DeKalb County 2012 Health Plan Options

Kaiser HMO
Premiums & Cost Sharing
- Lower monthly premiums than Cigna Open Access Plans - $15 doctor co-pay/$25 specialist co-pay - No co-pay for preventive care visits - No deductible for doctor/specialist visits - Co-pay for Outpatient Procedure ($100 Employee/$200 Family) - Co-pay for Inpatient Procedure ($200 Employee/$400 Family) - Emergency Room $75 - No co-insurance (80/20 split) Plan Usage - Must use in-network doctors at Kaiser facilities - Must use Kaiser pharmacy, lab, and specialists

Cigna Open Access Plus In-Network

(formerly known as Cigna HMO)

Premiums & Cost Sharing - Highest monthly premiums - $25 doctor co-pay/$40 specialist co-pay - No co-pay for preventive care visits - No deductible for doctor/specialist visits - Co-pay for Outpatient Procedure ($100 Employee/$200 Family) - Co-pay for Inpatient Procedure ($200 Employee/$400 Family) - Emergency Room $150 - No co-insurance (80/20 split) Plan Usage - Must use in-network doctors & specialists for lowest rates - Wider range of doctors than Kaiser - May use out-of-network doctors at higher cost - Caremark pharmacy plan

Cigna Open Access Plus

(formerly known as Cigna PPO High)

Cigna Choice Fund

(A new option also referred to as a Consumer Driven Health Plan,High Deductible Plan) with Health Savings Account (HSA))

Premiums & Cost Sharing - Monthly premium less than Cigna OA Plus In-network but higher than Kaiser and Cigna Choice Fund - $300 Employee/$600 Family Deductible In-network - $500 Employee/$1000 Family Deductible Out-ofnetwork - Emergency Room $150 co-pay plus 20% co-insurance - 20% In-Network co-insurance (after deductible is met) - 40% Out-of-network co-insurance (after deductible met) - Max out-of-pocket cost: $1500 Employee/$3000 Family - $10 (Generic)/$25 (Brand)/$50 (Specialty) pharmacy co-pays Plan Usage - No deductible for preventive care visits - No deductible for pharmacy; Caremark pharmacy plan - Employee pays 100% of cost up to deductible then 20% of cost after deductible is met - Must use in-network doctors/specialists for lowest rates - Wider range of doctors than Kaiser - May use out-of-network doctors at higher cost

Premiums & Cost Sharing - Lowest monthly premium but very high deductible - $1500 Employee/$3000 Family Deductible (County provides $750 toward Employee deductible and $1500 toward Family deductible) - 20% In-Network co-insurance (after deductible is met) - 40% Out-of-network co-insurance (after deductible is met) - Max out-of-pocket cost: $3000 Employee/$6000 Family Plan Usage - No deductible for preventive care visits - Employee pays 100% of cost up to deductible then 20% of cost after deductible is met (medical & pharmacy) - Must use in-network doctors & specialists for lowest rates - Wider range of doctors than Kaiser - May use out-of-network doctors at higher cost - Cigna pharmacy plan - Employee pharmacy co-pays apply to deductible - With HSA, unused end-of-year balances roll over to next year or may be transferred to another qualified health savings plan

HR

* This is intended for information purposes only and not to be construed as the official plan document. 10/12/11