Medical Plans

MS&A is pleased to offer employees a choice of three medical plans designed to meet a variety of healthcare needs and preferences:

• Cigna Exclusive Provider Organization (EPO)
• Cigna Preferred Provider Organization (PPO)
• Kaiser Permanente Health Maintenance Organization (HMO)

Cigna Exclusive Provider Organization (EPO)

A Cigna Exclusive Provider Organization (EPO) plan offers the flexibility to manage your healthcare without the need to select a Primary Care Physician (PCP) or obtain referrals to see in-network specialists.

To receive coverage, you must generally use healthcare providers, specialists, hospitals, laboratories, and other facilities that participate in the Cigna network. Except for emergency or urgently needed care as defined by the plan, services received outside the network are not covered.

Benefits of the Cigna EPO include:

• No Primary Care Physician (PCP) selection required
• No referrals needed to see in-network specialists
• Access to Cigna’s extensive nationwide provider network
• Predictable out-of-pocket costs when using in-network providers
• Greater convenience and flexibility while helping keep healthcare costs lower than many PPO plans

Cigna Preferred Provider Organization (PPO)

The Cigna Preferred Provider Organization (PPO) plan offers the greatest flexibility in choosing healthcare providers. You may visit any licensed physician or healthcare provider without a referral.

When you receive care from providers within the Cigna PPO network, you’ll benefit from negotiated rates and lower out-of-pocket costs. You may also choose to receive care from out-of-network providers; however, your costs will typically be higher, and you may be responsible for any charges that exceed the plan’s allowed amount.

Kaiser Permanente Health Maintenance Organization (HMO)

The Kaiser Permanente Health Maintenance Organization (HMO) plan centers on the relationship between you and your Primary Care Physician (PCP). When you enroll, you select a PCP who coordinates your medical care and refers you to Kaiser specialists when needed.

Your PCP also coordinates any necessary pre-authorizations for covered services (excluding emergencies). By receiving care through the Kaiser Permanente network, you’ll generally enjoy lower out-of-pocket costs and coordinated, integrated healthcare.

Ancillary Plans:

• Delta Dental DHMO Plan
• Delta Dental PPO Plan
• Mutual of Omaha Critical Illness Insurance
• Mutual of Omaha Hospital Care Coverage
• VSP Vision Plan
• Mutual of Omaha Basic & Voluntary Life Plans
• Mutual of Omaha Voluntary Short Term Disability Plan
• Mutual of Omaha Long Term Disability Plan
• Mutual of Omaha Employee Assistance Plan (EAP)
• Mutual of Omaha Travel Insurance
• Voluntary Pet Insurance Plans

These summaries are intended to highlight the most common procedures to assist employees in choosing the type of plan most suitable to their needs. They are not intended to be relied upon to fully determine coverage. Unless stated otherwise, the amounts shown are based on what you would pay. Any one plan may not cover all health care expenses. Please refer to your Certificate of Coverage for a complete listing of services, limitations, exclusions and a description of all terms and conditions of coverage. If these summaries/descriptions conflict in any way with the policies issued, the policies will prevail.

Medical

Choosing a medical plan is an important decision to make because of its direct impact to you and your family’s health care services. The benefit comparison chart below highlights the differences between the medical plans offered. You may want to review the Summary Plan Description for specific coverage information. The plan that is best for your depends on you and your family’s individual needs.

Remember, PPOs give you the freedom to visit any licensed professional without a referral from your personal doctor. When you choose to visit a doctor within the Blue Shield PPO network, you will benefit from lower co-insurance amounts and significant savings by receiving the contracted discounted rates after any applicable deductibles. If you choose a non-contracted doctor you will pay more for your health care.