2012 Colby Health Plan Options

Open-Access Plus In-Network (OAPIN) Plan:

• No increase to employee contributions in 2012!
• No changes to deductibles or coinsurance amounts.
• There is a $250 individual or a $500 family deductible.  Office visit co-pays do not apply to your deductible.
• A 90/10% coinsurance is applicable once the deductible has been met.
• Preventive office visits and related procedures performed in the doctor's office (coded as preventive by your physician) are covered at 100%.  Recommended procedures performed outside the doctor's office may result in deductible and coinsurance charges.
• Maximum Out-of-Pocket amounts are $1,250 for individual coverage or $2,500 for family coverage. 
• There are no copays for high-tech scans (CT/MRI/PET scans) or Emergency Room visits. HOWEVER, deductibles and coinsurance will apply.

 Open-Access Plus (OAP) Plan: 

• Reduced employee contributions in 2012!
• No changes to deductibles or coinsurance amounts.
• Preventive office visits and related procedures performed in the doctor's office (coded as preventive by your physician) are covered at 100%.  Recommended procedures performed outside the doctor's office may result in deductible and coinsurance charges.

CIGNA Choice Fund High-Deductible (HSA) Plan: 

• Reduced employee contributions in 2012!
• No changes to deductible or coinsurance amounts.
• Increase in Colby's monthly contribution to employee's health savings account!
• Limited Purpose Flexible Spending Account available for HSA participants.

The CIGNA Open Access Plus In-Network plan (OAPIN) offers access to CIGNA's broad national provider networks, while allowing members to make their own health care choices. This plan continues to have a deductible and coinsurance.  Important points about the plan include:

• No referrals are necessary to see any physicians or specialists in the network. Just choose the participating in-network doctor you prefer and make an appointment.
• The option to choose a Primary Care Physician (PCP) to serve as a personal physician providing routine care and referrals to specialists.  See information below about providers.
• Only health care professionals who are part of the CIGNA network are covered by this plan. If you chose a doctor who is not in the network, your care will not be covered except in emergencies.
• Emergency care is covered 24 hours a day, no matter where you receive it. You may go to any emergency facility, anywhere. Deductibles and coinsurance will apply.
• There is a $250 individual or a $500 family deductible. 
• A 90/10% coinsurance is applicable once the deductible has been met.
• Maximum Out-of-Pocket amounts are $1,250 for individual coverage or $2,500 for family coverage.
• Preventive office visits and related procedures performed in the doctor's office (coded as preventive by your physician) are covered at 100%.  Recommended procedures performed outside the doctor's office may result in deductible and coinsurance charges.
• Office co-pays are $20 for a sick office visit or $25 for a specialist.  Please note that copays to do not apply to your deductible.
• There are no copays for high-tech scans (CT/MRI/PET scans) or Emergency Room visits.  HOWEVER, deductibles and coinsurance will apply.
• Prescription co-pays are $10 for generic, $30 for preferred brands and $50 for non-preferred brands.
• Includes the CIGNA Vision Plan.  One routine eye exam is covered every 24 months, at an eye doctor who is a CIGNA VISION provider (as opposed to, or in addition to being a CIGNA MEDICAL provider.)  A $20 co-pay is applicable. 

Click here for more information on the Open Access In-Network Plan.
Click here for the detailed OAPIN Plan Summary.
For a summary of benefits and co-pays for all plans, click here.

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The Open Access Plus Plan (OAP) allows you to see any licensed provider you choose, though benefits are higher when you receive care from a provider in the Open Access Plus network.  Members have the option to choose a Primary Care Physician (PCP) to serve as a personal physician to help coordinate health needs.

• No referrals are necessary to see physicians and specialists within the network. Members choose the participating doctor you prefer and schedule an appointment. See information above about providers.
• When selecting physicians or specialists outside of the CIGNA network, your costs will be higher and you may need to file a claim form.
• Emergency care is covered 24 hours a day, no matter where you receive it. You may go to any emergency facility.
• Deductibles are $500 for individual and $1,000 for family coverage.
• For in-network doctors, a 80/20% coinsurance is applicable once the deductible has been met.  For out-of-network doctors, the coinsurance is 60/40%.
• Maximum Out-of-Pocket amounts are $1,500 for individual or $3,000 for family coverage.
• Preventive office visits -- covered at IN-NETWORK doctors only -- and related procedures performed in the doctor's office (coded as preventive by the physician) are covered at 100%.  Recommended procedures performed outside the doctor's office may result in deductible and coinsurance charges.
• Office co-pays are $20 for a sick office visit or a specialist for in-network office visits OR deductible and coinsurance for out-of-network office visits.
• Prescription co-pays are $10 for generic, $25 for preferred brands and $40 for non-preferred brands.

Click here for more information on the Open Access Plus Plan.
Click here for the detailed OAP Plan Summary. 
For a summary of benefits, co-pays and deductibles for all plans, click here.

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This high-deductible health savings account plan (HSA) was introduced in 2010 and is designed for people who are prepared to take a more active role in their health care. The plan offers a tax-deferred health savings account to help pay for covered health care expenses, administered by JP Morgan Chase. Colby will contribute $84/month for individual coverage or $167/month for family coverage into your HSA account. This enhanced contribution by the College can add up to $1,000 for individual or $2,000 for family coverage. The money in this account accumulates from year to year and should you leave Colby, any monies in the account are still accessible to you. Please note that Colby cannot guarantee continued contributions at these levels. 

HSA participants can choose to contribute to a Limited Purpose Flexible Spending Account through Group Dynamics.  For more information, please contact Human Resources.

In addition to health plan coverage, a CIGNA Choice Fund HSA offers:

• Control over how health care dollars are spent
• Freedom to choose doctors
• Convenient, online information and tools to help decide which doctors and services are desired
• Programs and services to help you stay well

Deductibles and out-of-pocket maximums are as follows:

• No co-pays are due at the time of an office visit. 
• Preventive office visits -- covered at IN-NETWORK doctors only -- and related procedures performed in the doctor's office (coded as preventive by your physician) are covered at 100%.  Recommended procedures performed outside the doctor's office may result in deductible and coinsurance charges.
• Some preventive drugs are covered at 100% for the HSA plan, with no co-pay or deductible.   Click here for a list of the most commonly used drugs that are covered at 100%.
• Deductibles - If enrolled in a family plan, all family members contribute to the family deductible which must be satisfied before the plan coinsurance is applied to any family member claim.
• Out-of-Pocket Maximums - If enrolled in a family plan, all family members contribute to the family out-of-pocket maxium, which must be satisfied before any family members' claims are covered 100%.

Click here for general information on how an HSA plan works.
Click here for the detailed HSA Plan Summary.
Click here for a list of eligible and ineligible expenses for the HSA.
Click here for a list of preventive care coverage.
For a list of Frequently Asked Questions, click here.  These are questions posed by Colby employees at the benefit information sessions.
For a summary of benefits, co-pays and deductibles for all plans, click here.

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Employee contributions for health coverage will remain the same in 2012 for the OAPIN.  Employee contributions will decrease in 2012 for the OAP and HSA plans.  Colby will be absorbing the increase in premiums, in order to keep employee rates from increasing.  In 2012, the additional cost results in a 4% increase to the College.

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Drug co-pays are as follows:

* Some Preventive Drugs are covered at 100% under the HSA, no plan deductible.  Click here for a list of the most commonly used drugs that are covered at 100%.

To see how your medications are covered, click here.

For a list of Maine pharmacies offering a 90-day supply for two co-pays, click here.  

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Click here for a list of CIGNA in-network Urgent Care Facilities in Maine. 

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• Open-Access Plus In-Network (OAPIN) Plan
• Open Access Plus (OAP) Plan
• CIGNA Choice Fund High-Deductible (HSA) Plan

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