Skip to content
English
  • There are no suggestions because the search field is empty.

Carolina Orthopaedic and Neurosurgical Associates - HSA Plan Benefits Guide

This is a Qualified High Deductible Health Plan (HDHP) with separate in-network (Tier 1) and out-of-network (Tier 2) benefits. The plan features higher deductibles and out-of-pocket maximums for Tier 2 services. TPA: 90 Degree Benefits. Network: CIGNA (Tier 1). Emergency services and ambulance services receive Tier 1 benefits regardless of network status. Dental and Vision benefits are Excepted (unbundled). Benefits applied per Calendar Year.

Plan Identification & Administrative Details

 

Field Details
Document Type Install Plan Document
Group Name Carolina Orthopaedic and Neurosurgical Associates
Legal Name Carolina Orthopaedic and Neurosurgical Associates
Master Group Number 65100
Subgroup 65101
Benefit Plan(s) HSA Plan
Effective Date 01/01/2026
Plan Type Qualified High Deductible Health Plan (QHDHP)
Grandfather Status No
ERISA Plan Yes
Dental/Vision Benefits Excepted (unbundled)
Fiscal Year Date (Plan Funding) 1/1 - 12/31
Benefits Applied Per Calendar Year
TPA 90 Degree Benefits
TPA Hours of Operation 8:00 AM - 5:00 PM CST

Network & Payment Structure

Benefit Level Plan Configuration

Tier Subgroup PPO Code Network/Payment Method
Tier 1 65101 3002 CIGNA
Tier 1 65101 11111 OVERRIDE TO PAY TIER 1
Tier 2 65100 0 130% OF MEDICARE FOR PROFESSIONAL; 150% OF MEDICARE FOR FACILITIES

Reference-Based Pricing (RBP)

Tier RBP % of Medicare
Tier 1 No N/A
Tier 2 Yes 130% (Professional) / 150% (Facilities)

Note: For 90 Degree Benefits Use Only


Annual Deductibles & Out-of-Pocket Maximums

Deductibles (Per Calendar Year)

Coverage Level Tier 1 (In-Network) Tier 2 (Out-of-Network)
Per Person $2,500 $10,000
Per Family $5,000 $20,000

Important Notes:

  • In and out of network deductibles DO NOT cross-apply (SEPARATE)
  • Deductible DOES apply to out-of-pocket maximum
  • Last 3 months carryover: NO
  • If yes, carryover deductible apply to OOP: N/A

Out-of-Pocket Maximums (Per Calendar Year)

Coverage Level Tier 1 (In-Network) Tier 2 (Out-of-Network)
Per Person $5,000 $15,000
Per Family $10,000 $30,000

Important Notes:

  • In and out of network OOP maximums DO NOT cross-apply (SEPARATE)
  • 3-month Carry Over Out-of-Pocket benefit: NO
  • Out-of-pocket IS integrated with pharmacy (Tier 1: Yes, Tier 2: Yes)
  • Copays DO apply to out-of-pocket maximum (Tier 1: Yes, Tier 2: Yes)

Coinsurance

Tier Plan Pays Patient Pays
Tier 1 80% 20%
Tier 2 50% 50%

After deductible is satisfied


Mental Health & Substance Abuse Coverage

Service Type Tier 1 Tier 2
Mental/Nervous Services Covered Yes Yes
Substance Abuse Services Covered Yes Yes

Comments: When covered, all Mental Nervous and Substance Abuse benefits are paid as any other illness.


Specialty Drugs & Appeals

Item Details
Specialty Drugs - New to Market Waiting Period 6 months (both tiers)
Levels of Appeals Before IRO 1

Additional Programs Available

Program Status Details
Teladoc Active $0 Consult fee
RBP (Reference-Based Pricing) Tier 2 Only 130% Medicare (Professional), 150% Medicare (Facilities)
A&G Editing/Bill Review Yes -
Patient Defender Yes -
Pace Yes -
CareConnect Yes Benchmark State: Utah

Eligibility

Employee Information

Item Details
Number of Employees 174
Medicare COB Note Special COB rules may apply for employees with Medicare if employer has less than 100 EEs
Standard FMLA Yes
Continuation for Disability (outside FMLA) NO
Continuation for Layoff NO
Leave of Absence (non-FMLA) NO
Benefits Limited to Full-Time Employees Only Yes

Dependent Eligibility

Dependent Type Eligible
Dependents Yes
Adopted Children Yes
Domestic Partners No
Common Law Spouse No
Foster Children No
Children Under Legal Guardianship No
Grandchildren No
Dependent Age Limit 26

Spouse Eligibility

Is Spouse eligible for coverage if able to obtain coverage elsewhere: Yes

Reinstatement of Coverage

  1. Employee is treated as a new hire: Yes
  2. If No, waiting period is waived if rehired within: 30 days

Stop Loss

Type Tracks To
Stop Loss - Specific MED/RX
Stop Loss - Aggregate MED/RX

Continuity of Care

Feature Details
Does the plan offer continuity of care benefits? Yes
Duration Standard 90 days
Notes For persons under care for a serious illness or pregnancy, network benefits are available for a limited period if the primary care physician leaves the network.

Pre-Certification / Notification

Item Details
Pre-certification Provided By CIGNA
Pre-certification Phone Number 888-832-4354
Applicable Services See CIGNA Pre-Certification Listing (attached to plan document)
Allow Retroactive Pre-certification NO - Services requiring pre-certification will be denied if not on file
Post-Service Pre-certification Penalty NO - No penalty amount
Pre-cert Required for Medicare Primary NO
Pre-cert Required if Other Coverage Primary NO

IMPORTANT: Refer to the separate CIGNA PRE-CERTIFICATION LISTING included with this plan document for specific services requiring pre-certification.


Medical Office Visits

Benefit Tier 1 Tier 2
Coverage Code AOV, AOVS, OV, OVS, POV, SMV, SOV, TELM, TELS, ZPOV, ZSMV, ZSOV  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Co-pay Amount N/A N/A
Plan Pays 80% 50%
Different Co-pay for Specialists No No

Office Surgery

Includes related anesthesia services

Benefit Tier 1 Tier 2
Coverage Code AF, AFQ, AFS, OPM, OPMS, SF, SFS  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Therapeutic Injections (Office)

Benefit Tier 1 Tier 2
Coverage Code INJ, INJS, MINJ, ZMIN  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Allergy Services

Allergy Injections and Serum

Benefit Tier 1 Tier 2
Coverage Code ALI, ALIS, ALS, ALSS  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Allergy Testing

Benefit Tier 1 Tier 2
Coverage Code ALT, ALTS  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Diagnostic Services - Office Setting

Office Charges for X-ray & Professional Component

Benefit Tier 1 Tier 2
Coverage Code XRDR, XRDS  
Covered Service Yes Yes
Includes High Cost Imaging (MRI, CT, PET, etc.) Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Office Charges for Laboratory & Professional Component

Benefit Tier 1 Tier 2
Coverage Code LBDR, LBDS, MOXL, SMOX, SOXL, ZMOX, ZSMX, ZSOXX  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Office Charges Diagnostic Testing

Benefit Tier 1 Tier 2
Coverage Code ODX, ODXS  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

All Other Office Related Services

Benefit Tier 1 Tier 2
Coverage Code HBOO, HBOS, HBPO, HBPS, OIV, OIVS, OMS, OMSS, OWCT  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Diagnostic Services - Outpatient/Independent

Independent Laboratory & Professional Component

Benefit Tier 1 Tier 2
Coverage Code LAB  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Lab/X-ray/Diagnostic Imaging (Including Ultrasound) - Outpatient Physician

Benefit Tier 1 Tier 2
Coverage Code PRF  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Lab/X-ray/Diagnostic Imaging (Including Ultrasound) - Outpatient Testing and/or Facility Fee

Benefit Tier 1 Tier 2
Coverage Code CUS, HLAB, HXL, HXR, MXL, OPDX, OUSS, SMXL, SXL, US, XRAY  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Major Diagnostic Procedures - Physician

Including, but not limited to: MRI, PET, CT, Nuclear Medicine, Myelogram, Cardiac Stress Test, Bone Scans, facility/professional expenses, all Outpatient and office places of service

Benefit Tier 1 Tier 2
Coverage Code PRF  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Major Diagnostic Procedures - Testing and/or Facility Fee

Including, but not limited to: MRI, PET, CT, Nuclear Medicine, Myelogram, Cardiac Stress Test, Bone Scans, facility/professional expenses, all Outpatient and office places of service

Benefit Tier 1 Tier 2
Coverage Code BONE, CAT, CST, HCAT, MRIO, MRIS, MYEL, NUC, NUCO, NUCS, OBON, OBOS, OCAT, OCSS, OCST, OCUS, OMRI, OMYE, OMYS, OPES, OPET, OSPC, OSPS, PET, SCAT, SPCT  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Sleep Studies

Benefit Tier 1 Tier 2
Coverage Code OSLP, SLPS  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Acupuncture Services

Benefit Tier 1 Tier 2
Coverage Code AP, APS  
Covered Service No No
Deductible Applies N/A N/A
Co-pay Applies N/A N/A
Plan Pays N/A N/A
Maximum Visits N/A N/A
Maximum Benefit N/A N/A

Ambulance and Medically Appropriate Transport

Ground and Air

Benefit Tier 1 Tier 2
Coverage Code AMB, AMBR, AR  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 80%
Include Facility to Facility When Medically Necessary Yes Yes

Comments: Tier 2 applies Tier 1 deductible/OOP


Chiropractic Services

Benefit Tier 1 Tier 2
Coverage Code CH, CHX  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%
Maximum Benefit $500 per calendar year $500 per calendar year

Durable Medical Equipment

Includes DME supplies

Benefit Tier 1 Tier 2
Coverage Code BRA, DIEQ, DME, DMS, DTE, MMS  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%
Insulin Pumps Considered DME Yes  
Includes Insulin Pump Supplies Yes  
Cover Cost of Repairs (not due to misuse) Yes  
Cover Replacements (outside warranty, unable to repair) Yes  
Cover Batteries Yes  
Cover Sales Tax and Shipping Charges Yes  
Rental Maximum up to Purchase Price Yes  

Extended Care Facility Benefits

Skilled nursing, subacute facility

Benefit Tier 1 Tier 2
Coverage Code SNF  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%
Maximum Days 60 days per calendar year 60 days per calendar year

Home Health Care Benefits

Benefit Tier 1 Tier 2
Coverage Code HHC, HHS, PHC, PHS  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%
Maximum Visits 60 visits per calendar year 60 visits per calendar year

Hospice Care Benefits

Benefit Tier 1 Tier 2
Coverage Code HO, OHO  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%
Maximum Days/Visits No day maximum No day maximum
Allow Custodial / Respite Care No  
Include in Hospice Benefit N/A  

Bereavement Counseling

Benefit Tier 1 Tier 2
Coverage Code HBC, HFC  
Covered Service Yes Yes
Include in Hospice Benefit Yes Yes
Maximum Visits No day maximum No day maximum
Timeframe Services must be furnished within 6 months of death  
Plan Pays 80% 50%

Emergency Services

Emergency Room Hospital Facility Services

Benefit Tier 1 Tier 2
Coverage Code ER, MNO, NER, SMOF, SNO  
Covered Service Yes Yes
All Emergency Services Paid In-Network Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Co-pay Amount N/A N/A
If Admitted Within 24 Hours, Waive Co-pay Yes Yes
Plan Pays 80% 80%

Comments: Tier 2 applies Tier 1 deductible/OOP

Emergency Room Hospital Professional Services

Benefit Tier 1 Tier 2
Coverage Code ERD, MERD, NERD, SAER, SMER  
Covered Service Yes Yes
All Emergency Services Paid In-Network Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Co-pay Amount N/A N/A
Plan Pays 80% 80%

Comments: Tier 2 applies Tier 1 deductible/OOP


Hospital Services

Inpatient Facility Services

Benefit Tier 1 Tier 2
Coverage Code BC, HM, HNS, ICU, IMC, MHM, MRB, RB, SHM, SMHM, SMRB, SRB  
Covered Service Yes Yes
Notification Penalty Waived for Emergency Admissions Yes Yes
If Admitted Through ER, is ER Copay Waived Yes Yes
Reduce to Semi-Private Room Rate if Available Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Ancillary (All Other Inpatient) Services

Benefit Tier 1 Tier 2
Coverage Code DX, HV, MID, MNI, PAT, RAD, SID, SIP, SMID, SMNI, WC  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Infusion Therapy

Benefit Tier 1 Tier 2
Coverage Code IVIN  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Surgery Services

Second Surgical Opinion

Benefit Tier 1 Tier 2
Coverage Code SV, SVS  
Covered Service Yes Yes

Comments: Paid same as any other illness

Anesthesia

Benefit Tier 1 Tier 2
Coverage Code AI, AIQ, AO, AOQ, MNA, SMA  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Surgeon / Assistant Surgeon / Co-Surgeon

Benefit Tier 1 Tier 2
Coverage Code CIRC, SI, SO, STER, TI, TO  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%
Assistant Surgeon Bill Limitation Yes (25% of U&C fee) Yes (25% of U&C fee)

Outpatient Hospital Surgery and Ambulatory Surgical Center

Benefit Tier 1 Tier 2
Coverage Code ASF, OHS  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Maternity & Newborn Services

Maternity Surgery (Includes Physician Attendance)

Benefit Tier 1 Tier 2
Coverage Code MAT, MATD, MATO  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Routine Newborn Care

Benefit Tier 1 Tier 2
Coverage Code CIRC, HNS, WC  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Pregnancy / Maternity Benefits - Miscellaneous

Question Answer
Services in Physician's Office Paid Per Medical Office Visit Section Yes
Services in Hospital Paid Per Hospital Section Yes
Allow Dependent Daughter Pregnancies Yes (If no, PPACA required services covered)
Allow Outpatient Birthing Centers Yes
Allow Home Deliveries Yes
Allow All Elective Abortions No
Cover Elective Abortions - Rape/Incest Yes (Must be compliant with applicable state law)
Cover Elective Abortions - Mother's Life in Danger Yes (Must be compliant with applicable state law)
Abortions Covered For All females covered under the plan
Allow Sterilization Yes

Newborn Enrollment Rules

Option Selected
Apply Normal Plan Benefits  
Process Under Mother  
Must Be Enrolled Within 31 days
Automatic 31-Day Coverage, Must Enroll Thereafter
Automatic 31-Day Coverage Only if EE Has Dependent Coverage  

Outpatient Services

Outpatient Hospital Services (Unless Otherwise Specified)

Benefit Tier 1 Tier 2
Coverage Code CO, HBO, HMIS, HOBS, HWCT, MNOP, PA, PADR, SAOP, SMPH  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Outpatient Physician Services (Unless Otherwise Specified)

Benefit Tier 1 Tier 2
Coverage Code DIED, HBP, PM  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Dialysis

Benefit Tier 1 Tier 2
Coverage Code DI, HDI  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Urgent Care Services

Benefit Tier 1 Tier 2
Coverage Code URG  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Include All Related Services Yes Yes
Plan Pays 80% 50%

"Ologist" Benefits (REAP)

REAP = Radiology, Emergency Room Physicians, Anesthesiology, Pathology, Hospitalists

Scenario In-Network Benefits Apply?
Hospitalists, Radiology, Pathology, Anesthesiology at Participating Facility Yes
Emergency Room Physicians Yes
Services Referred by Participating Physician Yes
Services Outside Service Area (>100 miles from residence) Yes
Services Unable to be Provided by Network Provider Yes
Emergency Care Out of Area or at Non-Network Hospital Yes

Infertility Treatment Services

Coverage Overview

Benefit Tier 1 Tier 2
Coverage Code INF, INFS, INFT, INHT, INIT, IVF, IVSF, SINT  
Covered Service No No

Specific Infertility Services

Service Type Tier 1 Tier 2
Diagnostic Only (to determine diagnosis) No No
Genetic Testing to Diagnose Infertility No No
Diagnostic & Other Services No No
Fertility Test No No
Tests/Exams for Induced Conception No No
Surgical Reversal of Sterilization No No
Sperm Enhancement Procedures No No
Direct Attempts to Cause Pregnancy No No
Hormone or Therapy Drugs No No
Artificial Insemination No No
Invitro Fertilization No No
Gamete Intrafallopian Transfer (GIT) No No
Zygote Intrafallopian Transfer (ZIFT) No No
Embryo Transfer No No
Freezing or Storage of Embryo, Eggs, or Semen No No

List of Covered Drugs: None


Cancer Treatment

Chemotherapy / Radiation Therapy - Professional

Benefit Tier 1 Tier 2
Coverage Code CT, HCT, HRT, RT  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Chemotherapy / Radiation Therapy - Facility

Benefit Tier 1 Tier 2
Coverage Code CT, HCT, HRT, RT  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Hearing Aids

Benefit Tier 1 Tier 2
Coverage Code HA, HA2, HARC  
Covered Service No No
Deductible Applies N/A N/A
Co-pay Applies N/A N/A
Plan Pays N/A N/A
Maximum Benefit No benefit maximum  

Orthotics

Benefit Tier 1 Tier 2
Coverage Code DS, OR, ORH, ORI, ORS  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%
Allow Custom-Molded Foot Orthotics Yes Yes
Allow Non-Custom Molded Shoe Inserts Yes Yes
Allow Diabetic Shoes Yes Yes
Diabetic Shoes Limits 1 pair per calendar year up to $500  

Prosthetics

Benefit Tier 1 Tier 2
Coverage Code PRO  
Covered Service Yes Yes
Initial Purchase, Fitting, Repair, Replacement Covered Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Preventive Care Services (ACA Covered Services)

Non-Grandfathered Plan

Coverage Code: AB, AB1, AB2, AB3, AB4, AB5, AB6, AB7, ABCV, ABH, ABNC, ABR, ABX

Plan follows US Preventive Services Task Force recommendations: http://www.uspreventiveservicestaskforce.org/BrowseRec/Index

Preventive services covered without cost sharing. This generally applies only when services rendered by network provider.

Benefit Tier 1 Tier 2
Covered Service Yes Yes
Deductible Applies No No
Co-pay Applies No No
Plan Pays 100% Not covered if out of network

Are there additional services covered under separate Wellness Benefit not included in USPSTF recommendations: No


Routine/Wellness Services (Outside of ACA)

Routine Physical Exam

Benefit Tier 1 Tier 2
Coverage Code HWC, WCB, WCBS, WLB, WLBS  
Additional Routine Physical Exams Not Required by ACA No No
Deductible Applies N/A N/A
Co-pay Applies N/A N/A
Plan Pays N/A N/A

Immunizations

Benefit Tier 1 Tier 2
Coverage Code IMAS, IMM, IMMA, IMMB, IMMG, IMMS, IMSH  
Additional Immunizations Not Required by ACA No No
Deductible Applies N/A N/A
Co-pay Applies N/A N/A
Plan Pays N/A N/A

List of Non-Covered Immunizations: (None specified)

Routine Diagnostic Tests, Labs, X-rays

Benefit Tier 1 Tier 2
Coverage Code HWL, WLAB, WXL, WXR  
Additional Tests Not Required by ACA No No
Deductible Applies N/A N/A
Co-pay Applies N/A N/A
Plan Pays N/A N/A

Routine Mammogram

Benefit Tier 1 Tier 2
Coverage Code MAM, MAM2, OMAM, OMAS, OMA2, OM2S  
Additional Routine Mammograms Not Required by ACA No No
Deductible Applies N/A N/A
Co-pay Applies N/A N/A
Plan Pays N/A N/A

Routine Pap Smear / Test and Pelvic Exam

Benefit Tier 1 Tier 2
Coverage Code PAP, PAPR, PAPS  
Additional Circumstances Beyond ACA No No
Deductible Applies N/A N/A
Co-pay Applies N/A N/A
Plan Pays N/A N/A

Routine Fecal Blood Culture

Benefit Tier 1 Tier 2
Coverage Code WLB  
Additional Circumstances Beyond ACA No No
Deductible Applies N/A N/A
Co-pay Applies N/A N/A
Plan Pays N/A N/A

Routine PSA Test and Prostate Exam

Benefit Tier 1 Tier 2
Coverage Code PS, PSS  
Cover Routine PSA Test and Prostate Exam Yes No
Deductible Applies No N/A
Co-pay Applies No N/A
Plan Pays 100% N/A

Details: Out of network is not covered

Routine Colonoscopy, Sigmoidoscopy and Similar Preventative Procedures

Benefit Tier 1 Tier 2
Coverage Code OCOL, OCOS, WLAB, WLB, WXL, WXLS  
Additional Circumstances Beyond ACA No No
Deductible Applies N/A N/A
Co-pay Applies N/A N/A
Plan Pays N/A N/A

Contraceptive Management

Benefit Tier 1 Tier 2
Coverage Code BCI, BCIS, BCR, BCRS, BINJ, BINS, CONS, CONT  
Additional Circumstances Beyond ACA No No
Deductible Applies N/A N/A
Co-pay Applies N/A N/A
Plan Pays N/A N/A

Routine Hearing Exam

Benefit Tier 1 Tier 2
Coverage Code RHE  
Additional Circumstances Beyond ACA No No
Deductible Applies N/A N/A
Co-pay Applies N/A N/A
Plan Pays N/A N/A

Nutritional Counseling

Benefit Tier 1 Tier 2
Coverage Code WCBS  
Additional Circumstances for Behavioral/Nutritional Counseling No No
Deductible Applies N/A N/A
Co-pay Applies N/A N/A
Plan Pays N/A N/A

Vision Care Benefits

Vision Plan Information

Item Details
Separate Benefit for Vision Care No
Other Vendor Yes - VSP
Medical Related Eye Exams and Glaucoma Testing Yes (covered under medical)
Glaucoma and Cataracts Yes (covered under medical)
Routine Eye Exams No (not covered under medical)
Routine Eye Exams Included In Vision care benefit (VSP)
Benefit for Routine Eye Refractions No (Tier 1), No (Tier 2)

Coverage Code: REE, VEX

Other Vision Care Services

Are any of these covered under Medical Plan?

Coverage Code: HW, PHW, VANA, VBL, VCD, VCL, VFR, VINE, VLB, VLS, VLT, VSL, VTL, VTNT

Service Tier 1 Tier 2 Maximum
Lenses - Single Vision No No N/A
Lenses - Bifocal No No N/A
Lenses - Trifocal No No N/A
Lenses - Lenticular No No N/A
Lenses - Progressive No No N/A
Lens Coating No No N/A
Frames No No N/A
Contacts No No N/A
Safety Lenses and Frames No No N/A
Sunglasses or Subnormal Vision Aids No No N/A
Eye Surgeries for Refractive Disorders (LASIK, Radial Keratotomy, etc.) No No N/A
Fitting/Dispensing Non-Prescription Glasses No No N/A
Vision Therapy Services (including orthoptics) No No N/A
Correction of Visual Acuity or Refractive Errors No No N/A
Aniseikonia (Each eye sees object differently) No No N/A

Oral Surgery Benefits (Paid Under Medical)

Coverage Code: See applicable benefit section

Benefit Tier 1 Tier 2
Covered Service Yes Yes

Covered Oral Surgery Services

Service Coverage Conditions
Excision of Partially or Completely Impacted Teeth Yes See comments
Excision of Tumors and Cysts Yes When conditions require pathological exams (jaw, cheeks, lips, tongue, roof and floor of mouth)
Surgical Procedures for Accidental Injuries Yes Jaws, cheeks, lips, tongue, roof and floor of mouth
Reduction of Fractures & Dislocations of Jaw Yes  
External Incision and Drainage of Cellulitis Yes  
Incision of Accessory Sinuses, Salivary Glands or Ducts Yes  
Excision of Exostosis of Jaws and Hard Palate Yes  
Frenectomy Yes Cutting of tissue in midline of tongue
Gingival Mucosal Surgery Yes Gingivectomy, osseous, periodontal surgery and grafting to treat gingivitis or periodontitis
Apicoectomy Yes Excision of tooth root without extraction of entire tooth
Root Canal Therapy Yes If performed in conjunction with Apicoectomy
Alveolectomy Yes Leveling of structures supporting teeth for dentures. NOT payable if performed with routine extraction

Other Dental Services

Coverage Code: See applicable benefit section

Service Tier 1 Tier 2
Dental Implants No No
Anesthesia, X-ray, Lab for Medically Appropriate Hospital Services Yes Yes
Any Other Dental Services Under Medical Plan No No

Temporomandibular Joint Disorder (TMJ) Benefits

Benefit Tier 1 Tier 2
Coverage Code TMJ, TMJO, TMJS  
Covered Service No No

Covered Services (if applicable)

Service Type Coverage
All (surgery, appliances, adjustments) No
Diagnostic Only No
Non-Surgical Treatment No
Surgery Only No

Maximum Lifetime Amount: N/A Services Maximum Applies To: N/A


Therapy & Rehabilitation Services

Physical Therapy (Outpatient Treatment)

Benefit Tier 1 Tier 2
Coverage Code DPT, HPT, PT  
Covered Service Yes Yes
PT and OT Combined Benefit Yes  
Aquatic Therapy with PT Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%
Maximum Benefit 36 VISITS per calendar year 36 VISITS per calendar year

Comments: Includes massage therapy performed by a covered provider.

Occupational Therapy (Outpatient Treatment)

Benefit Tier 1 Tier 2
Coverage Code HOT, OT  
Covered Service Yes Yes
PT and OT Combined Benefit Yes  
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%
Maximum Benefit 36 VISITS per calendar year 36 VISITS per calendar year

Comments: Includes massage therapy performed by a covered provider.

Speech Therapy

Benefit Tier 1 Tier 2
Coverage Code HST, ST  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%
Maximum Benefit 20 VISITS per calendar year 20 VISITS per calendar year

Other Outpatient Rehabilitative and Habilitative Services

ABA therapy, Cognitive Rehab, Cardiac rehab, Pulmonary rehab

Benefit Tier 1 Tier 2
Coverage Code ABA, ABAH, COGR, CR, PRHB  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%
Maximum Benefit No benefit maximum No benefit maximum

Massage Therapy (Performed by Massage Therapist)

Benefit Tier 1 Tier 2
Coverage Code MT  
Covered Service No No
Deductible Applies N/A N/A
Co-pay Applies N/A N/A
Plan Pays N/A N/A
Maximum Benefit No benefit maximum  

Comments: Massage therapy services are covered when a medical diagnosis exists and services are provided by a Physical Therapist, Occupational Therapist, or Physician.


Wigs (For Cancer Treatment or Medically Appropriate Condition)

Benefit Tier 1 Tier 2
Coverage Code WIG  
Covered Service No No
Deductible Applies N/A N/A
Co-pay Applies N/A N/A
Plan Pays N/A N/A
Maximum Benefit No maximum  

Transplant Services

Item Details
Separate Transplant Policy No (Tier 1), No (Tier 2)
Transplant Services Provided By (Phone number blank)
Covered When Donor Under Plan but Recipient Not Yes (Tier 1), Yes (Tier 2)

Transplant Facility Benefits - Recipient

Benefit Tier 1 Tier 2
Coverage Code TRN  
Covered Service Yes No
Deductible Applies Yes N/A
Co-pay Applies No N/A
Plan Pays 80% N/A

Facility - Travel and Housing - Recipient

Benefit Coverage
Coverage Code TRL, TRNT
Covered Service No
Airfare No (Tier 1), No (Tier 2)
Meals No (Tier 1), No (Tier 2)
Tolls No (Tier 1), No (Tier 2)
Parking Fees No (Tier 1), No (Tier 2)
Apartment Rental No (Tier 1), No (Tier 2)
Hotel / Motel No (Tier 1), No (Tier 2)
Relocation Fees No (Tier 1), No (Tier 2)
Taxes No (Tier 1), No (Tier 2)
Allow Travel Expenses No (Tier 1), No (Tier 2)

Facility Benefits - Living Donor

Benefit Tier 1 Tier 2
Coverage Code TRN  
Covered Service Yes No

Mental Health & Substance Abuse Services

Mental Nervous/Substance Abuse Residential Treatment Center

Benefit Tier 1 Tier 2
Coverage Code MRES, SRES  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Mental Nervous/Substance Abuse Outpatient Facility Treatment

All (PHP, DT, IOP, etc.)

Benefit Tier 1 Tier 2
Coverage Code DT, SDT, SMDT  
Covered Service Yes Yes
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

All Other Covered Services (Not Otherwise Specified)

Benefit Tier 1 Tier 2
Coverage Code (Not specified)  
Deductible Applies Yes Yes
Co-pay Applies No No
Plan Pays 80% 50%

Prescription Drug Benefits

Plan Overview

Item Details
Coverage Code PCS (Invoice only)
Prescription Drugs Covered Under Medical Plan Drug plan
6-Month Waiting Period for New to Market Specialty Drugs Yes
Name of RX Vendor TrueScripts
Deductible Applies Yes (Tier 1), Yes (Tier 2)
Co-pay Applies No (Tier 1), N/A (Tier 2)
Apply Deductible After Co-pay N/A (Tier 1), N/A (Tier 2)

Drug Tiers & Cost Sharing Structure

Drug Type Days Supply Copay Structure
TIER 1 1-30 100% until deductible met / 20% after deductible met
TIER 1 31-90 100% until deductible met / 20% after deductible met
TIER 2 1-30 100% until deductible met / 20% after deductible met
TIER 2 31-90 100% until deductible met / 20% after deductible met
TIER 3 1-30 100% until deductible met / 20% after deductible met
TIER 3 31-90 100% until deductible met / 20% after deductible met
SPECIALTY TIER 1 1-30 100% until deductible met / 20% after deductible met
SPECIALTY TIER 2 1-30 20% TO $550 MAXIMUM
SPECIALTY TIER 3 1-30 20% TO $2000 MAXIMUM
SPECIALTY TIER 4 1-30 20%
SPECIALTY TIER 5 1-30 50%

Specialty Pharmacy Injectable Drugs

Item Details
Coverage Code SPD
Injectable Drugs Covered Under Medical Plan Yes
Paid Same as Other Medical Office Services Yes

Comments: Medications and supplies related to the administration of injectable prescription medication may be covered under the Medical or Pharmacy benefits but not both.

Specific Item Coverage

How are the following items covered?

Item Medical Plan Tier 1 Tier 2 Drug Plan Not Covered
Diabetic Supplies Yes Yes    
Insulin Yes Yes    
Growth Hormones Yes Yes    
Take Home Medications Yes Yes    

Contraceptive Products

How are the following items covered?

Product Medical Plan Tier 1 Tier 2 Drug Plan Not Covered
Contraceptive Patches, Oral Tablets, Self-Insertable Vaginal Devices (Nuva Ring) Yes Yes    
Contraceptive Injections (Depo-Provera) Yes Yes    
Contraceptives Administered in Dr. Office (IUDs, Implants) Yes Yes    

Miscellaneous Services - Excluded/Covered Status

Complete Service List

Service Excluded Covered Coverage Code
Abortion - Elective   ABO
Alternative/Complementary Treatment (Holistic, Homeopathic, Hypnosis, Other)   INEL
Treatment for Acquired Brain Injury   See appropriate benefit section
Autism Services (Required per MHPAEA)   DEVD
Applied Behavior Analysis (ABA)   ABA, ABAH
Biofeedback   BFF
Blood Pressure Cuffs/Monitors   INEL
Botox (Medically Necessary)   BOT
Botox Coverage Through   Medical  
Breast Reductions (If Medically Appropriate)   See appropriate benefit section
Counseling - Marriage   INEL
Developmental Delays (OT, PT, Speech, Medical)   DEVD
Treatment of Bunions, Corns, Calluses, Toenails   INEL (unless medically necessary)
Gender Affirming Care   INEL
Genetic Counseling/Testing (Medical Appropriateness or Family History)   GEN
Gene Therapy - Medical and/or Prescription Drug Charges   GENE
Orphan Drugs - Medical and/or Prescription Drug Charges   ORPH
Implantable Hearing Devices (Cochlear, Soundtec)   CIRH, COCH
Learning Disability   DEVD
Enteral and Parenteral Support   MMS
Oral Nutrition Therapy (If Medically Necessary)   MMS
Supplies - Feeding Tubes, Pumps, Bags, Products   MMS
Orthognathic, Prognathic, Maxillofacial Surgery   See benefit section if covered (unless TMJ or Reconstructive)
Panniculectomy/Abdominoplasty   INEL
Sales Tax, Shipping and Handling   INEL
Complications from Non-Covered Service   INEL

Sexual Function Services

Service Excluded Covered Coverage Code
Diagnostic   See appropriate benefit section
Non-Surgical   See appropriate benefit section
Surgical   See appropriate benefit section
Prescription Drugs   See appropriate benefit section

Note: Any medications (oral or other) used to increase sexual function or satisfaction, or penile pumps and erectaid devices are not covered.

Sleep Disorders (If Medically Appropriate)

Service Excluded Covered Coverage Code
Sleep Studies   OSLP, SLMS, SLDM, SLPS

Telemedicine

Service Excluded Covered Coverage Code
Patient to Physician   TELM, TELS
Physician to Physician   INEL
Teladoc (Separate Benefit)   TELA, TELB

Smoking Cessation Drugs

If Covered Payment Method Coverage Code
Paid Under Medical Benefit   SMK
Paid Under Prescription Drug Benefit  

Weight Control (Morbid Obesity)

Service Excluded Covered Coverage Code
All Weight Control Services   BAR, BARS, OBE
Bariatric Therapy    
Gastric or Intestinal Bypass    
Stomach Stapling    
Prescription Medication for Weight Loss    
Physician Supervised Weight Loss Programs    
Diet Supplements    

Definition: Body mass index OR 100 pounds over body weight (not specified which applies)

Injuries

Injury Type Coverage Status
Injuries Incurred While Legally Intoxicated Not covered
Illegal Drugs or Medicines Not covered (illness or injury resulting from voluntary taking or being under influence of controlled substance, drug, hallucinogen, or narcotic not administered by Physician)

General Items

Dependent Age Limitations

Age Limit: 26

Usual and Customary Percentile (Out of Network)

Percentile Selected
80th (Standard)
85th  
90th  
95th  
% of Medicare 130/150%
Other  

Provider Types Normally Covered

Medical Providers

Provider Type Covered Requirements
CNM (Certified Nurse Midwife) Yes When acting within scope of license in state, performing service payable when done by MD
Chiropractor Yes Health care professional focusing on musculoskeletal and nervous system disorders
Massage Therapist Conditional Only when services provided by PT, OT, or Physician with medical diagnosis
Licensed Professional Counselor Yes For mental health
Certified Addiction Counselor Yes For substance abuse

Mental Health Treatment Providers

Provider Type Covered
PSY.D. (Therapist with PhD or Master's in Psychiatry) Yes
State Licensed Psychologist Yes
State Licensed or Certified Social Worker Yes
MSW (Masters in Social Work) Yes

Timely Filing Period

Option Selected
12 Months
15 Months  
18 Months  
24 Months  
Other  

Coordination of Benefits (COB)

COB Rules

Rule Setting/Answer
Is COB Same for Medicare Eligible Employees Yes
If No, COB Provision for Medicare Employees N/A
Medicare - Plan Not Primary, Part A but Not Part B Plan will NOT reduce benefits as if Part B elected
Birthday Rule or Gender Rule Birthday
Question Primary Carrier for Their Rule Yes

COB Savings Code

Selected Code: 0

Definition: Accumulated COB savings are applied toward satisfying the deductible and reducing the copayment on claims (both the current COB claim and future claims) until accumulated savings are used up. COB savings accumulate for each plan participant in a "COB bank" in the claimant's name.

All COB Savings Options:

Code Description
0 ✓ SELECTED - Savings applied to deductible and copayment for current and future claims in "COB bank"
1 COB savings applied to deductible and copayment of current claim only
2 Carve Out COB - Savings not used for deductible or copayment, accumulate in plan's name only

COB Payment Code

Selected Code: 0

Definition: COB savings are applied to the entire claimant's incurred charges, even if the charges are not eligible under the plan. For example, COB savings are used to pay for services denied as cosmetic.

All COB Payment Options:

Code Description
0 ✓ SELECTED - COB savings applied to entire incurred charges, even if not eligible
1 COB savings applied only to charges eligible under the plan
2 COB savings applied only to eligible charges, BUT savings will not apply to annual accumulators
3 COB Savings code not considered, savings will not be generated
9 COB processing ignored for group, regardless of any COB amounts entered

Document Completion & Approval

Form Completed By

Field Information
Completed By Susan Green
Title Plan Build
Date Completed 12/26/2025

Customer Approval Section

IMPORTANT NOTE: Your approval of this installation document is of critical importance. This information is used to ensure we quote benefits correctly and must accurately reflect your plan document.

Any changes requested after you approve this document or after the effective date of your plan will need to be submitted to us so we do not quote benefits incorrectly.

Signature Fields:

  • Customer Comments (if any): _______________
  • Date: _______________
  • Signature of Customer: _______________ (An electronic signature will be accepted)

Plan Modifications Section

For Future Use:

Field Information
Group Name  
Effective Date  
Group Number  
Modifications The Install Plan Document is hereby modified as follows:

Modification Completion

This Form Completed by: ________@ 90 Degree Benefits Date Completed: _______________

Customer Approval of Modifications

IMPORTANT NOTE: Your approval of these modifications is of critical importance. This information is used to ensure we quote benefits correctly and must accurately reflect your plan document.

Any further changes requested after you approve this document or after the effective date of your plan will need to be submitted to us so we do not quote benefits incorrectly.

Signature Fields:

  • Customer Comments (if any): _______________
  • Date: _______________
  • Signature of Customer: _______________ (An electronic signature will be accepted)

CIGNA Pre-Certification Listing

IMPORTANT: A separate CIGNA PRE-CERTIFICATION LISTING is included with this plan document detailing specific services that require pre-certification. All support staff must refer to this listing when processing claims or answering member questions about pre-certification requirements.

Pre-Certification Contact:

  • Provider: CIGNA
  • Phone: 888-832-4354
  • Retroactive Pre-cert: NOT ALLOWED - Services will be denied

Critical Reminders for Support Teams

Top Priority Items

  1. Emergency services and ambulance - ALWAYS paid at Tier 1 rates (80%) with Tier 1 ded/OOP, even if out-of-network provider
  2. Deductibles and OOP maximums are SEPARATE - Tier 1 and Tier 2 DO NOT cross-apply
  3. This is a Qualified HDHP - HSA eligible plan
  4. No copays on services - deductible + coinsurance structure (except specialty drugs have specific caps)
  5. Preventive care is 100% - In-network only, out-of-network NOT covered
  6. Pre-certification is REQUIRED - No retroactive approval, services denied if not on file
  7. Newborns - Must be enrolled within 31 days for continued coverage

Network & Payment Details

  1. Tier 1 Network: CIGNA (PPO Code 3002)
  2. Tier 2 Payment: 130% Medicare (professional), 150% Medicare (facilities)
  3. REAP providers - (Radiology, ER physicians, Anesthesiology, Pathology, Hospitalists) paid in-network when at network facility or medically necessary

Benefit Maximums to Remember

  1. Physical + Occupational Therapy COMBINED: 36 visits per calendar year
  2. Speech Therapy SEPARATE: 20 visits per calendar year
  3. Chiropractic: $500 maximum per calendar year
  4. Extended Care Facility: 60 days per calendar year
  5. Home Health Care: 60 visits per calendar year
  6. Diabetic Shoes: 1 pair per calendar year up to $500

Drug Benefits

  1. Specialty drugs - 6-month waiting period for new to market drugs
  2. Injectable drugs - Covered under medical (not pharmacy) when administered in office
  3. Diabetic supplies, insulin, growth hormones - All covered under medical plan at 80%/50%
  4. Prescription vendor: TrueScripts

Important Exclusions

  1. Infertility treatment - NOT covered (all services)
  2. Weight loss/bariatric surgery - NOT covered
  3. TMJ - NOT covered
  4. Hearing aids - NOT covered
  5. Vision services - Separate vendor (VSP), not covered under medical
  6. Gender affirming care - NOT covered
  7. Acupuncture - NOT covered

COB & Administrative

  1. Mental health & substance abuse - Paid same as any other illness
  2. Birthday rule - Used for COB determinations
  3. COB Savings Code 0 - Savings accumulate in member's "COB bank"
  4. Timely filing: 12 months
  5. Number of employees: 174 (may affect Medicare COB rules)
  6. Dependent age limit: 26

Important Contact Information

Contact Details
TPA 90 Degree Benefits
TPA Hours 8:00 AM - 5:00 PM CST
Pre-Certification CIGNA: 888-832-4354
Vision Benefits VSP (see member card for phone)
Prescription Benefits TrueScripts
Teladoc $0 consult fee (see member card)

Document Information

Field Details
Document Type Install Plan Document - FINAL Approved
Last Updated 1/30/2019 (Template)
Plan Build Date 12/26/2025
Plan Effective Date 01/01/2026
Total Pages 29 pages
Master Group 65100
Subgroup 65101

This knowledge base article contains all details from the Carolina Orthopaedic and Neurosurgical Associates HSA Plan Document. For questions or clarifications, contact 90 Degree Benefits during business hours (8:00 AM - 5:00 PM CST).

All information must match the signed plan document. Any discrepancies should be reported immediately to ensure accurate benefit adjudication.