MyHealth360 provides a comprehensive suite of health and wellbeing benefits including: a medical plan, prescription drug, dental and vision coverage, and Dependent Care Flexible Spending Accounts (FSA). If eligible, you can select one of four coverage levels: Employee Only, Employee + Child(ren), Employee + Spouse/Domestic Partner or Family.
In the Piedmont High-Deductible Health Plan (HDHP) with Health Savings Account (HSA), you have access to a tax-advantaged HSA that allows you to save pre-tax dollars to pay for eligible health care services. Plus, when you enroll in the Piedmont HDHP with HSA and your HSA is opened, Piedmont makes a lump-sum contribution to your account ($500 for employee only coverage; $1,000 for all other coverage levels).
The IRS maintains annual limits for combined (yours and Piedmont’s) HSA contributions ($3,350 for employee only coverage; $6,750 for all other coverage levels; $1,000 catch-up above the maximum allowed for employees age 55 and older). Your contributions are voluntary, and you can start, stop, increase or decrease your contributions at any time in Peoplesoft ESS.
HSA Eligibility
IMPORTANT: Before you enroll in an HSA, be sure you meet the IRS eligibility requirements. If you are not eligible and you enroll in an HSA, there will be negative tax implications. Learn more.
Questions about the Piedmont HDHP with HSA? Please contact Cigna at 877-601-3835 or visit mycigna.com.
What about the other MyHealth360 medical plan options?
Because Piedmont’s out-of-state remote employees are not typically in proximity to the Piedmont Preferred Network (Tier One) of providers and facilities, the Piedmont HDHP with HSA is designed to provide out-of-state remote employees with richer benefits and access to a nationwide network of providers in the Cigna Open Access Plus (OAP) network.
Provider Networks and Directories
The level of benefits you will receive depends on where you choose to receive care. In the Piedmont HDHP with HSA, you can choose to receive care from in-network or out-of-network providers. Remember, you pay for the full cost of health care services, including prescription drugs, until you reach the deductible.
You will receive high-quality care at the most affordable price possible when you use in-network providers and services in the Cigna Open Access Plus Network.
To locate a provider, use one of the following options:
MyHealth360 members: Open the Castlight mobile app and select “Find Care.” If you do not have the mobile app, you can register online at mycastlight.com/piedmont.
When you select an out-of-network provider, you will incur the highest out-of-pocket expenses. Providers and facilities are those not included in the Cigna Open Access Plus Network.
This example shows coverage using in-network providers. Learn more about how the HDHP and HSA work together (including the advantages of setting aside HSA contributions) to provide you and your family with access to comprehensive health care and financial support.
The deductibles are “non-embedded” (i.e., the plan does not pay until the family deductible is met; there are no individual deductibles for each family member).
The HSA features tax-free contributions, tax-free investment growth and tax-free withdrawals.
The money in your HSA rolls over every year, and it’s always yours to keep.
Still not sure how the plan works? Scroll through these examples:
Meet William
Plan: Piedmont HDHP with HSA Who’s Covered: Employee Only Premium: $62.94 (full-time, bi-weekly) HSA Contribution from Piedmont: $500 Out-of-Network Coverage: Yes Deductible: $1,500 (in-network: Cigna Open Access Plus) Out-of-Pocket Maximum: $4,500 (in-network: Cigna Open Access Plus)
Situation:
William is on vacation and gets into an accident. His one-day, out-of-state hospital stay costs $3,000 (emergencies are covered at the highest benefit level). Remember, William pays the full, upfront cost for any health care services until he reaches the deductible. William pays the $1,500 deductible, and he and the plan split the remaining $1,500 (he pays 10% – $150). He uses $150 from his HSA to pay for his portion of the remaining cost.
Martha wants to continue receiving care from her cancer doctor, who is not in the Cigna Open Access Plus (OAP) Network. Her deductible and out-of-pocket maximum will be higher. She will pay the full, upfront cost of care until she reaches these higher limits. Martha can offset these costs with the $1,000 HSA contribution she receives from Piedmont and any additional pre-tax HSA dollars she saves on her own.
Meet Jill
Plan: Piedmont HDHP with HSA Who’s Covered: Family Premium: $282.57 (full-time, bi-weekly) HSA Contribution from Piedmont: $1,000 Out-of-Network Coverage: Yes Deductible: $3,000 (in-network: Cigna Open Access Plus) Out-of-Pocket Maximum: $9,000 (in-network: Cigna Open Access Plus)
Situation:
Jill and her family have a very healthy year. All family members receive in-network preventive care, covered at 100%. Jill receives a $1,000 HSA contribution from Piedmont, and she saves $6,750 of her own money in her HSA (to reach the combined $7,750 annual IRS limit for family coverage). This money rolls over every year and can be used for future eligible health care expenses. Jill’s goal is to build a nest egg for health care expenses in retirement. She knows any investment growth on her account is tax free.
Prescription Drugs
Prescription drug coverage through Cigna is provided automatically when you enroll in the Piedmont HDHP with HSA. If your medication is not on the no-cost generic preventive medications listing, you will you pay the full cost until you reach your deductible. Any prescription drug costs you pay for on your own will contribute towards your annual deductible and out-of-pocket maximum.
When it comes to prescriptions, there are five easy guidelines to follow:
Use generic drugs when you can. Be sure to ask your physician or pharmacist if a generic substitute is available—it could save you money!
Take advantage of preventive medication at no cost to you. To help you maintain a steady treatment regimen, certain preventive medicines are paid at 100% with no deductible when you visit an in-network pharmacy. This includes many diabetes, cholesterol, blood pressure and other select medication categories.
When you use the broad Cigna/Express Scripts network of retail pharmacies, including Piedmont pharmacies, Oconee Drugs, Walgreens, Kroger, and Walmart retail pharmacies, you can get a 90-day supply of your medication for just two times your 30-day copay amount.
Consider using Cigna’s Home Delivery Pharmacy mail-order option for your maintenance medications—for 2.5x the 30-day copay for a 90-day supply, rather than receiving refills at a retail pharmacy. Review the Home Delivery FAQs for more details.
Remember to explore drug options with your physician to avoid costly name-brand and specialty drug copays that may not be necessary. If you must use brand or specialty drugs, to help offset the cost, take advantage of manufacturer coupons.
We offer life-changing specialty pharmacy services designed to simplify every aspect of your care. From obtaining financial assistance, to navigating through your insurance benefits, coordinating with providers, and managing refills, Piedmont Specialty Pharmacy patient liaisons are ready to help you and your family.
Our team can answer and address insurance-related questions and conduct prior authorizations for complex, rare and chronic medical conditions that require specialized medication therapy.
In-Region Remote (residing in Georgia, Alabama and South Carolina, including System Office and Physician Enterprise [Piedmont Clinic, PHI and PMCC] employees)
Out-of-Region Remote (All other U.S. states; including System Office and Physician Enterprise [Piedmont Clinic, PHI and PMCC] employees)
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To be considered eligible for an HSA, you must not be covered by any other health plan that is not an HDHP; not enrolled in Medicare or TRICARE; not claimed as a dependent on someone else’s tax return and not receiving reimbursement for medical expenses from someone else’s general-purpose Flexible Spending Account (FSA). For additional details, please refer to IRS Publication 969.
By enrolling in the Piedmont HDHP with HSA, you are authorizing an HSA to be opened on your behalf at HealthEquity. By law, HealthEquity must verify the identity of all customers opening an HSA; you may be asked to provide additional information and/or documentation before your account can be established. If you would like to opt-out of a HealthEquity HSA (and contributions from Piedmont), please email the Piedmont Benefits Department at benefits@piedmont.org.
Where can I get high-quality, low-cost care?
For non-emergency care, get a virtual visit on your computer or smartphone from anywhere. You have 24/7 access to board-certified doctors for a copay. Also, get same-day care for minor injury or illness at all Piedmont-branded urgent care centers for a copay. Most locations are open seven days a week with extended hours.
Is support available for diabetes and nutrition issues?
Yes. MyHealth360 members (regardless of what medical plan they choose) receive coverage on diabetic products, supplies and durable medical equipment. You can also attend unlimited pre-diabetes and diabetes education classes and counseling sessions and three nutrition consultations per year—with all costs covered by the plan. A referral from your primary care physician is required.
Cigna offers a network of national ancillary providers to ensure convenient access to cost-effective, quality durable medical equipment (DME) in the home setting. In addition to these national vendors, locally based participating DME providers are available. Check the Cigna provider directory to find a local provider.
What else should I know about the Piedmont HDHP with HSA?
In the Piedmont HDHP with HSA:
You can receive coverage for in- or out-of-network services
All services, except for preventive care, are subject to the deductible and count toward the out-of-pocket maximum, which means you pay the full cost of care for health care services and/or prescriptions until you reach the deductible.
The deductibles are “non-embedded” (i.e., the plan does not begin to pay until the family deductible is met; there are no individual deductible amounts for each family member).
You have access to a tax-friendly HSA where you can save for current and future eligible health care expenses.
To be eligible for an HSA, you must not be covered by any other health plan that is not an HDHP; not enrolled in Medicare or TRICARE; not claimed as a dependent on someone else’s tax return and not receiving reimbursement for medical expenses from someone else’s general-purpose Flexible Spending Account (FSA).
Legal / Disclaimer
This website is not inclusive of all situations and is provided for informational purposes only. It is not intended to be an official legal document. If there are conflicts between the website and IRS regulations, the member handbook, or the Summary Plan Description (SPD), IRS regulations, the member handbook, and the SPD will govern.
