Medical Coverage
2025 Changes
- New vendor: Pinellas County’s plan coverage for medical, behavioral/mental health and EAP will be changing vendors from Cigna to UMR, a UnitedHealthcare company. See New Medical Plan Vendor FAQs.
- Plans: Minor changes to medical plans include new plan names and expanded coverage. See 2025 Medical Plan Changes.
- Dependent Verification: If you will be covering a family member for medical benefits in 2025, you will need to provide verification. See Dependent Verification.
Pinellas County provides medical coverage to its employees through Cigna. Two plans are available as detailed below. Medical coverage is available to all permanent and long-term temporary employees scheduled to work a minimum of 20 hours per week.
Contact Cigna
Contact Cigna to:
- Consult with a nurse
- Get claims information
- Ask questions about coverage
- Request an ID card or print your own
- Find a doctor or hospital
- Learn how to lower out-of-pocket costs
- Schedule a virtual doctor visit
- View preventive care guidelines
Muscle or Joint Pain
Employees and dependents on the County medical plan have access to Hinge Health: Digital Exercise (Physical) Therapy.
This is a free virtual therapy program to support muscle and joint health. Hinge Health provides a personalized program and care team (via video) which may include a licensed physical therapist and exercise kit with wearable sensors.
- Website: www.myCigna.com
Select Register to create a new account. Use your personal email, not work email. View your medical, dental, and wellness information with the same login/account. - App: myCigna
- Phone: (800) 862-3557, option 1, available 24/7 to speak with a nurse or customer service
- Our Cigna onsite representatives assist employees in-person or by phone.
2025 Medical Plan Changes
- Medical plan names – The same two plans will have new names:
- Preferred Provider Organization (PPO) plan, currently called the Open Access Plus (OAP) plan
- High Deductible Health Plan (HDHP) with a Health Savings Account (HSA), currently called the Choice Fund Open Access Plus HSA plan
- Medical plan expanded coverage – There will be expanded coverage for mammograms, colonoscopies, therapy, and more as shown:
2025 Medical Plan Expanded Coverage (Both Plans)
| Benefit | 2024 Coverage | 2025 Coverage |
|---|---|---|
| Mammogram | Preventive mammograms covered at 100%; diagnostic mammograms subject to deductible, coinsurance and copayments | All mammograms covered at 100%, preventive and diagnostic |
| Colonoscopy | Preventive colonoscopies covered at 100%; diagnostic colonoscopies subject to deductible, coinsurance and copayments | All colonoscopies covered at 100%, preventive and diagnostic |
| Physical Therapy, Speech Therapy, Occupational Therapy | Maximum of 20 days per year per type of therapy | Maximum of 45 days per year per type of therapy |
| Home Health Care | Maximum of 40 visits per year | Maximum of 90 visits per year (combined with outpatient private duty nursing) |
| Hospice Care | Not specified | 8 hours per week |
| Bereavement Services | Not specified | Provided within 12 months of death |
- High Deductible Health Plan with HSA changes – Per IRS guidelines, there are increases in the deductible, out-of-pocket maximum, and contribution limits as shown below. The Health Savings Accounts will be moving from HSA Bank to Optum Bank.
2025 High Deductible Health Plan with HSA Changes
| Item | 2024 | 2025 |
|---|---|---|
| In-Network Annual Deductible |
Employee Only, $1,600 Employee +1 or More, $3,200 |
Employee Only, $1,650 Family, $3,300 |
| Out-of-Network Annual Deductible |
Employee Only, $3,000 Employee +1 or More, $6,000 |
Employee Only, $3,300 Family, $6,600 |
| In-Network Out-of-Pocket Maximum (includes medical and Rx) |
Employee Only, $3,000 Employee +1, $4,000 Employee +2 or More, $6,000 |
Employee Only, $3,000 Family, $6,000 |
| Out-of-Network Out-of-Pocket Maximum (includes medical and Rx) |
Employee Only, $4,200 Employee +1, $6,000 Employee +2 or More, $8,400 |
Employee Only, $4,200 Family, $8,400 |
| Contribution Limit for Employee Only* | $4,150 | $4,300 |
| Contribution Limit for Family* | $8,300 | $8,550 |
* Includes Pinellas County contribution of $500 or $1,200 (Age 55+ catch up contribution remains at an additional $1,000.)
Medical Plan Options
- Open Access Plus (OAP)
- Choice Fund Open Access Plus HSA
Additional medical plan information is available upon request for residents outside of Florida.
- Both plans offer the same low premiums which includes medical care, prescription coverage, behavioral/mental health and vision care:
Medical Plan Biweekly Premiums
| Coverage | 2024 and 2025 Biweekly Cost |
| Employee Only | $13.09 |
| Employee and Spouse or Domestic Partner | $151.16 |
| Employee and Child(ren) | $120.60 |
| Family | $247.67 |
- For more information, see Medical Plans Comparison & Cost.
- View machine-readable files for researchers, regulators, and application developers.
- Both plans are administered by Cigna.
- Both plans offer both in-network and out-of-network benefits.
- Both plans have the same network of hospitals and doctors.
- Both plans are open access, which means you may use any network physician, you do not have to select a primary care physician, and you do not need a referral to see a specialist.
- Both plans cover the same benefits, limitations, and exclusions.
- There are some distinct differences so please compare the plans carefully.
All employees and dependents who enroll in one of the medical plans are provided the following coverage:
ID Cards
Cigna will mail ID cards to new enrollments or if participants made a change to their plans. You may also access your ID card on the Cigna website or app.
Effective Date of Coverage
- Start Date: Coverage is effective for new employees on the first day of the month after 30 days of employment. For example, if you are hired on February 16, your benefits are effective on April 1.
- End Date: Your benefits coverage through the County ends on the last day of the pay period in which your separation occurs. For more information, see Employee Benefits: What Happens When I Leave?
Pre-Authorization
Some medical procedures, imaging, treatments, medications, and equipment need approval from Cigna before you receive care. View Pre-Authorization FAQs to learn about the process and what to do if authorization is denied.
Tax Saving Plans
Reduce your healthcare costs with the following options:
- Flexible Spending Accounts – Pinellas County offers FSAs to help you reduce out-of-pocket expenses for healthcare expenses (for employee and dependents) or dependent care expenses such as daycare costs by paying for them on a pre-tax basis. You do not have to be enrolled in the Group Health Plan to participate.
- Health Savings Account – An HSA is a tax-deductible savings account available to individuals enrolled in an IRS-qualified high-deductible health plan like Pinellas County’s Choice Fund Open Access Plus HSA Plan.
- Pre-Tax/Payroll Deductions – Payroll deductions for health and dental coverage may be deducted under the provisions of the Internal Revenue Service Tax Code, Section 125. Each year, during the County’s Annual Enrollment period, you have an opportunity to elect pre-tax health or dental premiums.
Enrollment
Important Links
- COBRA
- HIPAA
- Legal Notices
- Opt Out
- Preferred Premium (Biometric Screening/Health Assessment and Tobacco Premium)
11/25/24