HEALTH Insurance
Shelby County Schools offers medical benefits administered by Cigna Healthcare. Employees have a choice of three plans with different deductible levels and premiums to accommodate your healthcare needs and budget. The side-by-side comparison shown below highlights copayments, coinsurance, deductibles, and other pertinent information.
For more detailed information on each plan, please view the summary of benefits for each individual plan:
Eligibility & Enrollment Information:
- Full-time permanent employees (working 30 hours or more per week) may enroll in coverage within 30 days of their hire date (30 days for a re-hire). Employees may cover their legal spouse (if they do not have access to affordable employer sponsored group coverage) and their dependent children age 26 and under.
- Enrollment must be completed online at https://www.mybentek.com/scs.
- Coverage is effective the first day of the month after the completion of 30 days of employment.
- You can only make changes to your health benefits during Open Enrollment each year or within 30 days of a qualifying life event (example: marriage, divorce, birth/adoption of a child, loss of other coverage, dependent loss of other coverage, etc.).
- Enrolled employees and their eligible dependents will receive a COBRA notice to temporarily extend coverage under the Plan in the event that they separate employment or become benefits ineligible.
- To view your personal benefits enrollment information, go to www.mycigna.com. For additional questions about your coverage, contact Cigna at 1-800-736-7568.
Comparison of Plans:
CIGNA Medical Plan Comparison
| OAP IN- NETWORK PLUS | OAP BASIC OPTION | CHOICE FUND HRA | ||
In-network | In-network | Out-of- network | In-network | Out-of-network | |
You Pay | You Pay | You Pay | |||
| Annual deductible | |||||
| Employee Employee + 1 Family | $500 $1,000 $1,000 | $1,000 $2,000 $2,000 | $2,000 $4,000 $4,000 | $1,500 $3,000 $3,000 | $3,000 $6,000 $6,000 |
| Annual Out-of-pocket maximum* | |||||
| Employee | $3,000 | $4,000 | $8,000 | $7,150 | $14,300 |
| Employee + 1 | $9,000 | $12,000 | $24,000 | $14,300 | $28,600 |
| Family | $9,000 | $12,000 | $24,000 | $14,300 | $28,600 |
| Coinsurance | 20% | 20% | 50% | 30% | 50% |
| Annual Health Fund (HRA) | |||||
| Annual Health Fund provided to | |||||
| offset your deductible | |||||
| Employee Employee + 1 | N/A | N/A | N/A | $500 $1,000 | |
| Family | $1,000 | ||||
| Medical coverage | |||||
| Doctor’s office visits | $25 copay | 20% | 50% | 30% | 50% |
| Preventive care (mammograms, PAP test, physicals, immunizations) | 0% | 0% | Not Covered | 0% | Not Covered |
| Specialist visits | $40 copay | 20% | 50% | 30% | 50% |
| Telemedicine visits | $25 copay | Copay; 20% | N/A | Copay; 30% | N/A |
| Outpatient surgery | $250 copay | 20% | 50% | 30% | 50% |
| Inpatient hospital (per stay) | $500 copay | 20% | 50% | 30% | 50% |
| Emergency room | $250 copay | $400 copay | $400 copay | 30% | 30% |
| Labs and X-rays | 20% | 20% | 50% | 30% | 50% |
| Urgent Care | $75 copay | 20% | 50% | 30% | 30% |
| Prescription drugs | |||||
| Deductible | N/A | N/A | $100 per person | N/A | $100 per person |
| Generic (30-day supply) | $10 copay | $10 copay | 50% | $10 copay | 50% |
| Preferred Brand Formulary (30-day supply) | 20% ($25 min/$60 max) | 20% ($25 min/$60 max) | 50% | 20% ($25 min/$60 max) | 50% |
| Non-Preferred Brand (Non- formulary) (30-day supply) | 30% ($50 min/$80 max) | 30% ($50 min/$80 max) | 50% | 30% ($50 min/$80 max) | 50% |
| Mail Order (90-day supply) | 3 x retail copay | 3 x retail copay | Not covered | 3 x retail copay | Not covered |
Pricing Summary:
CIGNA Medical Plan Cost Comparison
| 20 Pay Premiums | 24 Pay Premiums | ||
Medical Plan | Non-Tobacco | Tobacco | Non-Tobacco | Tobacco |
| OAP In-Network Plus | ||||
| Employee Only | $125.81 | $155.81 | 104.85 | $129.85 |
| Employee + 1 | $280.39 | $310.39 | $233.66 | $258.66 |
| Family | $391.13 | $421.13 | $325.95 | $350.95 |
| OAP Basic | ||||
| Employee Only | $88.09 | $118.09 | $73.41 | $98.41 |
| Employee + 1 | $215.32 | $245.32 | $179.43 | $204.43 |
| Family | $300.36 | $330.36 | $250.30 | $275.30 |
| OAP Choice Fund HRA | ||||
| Employee Only | $55.80 | $85.80 | $46.50 | $71.50 |
| Employee + 1 | $147.76 | $177.76 | $123.13 | $148.13 |
| Family | $206.12 | $236.12 | $171.77 | $196.77 |
*All plans have an unlimited lifetime plan maximum
For questions, please feel free to call (901) 416-5304 or email us at [email protected].
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