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Health and Prescription Drug Insurance

Cigna Choice Fund HSA Plan

Cigna Choice Fund HSA Benefit Summary
Cigna Medical Claim Form

 

Full-time Employees - Per Pay Period Rates

 

12 Month Employees

10 Month Employees

Employee

$62.61

$81.40

Employee + l

$122.09

$158.72

Family

$178.45

$231.98


Part-time Employees - 2014 Rates (for employees hired before 1/1/93)
Part-time Employees - 2014 Rates (for employees hired after 1/1/93)
Cigna Web site

To enroll, you must submit the following:

on-line banking application

Open Enrollment ID: MontCollege2012
Password:Cigna

CIGNA Choice Fund HSA Salary Reduction Agreement Form

(only required for those participants wishing to fund the HSA with additional pre-tax dollars)

Montgomery College Group Insurance Enrollment Form

Copies of Marriage and/or Birth Certificates if adding dependents new to MC benefits


Cigna POS (Point of Service) Plan

POS Medical Benefits Summary

Out-of-Network Medical Claim Form

Full-time Employees - Per Pay Period Rates

 

12 Month Employees

10 Month Employees

Employee

$69.65

$90.54

Employee + l

$135.81

$176.56

Family

$198.49

$258.04


Part-time Employees - 2014 Rates (for employees hired before 1/1/93)
Part-time Employees - 2014 Rates (for employees hired after 1/1/93) 
 
Cigna web site


To enroll, you must submit the following:
 

Montgomery College Group Insurance Enrollment Form

Copies of Marriage and/or Birth Certificates if adding dependents new to MC benefits


Caremark Prescription Drug Plan ( applies only to Cigna Plans)

Cigna Choice Fund Benefits At-a-Glance
POS Prescription Benefits At-a-Glance
Mail Service Order Form
Caremark Web site

Kaiser Permanente HMO Plan

Kaiser Permanente HMO Medical Benefits Summary

 

Full-time Employees - Per Pay Period Rates

 

12 Month Employees

10 Month Employees

Employee

$50.34

$65.44

Employee + l

$100.68

$130.89

Family

$145.99

$189.78

 

Part-time Employees - 2014 Rates (for employees hired before 1/1/93)
Part-time Employees - 2014 Rates (for employees hired after 1/1/93)
Kaiser Permanente Web site

 

To enroll, you must submit the following:

Kaiser Enrollment Application Form
Montgomery College Group Insurance Enrollment Form
Copies of Marriage and/or Birth Certificates if adding dependents new to MC benefits

 


Montgomery College

Montgomery County, MD

240-567-5000

©2014, Montgomery College