Who is an eligible dependent?
Benefits-eligible employees have the option to cover eligible dependents on the medical plan. Eligible dependents include the employee’s spouse (as defined in the same manner as legally defined by the State of Oklahoma) and children up to the age of 26 (defined as a child by birth, adoption, or legal guardianship). If your spouse is also an OU employee, see the following question.
Children become eligible for coverage at birth or, in the case of adoption, on the date of placement. To begin coverage for a newborn or a newly adopted child, employees must notify their local Human Resources office within 31 days of the date of birth or placement.
A child’s coverage will terminate at midnight on the last day of the month in which they turn 26. The employee must notify Human Resources when a dependent is no longer eligible for coverage. A disabled child may continue coverage past age 26. Human Resources must be notified within 31 days after the child’s 26th birthday for coverage to be continued. Insurance carriers may require additional documentation from attending physicians.
My spouse is also an OU employee. Can one of us waive coverage and be
enrolled as a dependent on the other spouse’s OU insurance?
When both spouses are employed by OU, both employees must carry insurance as the primary insured. Neither employee can be enrolled as a dependent on the other spouse's OU insurance. In future years, that could change depending on the university’s contribution to dependent coverage.
How can you find out which network your provider is in?
You can search for your provider at myCigna.com
Can I waive insurance coverage?
If an employee has waived coverage in the past, they are not required to resubmit documentation annually. If an employee wants to waive medical coverage for the first time, then no proof of other medical coverage is required. There are no credits for waiving coverage. Keep in mind the Affordable Care Act (ACA) requires all US citizens to carry medical insurance coverage. If an individual does not carry this coverage, they will be subject to a penalty on their income tax return. Please visit healthcare.gov for additional information.
I recently went through a major life event- can I change my insurance coverage?
Depending on the event, you may make changes to your benefits outside of benefits enrollment by completing and submitting a Life Event in Self-Service. You can review that information on our website.
How do I know if my prescription is covered?
You can view the Prescription Drug List on Cigna's app or website. Please note you will need to log into the Cigna system to see the formulary.
Can I have an FSA account with the Cigna's HDHP plan?
No. Members enrolled in the Cigna HDHP Plan will have a Health Savings Account. OU and the employee can both contribute to the account, which can be used for medical expenses not covered by the plan.
How are providers and networks selected?
Carriers negotiate fees with each provider. If the physician participates in the carrier network it means they have agreed to be paid according to the negotiated fees. Many physicians see this as an opportunity to be available to a larger range of potential customers and will negotiate with most carriers. Physicians make a decision based on their own cost analysis. If they do not agree with the negotiated fee, they may choose not to participate in a carrier network. It is common for specialists (chiropractors, anesthesiologists, etc.) to choose not to participate in any carrier networks.