Open Access Plus

You have the freedom to choose doctors both in and out-of-network and may see a specialist without a referral. In-network and out-of-network benefits are subject to the applicable annual deductible and coinsurance. Office visits are generally paid at 100% after the applicable co-pay. No referrals required. Administered by Cigna.

Benefit Details


Cost

In-Network Benefits

Out-of-Network Benefits
PCP Office Visit and
Convenience Care Clinic
$20 / $15
20% after deductible / N/A
Specialist Office Visit
$35
30% after deductible
Deductible
$250 per individual
$750 per family
$1,500 per individual
$4,500 per family
Coinsurance
10%
20%
Out-of-Pocket Maximum
$4,000 per individual
$8,000 per family
$5,000 per individual
$15,000 per family