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Cigna Original Proposal
<br /> Current Plans Cigna Option i :Current Plans Cigna ption 2: Akernate Plans
<br /> NCACC - PPO NCACC -HMO PPO HMO PPO HSA
<br /> ZOll 2011 2012 2012 2012 2012
<br /> In-Network In-Network In-Network In-Network In-Network Io-Network
<br />Primary Care
<br />Physldan
<br />Visits $15 $15 $15 $15 520 80%after0ed.
<br />Specialist
<br />Physician
<br />visits $30 $30 $30 $30 $40 ' 80%after Ded.
<br />Preventive
<br />Gre 100% 100% 100% 100% 100% 100%
<br />Deductible 5250 $250 $250 $250 $750 $1,500
<br />Deductible-
<br />amity Max $750 $750 $750 $750 $2,250 $3,000
<br />Coinsurance
<br />Umh $1,000 $0 $1,000 $D $1,000 ~ $2,000
<br />Coinsunnee
<br />Family Max $3,000 $0 $3,000 SD $3,000 $2,000
<br />In-patient
<br />Hospital 90%after 9096 after 80%after
<br />Services Ded. 100%afterDed. Ded. 100%akerDed. Ded. 80%afterDed.
<br />Out-patent
<br />Hospital 90%aher 9096 after 80%after
<br />Services Oed. 300%afterDed. Ded. 100%afterDed. Ded. 80%afterDed.
<br />Emergency
<br />Room 5150 $150 $150 5750 $200' 80%afterDed.
<br />Pharmacy $0/$15/$30 $0/$15/$30 $0/$15/$30 $0/$35/$30 $0/530/545 80%afterDed.
<br />Lifetime
<br />Maximum Unlimted Unlimited Unlimited Unlimted Uniimhed Unlimited
<br />Rates Subs Monthly Premium Subs Monthly Premium Monthly Premium Monthly Premium Monthly Premium Monthly Premium
<br />Employee
<br />Only 64 $509.02 532,577.28 457 5531.44 5242,868.08 $622.82 $39,860.48 $647.89 $296,085.73 $572.24 $261,513.68 $436.06 $27,907.84
<br />Employee &
<br />Spouse 12 $1,074.02 $12,888.24 SS $1,121.32 $95,312.20 $1,307.84 $15,694.08 $1,360.49 $115,641.65 $1,201.63 $102,138.55 $915.64 $10,987.68
<br />Employee &
<br />Child 12 $712.62 $8,551.44 115 $743.98 $85,557.70 $1,183.46 $14,201.52 $1;231.08 $141,574.20 $915.91 $105,329.65 $698.02 $8,376.24
<br />Employee &
<br />Children 10 $982.42 $9,82420 77 51,025.66 $78,975.82 $1,183.45 $11,834.50 $1,231.08 $94,793.16 $1,287.37 599,127.49 $980.96 $9,809.60
<br />Employee &
<br />Family 19 $1,527.08 529,01452 76 $1,594.28 5124,353.84 $1,868.61 535,50359 $1,943.81 $151,617.18 51,716.87 $133,915.86 $1,308.32 524,858.08
<br />Monthly Cost 117 $92,855.68 812 $627,067.64 $117,094.17 $799,711.92 $702,025.23 $81,939.44
<br /> HSA ConMbution
<br /> $750 $87,750.00
<br />Mnwl $1,114,268.16 $7,524,811.68 $1,405,130.04 $9596,543.04 $8,424,302.76 $1,071,023.28
<br /> Total $8,639,079.64 $11,001,673.08 $9,495,326.04
<br />Increase over
<br />current 12735% Flrm 10953%
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