Human Resources > Benefits > High Deductible Plan with HSA

High Deductible Plan with HSA

The High Deductible Plan has two levels of deductible: Single ($1,500) and Family ($3,000) for in-network services. Deductibles are annual and reset each January. Additional details of the plan are available below.

Plan Info


Use Cigna


Medical Plan Highlights

  • Active employees may participate in a high deductible plan with Health Savings Account (HSA)
  • Medical benefits are provided by CIGNA Healthcare
  • Enrollment is allowed only as a new hire, through qualifying events, or open enrollment
  • Coverage is continuous unless actively changed
  • Preventive medical care is covered at 100%

Preventive Services List

  • Preventive drugs covered outside of the deductible, at coinsurance level

Preventive Drug List



2-Step Enrollment

There are two steps to enroll in the High Deductible Plan with Health Savings Account:


1. Complete the Medical/Dental/Vision enrollment form

- HSA/HDHP option

- HRA/HDHP option (if you have other insurance coverage, including Medicare, Medicaid, spouse plan, flexible spending, etc.)

2. Complete the Salary Reduction Agreement form (optional)
- if you intend to contribute your own money to your HSA.

- HRA participants cannot contribute their own money.

Provider Look-Up

logo_cigna_40x42.pngProvider Look-up
**If no providers are available within 25 miles of your location, contact Cigna for "Medical Certification for Network Adequacy" at:



Cigna Online
Website registration is required

  • Track HSA and claims
  • Download Explanations of Benefits
  • Pay bills out of your HSA
  • Verify coverage for prescription drugs
  • In-network provider look-up
  • Manage plan ID cards


Using MDLive:

MDLive Logo

Health Savings Account (HSA)


Tax-exempt contributions to an HSA remain exempt if you use them (and their earnings) to pay for qualifying Medical expenses.

Certain restrictions exist for participation in an HSA:

  • Must be enrolled in a high deductible health plan.
  • Must not have any other insurance coverage.
  • Dependents with other coverage may impact the amount you can save.

AUI contributes to employee HSAs. In 2016 the employer contribution will be $425 for individual accounts and $850 for families. This amount offsets the total contribution limits allowed by the IRS.

Contributions are made on a quarterly basis, beginning the first week of January.


Plan Documents and Links

Link to NRAO WebpageCurrent Year Medical Premiums


AUI Medical Insurance Plan
Legal document regulating AUI's employee and retiree medical plan administration.

Summary Plan Description

What your Cigna plan pays.

Enrollment Forms and Links

Medical/Dental/Vision enrollment form

Salary Reduction Agreement - HSA

HSA contributions can be changed at any time during the year.


Claim and Pre-Authorization Forms

Medical Claim Form
Medical Claim Form for out-of network claims, not for use with prescriptions.

Rx Drug Claim Form
Cigna uses a 3-step plan for prescription drugs. Step-1 and Step-2 drugs don't require pre-authorization. Use this form to file claims.

Rx Pre-Authorization Form
Use this form to receive pre-authorization for Step-3 prescription drugs.

Health Reimbursement Account (HRA)


Individuals who are not eligible for an HSA due to other medical coverage (Medicare, Medicaid, spouse insurance, flexible spending accounts, etc.) may receive the employer contribution given to HSAs through an HRA.

AUI contributes to employee HRAs in the same amount as HSAs. In 2016 the employer contribution will be $425 for individual accounts and $850 for families.

Contributions are available at the beginning of the year in their entirety, but are not rolled over to the next year.

HRAs are administered through Cigna directly. Participants receive a Cigna debit card to access their funds.

"Summary of Coverage and Benefits" document

The Patient Protection and Affordable Care Act (PPACA) requires the AUI Comprehensive Medical Insurance Plan to provide a “Summary of Coverage and Benefits” to plan participants prior to the close of annual open enrollment.

These documents were produced by Cigna HealthCare and follow specific federal guidelines. Please note that these are only summaries and do not outline the comprehensive details of your plan. For complete coverage details you should refer to the Summary Plan Description for your plan as posted on this site.

The updated current year Summary Plan Descriptions will be available online and in hard copy form upon request in the first quarter of the current year.

You have a right to receive a paper copy of the Summary of Coverage and Benefits upon request at no charge to you. If you would like to request a paper copy, or if you have any questions, please contact the benefits office.