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. Spitzer Industries make an initial deposit into your HSA to get you started:
- $250 if you choose individual coverage
- $500 if you cover yourself plus any dependents.
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 | $3,200/$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*) | $3,200/$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 |
Medical Plan Surcharges
An additional $23.08 will be added to the bi-weekly amounts for those who:
- Use tobacco or nicotine products
- Elect to enroll spouses into Spitzer’s plan when they are eligible for Medical benefits at their respective employer
- Did not complete their preventive exam by March 31 of the prior plan year. For example, you will pay the surcharge in 2024-25 if you did not complete the exam by March 31, 2024. To avoid the surcharge in 2025-26, complete your wellness exam by March 31, 2025.
Need help comparing plans?
By using our 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(Please note, this will open in a new window)
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, you save dollars when you choose an in-network provider. There is no out-of-network coverage for the Core or HDHP Silver plans, so please be sure to visit in-network providers!
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:
|
If you need immediate medical attention for a life-threatening condition, go to your nearest Emergency Room or call 911.
|
| 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:
|
| Emergency room | If you need immediate medical attention for a life-threatening condition, go to your nearest Emergency Room or call 911.
|
| 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.
This link leads to the machine-readable files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.
Downloads