Open Enrollment Is Closed For The 2021 Plan Year
This is your opportunity to review your current benefit elections, make changes to your medical, dental, and life insurance coverage, as well as enroll (or re-enroll) in a health care or dependent care Flexible Spending Account (FSA) for an effective date of January 1, 2021. You must enroll in the Flexible Spending Accounts during this Open Enrollment period in order to participate (your current FSA election, if applicable, will not automatically roll over into the new plan/calendar year).
Open Enrollment, for the new plan year (from January 1, 2021 through December 31, 2021), will be completed online via an electronic open enrollment form. The form allows you to login with your Portal credentials and enroll or change your benefits online–at work, at home, or from any computer with Internet access–at any time during the Open Enrollment period. Note: VPN access is NOT required. After successful completion of the process, you will receive a confirmation via e-mail to your Pace account.
If you do not have changes to make and do not wish to participate in the Flexible Spending Accounts, it is not necessary to complete the Open Enrollment form–your benefits will continue as they are. However, please review the “Updates for January 1, 2021–December 31, 2021” section below (including the General Reminders), as there are some plan modifications that will take effect on January 1, 2021.
All changes made during this Open Enrollment period will take effect on January 1, 2021* and will remain in effect through December 31, 2021. You cannot change your benefit selections until the next Open Enrollment period (which will be in fall 2021 for an effective date of January 1, 2022), unless you experience a qualifying change in family status during the new plan year.
*With the exception of voluntary life insurance changes for those currently on short-term disability, Family and Medical Leave, New York Paid Family Leave, Workers Compensation disability, or unpaid personal leave. Such changes will become effective on the first of the month following the employee’s return to work.
Updates For January 1, 2021–December 31, 2021
Cigna Medical/Vision Premiums
Employee premiums for medical coverage will increase by 3.4% in 2021. Vision premiums will remain unchanged.
Copayments for In-Network Mental Health and Substance Abuse (Outpatient) Visits
For the Network Core and Choice PPO medical plans, in-network mental health and substance abuse outpatient visits will be covered at the primary office visit copayment ($30). Previously these services were covered at the specialist office visit copayment ($50).
Cigna DENTAL Premiums
Dental premiums will reduce by 14.4% in 2021. The plan designs will remain unchanged.
Cigna Consumer Core High Deductible Health Plan (HDHP)–No Change in Deductible
The 2021 deductibles will remain the same at $1,400 (individual) and $2,800 (family).
New Cigna ID Cards For Medical/Prescription Coverage
As of January 1, 2021, Cigna will change the pharmacy claim system from Cigna Pharmacy to Express Scripts, a Cigna company. As a result of this change, all members will receive a new medical ID card. Please be sure to present your new ID card, after January 1st, to the pharmacy; your current ID card will not work after January 1, 2021. If you refill your prescriptions at the retail chains, Cigna will be transferring any open refills and pre-authorizations to the new system. If you are utilizing Cigna’s Home Delivery service, any open prescriptions will automatically be transferred to the new Express Scripts (PDF) system. Additionally, any prior authorizations will also carry over with the existing prior authorization end date. Members who utilize the myCigna.com or myCigna app for Home Delivery support will be redirected to the Express Scripts website for support and information.
Cigna Telemedicine Through MDLive
In 2020, we encouraged all participants to enroll in Cigna’s telemedicine programs. As of January 1, 2021, Cigna is only partnering with MDLive (PDF). We encourage you to register now, if you have not already done so. It is much easier to access this service if you have previously registered. Please note, MDLive offers both physical and mental health telemedicine services. For more information, please visit the MDLive for Cigna website or call 1 (888) 726-3171.
HSA Contribution Limits
Coverage Type: Individual $3,600
Coverage Type: Family $7,200
Health Care FSA and Dependent Care FSA Limits
The limit for the Health Care FSA (January 1, 2021–December 31, 2021) is unchanged at $2,750 ($114.59 per paycheck).
The limit for the Dependent Care FSA (January 1, 2021–December 31, 2021) is unchanged at $5,000 ($208.33 per paycheck); $2,500 ($104.16 per paycheck) if both spouses contribute via separate employers.
You must enroll, during each Open Enrollment period, in order to participate for the new plan year.
Reminder: Deductibles and annual limits are calculated on a calendar year basis. Please plan accordingly.
Per Paycheck Premiums (January 1, 2021–December 31, 2021)
medical plan waiver reimbursement for those newly waiving coverage
For those who are currently covered under our Cigna medical plans and will be waiving coverage for the first time as of January 1, 2021, you will receive an annual (12-month) reimbursement of $1,800 ($75 per paycheck). After 1 year (as of January 1, 2022), your annual (12-month) reimbursement will revert to $750 ($31.25 per paycheck). Those who are currently waiving medical coverage, and will continue to do so as of January 1, 2021, will receive an annualized reimbursement of $750 ($31.25 per paycheck).
Coverage to end of calendar year in which dependent turns age 26
A dependent is eligible for coverage under the medical/vision and dental plans until the end of the calendar year in which he/she turns age 26. A dependent who ages off the plans at age 26 will be offered the opportunity to continue dental coverage on COBRA and medical coverage on COBRA or under the New York State Young Adult Option (premiums are 2% less than COBRA).
Continuation of value prescription drug list
- $0 co-payments for generic preventive medications on this list (PDF)
- narrowing the list of high-cost brand drugs used to treat the same medical condition (unless proven clinically necessary through the medical exception process)
- moving certain drugs on the formulary to another tier
Please review the Cigna Value 3-Tier Prescription Drug List (PDF), especially the section entitled, “Medications That Are Not Covered” (beginning on Page 18) and discuss covered alternative medications with your physician prior to January 1st.
Urgent care facilities
In recent years, many Urgent Care centers have emerged in towns and cities, including within drug stores and medical groups. Urgent Care centers provide individuals with care when the situation isn’t life threating, but requires immediate attention. Urgent Care centers will typically cover conditions such as: earaches and infections, minor cuts, sprains and burns, fever and flu. Pace’s Network Core and Choice PPO plans require a co-payment of $30 for Urgent Care vs. an Emergency Room co-payment of $85. If a participant is enrolled in the Consumer Core HDHP, the cost of services will be less at an Urgent Care center than at the Emergency Room, so out-of-pocket costs will be less.
It is important to note that while a facility may be advertised as “Urgent Care”, the Urgent Care center or medical offices providing “urgent care services” could very well not be contracted with Cigna as a participating Urgent Care facility. Cigna participants have encountered this issue when a medical group has an Urgent Care center; however, this center is actually contracted with Cigna as a “specialist provider.” In this case, the Network Core and Choice PPO specialist co-payment–of $50 - applies. In order to find a contracted Urgent Care center ($30 co-payment), please contact Cigna or utilize the Cigna Mobile App (PDF) and search for “Urgent Care.”
For severe and life-threatening conditions (such as shortness of breath, chest pain, uncontrollable bleeding, etc.), the Emergency Room could be the more appropriate setting and a hospital will be better-equipped to handle these situations.
Cigna Lab Services
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 not covered at all (if you are enrolled in an in-network only plan). As such, we strongly recommend that you inform your provider of the participating labs whenever you utilize these services. The following provides some guidance on how to best handle these services.
What you need to do when lab work is needed:
- Find network labs by going to mycigna.com or calling the number on your Cigna ID card.
- Tell your doctor you want to use a Cigna network lab.
- If your doctor takes a sample in the office, tell him/her to send it 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 the lab is contracted within 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 at all, if you are in the Consumer Core HDHP, Network Core, or In-Net 50 plan), you do have the right to appeal the decision. Please contact Cigna’s customer service department at the number listed on your ID card.
Annual Deductibles, Out-Of-Pocket Maximums, Etc.
Annual deductibles, out-of-pocket maximums, etc. are based upon a calendar year.
Benefits to Consider During this Open Enrollment period
- Cigna Medical Plans
- Medical Plan Waiver
- Cigna Vision Plan
- Cigna Dental Plans
- Health Care Flexible Spending Account (FSA)
- Child and Dependent Care Flexible Spending Account (FSA)
- Cigna Voluntary Life Insurance
Benefits to Consider Throughout the Plan Year (Can be Changed During the Year)
- Commuter Reimbursement Accounts (CRA)
- New York 529 College Savings Program
- Long Term Care
- Employee Assistance Program (EAP)
- 403b Defined Contribution Retirement Plan