2022 Medical Insurance
This is the 2022 health insurance policy for US employees.
If you have questions regarding your health insurance, please email firstname.lastname@example.org.
All employees working 30 or more hours per week are eligible to enroll in a health plan immediately upon starting with thoughtbot. Your effective date is your start date.
2022 Medical Benefits
thoughtbot pays at least 90% of the medical insurance premiums for individuals and 80% for their families for all medical plans. Family plans cover spouses, domestic partners, and/or children. thoughtbot offers two Cigna plans to all full-time US team members, allowing you to pick the best plan for you and your family. Our plan years run on a calendar year cycle: January 1st to December 31st.
The two Cigna plans have the same network of doctors and cover all the same services, but the cost for those services vary. This section reviews some of the benefits of both plans.
With a PPO plan, you do not need to get a referral from a primary care doctor before seeing a specialist. But you should make sure all providers you see are in-network. In-network providers will get approval from Cigna before a procedure. It is your responsibility to get approval from Cigna before a procedure if you see an out-of-network provider.
Only the amount you pay for in-network covered expenses counts towards your in-network deductible. Only the amount you pay for out-of-network covered expenses counts towards your out-of-network deductible.
In compliance with the Transparency in Coverage rules, Cigna’s machine readable files are made available to everyone. The files include negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.
Cigna Open Access Plus $1000/$2500
This plan has a deductible of $1000 for individuals and $2500 for families. The individual member deductible is capped at $1000. So if you enroll in the employee + spouse/domestic partner plan, your family’s total deductible would be $2000.
Many services and prescriptions require that you pay a co-pay instead of an expensive deductible. In network preventative care is fully covered.
In-network coverage is fully covered or requires a modest co-pay ($20 for primary care doctor/specialists/urgent care visits-$150 for the ER) or deductible. Out-of-network coverage requires you to pay 20% co-insurance.
You are not eligible to enroll in the HSA if you select this plan.
For details, please see Cigna Open Access Plus $1000/$2500 Summary of Benefits & Coverage.
Cigna Open Access Plus $2000/$4000 + HSA
This plan has a deductible of $2000 for individuals and $4000 for families. There is no per member deductible cap on dependent plans. One family member could incur charges equalling the full deductible.
The deductible applies first to everything except preventative care. This includes specialist office visits, sick visits, urgent care, prescriptions, etc.
With an HSA-powered health plan, instead of making copayments at the time of service, you will have a deductible to meet. A deductible is the amount you are required to pay out-of-pocket for services before your health plan benefits kick in. While you may see a higher deductible than you’re used to, the plan has a lower monthly premium. Preventive care is always covered 100%.
If you enroll in an individual plan, thoughtbot will contribute $750 (prorated monthly) to your HSA account. This essentially reduces your deductible to $1250.
If you enroll in a plan with dependents, thoughtbot will contribute $1500 (prorated monthly) to your HSA account. This essentially reduces your deductible to $2500.
You are not eligible to enroll in the FSA if you select this plan.
For details, please see Cigna Open Access Plus $2000/$4000 + HSA Summary of Benefits & Coverage.
Monthly Premiums for Employees
|Medical Plans||Cigna Open Access Plus $1000/$2500||Cigna Open Access Plus $2000/$4000 + HSA|
|Employee + spouse/domestic partner||$234.29||$90.00|
|Employee + child(ren)||$202.27||$75.00|
|Employee + family||$394.38||$150.00|
Changing Your Benefits
You have 30 days to make changes after life events (marriage, childbirth, etc). Otherwise changes must be made during the open enrollment period. You may add or drop dependents with a qualifying life event to plans that you are currently enrolled in due to a life event. You may only switch plans during open enrollment.
To change your enrollment following a life event, visit Employee Navigator. We may follow up with you to collect additional information necessary to make the requested change.
Unless otherwise stated, upon termination, your medical benefits will remain in effect until the last day of the month in which you are terminated.
Upon termination you may be entitled to continuation or conversion of the group medical insurance plan in accordance with the terms of the policy and/or applicable state and federal law. For more information, contact email@example.com.