Medical Plans

What’s the Same

All three medical plans are administered by Cigna and provide quality coverage, which includes:

• No charge for in-network preventive care, like annual physicals, screenings, and immunizations
• An out-of-pocket maximum that limits the amount you have to pay out-of-pocket during a single year
• Prescription drug coverage provided by Express Scripts

What’s Different

There are a few important differences to consider:

• Out-of-network coverage: The OAPIN Silver option generally only allows you to receive coverage from an in-network provider. If you want the flexibility of going out-of-network, be sure to choose one of the other two options.
• Out-of-pocket expenses: Be sure to consider not only the semi-monthly premiums you’ll pay, but also how much you’ll pay out-of-pocket—deductibles, coinsurance, and out-of-pocket maximums—if you need care.
• Health Reimbursement Account (HRA): The HRA Choice Gold or HRA Standard Bronze plans come with an employer-funded HRA that pays for eligible health care expenses. The OAPIN Silver plan doesn’t offer an HRA.

Health Reimbursement Account

Only available if you enroll in the HRA Choice Gold or HRA Standard Bronze plan

An HRA is an employer-funded account that you can use to pay for eligible health care expenses. The HRA automatically pays first when you get care, so you won’t pay anything until all your HRA funds have been used. Any money you don’t spend will carry over to the next year.

County Contributions

The amount Shelby County contributes to your account depends on your coverage level.

Compare In-Network Costs

The plan highlighted in gray below generally only allows you to receive coverage from an in-network provider.

For more information, view a detailed comparison.

Medical Pre-Tax Premiums Per Pay Period

The premiums—the amount you pay per paycheck—depend on what plan you pick, who you cover, if you’ve met wellness program requirements, and the tobacco surcharge.

• Wellness requirements: Each year, complete the biometric screening and online health risk assessment by September 30 to be eligible for the Medical Plan Wellness Premiums for the following plan year. You can complete your biometric screening at the Employee Care Clinic (ECC).
• Tobacco surcharge*: If you or your spouse have used tobacco products more than four times a week within the past six months, you’ll pay $25 per person per pay period per month for one full year, beginning July 1, 2024. You can avoid the surcharge by participating in the Cigna Quit Today Program.

*Tobacco products include but are not limited to, cigarettes, electronic cigarettes, cigars, cigarillos, pipes, chewing tobacco, snuff, dip, and loose tobacco smoked via pipe. The surcharge does not apply to dependent children.

Be Smart About Where You Go for Care

Where you go for care will affect how much you pay. So be sure to consider all your options:

Pharmacy

Prescription drug coverage is provided automatically when you enroll in one of Shelby County’s Medical plans. The coverage is provided by Express Scripts and is the same for all medical plans.

The amount you pay will depend on the type of drug prescribed and the number of days of the supply. Keep in mind that the home delivery program can save you money.

Note: You will use the same ID card that you use for medical coverage for prescription drug coverage.

Note: If a brand name maintenance medication (90-day supply) is requested via home delivery and a generic drug is available, you’ll pay the difference between the brand and the generic prescription.