2026 Benefits
HDHP Medical Plan
High Deductible Health Plan paired with an HSA — lower premium, higher deductible.
Plan Details
HDHP (High Deductible Health Plan) is offered through Cigna on the Cigna OAP network. Review the details below to understand your coverage, costs, and pharmacy benefits.
HSA Eligible
Yes
FSA Eligible
Limited Use FSA only
HRA Included
No
Eligible States
All states
Semimonthly Payroll Contribution
| Coverage Tier | Employee Cost |
|---|---|
| Employee Only | $67.12 |
| Employee + Spouse | $227.42 |
| Employee + Children | $200.84 |
| Family | $298.30 |
Employee Only
Employee Cost$67.12
Employee + Spouse
Employee Cost$227.42
Employee + Children
Employee Cost$200.84
Family
Employee Cost$298.30
Calendar Year Deductible
| Tier | In-Network | Out-of-Network |
|---|---|---|
| Individual | $3,500 | $7,000 |
| Family | $7,000 | $14,000 |
Individual
In-Network$3,500
Out-of-Network$7,000
Family
In-Network$7,000
Out-of-Network$14,000
Out-of-Pocket Maximum
| Tier | In-Network | Out-of-Network |
|---|---|---|
| Individual | $5,000 | $15,000 |
| Family | $10,000 | $30,000 |
Individual
In-Network$5,000
Out-of-Network$15,000
Family
In-Network$10,000
Out-of-Network$30,000
Coinsurance (Plan Pays)
| In-Network | Out-of-Network | |
|---|---|---|
| After Deductible | 80% | 50% |
After Deductible
In-Network80%
Out-of-Network50%
Covered Services
| Service | In-Network | Out-of-Network |
|---|---|---|
| Preventive Care | Covered 100% | Not covered |
| Primary Care | 20% after deductible | 50% after deductible |
| Specialist Services | 20% after deductible | 50% after deductible |
| Diagnostic Care | 20% after deductible | 50% after deductible |
| Urgent Care | 20% after deductible | 50% after deductible |
| Emergency Room | 20% after deductible | 20% after deductible |
Preventive Care
In-NetworkCovered 100%
Out-of-NetworkNot covered
Primary Care
In-Network20% after deductible
Out-of-Network50% after deductible
Specialist Services
In-Network20% after deductible
Out-of-Network50% after deductible
Diagnostic Care
In-Network20% after deductible
Out-of-Network50% after deductible
Urgent Care
In-Network20% after deductible
Out-of-Network50% after deductible
Emergency Room
In-Network20% after deductible
Out-of-Network20% after deductible
Pharmacy Benefits — Retail (30-Day Supply)
| Tier | Cost |
|---|---|
| Preferred Generic | 20% after deductible |
| Preferred Brand | 20% after deductible |
| Non-Preferred | 20% after deductible |
| Specialty | 20% after deductible |
Preferred Generic
Cost20% after deductible
Preferred Brand
Cost20% after deductible
Non-Preferred
Cost20% after deductible
Specialty
Cost20% after deductible
Pharmacy Benefits — Mail Order (90-Day Supply)
| Tier | Cost |
|---|---|
| Preferred Generic | 20% after deductible |
| Preferred Brand | 20% after deductible |
| Non-Preferred | 20% after deductible |
Preferred Generic
Cost20% after deductible
Preferred Brand
Cost20% after deductible
Non-Preferred
Cost20% after deductible
