Consumer Driven Plan Suite
What is the Yellow Plan (formerly CDHP)?
- The Yellow Plan is an Open Access plan that does not require enrollees to select a PCP or obtain referrals to see other providers or specialists in the Cigna network. Doctors in the Cigna network are called participating providers.
- The plan provides preventive care and certain generic drugs at no cost to enrollees.
- All covered services (except no-cost preventive) apply to deductible and coinsurance.
- Prescription drugs (except certain generics) are also subject to deductible and coinsurance.
- Except in cases of emergency, enrollees must use participating providers to be eligible for benefits.
- While not required to select a primary care physician (PCP), members are encouraged to establish and maintain a relationship with a PCP. Also, a PCP may be helpful in coordinating your care and initially arranging referrals to specialists.
- This plan can be offered with or without an embedded HRA provided by SchoolCare to cover the first portion of the services that apply to the deductible.
What is the Orange Plan?
- The Orange Plan provides the same coverage and network as all the other SchoolCare plans
- The Orange Plan can be offered alongside the Yellow Plan.
- Preventive care and certain generic drugs covered at no cost.
- All covered medical services and prescription drugs apply to the deductible.
- Coinsurance begins after deductible has been met.
- Continue paying coinsurance until reaching the out of pocket maximum.
- The Orange Plan meets IRS requirements for Health Savings Account (HSA) to be used for qualified medical out of pocket expenses (deductible/coinsurance costs).