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Medical Overview Plan Highlights

SchoolCare has partnered with Cigna for Consumer Driven Suite Traditional Suite
many years to deliver comprehensive health
care service and claims administration. We use The Consumer Driven Plan Suite offers SchoolCare’s Traditional Plan Suite includes
comprehensive health plans with deductibles
long-established copay plans as well as a plan
Cigna’s National Open Access Plus network of that can be offered with an HRA or HSA, with a modest deductible for medical services.
providers. This gives you access to care in every depending on the plan. This gives you more
state of the country. Primary Care Provider control of personal health care expenses.
(PCP) referrals are not required to seek care
from a specialist. Yellow Plan Orange Plan Green Plan Red Plan

What Does National Network Mean? Moderate Deductible High Deductible Low out-of-pocket Low deductible

The expanded provider network consists of any Cigna Pair with HRA Pair with HSA HMO-like Coinsurance
contracted provider or facility in the country.
Participants have in-network coverage not only Combined Medical Combined Medical Office Visits & Rx Copays
regionally, but nationally as long as services are & Rx OOP & Rx OOP Rx Copays
provided by a Cigna contracted provider (you always
have access to emergency care anywhere, worldwide).

What Does Open Access Mean? All plans provide:

Open Access means there is no requirement to • Self-referral to any Cigna contracted provider in the country
designate a PCP for any plans. Therefore, no PCP • The same coverage for all services (your cost may vary)
referrals are required. Participants can make • Preventive care at no cost
appointments and receive services for in-network For more details on specific plans, please review Schoolcare health plan webinars.
covered benefits with any Cigna participating provider
without obtaining a referral from your PCP.
Review the Summary of Benefits and Coverage (SBC) to compare costs and coverage
between health plans based on price, benefits, and features important to you.
Key Terms

Don't Forget to Activate Your
Deductible Choice Fund
You must meet the entire deductible before the
plan starts to pay medical and prescription drug Out-of-pocket maximum Subscribers enrolled in the Yellow Plan with
benefits (excluding in-network preventive care Once your deductible and coinsurance add up to Choice Fund must complete a confidential
and certain preventive medications). the plan’s annual out-of-pocket maximum, the Cigna Health Assessment annually to
plan will pay 100% of all eligible covered services activate their Choice Fund. $1,000
NOTE: If you enroll one or more family members, for the rest of the plan year. • Biometric health data is not Single
you must meet the full family deductible before the required
plan starts to pay expenses for any one individual. NOTE: If you enroll one or more family members,
you must meet the full family out-of-pocket • Current subscribers must
st
Coinsurance maximum before the plan starts to pay covered complete between July 1 $2,000
st
Once you have met the plan’s annual deductible, services at 100% for any one individual. and August 31 Two-Person/
you are responsible for a portion of your medical Find your group’s plan offerings • New subscribers must Family
expenses, which is called coinsurance. at www.schoolcare.org complete within 60 days of
effective date.
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