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MyHealth360

MyHealth360 provides a comprehensive suite of health and well-being 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.

What to know

Piedmont HDHP with HSA

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 ($4,300 for employee only coverage; $8,550 for all other coverage levels; $1,000 catch-up above the maximum allowed for team members age 55 and older). Your contributions are voluntary, and you can start, stop, increase or decrease your contributions at any time by completing the HSA Contribution Election Form and emailing it to benefits@piedmont.com.

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.

Are you eligible for Medicare?

Medicare navigation support will be available through SmartConnect at no cost to you. All Medicare-eligible team members, spouses/domestic partners and dependents who are interested in enrolling in Medicare, Medicare Supplements or Medicare Advantage plans can receive assistance with plan comparisons, selection and enrollment. Additional resources include ongoing support for plan and claims questions, as well as access to educational materials, webinars and licensed agents. Learn more.

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:

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.

How the Piedmont HDHP with HSA Works

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.

What else should I know about the Piedmont HDHP with HSA?

Key Plan Details
  • 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.

Support for Reproductive Health

Fertility, pregnancy and postpartum benefits will be available through Progyny beginning Jan. 1, 2025. MyHealth360 plan members can receive up to two SmartCycles with coverage for IVF, IUI and fertility preservation through Progyny providers. This includes medical services and medication on each treatment journey. You also receive unlimited guidance and support from a dedicated patient care advocate who can help you navigate a large network of fertility experts. Progyny also offers menopause and midlife care. For more information, see the benefits overview and Progyny Member Guide. You can also call 833-233-0722 or visit progyny.com/benefits.

Why Progyny?

Partnering with Progyny closely aligns with our systemwide goal of improving and advancing maternal fetal health in Georgia and beyond.

Still not sure how the plan works? Scroll through these examples:

Meet William

Plan: Piedmont HDHP with HSA
Who’s Covered: Employee Only
Premium: $68.08 (full-time, bi-weekly)
HSA Contribution from Piedmont: $500
Out-of-Network Coverage:
 Yes
Deductible: $1,650 (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 $1,650 deductible, and he and the plan split the remaining $1,350 (he pays 10% – $135). He uses $135 from his HSA to pay for his portion of the remaining cost.

Meet Martha

Plan: Piedmont HDHP with HSA
Who’s Covered: Employee + Spouse
Premium: $245.08 (full-time, bi-weekly)
HSA Contribution from Piedmont: $1,000
Out-of-Network Coverage:
 Yes
Deductible: $12,000 (out-of-network)
Out-of-Pocket Maximum: $14,000 (out-of-network)

Situation:

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: $305.63 (full-time, bi-weekly)
HSA Contribution from Piedmont: $1,000
Out-of-Network Coverage:
 Yes
Deductible: $3,300 (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 $7,550 of her own money in her HSA (to reach the combined $8,550 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 administered directly by Express Scripts 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.

Please note: All fertility medications are managed through Progyny.

When it comes to prescriptions, there are five easy guidelines to follow:

  1. Register with Express Scripts for online account access.
  2. Use generic drugs when you can. Take a look at the drug pricing tool and mobile app; be sure to ask your physician or pharmacist if a generic substitute is available—it could save you money!
  3. 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.
  4. When you use the broad Express Scripts network of retail pharmacies, including Piedmont pharmacies, Oconee Drugs, Walgreens and Walmart retail pharmacies, you can get a 90-day supply of your medication for just two times your 30-day copay amount.
  5. 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.
Piedmont Direct Pharmacy

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.

For more information, visit Piedmont Direct Pharmacy, call 833-551-2024 (Monday through Friday, 8am – 4:30pm) or email piedmontdirect@piedmont.org.

Other Benefits to Consider

Dental Coverage

Vision Coverage

Flexible Spending Accounts (FSAs)

Location Selection

Notifications

Events

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Most Piedmont Locations

(team members at Atlanta, Athens, Columbus, Eastside, Fayette, Henry, Mountainside, Newnan, Newton, Rockdale, Walton, System Support Services and Physician Enterprise [Piedmont Clinic, PHI and PMCC])

In-Region Remote

(team members residing in Georgia, Alabama and South Carolina, including System Support Services and Physician Enterprise [Piedmont Clinic, PHI and PMCC])

Out-of-Region Remote

(team members in all other U.S. states; including System Support Services and Physician Enterprise [Piedmont Clinic, PHI and PMCC])

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