Medical Options

2020 Plan Year Information

Medical Plans

The Morgan Stanley Medical Plan is designed to help you and your family maintain your health and well-being while managing medical expenses. U.S. benefits-eligible employees may select coverage administered by Cigna or UnitedHealthcare (UHC).

California
In addition to the national options through Cigna and UHC, employees who live in California may instead choose to participate in a regional medical plan option through Kaiser Permanente HMO (in-network coverage only). Note that there are separate options for Northern and Southern California, based on your ZIP code.

Hawaii
Employees who live in Hawaii may enroll in medical coverage through either HMSA Medical Plan or Kaiser Permanente HMO (both are in-network coverage only). Coverage through Cigna and UHC is not available in Hawaii.

Certain U.S. Expatriates and International Employees
The Cigna Global Health Medical Plan is available to certain employees. Contact HR Services for additional information.

Medical Options A, B and C

Both UHC and Cigna offer three options:

  • Option A
  • Option B
  • Option C

Regardless of which option you choose, you’ll have access to the same networks (Cigna or UHC) and coverage for the same services. However, each option’s paycheck contributions, deductibles and out-of-pocket maximums differ.

UHC and Cigna Medical Plan Networks

Regardless of which Medical Plan Option you choose, your medical network is:

  • UHC: UHC Choice Plus Network
  • Cigna: Cigna Open Access Plus Network
Option AOption BOption C
Your Paycheck Contributions

Highest

Moderate

Lowest
Consider funding a Health Savings Account (HSA) with the money you save in paycheck contributions

Annual Deductible

Lowest

Moderate

Highest
Combined medical and prescription drug deductible

Annual Out-of-Pocket Maximum

Lowest

Moderate

Highest
Combined medical and prescription drug out-of-pocket maximum

Preexisting Conditions

The Medical Plan has no preexisting condition exclusions.

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)

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 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)

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.

Preferred Medical Plan Administrator

Depending on your state of residence, either UHC or Cigna may have negotiated greater discounts on average with its network providers.

View the list of preferred administrators for your state for 2020, or use the maps below. (View the 2019 list or maps.)

UHC Preferred National Health Plan Administrator

UHC is the preferred Medical Plan administrator in the following states and generally provides higher average negotiated discounts:

Cigna Preferred National Health Plan Administrator

Cigna is the preferred Medical Plan administrator in the following states and generally provides higher average negotiated discounts:

Both UHC and Cigna are Preferred National Health Plan Administrators

Both UHC and Cigna have negotiated comparable discounts and are priced equally in the following states. If you default into medical coverage in one of these states with comparable discounts, the default Medical Plan Administrator will be based on your state of residence:

Save with In-Network Services

Take advantage of in-network services. The fees for in-network services are typically set by your health plan administrator, which may offer you considerable savings over comparable out-of-network services. Additionally, the in-network deductible is generally half the amount of the out-of-network deductible and is waived for preventive care services received within your network. Finally, when using in-network services, the provider generally takes care of any required preauthorization and most paperwork, saving you time and money.

Care Designation and Premium Tier 1

UHC and Cigna distinguish in-network doctors and facilities that meet certain quality-of-care and cost efficiency measures. To qualify for this designation, doctors must be board certified in their specialty and have earned one or more quality designations from an independent rating agency such as the National Committee for Quality Assurance (NCQA). These doctors are highlighted on each administrator’s website and identified with specific icons.

You may obtain a complete list of qualifying physicians on each Plan administrator’s website.

Medical Plan ID Cards

If you are enrolling for medical coverage for the first time or switching Plan administrators, you will receive a medical ID card by mail. If you require proof of coverage before receiving your ID card, you may print a temporary ID card from the Plan administrator’s website.