| CIGNA HDHP WITH HSA | CIGNA EPO BASE | CIGNA PPO PREMIUM | KAISER PERMANENTE (CA RESIDENTS ONLY) | |||
|---|---|---|---|---|---|---|
| IN-NETWORK | OUT-OF-NETWORK | IN-NETWORK | IN-NETWORK | OUT-OF-NETWORK | IN-NETWORK | |
| Deductible (Individual/Family) | $2,000 / $4,000 | $3,200 / $6,400 | $1,000 / $2,000 | $750/ $1,500 | $2,500 / $5,000 | $0/$0 |
| Out-of-Pocket Max (Individual/Family) | $4,000 / $8,000 | $8,000 / $16,000 | $4,000 / $8,000 | $2,500 / $5,000 | $5,000 / $10,000 | $3,000/$6,000 |
| Coinsurance | 20% | 40% | 10% | 0% | 20% | 0% |
| Preventive Visit | $0 | 40% coinsurance after deductible |
$0 | $0 | 20% coinsurance after deductible |
$0 |
| PCP Office Visit | 20% coinsurance after deductible |
40% coinsurance after deductible |
$25 | $20 | 20% coinsurance after deductible |
$20 |
| Specialist Visit | 20% coinsurance after deductible |
40% coinsurance after deductible |
$40 | $30 | 20% coinsurance after deductible |
$20 |
| X-rays | 20% coinsurance after deductible |
40% coinsurance after deductible |
10% coinsurance after deductible |
$0 after deductible | 20% coinsurance after deductible |
$10 |
| Lab Work | 20% coinsurance after deductible |
40% coinsurance after deductible |
10% coinsurance after deductible |
$0 after deductible | 20% coinsurance after deductible |
$10 |
| Advanced Radiological Imaging (Includes MRI, MRA, CAT Scan, PET Scan, etc.) |
20% coinsurance after deductible |
40% coinsurance after deductible |
10% coinsurance after deductible |
$0 after deductible | 20% coinsurance after deductible |
$50 |
| Emergency Room | 20% coinsurance after deductible |
40% coinsurance after deductible |
$250 | $200 | $200 | $100 |
| Urgent Care | 20% coinsurance after deductible |
40% coinsurance after deductible |
$75 | $75 | 20% coinsurance after deductible |
$20 |
| Inpatient Care | 20% coinsurance after deductible |
40% coinsurance after deductible |
10% coinsurance after deductible |
$0 after deductible | 20% coinsurance after deductible |
$500/admission |
| Outpatient Care | 20% coinsurance after deductible |
40% coinsurance after deductible |
10% coinsurance after deductible |
$0 after deductible | 20% coinsurance after deductible |
$250/procedure |
| Physical Therapy, Occupational Therapy, Speech Therapy Limits |
Unlimited
|
|||||
| Prescriptions (In-Network Only) | ||||||
| Prescription Drug Deductible | After deductible: | N/A | ||||
| Generic | $0 | N/A | $0 | $0 | N/A | $10 |
| Preferred Brand | $35 | $35 | $35 | $30 | ||
| Non-Preferred Brand | $70 | $70 | $70 | $30 | ||
Preventive medications
Certain preventive medications for chronic conditions such as diabetes, high blood pressure, high cholesterol, asthma and heart conditions are covered at no cost for Cigna plan participants. See Cigna’s No Cost-Share Preventive Medication (ACA) list. Additionally, when you purchase other preventive medications listed on Cigna’s Preventive Generics and Preferred Brands Drug list, you will pay the applicable copay, but no deductible applies.
Choice of medical plans
Cigna high deductible health plan (HDHP Plus with HSA)
The HDHP offers the lowest premiums, but you have higher immediate out-of-pocket costs when you need care. However, the plan is paired with a Health Savings Account (HSA) partially funded by Sprinklr to cover some your deductible ($750 if you’re enrolled as an individual, or $1,500 if you’re enrolled in any other tier). You may also deposit pre-tax dollars in your account to cover medical expenses, saving you about 30%.
Cigna Exclusive Provider Organization (EPO Base)
The EPO plan offers a network of doctors and hospitals for you to choose from, and has lower premiums than the PPO plan. You don’t need to have a primary care physician or referral to see a specialist — you can generally see any provider if you stay in-network. Out-of-network care is not covered except in an emergency. If you’re looking for lower monthly premiums and can meet a higher deductible when you need care, the EPO may be right for you.
Cigna PPO Premium
The PPO plan has a large network so you have more doctors and hospitals to choose from. The premiums are higher than the other medical plan options, the copays and coinsurance for in-network care are low, and the out-of-pocket maximum is lower than the other plans. You also can see specialists and out-of-network doctors without a referral. If you know you’ll need more health care in the coming year and you can afford higher premiums, the PPO may be a good choice.
KAISER HMO (CA employees only)
The HMO plan has no deductible to meet and offers low copays for doctor visits. You must select a primary care physician, whom you’ll see for regular checkups and who will coordinate your care. Out-of-network care is not covered except in an emergency. HMOs are a good choice if you’re on a tight budget and don’t have many medical issues.
Kindbody family planning and fertility benefits
Sprinklr wants you to have access to convenient, affordable fertility and family-building care. That’s why we’re offering family building benefits through Kindbody including:
- Fertility benefits (IVF, IUI)
- Egg and embryo freezing
- Donor/surrogacy
- Adoption services
- Kindbody well-being sessions
- Prenatal and postnatal care
- Mental health and nutrition counseling
- Dedicated care navigation team
- Brick and mortar Kindbody clinics (U.S. only)
- And more!
Starting Jan. 1, 2024, all U.S.-based benefit-eligible Sprinklrites and their spouses/domestic partners are eligible are eligible for up to a $20,000 lifetime maximum benefit (currently $5,000) to be used towards family planning and fertility services.
All services offered through Kindbody are subject to local regulatory guidelines. Benefit amounts may differ due to deductibles imposed by regulatory guidelines. Employees with access to our internal benefit system can visit the U.S. Benefits Document Library for more information.
Virtual Health
Can’t make it in for an appointment? Connect with a board-certified doctor when, where, and how it works best for you—via video or phone. It’s like a doctor’s visit, but you never have to leave your house. Get the care you need—including most prescriptions (when appropriate)—for a wide range of minor conditions, such as allergies, asthma, cold and flu, rashes, sinus infections, and more.
MDLIVE for Cigna
If you enroll in a Sprinklr Cigna medical plan, MDLIVE offers reliable 24/7 health care by phone or video through its national network of board-certified doctors, pediatricians, dermatologists, psychiatrists, and therapists provides.
MDLIVE provides coverage for:
- Primary care: Including wellness screenings, routine care and specialist referrals.
- Urgent care: For non-emergency illness.
- Behavior care: Offers talk therapy and psychiatry.
- Dermatology: Care for skin, hair and nail conditions.
To connect to care:
- Access MDLIVE by logging into myCigna.com and clicking on “Talk to a doctor.” You can also call MDLIVE at 888.726.3171. (No phone calls for virtual dermatology.)
- Select the type of care you need: medical care or counseling; cost will be displayed on both myCigna.com and MDLIVE.
- Follow the prompts for an on-demand urgent care visit, to make an appointment for primary or behavioral care, or to upload photos for dermatology care.
Appointments are available via video or phone, whenever it’s most convenient for you. Virtual dermatology does not require an appointment.
Kaiser Telehealth
If you enroll in the Sprinklr Kaiser HMO plan, you can access virtual care by phone or video when you need quick, convenient care that doesn’t require immediate hands-on assistance from a health care professional. Examples include a urinary tract infection, pink eye, cold and flu, and other conditions where a clinician can virtually diagnose, recommend treatment, order prescriptions, and provide guidance about follow-up care.
To get started, sign in to kp.org or the Kaiser Permanente app and answer a few questions about your symptoms. Kaiser will recommend how you can get care quickly — either by phone, video, or both.
