Click here to Access the Transition of Care or Continuity of Care Form if you are under current care and/or have procedures planned.
The medical plans cover a wide range of services, from preventive and routine care to hospitalization and surgery. The medical plans include a prescription drug benefit through CVS Caremark, which covers prescriptions at participating pharmacies and mail-order maintenance drugs. Please see the Summary Plan Description for more details.
| Premier Plan | Saver Plan w/ HRA* | |||
|---|---|---|---|---|
| Medical Plan | In-Network | Out-of-Network | In-Network | Out-of-Network |
| Deductible** | $500 Individual $1,000 Family | $1,250 Individual $2,500 Family | $1,750 Individual $3,500 Family | $4,375 Individual $8,750 Family |
| Out-of-Pocket Maximum** | $9,100 Individual $18,200 Family | $18,200 Individual $36,400 Family | $9,100 Individual $18,200 Family | $18,200 Individual $36,400 Family |
| Coinsurance | 20% after ded. | 50% after ded. | 20% after ded. | 50% after ded. |
| Office Visit PCP | $15 copay | 50% after ded. | 20% after ded. | 50% after ded. |
| Office Visit Specialist | $30 copay | 50% after ded. | 20% after ded. | 50% after ded. |
| Preventive Care | No charge | 50% after ded. | No charge | 50% after ded. |
| Telehealth | $0 copay | n/a | $0 copay | n/a |
| Telehealth: Behavioral Health | $30 copay | 50% after ded. | 20% after ded. | 50% after ded. |
| Emergency Room | $500 copay | $500 copay | 20% after ded. | 50% after ded. |
| Inpatient/Outpatient Hospital Stay | 20% after ded. | 50% after ded. | 20% after ded. | 50% after ded. |
| Urgent Care Facility | $35 copay | 50% after ded. | 20% after ded. | 50% after ded. |
| * Health Reimbursement Account; ** Annual deductible and out-of-pocket maximums reset every January 1. Any expenses that have already been incurred toward your deductible and out-of-pocket maximums will continue to accumulate until January 1 of the following year. | ||||
Get Started with myCigna
You will be able to find in-network services, manage and track claims, see cost estimates and more.
- Go to mycigna.com or download the myCigna app and select REGISTER NOW
- Enter your requested information, review and submit
Contact Information:
- Group Number: 3343748
- Customer Service: 800-244-6224
- mycigna.com
If you are enrolled in the ConGlobal Saver Medical plan, each year (January 1) ConGlobal contributes money into an Health Reimbursement Account (HRA) that helps you pay for your medical and prescription expenses.
Employer Contributions
- Employee Only: The company applies $500 toward your medical and prescription expenses
- Employee + 1 or more family members: The company applies $1,000 toward your medical and prescription expenses
- Unused funds do not roll over from year to year
How an HRA Works
The Cigna Choice Fund HRA provides a health care plan with a health reimbursement account funded by your employer to help pay for some of your covered health care costs.
- At the start of the plan year, your employer puts a specific dollar amount into your HRA.
- When you receive health care services, your HRA can be used first to pay 100% of your eligible health care costs until the money is used up.
- The health care costs that were paid from your HRA typically count toward your deductible — an annual amount you’ll pay before the health plan begins to pay for covered health care costs.
- Once you meet your deductible, you pay a percentage of the cost (coinsurance) for your covered in-network health care expenses, and the health plan pays the rest.
- Your plan includes an out-of-pocket maximum. This means that if you spend up to that maximum amount during the plan year, your health plan will pay your covered health care costs at 100% for the remainder of the plan year.
- How your HRA is funded: Money from your employer that you receive automatically, or as rewarded for healthy actions
A prescription for better health. Making sure you have access to affordable medication and convenient options for filling is our priority. With CVS Caremark, you can decide the most convenient way to fill your Rx – with options like contact-less delivery to your door or pickup at a pharmacy in your network.
| Prescription Drugs | Premier Plan | Saver Plan w/ HRA |
|---|---|---|
| Generic | $0 copay | 20% after ded. |
| Formulary Brand | $40 copay | 20% after ded. |
| Non-Formulary Brand | $80 copay | 20% after ded. |
| Specialty | $100 copay | 20% after ded. |
| Home Delivery | $0 / $80 / $160 / $200 | 20% after ded. |
CVS Caremark Prescription Benefits
Home Delivery
You can get a 90-day supply of medications you take regularly delivered right to your door. For even more convenience, start automatic refills, too.
You’ll need a new 90-day prescription to get started.
Step 1: Register for an account at caremark.com. Then, select START RX DELIVERY BY MAIL from the Prescriptions tab, and you’ll be taken directly to the Check Drug Cost tool. Search for your medication name and dose.
Step 2: Select an option with 90-DAY SUPPLY MAIL SERVICE and click REQUEST A NEW PRESCRIPTION.
Step 3: Review your order and click or tap SUBMIT REFILLS to request a new 90- day supply of your Rx. CVS Caremark will contact your doctor for approval and then process your order.
CVS Caremark Mobile App
The CVS Caremark mobile app is available on Google Play and the App Store. After you download the app, you can create your own user name and password that will give you access to everything you need to manage your prescriptions.
CVS Caremark Contact Information
Customer Service & Mail Order: 844-203-6363
Speciality Rx: 800-237-2767
caremark.com
RXGRP: RX21AV
RXBIN:004336
RXPCN: ADV
Formularies:
