Medical & Rx Insurance
Your medical insurance is provided by Allied. All employees have the option to participate in the Preferred Provider Option (PPO) plan. This PPO plan is an open-access plan which means you do not have to get a referral from your primary care provider (PCP) before scheduling an appointment with an in-network specialist. We always recommend that you use in-network providers. GDS employees have access to the Cigna PPO Network. If you choose to seek care from an out-of-network provider, you will have to pay more out of pocket for these services.
Your prescription benefits are provided by RxBenefits who partners with CVS Caremark. You may register at www.caremark.com or download the CVS Caremark mobile app to access pharmacy locations, check drug cost and coverage or to manage refills.
The information contained below is an overview of your benefits. If you have specific questions regarding a provider or procedure, please call Allied at (800) 288-2078 or refer to the Medical Plan SPD.
Medical Plan Highlights
| Medical | PPO | Non-PPO |
| Deductible (Calendar Year) | ||
| Single | $500 | $750 |
| Family | $1,500 | $2,250 |
| Lifetime Maximum | Unlimited | Unlimited |
| Coinsurance | 80% | 60% |
| Max Out-of-Pocket (Includes medical deductible/copays) | ||
| Single | $1,500 | $2,750 |
| Family | $4,500 | $8,250 |
| Hospital Facility Services | ||
| Inpatient (requires precertification to avoid $500 penalty) | 80% after Deductible | 60% after Deductible |
| Outpatient | 80% after Deductible | 60% after Deductible |
| Emergency Room | $100, then 80% after Deductible | 60% after Deductible |
| Preventative Care | 100% | |
| Primary Care/Specialist Office Visit | $25 Copay | 60% after Deductible |
| Prescription Drug Coverage | Deductible: $100 Ind/$300 Fam | Deductible: $100 Ind/$300 Fam |
| Generic | $15 Copay | $15 Copay |
| Preferred Brand Name | $30 Copay | $30 Copay |
| Non-Preferred Brand Names | $45 Copay | $45 Copay |
| Mail Order | $30/$60/$90 | $30/$60$/$90 |
| Specialty Drugs – Coinsurance may be waived through participation in the PrudentRx program | 30% up to $5,000 Ind/$9,000 Fam | Must order through CVS Specialty Pharmacy* |
Medical Payroll Deductions
| Tier of Coverage | Employee Pays Monthly |
|---|---|
| Employee Only | $147.19 |
| Employee + 1 | $294.37 |
| Employee + 2 | $441.00 |
| Employee + 3 or more | $541.33 |
RX Savings
If you are already on or are newly prescribed, a specialty medication that is included in the PrudentRx program, you may be eligible to receive your medication at no cost to you. If your medication is included in the program you will be notified via PrudentRx or at your pharmacy at the point of sale.
Take advantage of the many prescription savings programs available to you through your local pharmacies. We recommend visiting each of the pharmacy websites below and printing out the covered generic medication list or discount medication list to take with you when you visit the doctor. This way, you can work with your doctor in selecting a medication from the list which will help you save even more money on prescription medications. Just click on the pharmacy to link to the website!
Costco Kmart Kroger Publix Rite Aid Target Walmart/Sam’s Club
Medical Resources:
Medical Summary Plan Description (SPD)
Allied Web Portal Registration Instructions
Allied Mobile App Registration Instructions
Allied Digital Granting Access for Family Member Accounts
Find a Cigna Health Care Provider
Paperless Explanation of Benefits User Guide
Paperless Explanation of Benefits Member Flyer
Granting Access for Family Members
Pharmacy Resources:
Caremark Rx Online Registration Instructions
Getting Started with 90 Day Mail Order
CVS Caremark Rx (800) 552-8159
*CVS Specialty Pharmacy (800) 237-2767
