main navigation
my pace
Human Resources

Network Core $25 Plan

The Network $25 plan offers in-network coverage only. That is to say that your provider must be contracted through the CIGNA Open Access Plus network, which is a national network (in-network providers are available nation-wide).

The features of this plan include:

  • $25 co-payment to visit a Primary Care Physician, OB-GYN, or Specialist.
  • No referrals are needed.
  • The annual (calendar year) Out-of-Pocket Maximum is $2,000 for individual coverage and $4,000 for employee +1 and family coverage.
  • Preventive care exams are covered at 100%.
  • No charge for in-network hospitalization.
  • $80 Emergency Room co-payment, which is waived if you (or a covered dependent) are admitted to the hospital.
  • In-network prescription co-payments of: $15 for generic medications, $30 for preferred brand medications, and $55 for non-preferred brand medications, after the calendar year deductible for non-generic prescriptions ($125 per person, $375 for +1 and family) has been satisfied. Certain maintenance medications are available via mail order for 1 co-payment for a 90-day supply.

There is no coverage for out-of-network services. The only exception may apply for an emergency situation, in which the charges are specifically coded as such.