Medical Care
All of the available options give you access to high-quality, comprehensive care. They differ largely in the way the cost of care is structured and in the strategies you can use to control your expenses:
- PPO Plans: these plans let you choose care inside or outside of the network you selected, but you will incur a higher out-of-pocket cost for services.
- HMO Plans: these plans offer a comprehensive, convenient approach, but require that you seek care within the network you selected.
- HDHP Plans: these plans are high deductible insurance plans that help protect against large claims as well as to cover preventive care at 100% (deductible is waived for preventive services). If you enroll in this plan, you are eligible to open a Health Savings Account (HSA) which can be used to help pay for qualified medical expenses. (Available to all employees)
- 2024 Employee and Employer Rate Sheet
- 2024 Payroll Deduction Calendar
- Total Rewards At CEI
- 2024 Benefits Post Enrollment
Employees who work in the city of San Francisco, please visit:
https://sfgov.org/olse/health-care-security-ordinance-hcso
for more information on the San Francisco Health Care Security Ordinance.
See comparison tables below for coverage details.
Contact Cigna - Group# 00651190
- mycigna.com
- 1-866-494-2111
Contact Kaiser - Group# 9680
- kp.org
- 1-800-464-4000 (English)
- 1-800-788-0616 (Spanish)
- Cigna OAP Benefit Summary
- Cigna OAP SBC
- Cigna OAP Certificate
- Cigna OAP HDHP Benefit Summary
- Cigna OAP HDHP SBC
- Cigna OAP HDHP Certificate
- Cigna OAP Plus Benefit Summary
- Cigna OAP Plus SBC
- Cigna OAP Plus Certificate
- Cigna Utah PPO Benefit Summary
- Cigna Utah PPO SBC
- Cigna Utah PPO Certificate
- Cigna Utah HDHP Benefit Summary
- Cigna Utah HDHP SBC
- Cigna Utah HDHP Certificate
- Cigna Utah PPO Plus Benefit Summary
- Cigna Utah PPO Plus SBC
- Cigna Utah PPO Plus Certificate
Cigna members in Utah will use the PPO Network while Cigna members in all other states will use the OAP Network.
Cigna - Group #00651190
- mycigna.com
- 1-866-494-2111
- OneGuide Pre-Enrollment
- Transition of Care
- Medical Claim Form
- Rx Claim Form
- Digital ID Card
- PHI Authorization
- Handicapped Disabled Dependent Family Form
- Handicapped Disabled Dependent Physician Form
- Behavioral Health - Emotional Wellbeing
- Virtual Care Services
- Virtual Wellness Screening
- Customer Resource Guide
- Healthy Rewards
- Healthy Rewards Active & Fit Direct
- Find a Network Provider
- Cigna Open Enrollment - Find a Doctor
- Urgent and Emergency Care Outside of the U.S.
- Health Information Line
- Performance 3 Tier Prescription Drug List
- Preventive Care Services
Kaiser Tools & Resources
CEI employees can now visit the nearest MinuteClinic and pay their standard copay if they get sick or injured while traveling in a state where Kaiser Permanente does not operate. All that is needed is a photo ID and their membership card or health/medical record number.
MinuteClinics are located in select CVS Pharmacy and Target locations, and are staffed by non-Kaiser Permanente nurse practitioners and physician assistants who can treat a range of simple urgent care services for conditions and symptoms. Members can visit a MinuteClinic with or without an appointment. The improved experience when paying for care at MinuteClinic gives Kaiser Permanente members one more convenient alternative for urgent (non-emergency) care.
Kaiser Permanente members who get sick or injured while traveling have multiple options — review the attached infographic to see the many ways members are covered while traveling.
As a reminder, here are the resources and services that make getting care away from home easier than ever:
- Away from Home Travel Line — A single number to call about getting care away from home: 951-268-3900. Available anywhere in the world, anytime. *
- kp.org/travel — The site covers many questions about getting care that come up before, during, or after travel.
- Early refill of eligible prescriptions — To help keep travel stress-free, members can request early refills of their prescriptions to ensure they last throughout their whole vacation.
Kaiser - Group #9680
- kp.org
- 1-800-464-4000 (English)
- 1-800-788-0616 (Spanish)
Kaiser Tools
Kaiser Resources and Programs
Kaiser Resources and Programs
- Healthy Resources Guide
- Preventive Care Services
- Emergency and Urgent Care Brochure
- Telehealth
- Video Visits
- Care Away From Home
- Mental Health Resources
- Mental Health Services Video
- Digital Health Offerings
- Total Health Assessment and Lifestyle Programs
- Wellness Coach
- ClassPass
- Healthy Rewards Active & Fit Direct
Deductible - The amount you must pay for medical services, before the plan pays a benefit. Preventative care is always covered at 100% with no deductible required.
Coinsurance - This is the percentage of the cost you pay for certain services after the deductible has been met. You can think of this as “cost sharing”. For example, once your deductible has been met you could pay 20% for the cost of certain services and the plan could pay 80%.
Copay - The flat fee paid by the member when a medical service is received, i.e. $20 for a doctor's visit or $20 for a prescription.
In Network Provider - An in-network provider is a hospital, doctor, medical group, and/or other healthcare provider contracted to provide services to insurance company customers for a discounted fee. Using these providers will lessen your medical expenses when using your benefits.
Out of Network Provider - An out of network provider is a hospital, doctor, medical group, or other healthcare provider who are not contracted to provide services to insurance company customers. Because the fees are not negotiated in advance with the insurance company, the provider can charge the member as much as they wish.
Out of Pocket Maximum - The maximum amount a member would have to pay out of their pocket for medical expenses for the year, with the exception of benefit premiums (which come out of your paycheck). Your out-of-pocket maximum includes your deductible, any coinsurance paid and all co-payments (medical and prescription drug).
PLAN COMPARISON | AT A GLANCE
|
|
|
|
|
|
|
In-Network* |
In-Network* |
In-Network* |
In-Network Only |
|
|
Annual Deductible (Individual / Family) |
$750 / $1,500 |
$250 / $500 |
$1,600 / $3,200 |
None |
|
Out-of-Pocket Maximum (Individual / Family) |
$5,000 / $10,000 |
$6,000 / $6,000 |
$6,000 / $6,000 |
$1,500 / $3,000 |
|
Office Visits |
$20 copay / $40 copay |
$20 copay / $40 copay |
10% / $10% |
$30 copay / $30 copay |
|
Preventive Care |
Covered in Full |
Covered in Full |
Covered in Full |
Covered in Full |
|
Outpatient Surgery |
20% |
20% |
10% |
$30 / procedure |
|
Inpatient Hospital |
20% |
20% |
10% |
$250 / admission |
|
Emergency Room (Waived if admitted) |
20% |
20% |
10% |
$100 / visit |
|
Retail Prescriptions (Up to 30 day supply) |
30 day supply Tier 1: $15 Tier 2: $35 Tier 3: $50 |
30 day supply Tier 1: $15 Tier 2: $35 Tier 3: $50 |
30 day supply Tier 1: $10 Tier 2: $30 Tier 3: $50 |
30 day supply Tier 1: $10 Tier 2: $25 Tier 4: 20% up to |
*Out of Network benefits available
Please keep in mind that this summary describes only the highlights of the benefits plans and policies available to you. The details of these plans and policies are contained in the official plan and policy documents. If there is a question about one of these plans or policies, or a conflict between this summary and the official plan and policy documents, the official documents will govern.