For employees who are eligible for the Mill Advantage, CDH Basic, CDH Plus and HSA Medical Plans 07 CIGNA Enrollment Guide 6-0 MILL ADV 09/6
YOUR CIGNA MEDICAL PLAN CHOICES
Cigna is pleased to team up with International Paper to meet your health care needs in 07. THREE HRA PLANS (MILL ADVANTAGE, CDH BASIC AND CDH PLUS) One Mill Advantage and two Consumer-Driven Health plans that include Health Reimbursement Accounts (HRAs) funded by International Paper. A HEALTH SAVINGS ACCOUNT MEDICAL PLAN A High Deductible Health Plan that allows you to contribute your own tax-free dollars to a Health Savings Account (HSA). SEE ANY DOCTOR IN THE CIGNA NATIONAL NETWORK All four plans include the Cigna national Open Access Plus (OAP) network with approximately 896,000 participating health care providers and,000 facilities (including 8,44 hospitals). You can see any doctor, including a specialist, without a referral. FIND OUT MORE Here are two easy ways you can learn more about your Cigna plan options. Visit the Cigna Pre-Enrollment Website By logging in to this site, you can confirm whether your doctor is in the Cigna OAP network and review each of the medical plans in greater detail. Go to: mycignaplans.com Open Enrollment ID: IPaperMill07 Open Enrollment Password: cigna Call the Cigna Pre-Enrollment Customer Service Line Customer service representatives are available at.800.40.404. They can provide more information about the Cigna plans available to you and tell you whether your doctor is in the network. Representatives are available 4 hours a day, 7 days a week. If you would like to talk with a representative who speaks Spanish or another language, just ask.
CIGNA MILL ADVANTAGE PLAN HRA Plan PREVENTIVE CARE Preventive care, including wellness visits and routine immunizations and screenings, is covered in full when you see a network doctor. Age and gender guidelines apply. Payments for covered preventive care services do not reduce the amount of your Health Reimbursement Account (HRA) balance. HEALTH REIMBURSEMENT ACCOUNT (HRA) Your HRA is funded by International Paper. The amount you receive each year depends on the level of coverage you select. Your HRA automatically pays first and covers 00% of your eligible medical and pharmacy expenses as long as there is money in your account. Any money left in your HRA at the end of the year will roll over for your use the following year. Mill Advantage Plan $00 $,000 YOUR SHARE If you spend all the dollars in your HRA, you are responsible for meeting the balance of your Deductible, which is called Your Share. All covered family members expenses count toward Your Share. Network doctors and hospitals will request payment from you once your claim has been processed by Cigna; network pharmacies, however, will request payment at time of purchase. Mill Advantage Plan $70 $,00 HRA Plan YOUR ANNUAL DEDUCTIBLE HRA + Your Share 4 OUT-OF-POCKET MAXIMUM COINSURANCE Mill Advantage Plan $,0 $,00 YOUR SHARE HEALTH REIMBURSEMENT ACCOUNT (HRA) DEDUCTIBLE PREVENTIVE CARE
4 COINSURANCE After you meet your Deductible (your HRA plus Your Share), you and the Mill Advantage Plan share costs through Coinsurance. There is a cap on the amount of Coinsurance you will pay. MILL ADVANTAGE MEDICAL PLAN EXAMPLE: Family of Two Medical Services Generic Prescription Drugs IN-NETWORK Plan pays 80% Plan pays at least 80% after deductible so that you pay no more than $ for each retail purchase or $ for each mail order purchase OUT-OF-NETWORK* Brand-Name Formulary Prescription Drugs and Brand-Name Non- Formulary Prescription Drugs without a Formulary Equivalent Brand-Name Non- Formulary Prescription Drugs with a Formulary Equivalent Plan pays at least 80% so that you pay no more than $0 for each retail purchase or $00 for each mail order purchase** Plan pays at least 60% so that you pay no more than $7 for each retail purchase or $0 for each mail order purchase** * Based on the maximum reimbursable charge for the service in your area. If you use an Out-of-Network provider, your expenses may exceed the Coinsurance amount shown because the Out-of-Network provider may choose to bill you for charges that are in excess of what your Plan reimburses for covered expenses. Covered Out-of-Network expenses are also subject to an additional Deductible/Out-of-Pocket Maximum of $00 for single coverage and $,000 for family coverage. ** You and your HRA also are protected against high drug costs while you are meeting your Deductible. Neither you nor your HRA will ever have to pay more than the maximum amounts listed for each in-network purchase of a prescription drug; the balance of the cost is paid by the Plan. OUT-OF-POCKET MAXIMUM Deductible + Coinsurance Maximum If you reach the Out-of-Pocket Maximum, your and your family s eligible expenses are covered at 00% for the rest of the year. Your Out-of-Pocket Maximum consists of your full annual Deductible plus your Coinsurance Maximum. Mill Advantage Plan $,000 $6,000 Note: Out-of-Network expenses are subject to an additional Deductible/Out-of-Pocket Maximum of $00 for single coverage and $,000 for family coverage. Here s how a year might look for a family of two. The family has selected the Mill Advantage Plan. All medical careis received in-network. HRA Fund IP Deposit................ $,000 Preventive Care Expenses physical exams and immunizations ($00 each)............... $600 Covered 00% in-network; no cost to family Medical Expenses 0 physical therapy sessions...... $,0 8 retail formulary prescriptions (at $0).................. $400 TOTAL..................$,60 How medical expenses are paid HRA (IP funded)............. $,000 You pay Your Share (00%) of balance of physical therapy........... $0 You pay Your Share (0%) of balance of 8 formulary prescriptions....... $80 Plan pays balance of prescriptions.... $0 HRA and Plan pay..........$,0 Family pays...............$0
CIGNA CONSUMER-DRIVEN HEALTH PLANS (CDH) CDH Basic and CDH Plus Plans PREVENTIVE CARE Preventive care, including wellness visits and routine immunizations and screenings, is covered in full when you see a network doctor. Age and gender guidelines apply. Payments for covered preventive care services do not reduce the amount of your Health Reimbursement Account (HRA) balance. HEALTH REIMBURSEMENT ACCOUNT (HRA) Your HRA is funded by International Paper. The amount you receive each year depends on the level of coverage you select. Your HRA automatically pays first and covers 00% of your eligible medical and pharmacy expenses as long as there is money in your account. Any money left in your HRA at the end of the year will roll over for your use the following year. CDH Basic $00 $,000 CDH Plus $00 $,000 YOUR SHARE If you spend all the dollars in your HRA, you are responsible for meeting the balance of your Deductible, which is called Your Share. All covered family members expenses count toward Your Share. Network doctors and hospitals will request payment from you once your claim has been processed by Cigna; network pharmacies, however, will request payment at time of purchase. HRA Plan CDH Basic $,000 $4,000 CDH Plus $,000 $,000 OUT-OF-POCKET MAXIMUM YOUR ANNUAL DEDUCTIBLE HRA + Your Share 4 COINSURANCE YOUR SHARE HEALTH REIMBURSEMENT ACCOUNT (HRA) DEDUCTIBLE CDH Basic $,00 $,000 CDH Plus $,00 $,000 PREVENTIVE CARE 4
4 COINSURANCE After you meet your Deductible (your HRA plus Your Share), you and the CDH Plan share costs through Coinsurance. There is a cap on the amount of Coinsurance you will pay. HRA MEDICAL PLAN EXAMPLE: Family of Four IN-NETWORK OUT-OF-NETWORK* Medical Services Plan pays 80% Generic Prescription Drugs Brand-Name Formulary Prescription Drugs and Brand-Name Non- Formulary Prescription Drugs without a Formulary Equivalent Plan pays at least 80% after deductible so that you pay no more than $ for each retail purchase or $ for each mail order purchase Plan pays 80% Here s how a year might look for a family of four. The family has selected the CDH Plus Plan. All medical care is received in-network. Brand-Name Non- Formulary Prescription Drugs with a Formulary Equivalent * Based on the maximum reimbursable charge for the service in your area. If you use an Out-of-Network provider, your expenses may exceed the Coinsurance amount shown because the Out-of-Network provider may choose to bill you for charges that are in excess of what your Plan reimburses for covered expenses. Covered Out-of-Network expenses are also subject to an additional Deductible/Out-of-Pocket Maximum of $,000 for single coverage and $,000 for family coverage. OUT-OF-POCKET MAXIMUM Deductible + Coinsurance Maximum If you reach the Out-of-Pocket Maximum, your and your family s eligible expenses are covered at 00% for the rest of the year. Your Out-of-Pocket Maximum consists of your full annual Deductible plus your Coinsurance Maximum. HRA Fund IP Deposit................ $,000 Preventive Care Expenses 4 physical exams and immunizations ($40 each).............. $,800 Covered 00% in-network; no cost to family Medical Expenses 8 office visits............... $,00 urgent care visits............ $700 prescriptions (brand-name)..... $00 TOTAL..................$,400 How medical expenses are paid HRA (IP funded)............. $,000 Your Share (paid by family)....... $,400 TOTAL..................$,400 CDH Basic $4,00 $9,000 family ($6,80 individual) * CDH Plus $,00 $7,000 family ($6,80 individual) * Mid-Year Note: Out-of-Network expenses are subject to an additional Deductible/Out-of-Pocket Maximum of $,000 for single coverage and $,000 for family coverage. * The Affordable Care Act limits the out-of-pocket maximum ("OOP maximum") for in-network services obtained by individuals enrolled for family coverage. Once an individual has paid $6,80 out of pocket for CDH Basic or CDH Plus in-network services, the Plan begins to pay 00% for in-network services for that family member for the rest of the calendar year. The Plan will not begin to pay 00% for the other family members until the $9,000 (CDH Basic) or $7,000 (CDH Plus) family OOP maximum has been reached. Enrollments If you enroll mid-year as a newly hired employee or as the result of a qualified change in status, International Paper s HRA contribution for your partial year of coverage is prorated. See mycignaplans.com for details. CHOOSING A CDH PLAN CDH Basic has lower premiums, while CDH Plus has a lower Deductible. After you ve been enrolled for a while, you may have a substantial HRA balance, including dollars you ve rolled over. In this instance, if you initially selected CDH Plus, you might want to consider switching to CDH Basic. You could save on your paycheck deductions and know you can cover the higher Out-of-Pocket Maximum should you have higher health care expenses that year.
CIGNA HIGH DEDUCTIBLE HEALTH PLAN (HDHP) Health Savings Account Medical Plan PREVENTIVE CARE Preventive care, including wellness visits and routine immunizations and screenings, is covered in full when you see a network doctor. There is no deductible for preventive care. Age and gender guidelines apply. HEALTH SAVINGS ACCOUNT (HSA) You can open a Health Savings Account with the financial institution of your choice, but if you choose to open an HSA with HSA Bank, you can make tax-free contributions through convenient payroll deductions. Your HSA Bank account balance earns interest, and once your balance reaches $,000, you can invest it in mutual funds. You own all dollars in your account. You can use the money to pay qualified health care expenses as well as eligible pharmacy, dental and vision expenses, or save it for the future. For 07, the maximum contribution is $,400 for employee coverage and $6,70 for family coverage. Individuals who will be or older in 07 can contribute up to an additional $,000 in catch-up contributions in 07. These limits are set by the IRS. DEDUCTIBLE The Deductible is the amount you pay for covered services before Coinsurance takes effect. You can use HSA dollars or pay out of pocket. All covered family members contribute toward one Deductible. Network doctors and hospitals will request payment from you once your claim has been processed by Cigna; network pharmacies, however, will request payment at the time of purchase. HSA MEDICAL Annual Deductible $,00 $,000 In 07, you can contribute up to $,400 to your HSA if you elect employee coverage; $6,70 if you elect family coverage. If you are or over in 07, you can contribute up to an additional $,000 to your HSA for a total of $4,400 for those electing employee coverage; $7,70 if electing family coverage. Advantages of an HSA Bank health savings account When you enroll in the Health Savings Account Medical Plan, you are eligible to open an HSA. Setting up your HSA with HSA Bank allows you to make HSA contributions through payroll deductions. Open your HSA by completing the Online HSA Bank Application on mycignaplans.com. Sign up now so you can begin contributing immediately after you enroll. 4 HSA Plan OUT-OF-POCKET MAXIMUM COINSURANCE DEDUCTIBLE PREVENTIVE CARE HEALTH SAVINGS ACCOUNT (HSA) Tips for using your CDH or HSA Medical Plan Always show your ID card to make sure you get the network discounts and that your claims are processed correctly. Once the claim has been submitted and processed by Cigna, you and your network provider will receive an explanation of benefits showing the network discount, the amount paid by your medical plan, and the balance you owe. At this point, the provider should send you an invoice for the correct balance. Pharmacies require payment at the time of purchase. 6
4 COINSURANCE After you meet your Deductible, you and the HSA Medical Plan share costs through Coinsurance. You can choose to use HSA dollars or pay out of pocket. HSA MEDICAL PLAN EXAMPLE: Family of Four Medical Services Generic Prescription Drugs Brand-Name Formulary Prescription Drugs & Brand-Name Non-Formulary Prescription Drugs without Formulary Equivalent IN-NETWORK Plan pays 80% Plan pays 80% Plan pays 80% OUT-OF-NETWORK* Brand-Name Non-Formulary Prescription Drugs with Formulary Equivalent * Based on the maximum reimbursable charge for the service in your area. If you use an Out-of-Network provider, your expenses may exceed the Coinsurance amount shown because the Out-of-Network provider may choose to bill you for charges that are in excess of what your Plan reimburses for covered expenses. Covered Out-of-Network expenses are also subject to an additional Deductible/Out-of-Pocket Maximum of $,000 for single coverage and $,000 for family coverage. OUT-OF-POCKET MAXIMUM Deductible + Coinsurance Maximum If you reach the Out-of-Pocket Maximum, your and your family s eligible expenses are covered at 00% for the rest of the year. Your Out-of-Pocket Maximum consists of your full annual Deductible plus your Coinsurance Maximum. HSA Medical Plan $,00 $7,000 family ($6,80 individual)* Note: Out-of-network expenses are subject to an additional Deductible/Out-of-Pocket Maximum of $,000 for single coverage and $,000 for family coverage. * The Affordable Care Act limits the out-of-pocket maximum ("OOP maximum") for in-network services obtained by individuals enrolled for family coverage. Once an individual has paid $6,80 out of pocket for in-network services, the Plan begins to pay 00% for in-network services for that family member for the rest of the calendar year. The Plan will not begin to pay 00% for the other family members until the $7,000 family OOP maximum has been reached. Here s how a year might look for a family of four. All medical care is received in-network. HSA Fund Family s HSA contribution....... $,00 Preventive Care Expenses 4 physical exams and immunizations ($40 each).............. $,800 Covered 00% in-network; no cost to family Medical Expenses 6 office visits................ $900 4 physical therapy visits........ $,000 prescriptions (brand-name)..... $00 TOTAL..................$,400 How medical expenses are paid The family elects to pay all $,400 from their Health Savings Account. The entire amount applies to their annual deductible. 7
SUPPORT FOR MANAGING YOUR PLAN AND YOUR HEALTH Cigna can help make your health care choices easier. Here are some of the tools available once you are enrolled. 8 4-Hour Health Information Line You can talk with a nurse 4 hours a day, seven days a week, 6 days a year for advice and health support around the clock. Call.800.44.64. 4-Hour Customer Service Cigna customer service representatives are available 4 hours a day, seven days a week, 6 days a year, including holidays, to answer your benefits and claims questions. Anytime you need help, call.800.44.64. mycigna.com Your personalized website provides online tools to help you manage all your health and claims information. Once you register, you can sign in anytime to: Verify what s covered by your medical plan or check the status of a claim Get estimated costs for common medical services and compare hospitals on cost and quality If you elect Cigna Dental coverage, there are even more tools: Search for a dentist Compare out-of-pocket costs among dentists Schedule an appointment online Cigna Healthy Pregnancies, Healthy Babies Get information to support your goal of having a healthy pregnancy. If you enroll during your first or second trimester and complete the program, you'll receive a reward card to help cover some of your maternity care expenses. Health Decision Support Cigna can work with you and your doctor to review treatment options and help you choose the right care. If you need to be hospitalized, Cigna will help determine your length of stay and help you plan for follow-up care after you leave the hospital. Healthy Rewards * You can receive discounts on many products and services not covered by your medical plan. Save on massage therapy, laser vision correction and weight loss programs. * Some Healthy Rewards programs are not available in all states. If your Cigna plan includes coverage for any of these services, this program is in addition to, not instead of, your plan benefits. Healthy Rewards programs are separate from your medical benefits. A discount program is NOT insurance, and you must pay the entire discounted charge. Cancer Care Specially trained nurses help individuals with cancer to better understand their diagnosis, treatment, medications and potential side effects. MDLIVE A leading telehealth provider of online and on-demand health care services, MDLIVE offers access to health care when you cannot get to your regular doctor and need help with a diagnosis and treatment. (MDLIVE is not available in some states.) MDLIVE provides: Immediate, 4/7/6 access to affordable, quality non-urgent care A national network of licensed, board-certified U.S.-based doctors and pediatricians Call.888.76.7 when you need to see a doctor. Transplant Network If you need an organ or bone marrow transplant, Cigna has a network of more than 00 transplant centers that are nationally recognized for their quality care. Save Money with Flexible Spending Accounts International Paper offers three flexible spending accounts you can use to reimburse certain out-of-pocket expenses with pre-tax dollars. Health Care Flexible Spending Account Dependent Day Care Flexible Spending Account Limited Purpose Health Care Flexible Spending Account (for dental and vision out-of-pocket expenses if you enroll in the HSA Medical Plan) For the current list of eligible health care expenses, go to Cigna.com/expenses. Get the Right Care with Best Doctors Program Get an In-Depth Medical Review through the Best Doctors program. A nationally recognized expert specialist will conduct a full review of your medical records, diagnosis and treatment plan. Best Doctors is an independent resource, not associated with your health plan, and no one at IP or your medical plan will know you called. Go to members.bestdoctors.com or call.866.904.090. Put Better Health Where Your Mouth Is Cigna offers the Cigna Dental Oral Health Integration Program (OHIP). The OHIP is designed to provide enhanced dental coverage for participants with certain eligible medical conditions. To learn more, call Cigna at.800.44.64.
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