Open Enrollment 2020
Open Enrollment is now closed for the 2020 calendar year.
All changes made during this Open Enrollment period will take effect on January 1, 2020* and will remain in effect through December 31, 2020. You cannot change your benefit selections until the next Open Enrollment period (which will be in fall 2020 for an effective date of January 1, 2021), 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, 2020 – December 31, 2020
Cigna Medical/Vision Premiums
We are pleased to announce that the employee premiums for medical coverage will reduce by 1.6 % in 2020. Vision premiums will remain unchanged.
Cigna DENTAL Premiums
The premiums for the Dental DHMO plan will remain unchanged in 2020. The premiums for the Dental PPO plan will increased by 4%. The plan designs will remain unchanged.
Cigna consumer core high deductible health plan (hdhp) – increased deductible
The 2020 deductible will increase to $1,400 (individual) and $2,800 (family) from the 2019 deductible of $1,350 (individual) and $2,700 (family).
HSA Contribution Limits
Coverage Type: Individual $3,550
Coverage Type: Family $7,100
Health Care FSA and Dependent Care FSA Limits
The limit for the Health Care FSA (January 1, 2020 – December 31, 2020) is $2,750 ($114.59 per paycheck).
The limit for the Dependent Care FSA (January 1, 2020 – December 31, 2020) is $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, 2020 – December 31, 2020)
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, 2020, you will receive an annual (12-month) reimbursement of $1,800 ($75 per paycheck). After 1 year (as of January 1, 2021), 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, 2020, 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 participants can see a board-certified doctor with private, online, and live appointments via a secure video or phone conversation. Participants are able to choose from two Telehealth vendors, American Well and MDLIVE, how they want to connect, and the time and day that works best for them with medical Telehealth services available 24/7/365. Telehealth doctors can treat many common health issues including cold & flu, joint aches and pains, fever, bronchitis and more. Participants with children can also turn to CignaTelehealth services for non-emergency pediatric care. Telehealth services provide a more immediate and potentially lower cost alternative to traditional ‘in person’ care, such as hospital ERs and Urgent Care clinics.
For more information - Cigna Telehealth (PDF).
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