How does the Cigna Choice Fund work?

The CIGNA Choice Fund is a health reimbursement arrangement where traditional medical coverage is combined with a Fund of contributions made by Metro. The HRA Fund can be used to pay for eligible health care and pharmacy expenses during the plan year. CIGNA has negotiated discounts with providers in their Open Access Plus Network and to receive the maximum benefits you should select providers in this network. There are no copays with the CIGNA Choice Fund; the full cost of the negotiated discount is the amount that is owed to the provider. If you choose to use an out-of-network provider, you will still receive benefits, but at a lower level and you may be required to pay the entire bill up front and file a claim with CIGNA for reimbursement.

Any money you have remaining in your HRA Fund at the end of the plan year will roll over to the next plan year and lower the amount of your deductible for that year. Once the Fund has been exhausted, there is a deductible that you must meet before the plan begins paying at the coinsurance level. When your annual out-of-pocket maximum has been met, you have 100% coverage for the remainder of the plan year.

Prescription drug coverage is provided by CIGNA and is available through most pharmacies and by mail order. While you are in the Fund and deductible levels, you will pay the full price of the discounted cost of the generic or brand-name drug. Once you have moved into the coinsurance level, you will pay 10% of the discounted cost for generic drugs and 30% of the discounted cost for brand name drugs. The pharmacy will determine the amount you owe, if any, for the prescription drug depending upon the fund balance in your HRA Fund and if you have met your deductible. If you have exhausted your fund but not yet met the deductible, you will pay the full price of the discounted cost of the drug at the time you pick up the drug. Contact a Benefits Representative at (615) 862-6700 for more details.