Understanding Benefits

Selecting insurance coverage can be complex. Why do you need different types of coverage, including:

Medical

Major medical insurance is a type of health care coverage that provides benefits for a broad range of medical expenses that may be incurred either on an inpatient or outpatient basis.

Why I Need Medical Insurance

Healthcare is one of the few things that people purchase and never know the true cost or value. If we knew the typical cost of common medical services we would realize how much we save by opting into a major medical plan.

  • The average 30-day prescription for a name brand is over $400. For a generic prescription, it is typically 80% to 85% less.
  • An average emergency room visit without insurance can range from $150 - $3,000 or more, depending on the severity of the condition.
  • A Well Baby Visit typically costs $204 and a regular delivery is $15,000.
  • Certain preventative care services are covered at 100% in-network.

Health Savings Account (HSA)

A Health Savings Account (HSA) is a personal savings account where the money can only be used for eligible medical expenses.  Contributions to Health Savings Account can only be used if you are also enrolled in a High Deductible Health Care Plan.

Why I need an HSA

Healthcare Savings Accounts are designed to work in conjunction with high deductible health plans (HDHPs) to help cover the rising costs of healthcare.

  • HSA funds accrue interest over time, tax-free with no lifetime limit.
  • HSA accounts are individual accounts. Contributions are yours to keep even if you leave your employer.
  • HSA funds can be used to pay for any qualified medical expense for you and your tax-eligible dependents, even if the expense is not covered by your insurance plan.

Flexible Spending Account (FSA)

A Flexible Spending Account (FSA) allows you to pay for eligible healthcare expenses with a pre-loaded debit card. You choose the amount to set aside from your paycheck every year, based on the annual plan limit. This money is use it or lose it with a $550 rollover.

WHY I NEED AN FSA

Your Flexible Spending Account saves you money by putting aside funds tax-free that can be used to pay for qualified medical expenses.

  • Your pre-loaded FSA debit card can be used at places like the doctors office or the pharmacy without the need for reimbursement forms.
  • You do not have to be enrolled in a medical plan to enroll in an FSA.
  • The funds in a full-purpose healthcare FSA can be used to pay for eligible medical expenses like deductibles, co-payments, prescription drugs, orthodontics, glasses and contacts for you and any tax-eligible dependents.

What is the difference between an HSA and FSA?

 HSAHealth Care FSA
Available if you enroll in the…Cigna HDHP PPO with HSA PlanCigna PPO $500 Deductible Plan or Cigna PPO $1,000 Deductible Plan or Kaiser Plans
Eligible for company contributions YesNo
Change your contribution amount anytimeYesNo
Access your entire annual election amount from the beginning of the plan yearNoYes
Access only funds that have been deposited YesNo
“Use it or lose it” at year-endNoYes (any amount over $550)
Money is always yours to keepYesNo

Telehealth

Telehealth provides 24/7/365 access to board-certified doctors via telephone or video consultations that can diagnose, recommend treatment and prescribe medication. Telehealth makes care more convenient and accessible for non-emergency care when your primary care physician is not available.

Why I need Telehealth

Healthcare should be simple, fast, and effective. Telehealth makes it easy to get treatment for your minor ailments without visiting urgent care or your primary care physician.

  • Virtual visits can treat mild conditions like sinus infections, allergies, and pink eye without waiting on the next available appointment.
  • No consultation fees on most plans.
  • Appointments while at work or traveling
  • 75% of all doctor, urgent care, and ER visits could be handled safely and effectively via telehealth.

When should I go to Urgent Care vs the Emergency Room?

Knowing when to go to an Urgent Care Center instead of the Emergency Room (ER) can save you time and money. When appropriate, going to an urgent care facility instead of an emergency room can save you on average $2,000! If you need medical attention but it’s not too serious or life threatening, you may not have to go to an ER. An urgent care center provides quality care like an ER, but also offers short wait times, extended hours and you will be seen by an experienced doctor or nurse!

Need help deciding where to go? Call your doctor or for more information you can call the toll-free number on your Cigna or Kaiser ID card. If it is a medical emergency, go to the nearest hospital or call 911. Visit myCigna.com or kp.org to find an urgent care center near you.

Where should I go?

If you’re unsure of where you should go for your current symptoms, check out the list below to help direct you to the right provider. Most issues can be treated at your local Urgent Care, while life- threatening issues should be directed to the emergency room or call 911. However, Urgent care is not intended to be a substitute for a primary care provider (PCP).  If you do not have a primary care physician, please access myCigna.com or KP.org to find a primary care physician near you.

Urgent Care

Get care for things like:

  •   Earaches and infections
  •   Minor cuts, sprains and burns
  •   Fever and flu symptoms
  •   Cough, cold and sore throat
  •   Animal bites
  •   Mild asthma
  •   Urinary tract infections
  •   Headaches
  •   Back and joint pain

Urgent care is not intended to be a substitute for a primary care provider (PCP). You should always consult your PCP for care and treatment recommendations. If you do not have a primary care physician, please access myCigna.com to find a primary care physician near you.

Emergency Room

Get care for things like:

  • Sudden numbness or weakness
  • Disorientation or difficulty speaking
  • Sudden dizziness or loss of coordination
  • Seizure or loss of consciousness
  • Shortness of breath or severe asthma attack
  • Head injury/major trauma
  • Blurry or loss of vision
  • Severe cuts or burns
  • Heart attack, chest pain or chest pressure
  • Overdose
  • Uncontrolled bleeding
  • Coughing or vomiting blood
  • Severe allergic reactions

Dental

Dental insurance is a coverage that helps defray the costs of dental care. It insures against the expense of routine care, dental treatment and disease.

Why I need Dental Insurance
  •  By opting into dental insurance, a person can save thousands of dollars per year on routine and emergency oral care. Average costs of dental procedures without insurance include:
    • Office visits = $288
    • Cavity filling = $200 - $600
    • Tooth extraction = $75-$4,000
  • Good dental care may improve your overall health.

Vision

Vision insurance provides coverage for routine eye examinations and can help with covering some of the costs for eyeglass frames, lenses or contact lenses.

Why I need Vision Insurance

Vision insurance reduces the costs of services and products such as vision exams, glasses, frames, and contact lens.

  • Regular eye exams can help detect other health issues such as diabetes, cancer, liver disease, and heart disease. 
  • Signs you need an eye exam include squinting, blurred vision, night vision issues, or chronic itching and redness.
  • 76% of adults use some sort of vision correction.

Disability

Disability insurance protects one of your most valuable assets, your paycheck. This insurance will replace a portion of your income in the event that you become physically unable to work due to sickness or injury for an extended period of time.

Why I need Disability Insurance

On top of the medical bills that come with a serious injury or illness, can you afford to be out of work for an extended period of time? Disability insurance can offer you peace of mind to protect your paycheck.

  • One in 8 workers will be disabled for 5 or more years during their working careers.  
  • A disabling injury occurs every eight seconds. 
  • Americans have a 50% chance of becoming disabled for 90 days or more between the ages of 35 and 65. 
  • Just over 1 in 4 of today’s 20 year-olds will become disabled before they retire.
  • 34.6 months is the duration of the average disability claim.

Life and AD&D

Group term life is the most inexpensive way to purchase life insurance. You have the freedom to select an amount of life insurance coverage you need to help protect the well-being of your family. Accidental Death & Dismemberment is life insurance coverage that pays a death benefit to the beneficiary, should death occur due to a covered accident. Dismemberment benefits are paid to you, according to the benefit level you select, if accidentally dismembered.

Why I need AD&D

Life insurance is never fun to think about and may seem like an unnecessary expense. However, if you have someone that depends on you financially, life insurance is really about protecting them if something were to happen to you. Life insurance and AD&D policies help your loved ones pay for expenses, such as:

  • Mortgage payments
  • College tuition
  • Burial expenses

Accident

Do you have kids playing sports, are you a weekend warrior, or maybe accident prone? Accident plans are designed to help pay for medical costs associated with accidents and benefits are paid directly to you.

Why I need Accident Insurance
  • Accident insurance will deliver a predetermined payment to you for various qualifying incidents. These occurrences may include: 
    •  Injuries such as fractures, dislocations, burns, concussions, lacerations, etc. 
    • Medical services and treatments such as emergency transportation and physical therapy.
    • Some plans also include accidental death and dismemberment or common carrier benefits as an add on benefit.

Hospital Indemnity

This is an affordable supplemental plan that pays should you be in-patient hospital confined. This plan complements your health insurance by helping you pay for costs left unpaid by your health insurance.

Why I need a Hospital Indemnity Plan

Hospital indemnity policies pay a set benefit based on your hospital stay. These funds:

  • Help cover high medical deductibles and copays.
  • Provide a safety net for unexpected medical expenses.
  •  Can be paid directly to you or the care provider.
  • The median hospital cost has grown to over $10,500 per stay.

Optional Life

Optional Life insurance is a policy that covers a single person and is intended to meet the financial needs of the beneficiary, in the event of the insured’s death. This coverage is portable and can continue after you leave employment or retire.

Why I need Optional Life

Optional life policies are owned by you and can be taken with you if you leave your employer and kept into retirement. These policies help protect loved ones from financial distress when you are gone.

  • Premiums are paid through your payroll deductions as long as you are with your employer. 
  • Premiums are based on coverage amount and age at time of purchase. 
  • Experts recommend at least x 10 your gross annual income in coverage when purchasing life insurance.

Employee Assistance Program (EAP)

An Employee Assistance Program (EAP) is a program that assists you in resolving problems such as finding child or elder care, relationship challenges, financial or legal problems, etc.  This program is provided by your employer at no cost to you.

Why I need Employee Assistance

Balancing work and life is difficult sometimes. Your EAP option covers trouble areas such as:

  • Stress management.
  • Financial problems.
  • Grief counseling.
  • Family counseling.