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CIGNA Group Medical Insurance
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CIGNA Open Access Plus (OAP) Standard Plans
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CIGNA OAP Standard Plans
- CIGNA OAP Standard Health Plans Comparison Grid
- OAP Standard Copay Summary of Benefits
- OAP Standard Passive Summary of Benefits
The Copay plan offers a higher level of benefits than the Passive Plan, overall. The Copay plan utilizes a network of health care providers. The network includes primary care physicians, as well as specialty providers such as internists, chiropractors, cardiologists and neurologists.
Each participant must choose a network provider to act as his or her Primary Care Physician (PCP) and provide the UMS Employee Benefits Center with each covered member's PCP identification number.
To find a PCP in Cigna's network call 1-800-244-622 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
PCP's are responsible for coordinating the care of their patients to ensure that patients receive the most appropriate care available. Participants in the Copay plan have the option to use network or non-network providers. Participants using network providers are covered 100% for hospitalization and pay only a co-payment for physician services. There are no deductibles or claim forms when using network providers.
Participants choosing to use non-network providers receive benefits similar to the Passive Plan, but with a higher out-of-pocket maximum. When participants receive care outside the network, this program also requires pre-certification and utilization review by Cigna for inpatient hospital stays and other listed procedures.
Cigna OAP Standard Copay Premiums
Health Insurance Rates will not increase for 2012 or 2013 unless and until collective bargaining agreements have settled.
TOTAL MONTHLY GROUP HEALTH PREMIUMS
Single Coverage |
Single +One Coverage |
Family Coverage |
| $547.66 | $1,204.82 | $1,533.40 |
EMPLOYEE SHARE OF GROUP HEALTH PREMIUMS
CIGNA OAP STANDARD COPAY HEALTH PLAN*
Full-time Regular Active Employees Also includes BR status employees, shared appointments, and partial/phased retirement. |
Single Coverage |
Single +One Coverage |
Family Coverage |
Faculty - Monthly Premium |
61.61 | 148.68 | 192.22 |
*Subject to ratification and execution of collective bargaining agreements where appropriate.
CIGNA OAP Standard Passive Plan
The Passive Plan allows complete freedom of provider choice so that participants needing care may select any medical care provider they wish. However, before charges are covered, participants must satisfy an annual deductible and pay 20% of the provider’s billed charges. Once the annual out of pocket charges are satisfied, covered services are paid at 100%.
This program requires pre-certification and utilization review by Cigna for inpatient hospital stays and other listed procedures.
2012 OAP Standard Passive Premiums
TOTAL MONTHLY GROUP HEALTH PREMIUMS
OAP STANDARD PASSIVE HEALTH PLAN
Single Coverage |
Single +One Coverage |
Family Coverage |
| $582.39 | $1,281.27 | $1,630.63 |
EMPLOYEE SHARE OF GROUP HEALTH PREMIUMS
OAP STANDARD PASSIVE HEALTH PLAN*
Full-time Regular Active Employees Also includes BR status employees, shared appointments, and partial/phased retirement. |
Single Coverage |
Single +One Coverage |
Family Coverage |
Faculty - Monthly Premium |
65.52 | 158.12 | 204.41 |
*Subject to ratification and execution of collective bargaining agreements where appropriate.
Prescription Drug Coverage
Both medical 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.
Related Information
Special Enrollment Rights under Health Insurance Portability & Accountability Act (HIPAA) and Consolidated Omnibus Budget Reconciliation Act (COBRA)
Domestic Partner Benefits
CIGNA Medical Claim Form (PDF)
Employee Assistance Programs (EAP)
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Notice of Privacy Practices - Revised 9/03
Authorization for the Use and/or Disclosure of Protected Health Information
UMS Health and Wellness
Family Leave Policies
Paid Leave (Vacation & Sick Time)
Retirees Health Plans
COBRA Continuation of Coverage
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: January 11, 2013