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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.
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.
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.
Bi-Weekly Premiums for Coverage
MyHealth360 Medical Plan Coverage Summary
Summary of Benefits and Coverage (SBC)
Questions about the Piedmont HDHP with HSA? Please contact Cigna at 877-601-3835 or visit mycigna.com.
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.
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.
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.
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.
Partnering with Progyny closely aligns with our systemwide goal of improving and advancing maternal fetal health in Georgia and beyond.
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.
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.
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 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: Weight loss drugs are not covered under any MyHealth360 medical plan, and all fertility medications are managed through Progyny rather than Express Scripts.
When it comes to prescriptions, there are five easy guidelines to follow:
Prescription Drug Formulary Summary
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.
To be considered eligible for an HSA, you must not be covered by any other health plan that is not an HDHP; not enrolled in Medicare or TRICARE; not claimed as a dependent on someone else’s tax return and not receiving reimbursement for medical expenses from someone else’s general-purpose Flexible Spending Account (FSA). For additional details, please refer to IRS Publication 969.
By enrolling in the Piedmont HDHP with HSA, you are authorizing an HSA to be opened on your behalf at HealthEquity. By law, HealthEquity must verify the identity of all customers opening an HSA; you may be asked to provide additional information and/or documentation before your account can be established. If you would like to opt-out of a HealthEquity HSA (and contributions from Piedmont), please email the Piedmont Benefits Department at benefits@piedmont.org.
For non-emergency care, get a virtual visit on your computer or smartphone from anywhere. You have 24/7 access to board-certified doctors for a copay. Also, get same-day care for minor injury or illness at all Piedmont-branded urgent care centers for a copay. Most locations are open seven days a week with extended hours.
Yes. MyHealth360 members (regardless of what medical plan they choose) receive coverage on diabetic products, supplies and durable medical equipment. You can also attend unlimited pre-diabetes and diabetes education classes and counseling sessions and three nutrition consultations per year—with all costs covered by the plan. A referral from your primary care physician is required.
In the Piedmont HDHP with HSA:
This website is not inclusive of all situations and is provided for informational purposes only. It is not intended to be an official legal document. If there are conflicts between the website and IRS regulations, the member handbook, or the Summary Plan Description (SPD), IRS regulations, the member handbook, and the SPD will govern.