EPISD Self-Funded Health Plan Administered by Cigna

  • As a District of Innovation (DOI), and in accordance with the amendment to the Local Innovation Plan, Administration has designed an alternative self-funded group health plan, hereafter referred to as Cigna, first becoming effective September 1, 2019. The Cigna plan is offered in addition to the TRS Active Care Health Plan without opting out of the program.

    Great benefits offered to those that choose the CIGNA plan include:

    Cigna utilizes a National Network of Providers as well as providing Out-of-Network coverage and lower out of pocket expenses for employees in most benefit coverages areas.

    Cigna provides 24/7 Customer Service 365 days a year to include a pre-enrollment guide to assist you with any questions you may have concerning medical coverage, pharmacy benefits, and your HSA.

    Employees can access the Cigna One Guide at 1-800-233-6224 which can be found on the back of your Cigna ID card. Additional resources are located at myCigna.com to include viewing your benefits, formulary, and claim history, and to get a price on a new medication as well as cost-saving alternatives (if available)

    Other exceptional coverage under Cigna is the coverage for Emergency Room visits. Under the High Deductible Option Emergency Room visit is 100% covered after the deductible is met. Coverage under the Cigna Traditional PPO for Emergency Room visit is $500 copay and then 20% after the Deductible is met.

    Preventive Care is Holistic in nature in that it provides both a Well Woman exam and a Complete Physical covered at 100%. This is especially important to EPISD since many of our employees are women.

    Consumer Driven Health Plan Option:

    Cigna CDHP (High Deductible) is still $0 for Employee Only coverage. The other Cigna CDHP tiers reduce premiums 13% on average as compared to plans offered by TRS-AC.

    If you enroll for the Cigna CDHP and choose the Health Savings Account (HSA) EPISD will contribute up to $500 towards your HSA even if you choose not to contribute yourself./p>

    Cigna High Deductible Option provides 100% coverage after the deductible is met and including the employer contribution to the Health Savings Account (HSA) limits an employee’s out of pocket costs to $2,500.

    Virtual appointments are covered 100% after deductible with two provider options.

    Traditional PPO Health Plan Option:

    Co-pays for Specialist office visits are lower than TRS ActiveCare Plan Options

    Rx copayments are less with the Cigna Traditional PPO Option.

    Using the 90 Now program through CIGNA will save you money for maintenance medicines that you take every day.

    Virtual appointments are covered 100% after deductible with two provider options.

    Annual Vision exam is covered at 100%

    Use the compare cost flyer to see how EPISD and Cigna are working together to benefit you and your family!