Cigna OAP

Open access plan that is closing to new enrollments.

Cigna OAP

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Plan Details

Carrier

Cigna

Network Name

Cigna

Plan Type

OAP

HSA Eligible

FSA Eligible

Yes

HRA Included

Premiums

Frequency: Biweekly

Coverage Tier	With LiveWell Credit	Without LiveWell Credit
EE Only	$152.00	$186.62
EE + Children	$307.00	$341.62
EE + Spouse	$375.00	$409.62
EE + Family	$531.00	$565.62

EE Only

With LiveWell Credit: $152.00
Without LiveWell Credit: $186.62

EE + Children

With LiveWell Credit: $307.00
Without LiveWell Credit: $341.62

EE + Spouse

With LiveWell Credit: $375.00
Without LiveWell Credit: $409.62

EE + Family

With LiveWell Credit: $531.00
Without LiveWell Credit: $565.62

Deductible, Out-of-Pocket & Coinsurance

Feature	Network	NON-Network
Deductible (Individual)	$600	$1,200
Deductible (Family)	$1,200	$2,400
Out-of-Pocket Max (Individual)	$2,600	$5,200
Out-of-Pocket Max (Family)	$5,200	$10,400
Employer Contribution - Per Individual	N/A	N/A
Employer Contribution - Per Family	N/A	N/A

Deductible (Individual)

Network: $600
NON-Network: $1,200

Deductible (Family)

Network: $1,200
NON-Network: $2,400

Out-of-Pocket Max (Individual)

Network: $2,600
NON-Network: $5,200

Out-of-Pocket Max (Family)

Network: $5,200
NON-Network: $10,400

Employer Contribution - Per Individual

Network: N/A
NON-Network: N/A

Employer Contribution - Per Family

Network: N/A
NON-Network: N/A

Covered Services

Service	Network	NON-Network
Preventive Care	100% covered	40%*
LW Clinic Visit	100% covered	N/A
Office Visits	20%*	40%*
Specialist Office Visits	20%*	40%*
Outpatient Surgery	20%*	40%*
Hospitalization and Inpatient Surgery	20%*	40%*
Mental Health	20%*	40%*
Virtual visits	$0 copayment	N/A
Urgent Care Facility	20%*	40%*
Emergency Room	20%*	20%*
Ambulance	20%*	20%*

Preventive Care

Network: 100% covered
NON-Network: 40%*

LW Clinic Visit

Network: 100% covered
NON-Network: N/A

Office Visits

Network: 20%*
NON-Network: 40%*

Specialist Office Visits

Network: 20%*
NON-Network: 40%*

Outpatient Surgery

Network: 20%*
NON-Network: 40%*

Hospitalization and Inpatient Surgery

Network: 20%*
NON-Network: 40%*

Mental Health

Network: 20%*
NON-Network: 40%*

Virtual visits

Network: $0 copayment
NON-Network: N/A

Urgent Care Facility

Network: 20%*
NON-Network: 40%*

Emergency Room

Network: 20%*
NON-Network: 20%*

Ambulance

Network: 20%*
NON-Network: 20%*

* After deductible ** New enrollments are not allowed for the 2026 plan year. If you're currently enrolled in the OAP plan, you can keep your coverage for 2026 - your enrollment will automatically carry over unless you make a change.

Pharmacy Benefits

Tier	Channel	Cost
Tier 1 Generic Drugs	Retail Rx (up to 30-day supply)	$5 copayment
Tier 2 Brand-name drugs (on the Preferred Drug List)	Retail Rx (up to 30-day supply)	$30 copayment
Tier 3 Brand-name drugs (not on the Preferred Drug List)	Retail Rx (up to 30-day supply)	$60 copayment
Tier 4 Specialty retail drugs (injection, infused or oral)	Retail Rx (up to 30-day supply)	$100 copayment (30-day supply)
Tier 1 Generic Drugs	Mail Order Rx (31 to 90-day supply)	$10 copayment
Tier 2 Brand-name drugs (on the Preferred Drug List)	Mail Order Rx (31 to 90-day supply)	$60 copayment
Tier 3 Brand-name drugs (not on the Preferred Drug List)	Mail Order Rx (31 to 90-day supply)	$120 copayment
Tier 4 Specialty mail order drugs (injection, infused or oral)	Mail Order Rx (31 to 90-day supply)	$100 copayment (30-day supply)

Tier 1 Generic Drugs

Channel: Retail Rx (up to 30-day supply)
Cost: $5 copayment

Tier 2 Brand-name drugs (on the Preferred Drug List)

Channel: Retail Rx (up to 30-day supply)
Cost: $30 copayment

Tier 3 Brand-name drugs (not on the Preferred Drug List)

Channel: Retail Rx (up to 30-day supply)
Cost: $60 copayment

Tier 4 Specialty retail drugs (injection, infused or oral)

Channel: Retail Rx (up to 30-day supply)
Cost: $100 copayment (30-day supply)

Tier 1 Generic Drugs

Channel: Mail Order Rx (31 to 90-day supply)
Cost: $10 copayment

Tier 2 Brand-name drugs (on the Preferred Drug List)

Channel: Mail Order Rx (31 to 90-day supply)
Cost: $60 copayment

Tier 3 Brand-name drugs (not on the Preferred Drug List)

Channel: Mail Order Rx (31 to 90-day supply)
Cost: $120 copayment

Tier 4 Specialty mail order drugs (injection, infused or oral)

Channel: Mail Order Rx (31 to 90-day supply)
Cost: $100 copayment (30-day supply)

Plan Notes

Pharmacy benefits are administered through Cigna and Express Scripts.
Preventive drug costs may be $0 cost to you.
Home delivery through Express Scripts Pharmacy — enroll at mycigna.com or myCigna app or call 800-835-3784.
Preventive Medication Program: Medications covered for chronic health conditions at a $0 copayment. Call 800-244-6224.
Prior Authorization Program: Requires prior authorization for certain medications.
Step Therapy Program: Requires you to try a proven, cost-effective medication before a more costly treatment.