Medical
Townsquare Media offers three Cigna medical plans. Each plan is available on two networks, so you choose a plan and a network:
- Cigna LocalPlus is a smaller, local network with lower paycheck costs. When you live in a LocalPlus service area, you must use LocalPlus providers for in-network benefits. When you are temporarily away from home, you can still get in-network care through Away From Home Care.
- Cigna Open Access Plus (OAP) is Cigna’s national network. It gives you the widest choice of providers at a higher paycheck cost.
Your benefits, deductibles and copays are the same on either network. Only the provider network and your paycheck cost change. No referrals are needed to see a specialist, and preventive care is covered at 100% in-network.
Prescription Drugs
If you enroll in the $7,000 HDHP, your prescriptions are covered through Cigna. If you enroll in the $5,500 or $4,250 plan, your prescriptions are covered through EmpiRx Health: call 877-323-0584 (24/7) or visit myempirxhealth.com. Maintenance medications can be filled for up to 90 days through EmpiRx Health’s mail-order pharmacy, Prescription Mart.
Each plan has different:
- Annual deductible amounts – the amount you pay each year for eligible in-network and out-of-network charges before the plan begins to pay.
- Out-of-pocket maximums– the most you will pay each year for eligible network services and/or prescriptions. After you reach your out-of-pocket maximum, the plan picks up the full cost of covered medical care for the remainder of the year.
- Copays – A copay is a fixed amount you pay for a health care service. Copays do not count toward your deductible but do count toward your annual out-of-pocket maximum.
- Coinsurance – Once you’ve met your deductible, you and the plan share the cost of care, which is called coinsurance. For example, you pay 30% for services and the plan pays 70% of the cost until you have reached your out-of-pocket maximum.
Cigna $7,000 HDHP OAP/LocalPlus HSA Plan
This high-deductible plan qualifies you to contribute to a Health Savings Account (HSA). Prescriptions are covered through Cigna.
Benefit Highlights
In-Network
Deductible (Individual/Family)
$7,000/$14,000
($7,000 for an individual within a family)
Out-of-Pocket Max (Individual/Family)
$7,000/$14,000
($7,000 for an individual within a family)
Preventive Care
No charge
Primary Care Visit
0% after deductible
Specialist Visit
0% after deductible
Virtual Visit (MDLIVE)
0% after deductible
Chiropractic (35 visits per year)
0% after deductible
Lab and X-ray
0% after deductible
Urgent Care
0% after deductible
Emergency Room
0% after deductible
Hospital Stay
0% after deductible
Outpatient Surgery
0% after deductible
Retail Rx (Cigna, Up to 30-Day Supply)
Rx Deductible and Out-of-Pocket Max
Combined with medical
Generic
0% after deductible
Brand Name
0% after deductible
Specialty
0% after deductible
Mail-Order Rx (Up to 90-Day Supply)
Generic
0% after deductible
Brand Name
0% after deductible
Out-of-Network
Deductible (Individual/Family)
$14,000/$28,000
($14,000 for an individual within a family)
Out-of-Pocket Max (Individual/Family)
$14,000/$28,000
($14,000 for an individual within a family)
Preventive Care
50% after deductible
Primary Care Visit
50% after deductible
Specialist Visit
50% after deductible
Virtual Visit (MDLIVE)
Not available
Chiropractic (35 visits per year)
50% after deductible
Lab and X-ray
50% after deductible
Urgent Care
50% after deductible
Emergency Room
50% after deductible
Hospital Stay
50% after deductible
Outpatient Surgery
50% after deductible
Prescription Drugs
Retail and Mail-Order Rx
Not covered
Plan Cost
Your cost per semi-monthly paycheck (24 per year):
| Coverage | LocalPlus | OAP |
|---|---|---|
| Employee Only | $77.69 (salary under $41,000) $162.68 (salary over $41,000) |
$77.69 (salary under $41,000) $169.19 (salary over $41,000) |
| Employee and Spouse | $340.26 | $353.87 (salary under $41,000) $353.29 (salary over $41,000) |
| Employee and Child(ren) | $307.97 | $320.29 |
| Employee and Family | $485.55 | $495.26 (salary under $41,000) $495.36 (salary over $41,000) |
Cigna $5,500 OAP/LocalPlus Plan
Prescriptions are covered through EmpiRx Health.
Benefit Highlights
In-Network
Deductible (Individual/Family)
$5,500/$16,500
Out-of-Pocket Max (Individual/Family)
$8,080/$18,160
Preventive Care
No charge
Primary Care Visit
$65 copay
Specialist Visit
$90 copay
Virtual Visit (MDLIVE)
$65 copay (urgent or primary care)
$90 copay (specialist)
Chiropractic (35 visits per year)
$90 copay
Lab and X-ray
No charge
Urgent Care
$100 copay
Emergency Room
$400 copay
Hospital Stay
30% after deductible
Outpatient Surgery
30% after deductible
Retail Rx (EmpiRx, Up to 30-Day Supply)
Rx Deductible (Individual/Family)
$200/$200
Rx Out-of-Pocket Max (Individual/Family)
$1,270/$2,540
Generic
$15 copay
Preferred Brand
$40 copay
Non-Preferred Brand
$65 copay
Specialty
$40 copay (preferred)
$65 copay (non-preferred)
Mail-Order Rx (Up to 90-Day Supply)
Generic
$37.50 copay
Preferred Brand
$100 copay
Non-Preferred Brand
$162.50 copay
Out-of-Network
Deductible (Individual/Family)
$8,500/$25,500
Out-of-Pocket Max (Individual/Family)
$14,500/$29,000
Preventive Care
50% after deductible
Primary Care Visit
50% after deductible
Specialist Visit
50% after deductible
Virtual Visit (MDLIVE)
Not available
Chiropractic (35 visits per year)
50% after deductible
Lab and X-ray
50% after deductible
Urgent Care
50% after deductible
Emergency Room
$400 copay
Hospital Stay
50% after deductible
Outpatient Surgery
50% after deductible
Prescription Drugs
Retail and Mail-Order Rx
Not covered
Plan Cost
Your cost per semi-monthly paycheck (24 per year):
| Coverage | LocalPlus | OAP |
|---|---|---|
| Employee Only | $189.01 | $222.57 |
| Employee and Spouse | $345.97 | $411.81 |
| Employee and Child(ren) | $319.37 | $384.15 |
| Employee and Family | $469.18 | $580.57 |
Cigna $4,250 OAP/LocalPlus Plan
Prescriptions are covered through EmpiRx Health.
Benefit Highlights
In-Network
Deductible (Individual/Family)
$4,250/$12,750
Out-of-Pocket Max (Individual/Family)
$7,000/$14,000
Preventive Care
No charge
Primary Care Visit
$65 copay
Specialist Visit
$90 copay
Virtual Visit (MDLIVE)
$65 copay (urgent or primary care)
$90 copay (specialist)
Chiropractic (35 visits per year)
$90 copay
Lab and X-ray
No charge
Urgent Care
$100 copay
Emergency Room
$400 copay
Hospital Stay
30% after deductible
Outpatient Surgery
30% after deductible
Retail Rx (EmpiRx, Up to 30-Day Supply)
Rx Deductible (Individual/Family)
$200/$200
Rx Out-of-Pocket Max (Individual/Family)
$1,000/$2,000
Generic
$15 copay
Preferred Brand
$40 copay
Non-Preferred Brand
$65 copay
Specialty
$40 copay (preferred)
$65 copay (non-preferred)
Mail-Order Rx (Up to 90-Day Supply)
Generic
$37.50 copay
Preferred Brand
$100 copay
Non-Preferred Brand
$162.50 copay
Out-of-Network
Deductible (Individual/Family)
$5,500/$16,500
Out-of-Pocket Max (Individual/Family)
$12,500/$25,000
Preventive Care
50% after deductible
Primary Care Visit
50% after deductible
Specialist Visit
50% after deductible
Virtual Visit (MDLIVE)
Not available
Chiropractic (35 visits per year)
50% after deductible
Lab and X-ray
50% after deductible
Urgent Care
50% after deductible
Emergency Room
$400 copay
Hospital Stay
50% after deductible
Outpatient Surgery
50% after deductible
Prescription Drugs
Retail and Mail-Order Rx
Not covered
Plan Cost
Your cost per semi-monthly paycheck (24 per year):
| Coverage | LocalPlus | OAP |
|---|---|---|
| Employee Only | $293.04 | $330.77 |
| Employee and Spouse | $538.77 | $612.32 |
| Employee and Child(ren) | $504.04 | $576.20 |
| Employee and Family | $742.62 | $859.48 |
Using Your Medical Plan
Know Where to Go
Where you get medical care can significantly affect the cost. Use this guide to choose based on your condition, budget and time.
| Visit type | Use it for |
|---|---|
| Nurse line ($) Often available 24/7 at no cost |
Quick answers from a trained nurse: whether you need immediate care, and home treatment options and advice |
| Online visit ($) Often available 24/7 |
Non-emergency issues: cold, flu, allergies, headache, migraine, rashes and skin conditions, minor injuries, mental health concerns |
| Office visit ($$) Regular business hours |
Routine care: preventive care, illnesses and injuries, managing existing conditions |
| Urgent care ($$$) Extended evening and weekend hours |
Urgent but not life-threatening: sprains or stitches, animal bites, high fever or respiratory infections |
| Emergency room ($$$) Open 24/7 |
Life-threatening conditions: suspected heart attack or stroke, broken bones, excessive bleeding, severe pain, difficulty breathing |
Enrolled in a Cigna medical plan? First Stop Health offers $0 virtual urgent care, primary care and mental health visits.
How to Find an In-Network Provider
Check whether your doctor or hospital is in your plan’s network before you get care.
- Go to cigna.com and click Find a Doctor. Under “How are you covered?” select Employer or School. (Already a Cigna member? Log in to myCigna.com or the myCigna app to search your current plan’s network.)
- Enter the city, state or ZIP code you want to search, choose a search type, and enter a name, specialty or other search term.
- Answer any clarifying questions and confirm where you live, which determines the networks available to you.
- Select the network for your plan. To see LocalPlus providers, choose LocalPlus from the list of plans.
You can refine results by distance, specialty, languages spoken and more. Questions? Call the number on the back of your ID card.
Save on lab work: using in-network national labs (Labcorp or Quest) can save you up to 70%.
Alternative Facilities
For non-emergency treatment, alternative facilities can provide the same results as a hospital at a fraction of the cost.
| Procedure | Alternative | Features | Potential savings* |
|---|---|---|---|
| Surgery | Ambulatory surgical center | Same-day surgeries such as cataracts, colonoscopies, upper GI endoscopy and orthopedic surgery. Held to the same safety standards as hospitals. | Up to 50% vs. a hospital stay |
| Physical therapy | Outpatient facility | Most cases are suited to outpatient therapy, with the same treatments and similarly skilled therapists. | 40% to 60% vs. a hospital setting |
| Sleep study | Home testing | Diagnoses obstructive sleep apnea. Often covered when medically necessary. | Up to $4,500 vs. a lab |
| Infusion therapy | Home or outpatient infusion | For drugs delivered by IV or epidural, given by a licensed infusion provider. | Up to 90% vs. a hospital stay |
*Savings estimates are based on in-network facilities and providers.
Ask your doctor whether your treatment must be done in a hospital, search for facilities on myCigna.com, or call Cigna member services. Some facilities charge a fee to cover overhead, so ask about facility fees before you schedule.
Preventive Care
Annual preventive checkups help you and your doctor establish your baseline health and catch issues before they become serious. In-network preventive care is covered at no cost to you, even before you meet your deductible.
Typical screenings for adults
- Blood pressure
- Cholesterol
- Diabetes
- Colorectal cancer screening
- Depression
- Mammograms
- OB/GYN screenings
- Prostate cancer screening
- Testicular exam
Be aware: not all exams and tests are considered preventive. Some screenings may be considered diagnostic based on your current medical condition, and exams by specialists are generally not considered preventive. If you’re unsure whether a service is covered as preventive care, contact Cigna.
You can also get a preventive care visit at no cost through First Stop Health.
Cigna One Guide
Cigna One Guide representatives help you understand your coverage, compare plan options, check whether your doctors are in network, and get answers to any questions about the plans and networks.
After you enroll, One Guide can help you resolve health care issues, find in-network providers, get cost estimates, avoid surprise expenses and understand your bills.
Call 800-244-6224, use live chat on myCigna.com, or use the myCigna app.
Prescription Benefits (EmpiRx Health) FAQs
These apply to the $5,500 and $4,250 plans, which use EmpiRx Health. HDHP members have prescription coverage through Cigna.
How do I use mail order?
Call EmpiRx Health Member Services at 877-323-0584 for help transferring prescriptions, or register at myempirxhealth.com and complete the New Patient Enrollment form in the Mail Order section. Ask your doctor to e-prescribe to Prescription Mart, or fax prescriptions to 409-866-1317. Prescriptions are not refilled automatically.
How do I find a network pharmacy?
Your EmpiRx Health ID card works at more than 68,000 pharmacies nationwide, including all major chains. Search at myempirxhealth.com or call 877-323-0584 (24/7).
What is the Mandatory Generic program?
When a generic is available and you choose the brand-name drug, you pay your copay plus the cost difference between the brand-name and generic drug.
What is Prior Authorization?
A review of certain high-cost or sensitive drugs before they can be filled. EmpiRx Health contacts your doctor to confirm the drug is appropriate and safe.
What is Step Therapy?
You try a lower-cost medication first before moving to a higher-cost drug in the same category. Your doctor confirms any change and sends a new prescription.
What are Quantity Limits?
A safety review to make sure a prescription is within FDA-approved limits. It can be resolved at the pharmacy or by your doctor adjusting the prescription.