Medical Plans
SELECT YOUR LOCATION:
Your Plans
To keep you and your family healthy, our medical benefits provide comprehensive coverage, from routine check-ups to emergency care.
Cigna Open Access Health Plan
- Pay predictable copays for many covered services
- Enjoy lower out-of-pocket costs when you need care throughout the year
- Access a broad network of providers and specialists without referrals
Cigna Consumer Health Plan (HDHP)
- Pair with a Health Savings Account (HSA)
- Pay lower paycheck contributions in exchange for a higher deductible
- Save tax-free dollars for current and future healthcare expenses through your HSA
Coverage (You pay)
To select the plan that best suits your needs, consider the key differences between the plans, the cost of coverage (including payroll deductions), and how the plan covers services during the year.
| Benefit/Covered Service | Cigna Open Access (In-network) | Cigna Open Access (Out-of-network) | Cigna Consumer Health (In-network) | Cigna Consumer Health (Out-of-network) |
|---|---|---|---|---|
| Preventive care (No deductible) | $0 | $0 | $0 | $0 |
| H&M's contribution to your HSA (Individual) | No contribution | No contribution | $500 | $500 |
| H&M's contribution to your HSA (Family) | No contribution | No contribution | $1,000 | $1,000 |
| Deductible (Individual) | $750 | $2,000 | $2,000 | $3,500 |
| Deductible (Family) | $1,500 | $4,000 | $4,000 | $7,000 |
| Coinsurance (After deductible) | N/A | N/A | 20% | 50% |
| Out-of-pocket max (includes deductible) (Individual) | $1,500 | $5,000 | $4,000 | $5,000 |
| Out-of-pocket max (includes deductible) (Family) | $3,000 | $15,000 | $8,000 | $10,000 |
| Lifetime maximum (except where otherwise noted) | Unlimited | Unlimited | Unlimited | Unlimited |
| Primary care physician | $20 copay (no deductible) | 40% after deductible | 20% after deductible | 50% after deductible |
| Specialty care office visit | $35 copay; No deductible (no referral needed) | 40% after deductible | 20% after deductible | 50% after deductible |
| Diagnostic outpatient testing | Covered in full at an independent lab** | 40% after deductible | 20% after deductible | 50% after deductible |
| Inpatient hospitalization & surgery | $250 copay per admission | 40% after deductible | 20% after deductible | 50% after deductible |
| Outpatient surgery | $50 copay | 40% after deductible | 20% after deductible | 50% after deductible |
| Emergency room | $200 copay (waived if admitted) | $200 copay (waived if admitted) | 20% after deductible | 20% after deductible |
| Urgent care | $35 copay; No deductible | $35 copay; No deductible | 20% after deductible | 20% after deductible |
| Mental health/alcohol & drug abuse (Inpatient) | $250 copay per admission | 40% after deductible | 20% after deductible | 50% after deductible |
| Mental health/alcohol & drug abuse (Outpatient) | $35 copay (no deductible) | 40% after deductible | 20% after deductible | 50% after deductible |
| Bariatric surgery | $8,000 lifetime limit | Not covered | Not covered | Not covered |
| Infertility | $20,000 lifetime max | Not covered | $15,000 lifetime max | Not covered |
* These out-of-network services are subject to Reasonable and Customary (R&C) limitations. This means you are responsible for all charges over this allowance.
**Physician’s office visit copay applies for an office visit or plan deductible may apply for an outpatient facility.
Contributions
Contributions are deducted from paychecks on a pre-tax basis.
Cigna Open Access Health Plan
- Higher paycheck contributions
- Lower cost for services at the doctor, pharmacy, etc.
| How much you pay | Weekly | Bi-weekly |
|---|---|---|
| Employee | $42.00 | $84.00 |
| Employee + Spouse | $107.00 | $214.00 |
| Employee + Child(ren) | $83.50 | $167.00 |
| Family | $142.50 | $285.00 |
Cigna Consumer Health Plan (HDHP)
- Lower paycheck contributions
- Higher cost for services at the doctor, pharmacy, etc.
| How much you pay | Weekly | Bi-weekly |
|---|---|---|
| Employee | $24.50 | $49.00 |
| Employee + Spouse | $74.00 | $148.00 |
| Employee + Child(ren) | $67.50 | $135.00 |
| Family | $100.50 | $201.00 |
Extra Programs Included With Coverage
Virtual women’s health clinic, gym memberships, and more are included with your Cigna medical coverage.
Need Help Choosing a Plan?
BenefitsVIP is available to answer questions about enrollment, plan coverage, and benefits support.
Contact BenefitsVIP
- hmbenefits@benefitsvip.com
- 877-482-6777
- Monday–Friday, 8:30 am–8:00 pm EST
Medicare Enrollment Support
If you or a family member is approaching age 65 or enrolling in Medicare for the first time, H&M partners with HTA (Healthcare Transition Advisors) to simplify the process.
HTA offers personal guidance to help you understand your options, select the right plan, and make a smooth coverage transition.
Connect with an advisor or learn more on the HTA website.