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PPO
HSA
Other Services

PPO

Tier 1

Provider Information

https://www.cigna.com

Deductibles

$3,000

Employee

$6,000

Family

Max Out of Pocket

$5,600

Employee

$11,200

Family

Non-Network

Provider Information

Deductibles

$6,000

Employee

$18,000

Family

Max Out of Pocket

$21,000

Employee

$48,000

Family

HSA

Tier 1

Provider Information

https://www.cigna.com

Deductibles

$2,800

Employee

$5,600

Family

Max Out of Pocket

$2,800

Employee

$5,600

Family

Non-Network

Provider Information

Deductibles

$5,600

Employee

$11,200

Family

Max Out of Pocket

$11,200

Employee

$22,400

Family

Other Services

Provider Information

Pre-certification
Vendor

Consociate

800-798-2422

Telehealth
Services

https://www.memd.net

Pharmacy
Networks

empirxhealth.com

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