Page 9 - Enrollment guide 2024-25 - v3

Medical Overview Plan Highlights

SchoolCare has partnered with Traditional Suite Consumer Driven Suite
Cigna for many years to deliver
comprehensive health care Green Plan Red Plan Yellow Plan Orange Plan
service and claims administration.
We use Cigna’s National Open
Access Plus network of providers. Low out-of-pocket Low deductible Moderate Deductible High Deductible
This gives you access to care HMO-like Coinsurance Pair with HRA Pair with HSA
in every state of the country.
Primary care provider (PCP) Office Visits & Rx Copays Combined Medical Combined Medical
referrals are not required to seek Rx Copays & Rx OOP & Rx OOP
care from a specialist.

All plans provide:
What Does National Network Mean? • Self-referral to any Cigna contracted provider in the country
Key Terms • The same coverage for all services (your cost may vary)
The expanded provider network consists of any Cigna • Preventive care at no cost
contracted provider or facility in the country.
Participants have in-network coverage not only Deductible For more details on specific plans, please review Schoolcare health plan webinars.
regionally, but nationally as long as services are
provided by a Cigna contracted provider (you always You must meet the entire deductible before the
have access to emergency care anywhere, worldwide). plan starts to pay medical and prescription drug Review the Summary of Benefits and Coverage (SBC) to compare costs and coverage
benefits (excluding in-network preventive care between health plans based on price, benefits, and features important to you.

What Does Open Access Mean? and certain preventive medications). NOTE: If you
enroll one or more family members, you must
meet the full family deductible before the plan
Open Access means there is no requirement to starts to pay expenses for any one individual. Finding Care & Costs
designate a PCP for any plans. Therefore, no PCP
referrals are required. Participants can make
appointments and receive services for in-network Coinsurance Access the myCigna Directory 24/7
covered benefits with any Cigna participating provider
without obtaining a referral from your PCP. Once you’ve met the plan’s annual deductible, After you enroll, you’ll have access to myCigna.com – your one-stop source for managing your health plan,

you are responsible for a portion of your anytime, just about any place. Finding an in-network provider has never been easier. Whether you're looking
for a doctor, dentist or hospital, find the best choice for you in just four simple steps.
Traditional Plan Suite medical expenses, which is called coinsurance.

Cigna Care Designation
The Traditional Plan Suite includes long-established Out-of-pocket maximum
copay plans as well as a plan with a modest deduct- Whether looking for a primary care or specialty
ible for medical services. Once your deductible and coinsurance add up physician, finding the right doctor isn't always easy.
to the plan’s annual out-of-pocket maximum, Care Designation can help you find cost-effective care.
Consumer Driven Plan Suite the plan will pay 100% of all eligible covered
services for the rest of the plan year. NOTE:
If you enroll one or more family members,
The Consumer Driven Plan Suite offers comprehensive you must meet the full family out-of-pocket Refer to the SchoolCare
health plans with deductibles that can be offered with maximum before the plan starts to pay covered Health Benefits Booklet (HBB)
an HRA or HSA, depending on the plan. This gives you services at 100% for any one individual. for more detailed information.
more control of personal health care expenses.
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