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
  • With the Choice option, you will pay less per pay period, but you will pay considerably more in out-of-pocket costs when you receive medical services
  • There are three coverage levels within each medical option:​  
  1. BJC Facilities: You will save the most when you receive services from BJC facilities; deductibles, coinsurance and copayments are the lowest when you use BJC facilities.You may also use BJC facilities that provide mental health and substance abuse services.
  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 preventive services. 
  • Cigna Telehealth Connection: For Medical Plan members, BJC has waived out-of-pocket expenses for Cigna Telehealth Connection. When BJC Medical Plan members make virtual care visits through AmWellforCigna.com, 855.667.9722 or MDLIVEforCigna.com, 888.726.3171 to a board-certified doctor to help with minor, non-life-threatening conditions (e.g., cold or flu, rashes, sore throat, mild fever), there will be no out-of-pocket costs for the virtual care visit. These services can also be provided to infants and children. Plan members can also access Cigna Behavioral Health Telehealth providers for covered services related to mental health and substance abuse, without incurring a copayment. For more information, log in to www.myCigna.com and search "Talk to a doctor or nurse 24/7." 

Medical Coverage Chart

Effective January 1, 2020 BJC Medical Plan members will incur NO out-of-pocket expenses (deductibles, coinsurance or copayments) when receiving any outpatient lab work (e . g ., blood draw) and/or outpatient radiology/imaging (including physician/ technician fees) at a BJC facility. Learn more about no out-of-pocket expenses.

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* $0 Not Covered N/A* $0 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 $0 $35 50% $0 $50 75%
Chiropractic Care N/A* $25 Not covered N/A* $25 Not covered
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 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. 

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

  Full-Time Part-Time
Choice Plus
Employee only $79.48 $119.22
Employee + Children $133.68 $200.52
Employee + Spouse $190.80 $286.20
Employee + Family $244.82 $367.23
Choice
Employee only $41.76 $62.64
Employee + Children $76.22 $114.33
Employee + Spouse $111.32 $166.98
Employee + Family $146.43 $219.65

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 team members who participate in the Employee Health Plan.  We understand that some team members may have been unable to see a physician for a blood draw given the recent pandemic or simply are hesitant to move forward now with testing while safety and social distancing guidance is in place.  Given we have no clear timeline for when our current risks will change as it relates to COVID 19,  we are providing employees with a modified option to earn a $100 incentive when completing only the Cigna Health Risk Assessment (HRA) by June 30, 2020.  

Remember, BJC employees who were actively covered as the main subscriber in the BJC Medical Plan on January 1, 2020, can earn a wellness incentive of $225 by completing the following two steps below between July 1, 2019 and June 30, 2020

STEP 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.      

STEP 2: Complete the Cigna Health Risk Assessment (HRA) on www.myCigna.com. This includes entering into your HRA your most recent health screening or blood draw results.  

You must complete both steps 1 and 2 to earn the $225 annual wellness incentive OR complete ONLY step 2 (no health screening or blood draw results required) by June 30, 2020 to earn a modified $100 wellness incentive opportunity for 2020. 

Please note that spouses are no longer eligible for the wellness incentive. No documentation is required to prove that you completed the requirements of steps 1 and 2 as this will be validated through CIGNA and reported to BJC.       

BJC does not have wellness incentive completion data at this time (as we must wait for claims processing which can take several months past the deadline above for those obtaining lab work).  The wellness incentive will be awarded to employees on the first paycheck in December. 

If you would like to view your Cigna HRA confirmation statement, login to www.myCigna.com and choose My Health Assessment from the Wellness section or call Cigna at 800-244-6224.

Questions?  Call the BJC Employee Service Center at 314-362-2184 or toll-free 855-362-2184, or email Employee_Service_Center@bjc.org.