Independence Administrators (IA) are the Fund's major medical insurance provider for doctors, hospitals, and specialists. When Participants visit providers who are in-network with Independence Administrators or the local Blue Cross/Blue Shield Plan in your state, the Fund pays the coinsurance percentage of the total IA allowance, leaving the Participant responsible for the their coinsurance portion. Participants are responsible for the coinsurance until they have met their out-of-pocket maximum (OOP). Once an individual or family has reached their OOP Max, the Plan will pay 100% for all further In-Network claims for the duration of the Plan Year (April 1 through March 31).
MAJOR MEDICAL COVERAGE
- Annual Out-of-Pocket Maximums $1,000 individual / $2,000 familyThe annual out-of-pocket maximum for In-Network Services through Independence Administrators (IA) and Mental Health Consultants (MHC) are $1,000.00 for an individual and $2,000.00 for a family. Participants are responsible for the coinsurance until they have met their out-of-pocket maximum (OOP). Once an individual or family has reached their OOP Max, the Plan will pay 100% for all further In-Network claims for the duration of the Plan Year (April 1 through March 31).
- Labwork covered 100% through LabCorpLab Work is covered 100% if processed through LabCorp. If processed through an in-network lab, doctor or hospital, it would be covered under your 90/10 coinsurance plan.
- Chiropractic Treatment52 visits per year at any in-network provider. 10% coinsurance.
- Accupuncture Treatment18 visits per year at any in-netowrk provider. 10% coinsurance.
90/10 Coinsurance Whiteboard Video
- 90-day supplies covered through CVS or Express Scripts Mail Order
- Generic Medications: $5 for 30-day / $10 for 90-day supply
- Preferred Brand Medications: 25% coinsurancePreferred Brand Medications have a 25% coinsurance with a max of $75 for 30-day and $150 for 90-day supply
- Non-Preferred Brand Medications: 40% coinsuranceNon-Preferred Brand Medications have a 40% coinsurance with no maximum copay
The prescription drug plan through Express Scripts offers low co-pays for generic medication, convenient way to get 90-day prescriptions filled, and a specialty pharmacy for some long term health conditions that require special medicines.
With a Cigna DPPO plan, you have access to a national PPO network with over 100,000 providers. You don't need to choose a primary dentist for care, and you don't need referrals to visit specialists. And since many dentists offer online appointment scheduling through myCigna, it's easy to make appointments and receive reminders.
CIGNA DENTAL COVERAGE
- $2,500 Annual Family AllowanceThere is a $2,500 Annual Family Allowance for all services (April 1 - March 31). Once the allowance is met, you will be responsible for 100% of all dental services for the remainder of the benefit year
- Check-ups Covered 100%All preventative 6-month cleanings and checkups are covered at 100% (counts against $2,500 annual allowance)
- $3,200 Lifetime Orthodontia AllowanceThis dental plan also includes a separate lifetime orthodontia allowance of $3,200 per family member
Dental Coverage Explainer Video
- Vision Exams Covered at 100%Annual vision exams are covered 100% for you and your eligible dependents ($40 allowance for out-of-network providers). Plan year runs April 1 through March 31.
- $100 Allowance for EyewearFrames, Lenses, or Contacts once per year for each eligible family member (same allowance for out-of-network).
- Additional $50 Allowance at Visionworks.A total allowance of $150 for frames and lenses at Visionworks providers (In-network only).
- Covered Once Per YearAll eligible Participants can go for exams, lenses, frames, or contacts each Benefit Year (April 1 through March 31).
Davis Vision has been providing comprehensive vision care benefits for over 50 years. Access to better vision begins with having the qualified eye care professionals in our network, which helps us to ensure our members can find cost-effective care, and a variety of styles. Davis Vision has a large national network comprised of over 100,000 facilities, giving you access to live customer service 7 days a week.