Medical & Prescription
Administered by Cigna
FirstCall offers two (2) medical plan options to meet the needs of you and your family, wherever you might be on life's journey. You can choose from the Exclusive Provider Organization (EPO) plan or the HSA-eligible High-Deductible Health Plan (HDHP). Cigna is the carrier of our medical plans and the Pharmacy Benefit Manager (PBM). In-network benefits are covered under the Cigna PPO Network for both plans.
Terms to Know Before You Begin
HDHP
A High-Deductible Health Plan (HDHP) is a plan with a higher deductible than a traditional insurance plan. The monthly premium is usually lower, but you pay more health care costs yourself before the insurance company starts to pay its share (also called your deductible). You must be enrolled in an HDHP to qualify for an HSA or HRA.
EPO
An Exclusive Provider Organization (EPO) refers to the rule of this type of plan that requires members to get care within the plan’s network of select providers. If you get care outside the EPO network, you’ll likely have to pay the full cost of that visit.
Network
A group of health care providers, including dentists, physicians, hospitals and other health care providers, that agrees to accept previously determined rates when serving members. In-network services are typically more cost effective than using out-of-network provider.
Deductible
Total dollar amount, based on the allowed amount, you must pay out of pocket for covered medical expenses each calendar year before the plan pays for most services. The deductible does not apply to in-network preventive care and any services where you pay a co-payment rather than coinsurance.
Embedded
There are two parts to a plan with an embedded deductible. The first is an individual deductible, which applies to each family member, and the second is an overall family deductible. When an individual meets their deductible, the insurance company will begin paying according to the plan’s coverage for that member. When the family deductible or out-of-pocket maximum is reached, coverage begins for everyone.
Coinsurance
A percentage of the medical costs, based on the allowed amount, you must pay for certain services after you meet your annual deductible. For example: If your coinsurance is 90 percent, insurance pays 90 percent and you pay 10 percent.
Copay
A copayment (copay) is a set dollar amount you pay for in-network doctors’ office visits, emergency room services and prescription drugs.
Out-of-Pocket Maximum
The maximum amount of coinsurance a Plan member must pay toward covered medical expenses in a calendar year for both network and non-network services. Once you meet this out-of- pocket maximum, the Plan pays the entire coinsurance amount for covered services for the remainder of the calendar year. Deductibles and copays apply to the annual out-of-pocket maximum.
Click to visit the glossary on the Resources page for more benefits terms.
Medical Plan Highlights
Cigna | Cigna PPO Network
HDHP
In-Network
Type of Deductible
Embedded
Plan Year Deductible (Individual / Family)
$5,000 / $10,000
Your Coinsurance
0%
Out-of-Pocket Maximum (Individual / Family)
$5,000 / $10,000
Physician Visit (Primary Care / Specialist)
Deductible, then covered 100%
Preventive Care Services
Covered 100%
Hospital Services
Deductible, then covered 100%
Urgent Care Visit
Deductible, then covered 100%
Emergency Room Visit
Deductible, then covered 100%
Out-of-Network
Plan Year Deductible (Individual / Family)
$7,500 / $15,000
Your Coinsurance
20%
Out-of-Pocket Maximum (Individual / Family)
$10,000 / $20,000
EPO
In-Network
Type of Deductible
Embedded
Plan Year Deductible (Individual / Family)
$2,000 / $4,000
Your Coinsurance
0%
Out-of-Pocket Maximum (Individual / Family)
$5,500 / $11,100
Physician Visit (Primary Care / Specialist)
$25 / $40 copay
Preventive Care Services
Covered 100%
Hospital Services
Deductible, then coinsurance
Urgent Care Visit
$40 copay
Emergency Room Visit
$250 copay
Out-of-Network
Plan Year Deductible (Individual / Family)
Not applicable
Your Coinsurance
Not applicable
Out-of-Pocket Maximum (Individual / Family)
Not applicable
Prescription (Rx) Plan Highlights
Cigna | Cigna PPO Network
HDHP
Retail (30-day supply)
Tier 1 - Generic
Deductible, then covered 100%
Tier 2 - Preferred Brand
Deductible, then covered 100%
Tier 3 - Brand Name
Deductible, then covered 100%
EPO
Retail (30-day supply)
Tier 1 - Generic
$25 copay
Tier 2 - Preferred Brand
$50 copay
Tier 3 - Brand Name
$150 copay
Contribution Rates
Rates Per Weekly Pay Period (52 Per Year)
Employee Only
PPO Base
$0.00
PPO Mid
$39.23
PPO Buy-Up
$60.90
Employee & Spouse
PPO Base
$88.63
PPO Mid
$154.29
PPO Buy-Up
$201.92
Employee & Child(ren)
PPO Base
$46.62
PPO Mid
$90.48
PPO Buy-Up
$121.04
Employee & Family
PPO Base
$96.29
PPO Mid
$191.80
PPO Buy-Up
$240.17
Your Medical & Rx plan is administered by Cigna.
Cigna has developed a microsite experience that goes into additional detail about your plan options as well as additional resources and programs to support your overall wellbeing. Click the button below to learn about the medical plan offerings and more.
Contact the provider of these benefits by calling this phone number or visiting this website: Cigna Healthcare Customer Service - 1 (800) 997-1654, www.cigna.com
Questions?
Call the Care Line at (877) 835-1361.
Care Line is an NFP-sponsored program that is staffed by dedicated professionals to help you understand the benefit options made available to you. Whether you have concerns about a recent claim or bill, finding an in-network doctor or just some guidance on which medical plan is right for you and your family, the Care Line can help educate and advocate.
The Care Line is open Monday through Friday from 9:00 am - 6:00 pm ET.
For questions related to your benefits (enrollment, coverage, etc.), our Benefits Concierge team is here to help, email dbbenadmin@nfp.com.
For any claims-related issues, please reach out to our dedicated Claims Specialists, email csclaims@nfp.com.
FirstCall Benefits Team
Our very own internal Benefits Team is at your disposal. If you have any questions about your benefits, need help understanding eligibility or the enrollment process, or experience a qualifying life event, please contact us at benefits@firstcallmechanical.com.
This Digital Benefits Guide is intended to highlight available benefits and should be relied upon to fully determine coverage. The benefits plan may not cover all health care expenses. More complete descriptions of benefits and the terms under which they are provided are contained in the Certificate of Coverage that you will receive upon request. If this Digital Benefits Guide conflicts in any way with the policy issued by the employer, the policy shall prevail.