The University currently offers full-time employees the alternative to enroll in two levels of coverage; Preferred Provider Organization (PPO) including a prescription drug plan, Health Maintenance Organization (HMO), or electing no coverage at all.

Cigna PPO

  • Adelphi offers two PPO (Standard and High) medical plan options with Cigna.
    • The Health Reimbursement Account (HRA) is funded solely by Adelphi and can be used to pay for eligible health care expenses. Beginning January 1, 2020, Adelphi will contribute $400 per year if you elect Individual coverage and $750 if you elect Family coverage with Cigna.
  • Cigna has a broad national network of pharmacies. You will continue to be able to go to CVS, Walgreens, Costco and Duane Reade for your prescriptions, in addition to many other chains and independent pharmacies.
  • Cigna 90 Now Retail Pharmacy. You may now purchase maintenance prescriptions (90 day) at certain retail pharmacies.
  • There will be only one ID card.
  • Cigna offers both Quest Diagnostics and LabCorp as in-network laboratories.
  • Cigna’s network is called: Cigna’s Open Access Plus (OAP) plan.

Dependents under age 26 will be eligible for medical coverage until the end of the calendar month he/she turns 26, regardless of student and marital status.

For more information or any questions regarding Cigna claims, please visit Cigna.com or call 800.244.6224.

Health Reimbursement Account (HRA) for the Cigna Medical Plan only.

  • The Health Reimbursement Account (HRA) is funded solely by Adelphi and can be used to pay for eligible health care expenses. Adelphi will contribute $400 per year if you elect individual coverage and $750 if you elect family coverage with Cigna.
  • Unused Health FSA elections from the prior plan year, subject to the Annual Grace Period (March 15), will pay for Eligible Medical Expenses first until the end of the Annual Grace Period, followed by Employee Health FSA elections, followed by Employer Credits to the HRA plan.
  • Visa Debit Card can still be used until the expiration date on the card.
  • If you use your WageWorks card to pay for eligible medical expenses, you will likely have little or no claim forms to complete.

How does my Health Reimbursement Account (HRA) save me money?

  • Your account is funded by Adelphi University for electing Cigna’s medical plan.
  • Your HRA account allows you to use your funds for eligible medical expenses, as well as other expenses including prescriptions, some over-the-counter medications, doctor office co-pays, health insurance deductibles and coinsurance. You can even use your HRA funds for dental services and vision expenses.
  • Your HRA funds may even be used for eligible expenses for your spouse or federal tax dependent(s).

For more information or any questions regarding Wage Works claims, please visit WageWorks.com or call 800.678.6684.

EmblemHealth HMO

  • Emblem Health is a Health Maintenance Organization (HMO). HIP Prime HMO network connects you to the care you need where you live and work
  • Choose an in-network primary care physician (PCP) who provides you with most of your primary and preventive care, refers you to specialist, and arranges for hospital admissions when necessary
  • With lower co-pays, no deductible, and no co-insurance, this is a less expensive option.
  • You must choose an in-network primary care physician (PCP) who provides you with most of your primary and preventive care, refers you to specialists, and arranges for hospital admissions when necessary.
  • All care must be coordinated through your PCP.

As a reminder, effective January 1, 2014, in order to comply with the ACA, EmblemHealth ensures that employee medical cost share (deductibles, coinsurance and copays) accumulate to the medical Out-of-Pocket (OOP) maximum, (inclusive of pharmacy copays). That means once your deductibles, coinsurance and copay amounts reach a maximum OOP amount of $6,350 for individuals or $12,700 for your family, you would not be subject to any other OOP costs for the remainder of the calendar year.

Dependents under age 26 will be eligible for medical coverage until the end of the calendar month he/she turns 26, regardless of student and marital status.

For more information or any questions regarding claims, please visit EmblemHealth.com or call 800.447.8255.

Cigna Wraparound Plan

Employees who were enrolled in the indemnity plan (Wraparound) prior to October 1, 1995, and are still enrolled, have the option of remaining in that plan. The indemnity plan (Wraparound) is not available to new employees, rehired employees and employees who are no longer enrolled in that plan.

The University pays a portion of the premium and the employees pay a portion. The amount of the premium paid by the University depends upon the plan option selected by the employee.

Part-time/Hourly Eligibility for Medical

In order to comply with the Affordable Care Act (ACA), Adelphi will offer group health plan coverage to part-time and hourly employees if they meet the definition under the ACA of a “Full-Time Employee”. Under the ACA, a Full-Time Employee generally is an employee who works an average of at least 30 hours per week. This “full-time status” only applies to medical benefit eligibility. Example: You must complete 1,560 hours of service by October 31, in order to be eligible for coverage during the corresponding 12 month period beginning January 1.

In order to determine which part time and hourly employees will be considered “Full-time Employees” for medical benefit eligibility only, please see Part-time/Hourly Eligibility for Medical (PDF).

Each year, Annual Enrollment is provided in November during which time employees may elect to change plans with the change being effective on the subsequent January 1.

Medicare Creditable Coverage

Health Insurance Marketplace Coverage (PDF)

Premium Assistance for Medicaid and CHIP

Forms


Provider Contacts

Cigna:

Call the Cigna One Guide phone line with questions: 888.506.5042

Access your online account at Cigna

EmblemHealth:

For important phone numbers, please choose your plan on the following page:
emblemhealth.com/contact-us

Contact
Phone Number
Location
Levermore Hall, 203
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