Medical

BJC offers two medical options: Choice Plus and Choice. Both are administered by Cigna, allow access to the Cigna Open Access Plus (OAP) Network of preferred providers, and cover the same medical services. Similarities and differences:

  • Both medical options include Prescription Drug coverage
  • In general, you will pay more out of your bi-weekly paycheck for Choice Plus, but pay considerably less in out-of-pocket costs for deductibles, copayments and coinsurance for medical services
  • Conversely, you will pay less per pay period for Choice, but pay considerably more in out-of-pocket costs when you receive medical services
  • There are three coverage levels within each medical option:​  
  1. BJC Facility Network: You will save the most when you receive services from BJC facilities; deductibles, coinsurance and copayments are the lowest when you use the BJC Facility Network; the BJC Facility Network does not include physicians
  2. Cigna OAP Network: Facilities and physicians, including BJC Medical Group and Washington University School of Medicine physicians, who have agreed to provide services to BJC Medical Plan members at a reduced cost; deductibles, coinsurance and copayments for facility services are much lower than those from Non-Network providers, but higher than BJC Facility Network providers
  3. Non-Network: Services from health care providers not within the BJC Facility Network or Cigna OAP network may not be discounted
  • Many preventive services are covered at 100 percent (you owe nothing) if received from a BJC facility or Cigna Network OAP provider. Learn more about Cigna preventive services.
  • For a $25 copay, BJC Medical Plan members can access doctors 24/7/365 via secure video chat or phone, without leaving their home or office; Cigna Telehealth includes national telehealth providers AMWell and MDLIVE who will treat you and your dependents (including infants and children) for minor, non-life-threatening illnesses. Prescriptions can also be obtained. To use the service, plan members must register with one or both: AmWellforCigna.com, 855.667.9722; MDLIVEforCigna.com, 888.726.3171. Learn more here.

Medical Coverage Chart

This chart provides a few examples of your payment responsibility under each medical option. Consult the Summary Plan Descriptions (SPD) for coverage details.​​​

  Choice Plus Choice
BJC Facility Network Cigna OAP Network Non-Network BJC Facility Network Cigna OAP Network Non-Network
Annual Deductible – Per Individual
(3x Family)
$200 $600 $3,000 $600 $2,500 $5,000
Annual Out-of-Pocket Maximum
Per Individual $1,200 $4,600 Unlimited $4,000 $4.600 Unlimited
Per Family $3,600 $9,200 $9,200 $9,200
Urgent Care $50 $60
Emergency Room $150 $200
Wellness and Preventive Care $0 $0 50% $0 $0 75%
Cigna Telehealth N/A* $25 Not Covered N/A* $25 Not Covered
Diagnostic/Non-Preventive Office Visit
Primary Care Physician (PCP) N/A* $25 50%* N/A* $40 75%
Specialists N/A* $50 50%* N/A* $60 75%
Outpatient Short-Term Therapy $20 $35 50% $30 $50 75%
Outpatient Surgery 0% 40% $1,500 & 50% 15% 60% $3,000 & 75%
Hospital Services
Inpatient Technical Charges** 0% 40% $2,500 & 50% 15% 60% $5,000 & 75%
Outpatient Technical Charges** 0% 40% 50% 15% 60% 75%
Inpatient Professional Charges*** N/A* 20% 50% N/A* 40% 75%
Outpatient Professional Charges*** N/A* 20% 50% N/A* 40% 75%

* The BJC Facility Network does not include physicians; BJC Medical Group, Memorial Medical Group and Washington University physicians are included in the Cigna OAP Network. ** Billed by Facility. Technical charges for the tools and services that a professional uses to provide health care services, such as equipment, supplies, operating room time, radiology, general nursing care, etc. *** Billed by Physician. Professional charges for a physician or other licensed health care professional’s time and expertise to provide health care services to an individual.

Understanding Benefit Terms

Both medical options, Choice Plus and Choice, cover the same medical services, such as a visit to a primary care physician or specialist, a trip to the emergency room, or outpatient surgery. What is primarily different about the two options is the amount you pay for services, as well as the bi-weekly deductions from your paycheck (contributions), copayments, deductibles and coinsurance. To gain a better understanding, spend some time reviewing this Choice-Choice Plus infographic.

For more information, call Cigna 800.244.6224 or log in to your myCigna account.

This chart provides a few examples of your payment responsibility under each medical option. Consult the Summary Plan Descriptions (SPD) for coverage details.

Employee Costs for Medical Coverage

The contributions listed below are pre-tax, per-pay-period deductions, based on 26 pay periods a year.

  Full-Time Part-Time
Choice Plus
Employee only $77.92 $116.88
Employee + Children $131.06 $196.59
Employee + Spouse $183.46 $275.19
Employee + Family $235.40 $353.10
Choice
Employee only $40.94 $61.41
Employee + Children $74.73 $112.10
Employee + Spouse $107.04 $160.56
Employee + Family $140.80 $211.20

Note: Additional coverage costs may apply due to the Working-Spouse Surcharge and/or the Tobacco-User Surcharge.

Annual Wellness Incentive

The Annual Wellness Incentive is just one of the many benefits BJC provides to help support our efforts in achieving and sustaining healthy outcomes for our team members.

For 2020, the incentive has been raised from $175 to $225. We have also made it easier to earn by requiring the completion of only 2 simple steps:

1) Complete one of the following:
•    a blood draw at a BJC facility; or
•    an at-work health screening at a BJC health fair or the Boone Hospital WELLAWARE health fair. The screening needs to include height, weight, waist circumference, blood pressure and a finger-stick blood draw for cholesterol and blood glucose. See a calendar of health screenings under Resources below.
    
2) Complete the Cigna Health Risk Assessment (HRA) via myCigna.com, which includes entering your health screening or blood draw results. See HRA instructions under Resources below.  

To earn the wellness incentive, both steps need to be completed between July 1, 2019 and June 30, 2020. In addition, the 2020 wellness incentive can only be earned by employees who are actively covered as the main subscriber in the BJC Medical Plan on January 1, 2020.

Please note: Covered spouses are no longer eligible for the wellness incentive. Our focus in 2020 is to concentrate our efforts on engaging our employees who enroll in our health plan first and to see increased participation from this group before expanding our efforts.  With more than 25,000 employees enrolling in benefits, we have a great opportunity to improve our employees' health and measure our ability to do so. Spouses receive all other plan benefits but are not the focus of the wellness incentive for 2020.

No documentation is required to prove that you completed the health screening at a BJC health fair or blood draw at a BJC facility. BJC will obtain completion reports on your behalf.  

BJC thanks you for “owning” your health and working to be the best you can be.  BJC will continue to partner with you so you can THRIVE every day.