Take an active role in your healthcare coverage with one of WGU’s available medical coverage options:
Our benefits program includes medical plan options with a range of coverage levels and costs so you can choose the one that’s best for you. These plans are administered by Cigna. You can enroll as a new hire, during Open Enrollment, or if you have a qualifying life event. You may also view your premiums.
Administered by: Cigna
Take charge of your spending through lower premiums, higher deductibles, and a tax-free Health Savings Account (HSA) with contributions from Western Governors University that you own for life.
Administered by: {MED2CARRIER}
Consider this plan if you prefer the predictability of office visit copays and lower deductibles, but with a significantly higher paycheck deduction.
The amount you pay before the plan begins to pay
Expenses you pay yourself, such as deductibles, copays, and the remaining amounts after plan coinsurance is paid
The maximum amount you pay for covered services in a year (you may need to pay additional amounts if coverage is received from an out-of-network provider)
An amount you pay for a covered service each time you use that service, which usually does not apply toward the deductible
Before choosing which medical plan to enroll in, it's important to understand how they compare. The table provides a high-level comparison.
| The High Deductible Health Plan (HDHP) | The Traditional Low Deductible Plan (LDHP) |
|---|---|
| What is different? | |
| Premiums, Deductibles, Prescription Drugs | |
|
|
| HSA and FSA | |
|
|
| What is the same? | |
|
|
Western Governors University is proud to offer enhanced Post-traumatic stress disorder (PTSD) and behavioral health (BH) support, including coverage for Cognitive Processing Therapy (CPT), Prolonged Exposure (PE), Eye Movement Desensitization and Reprocessing (EMDR), and treatment of disorders that have been diagnosed as organic mental disorders associated with permanent dysfunction of the brain.
Visit the Cigna website or call 800-244-6224 to learn more.
| The High Deductible Health Plan (HDHP) | The Traditional Low Deductible Plan (LDHP) | |||
|---|---|---|---|---|
| Choice of Providers | Cigna network. | |||
| Health Savings Account (HSA) ($4,150 Employee Only or $8,300 for Family annual limit.) If you are over age 55, you are able to contribute an additional $1,000. | Available with this plan. Refer to Health Savings section for details. | Not available | ||
| Healthcare FSA | Not available | Available for medical, dental, and vision | ||
| Limited Purpose FSA | Available for dental and vision expenses only | Not available | ||
| In-Network | Out-of-Network | In-Network | Out-of-Network | |
| Calendar Year Deductible | ||||
| Individual (Note: only applies to Employee Only coverage under HDHP.) |
$2,000 | $4,000 | $0 | $0 |
| Family | $3,500 | $8,000 | $3,000 | $8,000 |
| Calendar Year Out-of-Pocket Maximum (Includes Deductible) | ||||
| Individual | $4,000 | $8,000 | $3,000 | $8,000 |
| Individual Within a Family | $7,000 | $16,000 | N/A | N/A |
| Family | $8,000 | $16,000 | $6,000 | $16,000 |
| You Pay | You Pay | |||
| Coinsurance | ||||
| Preventive Care | $02 | 40%1 | $0 | $100 copay/visit |
| Physician Office Visits | 20%1 | 40%1 | $10 - $65 copay/visit | $195 copay/visit |
| WGU Virtual Care | $55/visit until deductible is met; 20% thereafter | $10 - $65 copay/visit4 | ||
| Emergency Room | 20%1 | 20%1 | $375 copay | $375 copay |
| Inpatient Hospital Care | 20%1 | 40%1 | $150 - $2,500 copay/stay | Up to $7,00 copay/stay |
| Outpatient Surgery3 | 20%1 | 40%1 | $15 - $2,500 copay/visit | $15 - $2,500 copay/visit |
1 After deductible.
2 Deductible does not apply to in-network preventive services. (Deductible applies for out-of-network preventive services.)
3 Out-of-network treatment for dialysis is not covered.
4 Cost share applies to any other Telehealth service based on provider type. If you receive services in addition to office visit, additional copays may apply.
With advancements in technology, we have become comfortable with managing activities remotely – including virtual healthcare, primary care behavioral, and dermatology support. Whether you’re dealing with a routine illness or injury, or need access to counseling or mental health providers, WGU’s expanded virtual care options deliver cost-effective, around-the-clock access to consultations with board-certified providers via video, phone or app with our partners.
We often think of virtual healthcare for fast access to a physician, but you can use virtual care for primary care appointments, too. Board-certified doctors can help identify any potential health issues, discuss ways to improve your health, and even recommend follow-up care, if necessary. Virtual primary care helps you skip the drive and waiting to see a physician for your preventive care and wellness screening visits. Connect from just about anywhere via video or phone — 7 days a week, 365 days a year, including flexible hours.
If you are enrolled in a WGU medical plan, you and your enrolled dependents can get treatment for general illnesses, prescriptions for a range of medical conditions (subject to applicable state laws), dermatology support, primary care, and advice by live computer video or phone consultations for conditions such as:
You have immediate access to your Cigna ID cards and proof of coverage anytime via the {MED2CARRIER} mobile app. You can view your cards on your device and digitally share it with your providers.
WGU has partnered with HealthEquity to provide an easy-to-use online tool to help you identify the medical plan option that may be best for you. Answer a few simple questions about your likely medical needs for the coming year and the tool will calculate estimated outcomes for each medical coverage option. Give it a try now! Go to comparemyhsa.com/wgu.
If you have further questions and would prefer to speak with someone over the phone, you may contact Health Advocate. Our partners at Health Advocate are extremely knowldegable in all of WGU’s benefits and will be able to help you dial in which plan may work best for you and your family. You may contact Health Advocate at 866-695-8622.
Save money when receiving care from an in-network provider.
Certain preventive medicines on Cigna’s ACA preventive drug list are covered under both the HDHP and Traditional Plan at no cost. Examples: contraceptives, select vaccines, folic acid, and breast cancer prevention. For a complete list of medications covered under this list, visit the Cigna website. In addition, some diabetic supplies, such as needles, lancets, and test strips are available to members at no cost when purchased on the same day as injectable insulin.
Don’t forget — certain other common medications for chronic conditions are covered the same as they are under the Traditional Plan. Examples: antidepressants, medications for diabetes, high blood pressure, high cholesterol, osteoporosis, and respiratory conditions. Under the HDHP, plan coverage for certain medications will apply right away, even if you have not met the plan deductible yet. To view these medications, refer to myCigna.com and access the “Prescriptions” section. Find a participating pharmacy, check drug coverage, arrange for home delivery, and compare prices at Cigna.
The High Deductible Health Plan (HDHP) pairs low-premium, high-deductible coverage with a tax-free Health Savings Account (HSA) that helps you save money and plan ahead for future medical expenses. This combination gives you more control over your money and rewards you for making healthy, cost-conscious choices.
Under the HDHP, on an annual basis, WGU contributes up to $1,000 for Employee Only coverage and up to $2,000 for Employee plus Dependents coverage, as long as you are contributing at least that much over the year. This means you will need to contribute a minimum of $38.46 per paycheck for an employee only plan and $76.92 per paycheck for employee plus dependent(s) plan.
You pay the plan premium from your paycheck to have coverage.
HSA
You can set aside tax-free money from your paycheck and receive company contributions to help cover your costs — now, or in the future.
Deductible
You pay 100% of your medical and prescription costs until you meet the annual deductible.
Coinsurance
After meeting the deductible, you and the plan share the cost of covered medical care and prescriptions, with the plan paying the majority.
Out-of-Pocket Maximum
You’re protected by an annual limit on costs — the plan pays 100% of any further covered expenses for the rest of the year.
Contributing to your HSA is a great way to budget for deductibles and other out-of-pocket expenses while also saving money — your HSA contributions are tax-free!*
Keep in mind:
*Contributions are not subject to federal income tax. However, HSA contributions are currently subject to state income tax in CA and NJ. Consult with your tax advisor to understand the potential tax implications of enrolling in an HSA. Money in an HSA can be withdrawn tax-free as long as it is used to pay for qualified health-related expenses. If money is used for ineligible expenses, you will pay ordinary income tax on the amount withdrawn, plus a 20% penalty tax if you withdraw the money before age 65.
The Traditional Low Deductible Plan (LDHP) gives you access to the same broad coverage and free in-network preventive care as the HDHP because it leverages the same network of in-network providers. It’s designed to offer you a simpler healthcare experience, with a focus on greater clarity around costs of care. Consider how the ICHP’s features might fit your needs. Plus, you get access to a Lifestyle Spending Account that provides benefits to employees for completing wellbeing activities.
The Traditional Low Deductible Plan (LDHP) makes it easy to spot high-quality providers in the broad UnitedHealthcare network. When you search for a provider, you’ll see a range of copays (flat fees for services) for the providers in your area. Providers with higher quality ratings have lower copays.
The Surest app makes it easy for you to understand what you’ll pay before you go to the doctor, so you’ll know in advance exactly what your cost will be. You can also make tax-free contributions to a healthcare FSA to pay eligible medical expenses.
The Traditional Low Deductible Plan (LDHP) does not have a deductible, meaning you will be able to access care at predictable copays from your very first doctor’s visit.
Surest’s app and member portal offer an integrated, seamless experience, making it easy to access your healthcare information whenever you need. The Traditional Low Deductible Plan (LDHP) provides clear, upfront prices for the care that you need. You’ll pay an assigned price for care until you meet your annual out-of-pocket maximum.
You pay the plan premium from your paycheck to have coverage.
Deductibles and Coinsurance?
There are no deductibles or coinsurance.
Getting Care
Whenever you need care, you’ll visit the Surest app or website to search for your condition, treatment, or procedure to find a provider near you.
Copays
You’ll pay set copays for care and prescriptions based on the transparent pricing shown in the Surest app, When you’re “shopping around,” you’ll see a range of copays for all in-network providers, so you know exactly what you’ll pay before you get care. You will pay higher costs to see providers that are not in-network.
Out-of-Pocket Maximum
If you meet your out-of-pocket maximum, the plan pays 100% of any further covered expenses for the rest of the year. Be sure to use in-network providers to maximize your savings.
When you enroll in a Western Governors University medical plan, you automatically receive prescription drug benefits through CVS Caremark.
All your pharmacy benefits will be available via CVS Caremark. You will have expanded options to receive pharmacy benefits through Costco, CVS, Kroger (Smith’s), Sav-On, and Walgreens, among others. Your medications can be delivered to your home via the CVS Caremark mail order program, too. Most pharmacy benefits will be enhanced or stay the same, backed by CVS Caremark’s commitment to cost transparency and implementing formulary strategies that drive down prices. Visit the CVS Caremark site for your specific plan (each plan's site is linked below) for more information:
| The High Deductible Health Plan (HDHP) | The Traditional Low Deductible Plan (LDHP) | |||
|---|---|---|---|---|
| Pharmacy | In-Network | Out-of-Network | In-Network | Out-of-Network |
| Retail Rx (up to a 30-day supply)2 | ||||
| Generic | $101 | 40%1 | $10 | 40% |
| Preferred | 35%1 | 40%1 | 35% | 40% |
| Non-Preferred | 50%1 | 40%1 | 50% | 40% |
| Mail Order Rx (up to a 90-day supply)2,3 | ||||
| Generic | $101 | Not covered | $10 | Not covered |
| Preferred | 35%1 | 35% | ||
| Non-Preferred | 50%1 | 50% | ||
See how medications are covered by logging in to your prescription account on the CVS Caremark website.
The cost of prescription drugs is rising faster than many other health care services and supplies. But there are ways for you to save.
Generic medications are generally just as effective as brand-name medications, but they typically cost between 80% and 85% less.
If you take maintenance medication to treat a chronic condition — such as an allergy, heart disease, high blood pressure, or diabetes — the convenience and cost savings of the home delivery prescription programs through CVS Caremark will save you time and money.
CVS Caremark specific discounts and benefits
If you are enrolled in a Traditional Low Deductible Plan (LDHP), you have access to Cigna’s Saveon Prescription Specialty Coupons.
Take advantage of these valuable programs and resources to better manage your health and financial well-being.
If you are enrolled in a WGU medical plan, you and your eligible dependents have access to Omada® (a Cigna Partnership) Diabetes Prevention Support.
Omada® is a personalized program designed to help you reach your health goals—whether that’s losing weight or improving your overall health. It combines real human support with the latest technology so you can make lasting changes, one step at a time.
Eat healthier
Learn the fundamentals of making smart food choices.
Increase activity
Discover easy ways to move more and boost your energy.
Overcome challenges
Gain skills that allow you to break barriers to change.
Strengthen habits
Zero in on what works for you, and find lasting motivation.
Stay healthy for life
Continue to set and reach your goals with strategies and support.
To ensure that WGU employees have access to high-quality, affordable healthcare, regardless of where they live, we have expanded the travel reimbursement benefit to apply to all healthcare services covered under the WGU Medical Plan. This travel reimbursement benefit is currently available to those enrolled in a WGU medical plan who live more than 50 miles from a contracted provider* as well as those who live in states where a covered service is limited. In addition, broader coverage for abortion care has been added to WGU's Medical Plan.
This Travel and Lodging benefit covers up to $2,500 in total travel expenses for employees and/or their covered dependents. It also includes a $50 daily lodging cap for an individual and a $100 daily lodging cap for employees traveling with a companion. For additional details on these enhanced travel and lodging benefits as well as instructions on how to file a claim for reimbursement, please contact Cigna at 800.244.6224.
*Travel & lodging benefit available for in-network providers only
Visit omadahealth.com/omadaforcigna.
Employees with WGU medical coverage have access to Cigna support resources for conditions like diabetes, COPD, asthma and other chronic health matters. One-on-one assistance is available to help you with:
Log in to the myCigna app or the Cigna website to learn more about their diabetes management program, available to medical plan members who have been diagnosed with diabetes. Receive a smart touchscreen glucose meter that automatically uploads readings and provides personalized tips, as well as unlimited test strips and support from coaches.
Receive high level support from a team of Cigna experts called the Gender Affirmation Support Champion Team regarding eligibility and other questions during a gender affirmation journey.
The Gender Affirmation Support Champion Team are experienced with gender transitioning and can help:
Call Cigna at 800-244-6224 or visit the Cigna website.
Visit your medical plan website to find a doctor, compare costs, manage claims, and more.
Visit your prescription plan website to order or refill prescriptions, sign up for home delivery, and more.
Visit your tax-advantaged account website to manage your HSA or FSA accounts online, use calculators, and more.
Using in-network providers saves you money. If you are enrolled in a Western Governors University medical plan, find doctors in your plan network to save money.
Both the HDHP and Traditional Low Deductible Plan (LDHP) use a national network called Choice Plus. Specifically in Utah, the network is called Options PPO.
When you carefully consider the financial impact of your health care choices, you can help lower costs for yourself and the entire company. Get the most from your medical benefits by following these tips to be well and buy smart:
| Telehealth | Doctor’s office | Urgent care clinic | Emergency room |
|---|---|---|---|
| Use it for | |||
| A common, non-emergency medical issue that can be diagnosed by phone or online | A condition that doesn’t need immediate attention and can wait until the next day | A condition that needs immediate care but is not life- or limb-threatening | A life-threatening or potentially crippling condition that needs immediate attention |
| Examples | |||
|
|
|
|
| Cost | |||
| You pay: $ | You pay: $ | You pay: $$ | You pay: $$$ |
| Find it | |||
| Call your regular doctor or search for an in-network provider on your medical plan carrier’s website | Search for urgent care clinics near you at https://www.solvhealth.com/urgent-care | Call 911 or search online for the nearest hospital | |
