FAQ
- Benefit Plan Information Summary
- The City of Scottsdale's benefit plans are designed to support its employees through various health and insurance options.
- Self-Insurance Model
- In a self-insurance model, the city funds claim payments while Cigna processes these claims and offers customer service. Cigna also provides access to networks, case management, and programs such as a nurse line and disease management. To manage excessive claims, the city has stop loss insurance.
- Health Plan Types
- Understanding the difference between health plans is crucial. An HMO (Health Maintenance Organization) and an EPO (Exclusive Provider Organization) both require using in-network providers to receive benefits. The primary distinction lies in their funding; HMO plans are typically insured by an insurance company, whereas EPO plans are self-insured by the employer, which in this case, is the city. A PPO (Preferred Provider Organization) offers two levels of coverage—higher benefits for in-network services and lower for out-of-network, unlike HMOs or EPOs which do not cover out-of-network services.
- ID Cards
- Employees' social security numbers will not be displayed on ID cards; instead, a unique identifier will be used.
- Online Access
- Access to Cigna Plan websites is provided, with limited access from work and full access from home.
- Prescription Drug Plan
- Each health plan includes a prescription drug component, requiring employees to share costs through co-payments based on drug tiers. Additionally, mail order programs are available for cost-effective purchasing of maintenance medications. Drugs not listed in the plan's preferred formulary are considered non-formulary and incur higher costs.
- Disability and Life Insurance
- The city provides basic life insurance and short-term disability insurance to benefited employees. Additional voluntary life insurance is also available, with specific age-related reductions detailed in the policy.
- Assistance and Family Involvement
- For assistance with benefit choices, the HR staff is available via email, phone, or in-person. Family members can also access benefits information through the city's website or by contacting HR directly.
- Deductibles and Out-of-Pocket Maximums
- Deductibles and out-of-pocket maximums are calculated on a fiscal year basis, from July 1 to June 30. Each plan has specific deductibles. For example, the Cigna OAP In-Network Plan has no deductible, while the Cigna OAP and Cigna OAP + HSA plans have varying deductibles for in-network and out-of-network services. Out-of-pocket maximums include deductibles, co-payments, and co-insurance for medical services and prescription drugs, although some expenses do not count towards these maximums. Separate deductibles apply for in-network and out-of-network benefits, and there are distinctions between individual and family deductibles, where the latter covers the combined expenses of all family members.
- Provider Networks
- To ensure that employees receive the most up-to-date information on network providers, it is recommended to verify participation directly through the plan's website or member services, as printed materials can quickly become outdated.