical Plan Overview 2025
Cigna Summary Plan Description (SPD)
Summary of Benefits and Coverage (SBC) - 2024
Summary of Benefits and Coverage (SBC) - 2025 - $2300 Deductible Plan
Summary of Benefits and Coverage (SBC) - 2025 - $4000 Deductible Plan
Illinois Consumer Coverage Disclosure
Medical / Cigna
Changes for 2025:
New second medical plan being offered
Change in current medical plan rates, deductibles, and out-of-pocket maximums
New for 2025, there is a second medical plan being offered, which is also administered by Cigna. This second plan (the Cigna $4000 Deductible Plan), is being added to give you a choice in how you pay for your healthcare coverage. You may be interested in enrolling in this plan option if you prefer to pay less in employee contributions out of your paycheck but still want to have protection for catastrophic events and are willing to pay more at time of service through higher deductibles and out-of-pocket maximums than the current medical plan provides. This may appeal to you if you typically have low utilization of medical and prescription expenses or use the plan primarily for preventive services which are paid at 100% by the plan when using in-network providers.
If you prefer to have a plan with lower deductibles and out-of-pocket maximums and pay more through your payroll contributions, then you may prefer the original medical plan, (being renamed as the Cigna $2300 Deductible Plan), we have offered in prior years, however, with the changes in rates, deductibles, and out-of-pocket maximums being implemented for 2025. The choice is yours.
Both medical plans are Consumer Driven Health Plans (CDHP), with a Health Savings Account (HSA) utilizing the Cigna Open Access Plus Network. With these plans, you can utilize the service of almost any provider. However, benefits are greater when you use in-network (Open Access Plus) providers, hospitals, and facilities.
The new second plan option for 2025 has lower employee rates and Maritz HSA contributions, with higher deductibles and out-pocket maximums than the current medical plan offered in 2024. If you choose the new plan option, you may want to consider contributing more to your HSA to pay for your out-of-pocket expenses with pre-tax dollars or supplement your medical coverage by enrolling in one of the Voya voluntary plans (Accident, Critical Illness, or Hospital plans), which are very affordable. For additional details refer to the Accident, Critical Illness, & Hospital Plans page under the Health tab on this website. Keep in mind you also have the Paytient debit card available to you when you incur medical out-of-pocket expenses and can pay for them over time with the convenience of payroll deductions. Additional information about Paytient can be found under the Income Protection tab of this website. Also remember to use the Healthcare Bluebook cost comparison tool to receive care at the lowest-cost facilities when possible, which helps you lower your out-of-pocket costs.
To reduce the amount of increase in premiums in 2025 for the current medical plan, we are also increasing the deductibles and out-of-pocket maximums as follows:
Plan Rates, Limits, and Maritz HSA Contributions
True Family Deductible means the full family deductible must be met before any family member’s claims are paid by the plan.
Embedded Deductible means one family member only needs to meet the individual deductible before the plan begins to pay on their claims. They do not have to satisfy the full family deductible first. The rest of the family members’ claims continue to apply to the remaining family deductible.
Embedded Out-of-Pocket Maximum means one family member only needs to meet the individual out-of-pocket maximum before the plan begins to pay 100% on their claims, while the rest of the family members’ claims continue to apply to the remaining family out-of-pocket maximum before their claims begin to be paid at 100% the remainder of the calendar year.
Example: Mike has family coverage with his wife Emma and son Mason. Emma incurred medical services during the year that totaled $8,000. All of her providers were in-network. Mike and Mason have not had any claims this year. They are enrolled in the medical plan that has the $2300 Individual/$4600 Family Deductible.
For this plan, Emma has to satisfy the full $4600 family deductible before the plan will pay any of her claims since it is a “True Family” Deductible. However, since this plan has an “Embedded” Out-of-Pocket Maximum she only has to satisfy the individual out-of-Pocket limit of $4600, which happens to be the same as the family deductible on this plan. Since that has already been satisfied, the plan will pay the remaining $3400 at 100% and Emma’s total cost on this claim is $4600.
If that plan had been an “Embedded” Deductible, Emma would only need to satisfy the individual deductible of $2300, then the plan would pay 80% of the remaining $5700, or $4560, and Emma would have paid the remaining 20% or $1140. Emma’s Total cost would have been $3440.
Please note that the well credit and the total premium will be listed as separate line items on your paycheck. The well credit will be listed in the earnings portion of your paycheck, and the premium will be listed in the deductions section of the paycheck. Read below for additional information.
The calendar year deductible applies to all covered expenses unless otherwise indicated. The annual out-of-pocket limit includes the calendar year deductible and coinsurance paid by the employee.
Continue to use the cost comparison tools available to you in an effort to fight the increasing cost of health care (see Healthcare Bluebook page of this website for more information).
Not yet enrolled in a Cigna plan, but have questions? Call the Cigna pre-enrollment line at 888.806.5042.
Well Credit
Employees hired on or before November 15: By participating in a biometric screening, you can earn up to a $600 Well Credit each year. Your spouse can also earn up to a $600 Well Credit if they’re enrolled in the Maritz medical plan. Screenings must be completed between January 1st and December 15th. Additional information can be found on the Wellness Page.
Hire date, status change, or life event after November 15: You and your spouse (if enrolled in the medical plan) will automatically receive the full Well Credit for the remainder of the current calendar year and for the following calendar year.
Plan Summary
|
Description of Service |
Plan Pays In-Network (after the annual deductible is satisfied) |
Plan Pays Out-of-Network (after the annual deductible is satisfied) |
|
Routine Preventive Care |
100% (deductible is waived for preventive care) |
Not Covered |
|
Physician Care Office visit, surgery, diagnostic x-ray or lab, inpatient visit by physician, or nervous/mental/chemical dependency |
80% |
60% |
|
Physical Therapy |
80% up to 60 days per calendar year |
60% up to 60 days per calendar year |
|
Chiropractic Care |
80% up to 30 days per calendar year |
60% up to 30 days per calendar year |
|
Hospital Inpatient, outpatient, emergency room, urgent care, nervous or mental/chemical dependency, hospice |
80% |
60% |
|
Skilled Nursing Facility |
80% up to 120 days per calendar year |
60% up to 120 days per calendar year |
|
Home Health Care |
80% up to 100 days per calendar year |
60% up to 100 days per calendar year |
|
Hearing Aids |
80% up to $1,000 per calendar year |
60% up to $1,000 per calendar year |
|
Prosthetic Devices, Appliances, Durable Medical Equipment (initial purchase or rental) |
80% |
60% |
Identity Force
When you enroll in the medical plan, you have access to identity theft protection through Cigna’s Identity Force at no additional cost to you and your enrolled dependents under 18 years old. Click here for details.
Cigna Employee Assistance Program (EAP)
As a Cigna member, you have access to work/life resources, and licensed clinicians to help you cope with a wide variety of concerns, from family and financial issues to substance use, emotional health, and stress. You are eligible for up to 3 visits at no cost. To find a Cigna EAP, login to MyCigna.com, click Employee Assistance Program (EAP) under the Coverage tab or call Cigna at (800) 244-6224.
Second Opinion Program
Cigna health plan members have online access to the MyConsult® Cleveland Clinic Second Opinion program. In this program, Cleveland Clinic physician experts review medical records and diagnostic test results and render an online medical second opinion that includes treatment options or alternatives and recommendations regarding future therapeutic considerations for over 1,200 diagnoses. These diagnoses can include conditions that impact your qualify of life or conditions that may be more serious. Getting a second opinion from MyConsult® can provide you with the education, confidence, and peace of mind that you are making the right choice for your health, or that of a loved one, without having to leave the comfort of home. These second opinions are provided at no cost to all eligible participants.
To get started, log in to Cleveland Clinic's Second Opinion for Cigna webpage.
Create your log-in (name, email address and password)
Complete your Profile
Select Check Insurance
Select Cigna
Enter your subscriber ID
Select Yes or No to answer if you are the subscriber
Service Key enter ‘Cigna’
Once you have submitted your opinion request, you may check on the status by logging on to the secure website. In addition, you will be notified by email when your online medical second opinion is ready for your review.
Questions? Contact the MyConsult® Clinical Operations Office:
Email: myconsult@ccf.org
Phone: 1.800.223.2273 ext. 43223
Healthy Pregnancies, Healthy Babies®
Cigna Healthy Pregnancies, Healthy Babies® program provides expectant mothers with the information and support they need to optimize their chances of having a healthy, full-term pregnancy. This program helps to prevent high-risk pregnancy and premature births through early risk detection and on-going monitoring and coaching. Once a member enrolls in the program, a Cigna pregnancy specialist interviews the expectant mother to understand her history. Links are provided to maternity information and resources, and a pregnancy workbook is provided to keep the coach and mom in sync. Enrolled members have access to unlimited coaching calls which provide caring support, so that mom, her OB/GYN, and Cigna can work together for a successful outcome.
But wait - there’s more! To inspire and motivate moms to do everything possible to care for themselves during pregnancy, those who enroll will receive incentives delivered via Motivate Me, an integrated platform on MyCigna.com and Cigna Healthy Pregnancy™ App, once they complete the program. Members who enroll during the first trimester of pregnancy will receive a $150 incentive upon completion of the program, and members who enroll during the second trimester of pregnancy will receive a $75 incentive upon completion of the program. The incentive dollars can be redeemed for various gift cards available through the Motivate Me platform on MyCigna.com and Cigna Healthy Pregnancy™ app.
To get started, call Cigna at the number on the back of your ID card.
At-Home Physical Therapy
Cigna health plan members will have access to Hinge Health, a 12-week coach-led digital at-home exercise and physical therapy program for chronic back and joint pain. Therapy programs for women’s pelvic health are being added beginning 1/1/2024. Members interested in the program should go to hingehealth.com/maritz or call 855.902.2777 and complete the online screening process to see if you qualify. Once approved for the program, you will be provided with a free tablet and wearables, unlimited health coaching and personalized exercise therapy. You will also receive help with weight loss and low mood, which contribute to chronic pain.
Preventive, acute, and chronic pain therapy programs are available, as well as therapy following surgery.
There is no cost to the member for this program.
Lifestyle Change Program
Omada® is a digital lifestyle change program that can help you lose weight, feel fantastic, and develop long-term healthy habits.
Omada includes:
An interactive program to guide your journey
A wireless smart scale to monitor your progress
Weekly online lessons to empower you
A professional Omada health coach to keep you on track
Small online group of participants to keep you engaged
More great news: You’ll receive the program at no additional cost if you or your adult family members (18 or older) are enrolled in the Maritz medical plan offered through Cigna, are at risk for diabetes, and are accepted into the program.
Take Omada’s 1-minute health screener to see if you’re eligible: Maritz Omada Program Website