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MEDICAL & PRESCRIPTION

MEDICAL & PRESCRIPTION

DG3 North America, Inc. seeks to provide the best possible medical benefits at a reasonable cost. Employees are provided with a medical plan option thought CIGNA that includes prescription drug coverage.  

CIGNA | MEDICAL
HOW THE PLAN WORKS

Preventive Care: The plan pays 100% for in-network preventive care.

Annual Deductible: For non-preventive care there is an annual deductible that must be met. The annual deductible is $6,000 for Individual coverage and $12,000 for Family Coverage when you use in-network providers.

Out-of-Pocket Maximum: This is the most that you will have to pay for covered services in a plan year. All medical and prescription drug deductibles, co-payments and coinsurance apply toward the out-of-pocket maximum. Once you meet the out-of-pocket maximum then the plan pays 100% of your eligible expenses, including the cost of all office visits and prescription drugs, for the remainder of the year.

For 2024 the deductible will increase from $2,500 to $6,000 for singles and from $5,000 to $12,000 for family.   To lessen the impact on employees, DG3 is offering a Health Reimbursement Arrangement (HRA). Once you meet the deductible of $2,500 for single or $5,000 for employee plus one or more dependents you can submit eligible claims ($3,500 for single or $7,000 for employee plus one or more dependents) to be reimbursed by the Health Reimbursement Account. Contact Human Resources for a claim form.

As a reminder, to submit for reimbursement you must complete the claim form provided and submit, along with your corresponding explanation of benefits, to the email address on the form.

In-Network Advantage (Open Access Plus, OA Choice Fund OA Plus)

When you use an in-network provider, the percentage you pay out-of-pocket will be based on a negotiated fee, which is usually lower than the actual charges. If you use a provider who is outside of the network, you may be responsible for paying for the difference between the Usual, Customary and Reasonable (UCR) charges and what the provider charges. You also may need to submit claim forms

How To Search for a Provider

Step 1 Visit cigna.com, Click on Find A Doctor then Click on Employer or School and enter your address, city or zip code

Step 2 Choose Doctor by type, name or search health facility for Medical, Dental or Vision. 

Step 3 Continue as a guest.

  Select a plan/network:

  Medical: Open Access Plus, OA Choice Fund OA Plus;

Step 4 Search based on type of provider or facility, locations near you or by a provider’s name

Step 5 View your results and find out about their training, languages spoken, provider location and phone number

CIGNA HDHP

In Network Providers

National PPO (BlueCard PPO)

Out of Network Providers
Calendar Year Deductible: Single/Family $6,000 / $12,000 $6,000 / $12,000
Coinsurance 20% after deductible 40% after deductible
Maximum Out of Pocket Limit: Single / Family
(Includes the deductible)
$7,000 / $14,000 $14,000 / $28,000
Office Visit 20% after deductible 40% after deductible
Specialist Office Visit 20% after deductible 40% after deductible
Surgical Services 20% after deductible 40% after deductible
Complex X-Ray and Lab – CT, PET, MRI, MRA 20% after deductible 40% after deductible
Urgent Care Centers 20% after deductible 20% after deductible
Emergency Medical Care 20% after deductible 20% after deductible
In-Patient Hospital Services 20% after deductible 40% after deductible
Out-Patient Hospital Services 20% after deductible 40% after deductible
Prescription Drugs: Medical Deductible applies first, then;
Retail (30 day supply)

Tier 1 – $5 / Tier 2 – $30 / Tier 3 – $60

40% after deductible

Covered at participating pharmacies only

Mail Order (90 day supply) Tier 1 – $10/ Tier 2 – $60 /Tier 3 – $120

30% after deductible

Covered at participating pharmacies only

The drug formulary is called Cigna Advantage 3-Tier Prescription Drug List.

Mail Order: Express Scripts Pharmacy®, our home delivery pharmacy, is a convenient option if you’re taking a medication on a regular basis to treat an ongoing health condition. Express Scripts Pharmacy, which is a Cigna company, is one of the country’s largest home delivery pharmacies.

Use the myCigna® App or website to manage your medications.

  • See which medications your plan covers. You can also see which tier they’re covered on.
  • Use Price a Medication to see how much your medication costs. You can also see if there are lower cost alternatives available.
  • See your pharmacy claims and coverage details.
  • Connect to your Express Scripts online account. There, you can:
  • Refill your prescriptions and/or request anew prescription from your doctor
  • Check your order status and track your order
  • Sign up for automatic refills (if your medication is eligible)
  • View your order history
  • Update your profile information (shipping address and phone number, payment information, allergies and/or health conditions, how you’d like to be contacted)

Pay your bill online