Cigna Scripps Select (HMO) Premiums
Cigna Scripps Select HMO Benefit Summary FY21
Cigna Vision Summary of Benefits FY21
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| Coverage Type | Annual | Monthly | Semi-monthly (24 pay periods)* |
||
|---|---|---|---|---|---|
| Post-tax | Pre-tax | ||||
| Employee only | $6,582 | $548.49 | $0.00 | $274.24 | |
| Employee & Spouse/Domestic Partner | $14,412 | $1,201.00 | $0.00 | $600.50 | |
| Employee & Domestic Partner (post-tax)** | $14,412 | $1,201.00 | $326.25 | $274.24 | |
| Employee & Children | $12,506 | $1,042.20 | $0.00 | $521.10 | |
| Family | $20,010 | $1,667.51 | $0.00 | $833.75 | |
| Family (Domestic Partner post-tax)** | $20,010 | $1,667.51 | $312.66 | $521.10 | |
* Variances Due to Rounding
**Domestic partners can only be enrolled on a pre-tax basis if they qualify as a tax dependent under IRS guidelines. To enroll your Domestic Partner on a pre-tax basis, submit a Tax Dependent Certification form which can be found on the Flexible Benefits website.