Medical

Looking after your health is important, and prevention is better than cure, which is why 100% of the cost of preventive services is covered by all of our plans. We offer three Medical plans through Cigna.

Prescription Drug coverage is administered by Express Scripts. Read more about Prescription Drug coverage.

How does it work?

You can choose between the HDHP Silver, the HDHP Gold and the Core Plan.

All three plans use the Cigna Open Access Plus network and cover 100% of the cost of preventive care services, like annual physicals and routine immunizations.

The way you pay for care is different with each plan.

Core Plan

The Core Plan has set copays for some services and coinsurance (after the annual deductible is met) for others. Copays do not apply toward your annual deductible, so you will pay copays until you reach your annual out-of-pocket maximum.

This plan has higher paycheck deductions than the HDHPs.

HDHP Silver and HDHP Gold

With both HDHPs, you pay the full contracted rates for medical services and prescriptions until you meet your annual deductible.

Once you’ve met your annual deductible:

  • HDHP Silver: The plan pays for 100% of covered services for the rest of the year.
  • HDHP Gold: You and the plan both pay a portion of your expenses for covered services (coinsurance) until you reach your annual out-of-pocket maximum. After that, the plan pays for 100% of covered services for the rest of the year.

You can use a Health Savings Account to pay for qualified expenses.

Read more about Health Savings Accounts.

The Core and HDHP Silver Plans provide in-network coverage only.

HDHP Gold is the only plan that provides out-of-network coverage.

These plans have lower paycheck deductions than the Core Plan.

Plan comparison

Core Plan HDHP Silver and HDHP Gold
Per-paycheck cost for coverage Highest Lowest
Annual deductible Lowest Highest
Annual out-of-pocket maximum Lowest Highest
Using the plan Pay more with each paycheck and less when you need care Pay less with each paycheck and more when you need care
Spending account options None Health Savings Account
Per-paycheck cost for coverage
Core Plan Highest
HDHP Silver and HDHP Gold Lowest
Annual deductible
Core Plan Lowest
HDHP Silver and HDHP Gold Highest
Annual out-of-pocket maximum
Core Plan Lowest
HDHP Silver and HDHP Gold Highest
Using the plan
Core Plan Pay more with each paycheck and less when you need care
HDHP Silver and HDHP Gold Pay less with each paycheck and more when you need care
Spending account options
Core Plan None
HDHP Silver and HDHP Gold Health Savings Account

What am I covered for?

Summary Core Plan (in network* only) HDHP Silver (in network* only) HDHP Gold (in network*) HDHP Gold (out of network*)
Annual deductible (individual/family) - the out-of-pocket amount you have to pay before the plan starts paying coinsurance $2,500/$5,000 $6,000/$12,000 $3,000/$6,000 $9,000/ $18,000
Coinsurance - your portion of your expenses after you meet your annual deductible; the plan pays the rest 20% after annual deductible 0% after annual deductible 20% after annual deductible 50% after annual deductible
Annual out-of-pocket maximum (individual/family) - the most you have to pay for covered services during the plan year; after that, the plan pays the rest $5,000/$10,000 $6,000/$12,000 $6,000/$12,000 $18,000/$36,000
Preventive care No cost No cost No cost 50% after annual deductible
Emergency Room $250 + 20% after annual deductible 0% after annual deductible 20% after annual deductible 20% after annual deductible
Annual deductible (individual/family) - the out-of-pocket amount you have to pay before the plan starts paying coinsurance
Core Plan (in network* only) $2,500/$5,000
HDHP Silver (in network* only) $6,000/$12,000
HDHP Gold (in network*) $3,000/$6,000
HDHP Gold (out of network*) $9,000/ $18,000
Coinsurance - your portion of your expenses after you meet your annual deductible; the plan pays the rest
Core Plan (in network* only) 20% after annual deductible
HDHP Silver (in network* only) 0% after annual deductible
HDHP Gold (in network*) 20% after annual deductible
HDHP Gold (out of network*) 50% after annual deductible
Annual out-of-pocket maximum (individual/family) - the most you have to pay for covered services during the plan year; after that, the plan pays the rest
Core Plan (in network* only) $5,000/$10,000
HDHP Silver (in network* only) $6,000/$12,000
HDHP Gold (in network*) $6,000/$12,000
HDHP Gold (out of network*) $18,000/$36,000
Preventive care
Core Plan (in network* only) No cost
HDHP Silver (in network* only) No cost
HDHP Gold (in network*) No cost
HDHP Gold (out of network*) 50% after annual deductible
Emergency Room
Core Plan (in network* only) $250 + 20% after annual deductible
HDHP Silver (in network* only) 0% after annual deductible
HDHP Gold (in network*) 20% after annual deductible
HDHP Gold (out of network*) 20% after annual deductible

Office visits

Visit Core Plan (in network* only) HDHP Silver (in network* only) HDHP Gold (in network*) HDHP Gold (out of network*)
Telemedicine $30 copay** 0% after annual deductible 20% after annual deductible 50% after annual deductible
Primary care $30 copay** 0% after annual deductible 20% after annual deductible 50% after annual deductible
Specialist $60 copay** 0% after annual deductible 20% after annual deductible 50% after annual deductible
Urgent care $75 copay** 0% after annual deductible 20% after annual deductible 50% after annual deductible
Telemedicine
Core Plan (in network* only) $30 copay**
HDHP Silver (in network* only) 0% after annual deductible
HDHP Gold (in network*) 20% after annual deductible
HDHP Gold (out of network*) 50% after annual deductible
Primary care
Core Plan (in network* only) $30 copay**
HDHP Silver (in network* only) 0% after annual deductible
HDHP Gold (in network*) 20% after annual deductible
HDHP Gold (out of network*) 50% after annual deductible
Specialist
Core Plan (in network* only) $60 copay**
HDHP Silver (in network* only) 0% after annual deductible
HDHP Gold (in network*) 20% after annual deductible
HDHP Gold (out of network*) 50% after annual deductible
Urgent care
Core Plan (in network* only) $75 copay**
HDHP Silver (in network* only) 0% after annual deductible
HDHP Gold (in network*) 20% after annual deductible
HDHP Gold (out of network*) 50% after annual deductible

Prescriptions - retail (30 day supply)

Type Core Plan (in network* only) HDHP Silver (in network* only) HDHP Gold (in network*) HDHP Gold (out of network*)
Generic $15 copay** 0% after annual deductible 20% after annual deductible 20% after annual deductible
Preferred $35 copay** 0% after annual deductible 20% after annual deductible 20% after annual deductible
Non-preferred $50 copay** 0% after annual deductible 20% after annual deductible 20% after annual deductible
Specialty $250 copay** 0% after annual deductible 20% after annual deductible 20% after annual deductible
Generic
Core Plan (in network* only) $15 copay**
HDHP Silver (in network* only) 0% after annual deductible
HDHP Gold (in network*) 20% after annual deductible
HDHP Gold (out of network*) 20% after annual deductible
Preferred
Core Plan (in network* only) $35 copay**
HDHP Silver (in network* only) 0% after annual deductible
HDHP Gold (in network*) 20% after annual deductible
HDHP Gold (out of network*) 20% after annual deductible
Non-preferred
Core Plan (in network* only) $50 copay**
HDHP Silver (in network* only) 0% after annual deductible
HDHP Gold (in network*) 20% after annual deductible
HDHP Gold (out of network*) 20% after annual deductible
Specialty
Core Plan (in network* only) $250 copay**
HDHP Silver (in network* only) 0% after annual deductible
HDHP Gold (in network*) 20% after annual deductible
HDHP Gold (out of network*) 20% after annual deductible

Prescriptions - mail-order (90 day supply)

Type Core Plan (in network* only) HDHP Silver (in network* only) HDHP Gold (in network*) HDHP Gold (out of network*)
Generic $30 copay** 0% after annual deductible 20% after annual deductible 20% after annual deductible
Preferred $70 copay** 0% after annual deductible 20% after annual deductible 20% after annual deductible
Non-preferred $100 copay** 0% after annual deductible 20% after annual deductible 20% after annual deductible
Specialty N/A 0% after annual deductible 20% after annual deductible 20% after annual deductible
Generic
Core Plan (in network* only) $30 copay**
HDHP Silver (in network* only) 0% after annual deductible
HDHP Gold (in network*) 20% after annual deductible
HDHP Gold (out of network*) 20% after annual deductible
Preferred
Core Plan (in network* only) $70 copay**
HDHP Silver (in network* only) 0% after annual deductible
HDHP Gold (in network*) 20% after annual deductible
HDHP Gold (out of network*) 20% after annual deductible
Non-preferred
Core Plan (in network* only) $100 copay**
HDHP Silver (in network* only) 0% after annual deductible
HDHP Gold (in network*) 20% after annual deductible
HDHP Gold (out of network*) 20% after annual deductible
Specialty
Core Plan (in network* only) N/A
HDHP Silver (in network* only) 0% after annual deductible
HDHP Gold (in network*) 20% after annual deductible
HDHP Gold (out of network*) 20% after annual deductible

* Network: The providers and facilities that a plan has contracts with to provide services to you at a discounted cost.

** Copay: A set dollar amount you pay for a service, usually when you receive the service.

Read more about Prescription Drug coverage.

How much will coverage cost me?

Coverage tier Core Plan
bi-weekly cost for coverage*
HDHP Gold
bi-weekly cost for coverage*
HDHP Silver
bi-weekly cost for coverage*
Employee only $123.75 $24.22 $6.97
Employee + spouse $275.02 $142.32 $102.42
Employee + child(ren) $241.94 $128.74 $98.29
Employee + family $350.14 $174.84 $123.25
Employee only
Core Plan
bi-weekly cost for coverage*
$123.75
HDHP Gold
bi-weekly cost for coverage*
$24.22
HDHP Silver
bi-weekly cost for coverage*
$6.97
Employee + spouse
Core Plan
bi-weekly cost for coverage*
$275.02
HDHP Gold
bi-weekly cost for coverage*
$142.32
HDHP Silver
bi-weekly cost for coverage*
$102.42
Employee + child(ren)
Core Plan
bi-weekly cost for coverage*
$241.94
HDHP Gold
bi-weekly cost for coverage*
$128.74
HDHP Silver
bi-weekly cost for coverage*
$98.29
Employee + family
Core Plan
bi-weekly cost for coverage*
$350.14
HDHP Gold
bi-weekly cost for coverage*
$174.84
HDHP Silver
bi-weekly cost for coverage*
$123.25

* An additional $23.08 will be added to the bi-weekly amounts for those who:

  • Did not complete the routine physicals between April 1 and March 31 of previous plan year. Please note the wellness surcharge will be suspended for the 2021 Plan Year (July 1, 2021 – June 30, 2022) only. In order to avoid the surcharge for the 2022 Plan Year you must complete a routine physical between April 1, 2021 and March 31, 2022.
  • Use tobacco or nicotine products
  • Elect to enroll spouses into Spitzer’s plan when they are eligible for Medical benefits at their respective employer

Need help comparing plans?

By using our new tool, you can compare the costs of the three medical plans Spitzer has to offer. You can personalize the figures to get an estimate of your medical costs based on your anticipated healthcare needs for the forthcoming year, and you will see a comparison of costs based on the information you provide.

Do the math on medical now

How do I find a provider?

Visit member.alight.com or call 800.513.1667 to find in-network and out-of-network providers.

When asked for your Group Number, please provide the number 3339897.

Remember, if you enroll in the HDHP Gold you save dollars when you choose an in-network provider.

Should you require more assistance, visit my.cigna.com or call 800.244.6224 to find providers in the Cigna Open Access Plus network.

Virtual doctor visits with MDLIVE

Virtual doctor visits are available if you’re unwell with a minor, non-life-threatening condition and you can’t or feel too unwell to leave home to see your doctor in person. You can connect with a board-certified doctor at any time day or night via secure video chat or phone to discuss a wide range of minor conditions including:

  • Sore throat
  • Headache
  • Stomachache
  • Fever
  • Cold and flu
  • Allergies
  • Rash
  • Acne
  • UTIs and more

Visit mdliveforcigna.com , download the MDLIVE: Talk to a Doctor 24/7 app , or call 888.726.3171 .

You will need to register for the service via the relevant website or app before you can arrange a virtual visit.

For covered services related to mental health and substance abuse, you must access the Cigna Behavioral Health network of providers. Visit my.cigna.com to search for a video telehealth specialist, then call the phone number provided to make an appointment with your selected provider. Telehealth visits with Cigna Behavioral Health Network providers cost the same as an in-office specialist visit.

Urgent Care vs. Emergency Room

You should only visit an Emergency Room for medical emergencies. Urgent Care facilities are available if you need immediate medical attention for non-life-threatening conditions.

Urgent Care vs. Emergency Room

Cost per visit Urgent care Emergency room
When to visit

You can visit an Urgent Care facility if you’re unwell with a non-life-threatening condition that cannot be discussed on a virtual doctor visit with MDLIVE. These facilities are staffed with doctors and nurses who have access to x-rays and labs on site, and most are open late and on the weekends and holidays. They can handle conditions requiring immediate medical attention including:

  • Minor cuts, sprains and burns
  • Animal bites
  • Mild asthma
  • Back and joint pain

If you need immediate medical attention for a life-threatening condition, go to your nearest Emergency Room or call 911.

  • Sudden numbness or weakness
  • Disorientation or difficulty speaking
  • Sudden dizziness or loss of coordination
  • Seizure or loss of consciousness
  • Shortness of breath or severe asthma attack
  • Head injury/major trauma
  • Blurry or loss of vision
  • Severe cuts or burns
  • Heart attack, chest pain or chest pressure
  • Overdose
  • Uncontrolled bleeding
  • Coughing or vomiting blood
  • Severe allergic reactions
Core Plan $75 copay $250 + 20% after annual deductible
HDHP Silver 0% after annual deductible 0% after annual deductible
HDHP Gold 20% after annual deductible 20% after annual deductible (50% out of network)
When to visit
Urgent care

You can visit an Urgent Care facility if you’re unwell with a non-life-threatening condition that cannot be discussed on a virtual doctor visit with MDLIVE. These facilities are staffed with doctors and nurses who have access to x-rays and labs on site, and most are open late and on the weekends and holidays. They can handle conditions requiring immediate medical attention including:

  • Minor cuts, sprains and burns
  • Animal bites
  • Mild asthma
  • Back and joint pain
Emergency room

If you need immediate medical attention for a life-threatening condition, go to your nearest Emergency Room or call 911.

  • Sudden numbness or weakness
  • Disorientation or difficulty speaking
  • Sudden dizziness or loss of coordination
  • Seizure or loss of consciousness
  • Shortness of breath or severe asthma attack
  • Head injury/major trauma
  • Blurry or loss of vision
  • Severe cuts or burns
  • Heart attack, chest pain or chest pressure
  • Overdose
  • Uncontrolled bleeding
  • Coughing or vomiting blood
  • Severe allergic reactions
Core Plan
Urgent care $75 copay
Emergency room $250 + 20% after annual deductible
HDHP Silver
Urgent care 0% after annual deductible
Emergency room 0% after annual deductible
HDHP Gold
Urgent care 20% after annual deductible
Emergency room 20% after annual deductible (50% out of network)

Healthcare concierge

If you need help choosing a provider, Alight Solutions gives you access to a personal Health Pro® consultant who can assist you and your family with:

  • Understanding your benefits
  • Finding highly-rated doctors, dentists and eye care professionals
  • Saving money by comparing prices for you and helping you to choose more cost-effective options
  • Paying less for prescriptions by recommending lower-cost prescription drugs
  • Resolving billing errors
  • Scheduling appointments at times most convenient for you

To use this service, complete your health profile at member.alight.com and call 800.513.1667 to get assistance.