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CIGNA Medical Home | Quality Incentive Plans | Standard Plans | Health Reform
Open Access Plus (OAP) Quality Incentive Plans
- UMPSA effective Nov. 1, 2012
- ACSUM effective Nov. 1. 2012
- Non-Represented Employees
- Police unit members
- Service & Maintenance
- PATFA
Listen and Watch Recorded Informational Broadcast - For All Employees - Introduction to Cigna
Listen and Watch Recorded Informational Broadcast - Health Plan Changes for Non-Represented Employees, Police, Service & Maintenance and PATFA unit members Only
What You Need To Know
Plan Changes - January 1, 2012 (UMPSA & ACSUM - November 1, 2012)
Click on Plan Name to view Summary of Benefits
Both OAP Quality Incentive plans include:
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Primary Care Provider (PCP) referrals not necessary
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National network of participating providers
Prescription Drug Coverage
Both OAP Quality Incentve plan options offered by the University of Maine System provide employees with prescription drug coverage. All employees are covered for both generic drugs and brand name drugs. Because brand name drugs are typically more expensive than generic drugs, you should ask your physician to prescribe a generic drug, if appropriate.
All enrollees have the opportunity to use the mail order program. The mail order program allows the convenience of having a three-month supply of maintenance drugs delivered right to their home!
Any questions on how to best utilize prescription drug coverage should be directed to CIGNA at 1-800-244-6224.
Quality Incentive Health Plan Premium Rates
Health Insurance rates will increase 7.5% effective January 1, 2013
Important Note:
Health Insurance rates are affected significantly by particpation (or not) in the UMS RiseUp Wellness Program -Level 1
What You Need To Do
To Save on Costs
Choose a Cigna Primary Care Provider (PCP)– Choosing a “quality” PCP will ensure less out-of-pocket expenses and better outcomes. Visit www.getbettermaine.org for doctor ratings. Your doctor's practice must have a minimum of 2 ratings of Good, Better or Best to be considered UMS Preferred.
To find a PCP in Cigna's network call 1-800-244-6224 or:
- Click this link: http://cigna.benefitnation.net/cigna/docdir.aspx
- Select Physician
- Enter name and/or location and then click Next
- Select the network: Open Access Plus, OA Plus, Choice Fund OA Plus WITH CareLink and then click Search
See if your Hospital is Preferred – Choosing a “quality” hospital will ensure less out-of-pocket expenses and better outcomes. When planning a hospital in-patient stay, consider using a UMS Preferred Hospital. Overnight in-patient stays at UMS Non-Preferred Hospitals require a $100 co-pay.
Check your Tier for Prescription Drugs – Tier levels determine your cost. Visit http://www.cigna.com/individualsandfamilies
Talk to your doctor about alternatives to the Emergency Room
Whenever possible, see your PCP or use a walk-in health care facility in your community instead of going to a hospital Emergency Room. Emergency Room visits have a $100 employee co-pay (unless admitted to the hospital).
Schedule your annual physical with your PCP. Remember, there is no cost to you for this annual preventive care visit – the co-payment or co-insurance is waived.
Participate in UMS RiseUp Wellness Program
Within 90 days of your effective date of enrollment in the health plan, and January - March of each subsequent year, complete Level 1 of RiseUP, the University’s wellness program to be eligible for reduced premiums and to avoid an increase in premiums (you and your covered spouse/domestic partner must both participate). Premiums, which are currently approximately 10%*, will increase to approximately 20%* after 90 days depending on whether you participate in Level 1 of RiseUP.
*Full-time regular employee share - see Rate Chart for part-time employee rates
Watch mail, email and visit http://www.umsriseup.maine.edu for details or call APS Healthcare at 855-2RISEUP (855-274-7387).
- How Do I know If I Completed RiseUp Level 1 & Level 2?
- RiseUp Tutorial Video
- Meeting RiseUp Level I Criteria Video
Related Information
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Health Insurance Portability and Accountability Act of 1996 (HIPAA)
See also: Understand Your Pay Stub
Contact the Employee Benefits Center
The above is a brief summary of benefits offered by the University of Maine System. If you have a question about benefits enrollment, call The UMS Employee Benefits Center toll-free 866-269-9635 (or 973-3373) or email benefits@maine.edu. Have your Employee ID number for faster service.
Last Updated: March 13, 2013
