Medical – ALL OTHER – Frontier Dental Labs

Which Medical Plan is Right?

Medical coverage is provided through Cigna. The medical coverage includes a national network of physicians, specialists and hospitals. Frontier Dental Labs offers employees medical coverage through Cigna’s Open Access Plus (OAP) Network. Below is a snapshot of what is covered under the plan. To see a full, comprehensive list, please refer to the Summary of Benefits. Plan Costs are communicated separately.

We understand how confusing and overwhelming it can be to review your health plan options. And we want to help by providing the resources you need to make a decision with confidence. That’s why Cigna One Guide® service is available to you now.

Call a Cigna One Guide representative during preenrollment to get personalized, useful guidance.

Your personal guide will help you:

Easily understand the basics of health coverage
Identify the types of health plans available to you
Check if your doctors are in-network to help you avoid unnecessary costs
Get answers to any other questions you may have about the plans or provider networks available to you

The best part is, during the enrollment period, your personal guide is just a call away.

Don’t wait until the last minute to enroll.

Call 888.806.5042 to speak with a Cigna One Guide representative today.

Medical Plan Comparison

Cigna	OAP In-Network Only			Open Access Plus			Open Access Plus HDHP
Benefit	In-Network	Out-of-Network	In-Network	Out-of-Network	In-Network	Out-of-Network
Contract Year Deductible	$1,000 Individual $2,000 Family	N/A	$2,000 Individual $4,000 Family	$4,000 Individual $8,000 Family	$3,200 Individual $6,400 Family	$6,400 Individual $12,800 Family
After Deductible Plan Pays	80%	N/A	80%	60%	90%	60%
Contract Year Out-of-Pocket Maximum (includes Rx)	$4,000 Individual $8,000 Family	N/A	$5,000 Individual $10,000 Family	$8,000 Individual $16,000 Family	$5,000 Individual $10,000 Family	$10,000 Individual $20,000 Family
Lifetime Maximum	Unlimited	N/A	Unlimited	Unlimited	Unlimited	Unlimited
Preventive Care for Adults & Children	100%	N/A	100%	60%, after deductible	100%	60%, after deductible
Doctors Office Visits Primary Care Specialist Urgent Care	$25 Copay / $60 Copay / $50 Copay	N/A	$30 Copay / $70 Copay / $60 Copay	60%, after deductible	90%, after deductible	60%, after deductible
Inpatient / Outpatient Facility Charges	80%, after deductible	N/A	80%, after deductible	60%, after deductible	90%, after deductible	60%, after deductible
Emergency Room Facility Charges*	$400 Copay 80% after deductible	N/A	$400 Copay 80% after deductible	$400 Copay 80% after deductible	90%, after deductible	90%, after deductible
Ambulance	80%, after deductible	N/A	80%, after deductible	80%, after deductible	90%, after deductible	90%, after deductible
Chiropractic Benefits ($1,500 annual max)	$25 Copay	N/A	$30 Copay	60%, after deductible	90%, after deductible	60%, after deductible
Independent Labs	80%, after deductible	N/A	80%, after deductible	60%, after deductible	90%, after deductible	60%, after deductible

Prescription Drugs Plan Comparison

Benefit	OAP In-Network Plan	OAP Plan	OAP HDHP Plan
Retail Pharmacy (per 30-day supply) Generic Brand Non-preferred Specialty	$10 Copay $30 Copay $50 Copay $100 Copay	$10 Copay $30 Copay $50 Copay $100 Copay	10% up to $25 Copay 10% up to $50 Copay 10% up to $75 Copay 10% up to $100 Copay
Retail and Home Delivery Pharmacy (per 90-day supply) Generic Brand Non-preferred	$20 Copay $60 Copay $100 Copay	$20 Copay $60 Copay $100 Copay	10% up to $50 Copay 10% up to $100 Copay 10% up to $150 Copay