Medical Comparison Chart

2020 and 2021 Plan Year Information

National Medical Plans: Cigna and UnitedHealthcare

Here’s a look at the benefits provided under the Options A, B and C of the Medical Plan. Please note that your deductible and out-of-pocket maximum reset each Plan year.

Option AOption BOption C
Note

The figures in the chart below reflect what the Plan pays, with the exception of deductibles and out-of-pocket maximums.

Individual Deductible

In-Network:
$600

Out-of-Network:
$1,200

In-Network:
$1,200

Out-of-Network:
$2,400

In-Network:
$2,300 (includes prescription drugs)

Out-of-Network:
$4,600 (includes prescription drugs)

Family Deductible

In-Network:
$1,250

Out-of-Network:
$2,500

In-Network:
$2,500

Out-of-Network:
$5,000

In-Network:
$4,600 (includes prescription drugs)

Out-of-Network:
$9,200 (includes prescription drugs)

Individual Out-of-Pocket Maximum

In-Network:
$2,000

Out-of-Network:
$4,000

In-Network:
$3,000

Out-of-Network:
$6,000

In-Network:
$5,500 (includes prescription drugs)

Out-of-Network:
$11,000 (includes prescription drugs)

Family Out-of-Pocket Maximum

In-Network:
$5,000

Out-of-Network:
$10,000

In-Network:
$7,500

Out-of-Network:
$15,000

In-Network:
$11,000 (includes prescription drugs)

Out-of-Network:
$20,000 (includes prescription drugs)

Diagnostic and Preventive Care

In-Network:
100% (no annual deductible)

Out-of-Network:
100% up to a maximum of $250 (no annual deductible) then 60% of eligible expenses (no annual deductible)

In-Network:
100% (no annual deductible)

Out-of-Network:
100% up to a maximum of $250 (no annual deductible) then 60% of eligible expenses (no annual deductible)

In-Network:
100% (no annual deductible)

Out-of-Network:
100% up to a maximum of $250 (no annual deductible) then 60% of eligible expenses (no annual deductible)

Most other services, including inpatient and outpatient hospital and specialist visits

In-Network:
80% after annual deductible

Prior proof of medical necessity may apply for certain services. Check with your health plan administrator to verify coverage and if preauthorization is required.

Out-of-Network:
60% of eligible expenses after annual deductible

Prior proof of medical necessity may apply for certain services. Check with your health plan administrator to verify coverage and if preauthorization is required.

In-Network:
80% after annual deductible

Prior proof of medical necessity may apply for certain services. Check with your health plan administrator to verify coverage and if preauthorization is required.

Out-of-Network:
60% of eligible expenses after annual deductible

Prior proof of medical necessity may apply for certain services. Check with your health plan administrator to verify coverage and if preauthorization is required.

In-Network:
80% after annual deductible

Prior proof of medical necessity may apply for certain services. Check with your health plan administrator to verify coverage and if preauthorization is required.

Out-of-Network:
60% of eligible expenses after annual deductible

Prior proof of medical necessity may apply for certain services. Check with your health plan administrator to verify coverage and if preauthorization is required.

Cancer Support Program

In-Network:
100% covered after annual deductible if enrolled in program within 30 days of diagnosis. 80% after annual deductible if not enrolled in program.

Out-of-Network:
60% after annual deductible

In-Network:
100% covered after annual deductible if enrolled in program within 30 days of diagnosis. 80% after annual deductible if not enrolled in program.

Out-of-Network:
60% after annual deductible

In-Network:
100% covered after annual deductible if enrolled in program within 30 days of diagnosis. 80% after annual deductible if not enrolled in program.

Out-of-Network:
60% after annual deductible

Bariatric Surgery

In-Network:
Cigna: 100% at Cigna Certified Hospitals for bariatric surgery; 80% after annual deductible at other in-network facilities.

UHC: Surgery must be received at a UHC designated Center of Excellence (COE) and will be covered at 100% no annual deductible; all other services related to the surgery covered at 80% after annual deductible.

Out-of-Network:
Cigna: 60% of eligible expenses after annual deductible

UHC: No coverage

In-Network:
Cigna: 100% at Cigna Certified Hospitals for bariatric surgery; 80% after annual deductible at other in-network facilities.

UHC: Surgery must be received at a UHC designated Center of Excellence (COE) and will be covered at 100% no annual deductible; all other services related to the surgery covered at 80% after annual deductible.

Out-of-Network:
Cigna: 60% of eligible expenses after annual deductible

UHC: No coverage

In-Network:
Cigna: 100% after annual deductible at Cigna Certified Hospitals for bariatric surgery; 80% after annual deductible at other in-network facilities.

UHC: Surgery must be received at a UHC designated Center of Excellence (COE) and will be covered at 100% no annual deductible; all other services related to the surgery covered at 80% after annual deductible.

Out-of-Network:
Cigna: 60% of eligible expenses after annual deductible

UHC: No coverage

Maternity

In-Network:
80% after annual deductible

Out-of-Network:
60% of eligible expenses after annual deductible

In-Network:
80% after annual deductible

Out-of-Network:
60% of eligible expenses after annual deductible

In-Network:
80% after annual deductible

Out-of-Network:
60% of eligible expenses after annual deductible

Fertility Coverage (includes cryopreservation, artificial insemination, IVF, GIFT and ZIFT)

In-Network:
Cigna: 80% after annual deductible

UHC: Members must enroll in the Fertility Solutions program and treatment must be received at UHC’s Centers of Excellence; 80% after annual deductible.

Out-of-Network:
Cigna: 60% of eligible expenses after annual deductible

UHC: No coverage

In-Network:
Cigna: 80% after annual deductible

UHC: Members must enroll in the Fertility Solutions program and treatment must be received at UHC’s Centers of Excellence; 80% after annual deductible.

Out-of-Network:
Cigna: 60% of eligible expenses after annual deductible

UHC: No coverage

In-Network:
Cigna: 80% after annual deductible

UHC: Members must enroll in the Fertility Solutions program and treatment must be received at UHC’s Centers of Excellence; 80% after annual deductible.

Out-of-Network:
Cigna: 60% of eligible expenses after annual deductible

UHC: No coverage

Out-of-Network Reimbursements

Out-of-network reimbursements are based on eligible expenses as determined by the Plan administrator. You are responsible for any payments required to the provider in excess of the reasonable and customary amount.

Amounts paid to out-of-network providers count toward the in-network and out-of-network annual deductible. The amount you pay toward your annual deductible is included in your out-of-pocket maximum.

Non-Preventive Services

For non-preventive health care services, including office visits, coinsurance will apply after you have met your annual deductible. That means you will pay a percentage of the cost of services (coinsurance) rather than a flat fee (copay). The amount you pay in coinsurance plus the annual deductible during the year will not exceed your annual out-of-pocket maximum.

Cancer Support Program Coverage

Upon enrolling in the program within 30 days of a cancer diagnosis and meeting your annual deductible, Morgan Stanley will cover 100% of the cost of all treatments and procedures provided by in-network doctors and facilities.

Fertility Coverage Lifetime Maximum

A lifetime maximum of $30,000 for medical services and prescription drugs applies to each individual and amounts cannot be transferred whether covered as an employee or a dependent. The combined in- and out-of-network lifetime maximums apply across Plan administrators regardless of which carrier you choose. Cryopreservation storage is limited to a 12-month period. Please contact your Plan administrator for further details.

Eligible Expenses

Eligible expenses, otherwise known as Reasonable and Customary (R&C) charges, are determined by the health plan administrator. If you receive services from an out-of-network provider, you may be responsible for the amount billed in excess of the eligible expense.