Compare Medical Plans

Find which plan works for you!

The chart below offers a quick comparison of in-network costs for each plan. Out-of-network services will cost more, and you’ll be responsible for any charges above what is considered an allowable charge.

EPO 1000 Buy Up PPO Base PPO HDHP
Annual deductible – the amount you pay before the plan starts to pay
Individual $1,000 $500 $1,000 $2,500
Employee + 1 or more dependents $2,000 $1,000 $2,000 $5,000
Annual out-of-pocket maximum – the most you’ll pay out-of-pocket each plan year
Individual $3,000 $2,500 $3,500 $3,500
Employee + 1 or more dependents $6,000 $5,000 $7,000 $7,000
Coinsurance
Employee Responsibility 20% 10% 20% 10%
Services
Preventative Care no cost no cost no cost no cost
Primary Care or Specialist office visit $30 $20 $25 Deductible then Coinsurance
Specialist $50 $20 $40 Deductible then Coinsurance
Inpatient Hospital Deductible then Coinsurance Deductible / Coinsurance Deductible then Coinsurance Deductible then Coinsurance
Emergency Room $150 $150 $200 Deductible then Coinsurance
Urgent Care $50 $20 $50 Deductible then Coinsurance
Prescription (Rx) Coverage
Tier 1 Retail $10 $10 $10 Deductible then $10
Tier 2 Retail $20 $35 $50 Deductible then $30
Tier 3 Retail $40 $70 $100 Deductible then $50

Important notes about deductibles and out-of-pocket maximums

  • Both your deductible and out-of-pocket maximums reset each year. Your out-of-pocket expenses paid in the previous year do not carry over, no matter when you first enrolled.
  • In-network expenses don’t apply toward your out-of-network deductible or out-of-pocket maximum, and out-of-network expenses don’t apply toward your in-network deductible or out-of-pocket maximum.

Choosing the right plan for you

When deciding which medical plan is right for you, consider how much you typically use your health coverage and how you prefer to pay out-of-pocket costs, so you don’t pay more than you need. Cigna has a helpful Easy Choice Tool (Access code: PIOG-0723) which will help determine what medical plan is right for you!

    Monthly Employee Payroll Contributions

    Please note benefit deductions will occur based on your payroll frequency (semi-monthly 24 pay periods or biweekly 26 pay periods)

    EPO 1000 Buy Up PPO Base PPO HDHP
    Employee Only $65.94 $117.42 $83.71 $43.13
    Employee + Spouse $144.79 $257.88 $183.81 $94.69
    Employee + Child(ren) $136.91 $243.83 $173.80 $89.53
    Employee + Family $204.59 $364.39 $259.71 $133.79