Human Resources

Health Benefits FAQs

• Eligibility

  Wesleyan’s medical plans are the foundation of our comprehensive benefits package, and are available to all benefits-eligible employees.

  Faculty and administrative staff who work at least half-time (.50 FTE) may participate in medical, dental, and vision coverage. Bargaining unit employees should refer to the terms of their contract for additional benefits information.

  Wesleyan University recognizes Civil Unions between same-sex couples as the equivalent to marriage for the purpose of benefit eligibility.

  Wesleyan University recognizes Domestic Partnerships for the purpose of benefit eligibility. A signed Affidavit of Domestic Partnership is required and may be obtained on WesPortal. Information on applicability of pre-tax premium payment is found on the Health Premiums page.

  Coverage is effective on the date of hire for new employees and on the date of a status change for employees moving into a benefits-eligible position.

  Wesleyan offers three medical plans:

  • Cigna Open Access Plus High Deductible Health Plan (HDHP w/HSA)
  • Cigna Open Access Plus – In-Network Only (OAPIN)
  • Cigna Open Access Plus (OAP)

   Those who qualify under the Affordable Care Act will be offered coverage in the HDHP w/HSA plan.
  
  Wesleyan also offers dental and vision plans:

  • Delta Dental Premier Plan
  • EyeMed Select Plan

   

  Dependent Eligibility

  The following are eligible dependents under the medical, dental, and vision plans:

  • Spouse
  • Domestic partner (mutual residence of six months required, as well as mutual financial support)
  • Children, including stepchildren and child(ren) placed for adoption, who meet the IRS dependent definition until the end of the month in which they turn age 26 unless they are totally diabled (please contact benefits@wesleyan.edu for more information).
  • Children the employee is legally obligated to support

• Key Features of Wesleyan's Medical Plans

  Preventive care services are covered in network at 100%. This means certain services are covered before the deductible is met, including an annual physical and associated lab tests, annual OB/GYN visit, prenatal visits, well child visits, new baby visits and associated immunizations, mammogram screening, colonoscopy screening, and an annual eye exam.

  • Wesleyan Preventive Care Presentation
  • Preventive Customer Reference Guide
  • Cancer Support Program - Oncology
  • Cancer Support Program

   

  Pharmacy and prescription drug benefits are included in Wesleyan’s medical plans.

  • Wesleyan’s Prescription Drug Program
  • Patient Assurance Program - Diabetes
  • Patient Assurance Program Drug List

• Benefit Summaries and Resources
  • OAPIN Benefit Summary
  • OAP Benefit Summary
  • HSA Benefit Summary
  • Cigna Benefit Guide
  • Cigna One Guide
  • Cigna Presentation
  • Medical Claim Form
  • Prescriptions and Cigna ID Card
  • Prescription Claim Form
  • Precertification Process
  • Virtual Wellness Screening
  • Preventive Care Customer Reference Guide
  • FDA-Authorized COVID-19 Testing Kit Coverage Information
  • Cigna Behavioral Health Claim Form

• Enrolling in Benefits at Wesleyan University

  Wesleyan University is committed to providing a comprehensive benefits program for its employees. As part of the onboarding process, as a new hire or newly eligible employee, you will receive an important "Enroll in Benefits" event in your Workday Inbox that needs to be completed and submitted within 31 days of your eligibility/hire date. Coverage will be retroactive to that date and deductions will begin the following pay period.

  
  Wesleyan University offers a Retirement Savings Plan, accessed through Retirement@Work. Through Retirement@Work, you will enroll in the plan, change your voluntary contributions, choose your preferred retirement plan provider(s), view your plan balances and investment providers, and access tools and resources for planning for your retirement. The Retirement@Work link is located in WesPortal, under My Information.

  
  Contact Human Resources at benefits@wesleyan.edu or 860-685-2100 if you have questions.

• Cigna One Guide
  Cigna One Guide
  Whether you’re a current Cigna customer or considering Cigna for the first time, we understand how confusing and overwhelming it can be to review your health plan options. We want to help by providing the resources you need to make a decision with confidence. That’s why One Guide is available to you:
  
  Before Enrollment
  

  • Call a Cigna One Guide representative before you enroll to get personalized, useful guidance. Your personal guide will help you: Easily understand the basics of health coverage
  • Identify the types of health plans available to you that best meet the needs of you and your family
  • Check if your doctors are in-network to help you avoid unnecessary costs
  • Get answers on any other questions you may have about the plans or provider networks available to you.  The best part is, during the enrollment period, your personal guide is just a call away.

  After Enrollment
  After enrollment, the support continues for Cigna customers. Your Cigna One Guide representative will be there to guide you through the complexities of the health care system, and help you avoid costly missteps. Cigna One Guide service provides personalized assistance to help you:
  

  • Resolve health care issues
  • Save time and money
  • Get the most out of your plan
  • Find the right hospitals, dentists and other health care providers in your plan’s network
  • Get cost estimates and avoid surprise expenses
  • Understand your bills
  • Connect to clinical programs, lifestyle coaching and behavioral health services.

  
  Simply call us (800.Cigna24), click-to-chat on myCigna.com or use the myCigna® App. You’ll automatically be connected with a One Guide representative who will help guide you where you need to go.

• Telehealth

  Telehealth

  Cigna Telehealth Connection provides care—including most prescriptions—for a wide range of minor conditions. Patients can connect with a board-certified doctor when, where, and however it works best for them—via video or phone—without having to leave home or work.

  Choose when - Day or night, weekdays, weekends, and holidays.

  Choose where - At home, at work, or on the go.

  Choose how - Phone or video chat.

  MDLIVE televisits can be an affordable alternative to a convenience care clinic or urgent care center, and cost less than going to the emergency room. Costs are the same or less than a visit to a primary care provider.

  MDLIVE

  Access is available through mdliveforcigna.com, or by calling 888-726-3171.

   

• Behavioral Health

  Behavioral Health Options with MyCigna.com

  Cigna Total Behavioral Health Program
  Many physical conditions can worsen with stress, substance abuse and other behavioral health issues. Cigna Total Behavioral Health is a comprehensive program that provides dedicated support, lifestyle coaching, and online tools to help manage life events.

  Telehealth Behavioral Health Visits
  Members can use their smartphone, tablet or computer for online video conferencing. The out-of-pocket cost is the same as a behavioral health outpatient office visit. Refer to plan documents for costs and details of coverage. To find a Cigna network provider, visit mycigna.com, go to “Find Care & Costs” and enter “Virtual counselor” under “Doctor by Type.”

  Happify
  Everyday stressors can impact relationships, work, health, and emotional well-being. Cigna has partnered with happify, a free app with science-based games and activities that are designed to help defeat negative thoughts, gain confidence, reduce stress and anxiety, increase mindfulness and emotional well-being, and boost health and performance. Sign up and download the free app at happify.com/cigna.

  iPrevail
  Members can learn how to boost their mood and improve mental health with on-demand coaching that is available 24/7. After completing a brief assessment, participants will receive a program tailored to their needs that includes interactive lessons and tools. They will also have access to a peer coach who is matched based on symptoms. Participants can join support communities focused on stress, anxiety, depression, and more. Sign up on mycigna.com.

  Headspace Care
  Everyone deserves access to incredible mental healthcare. That’s why Headspace Care created the world’s first integrated mental healthcare system where coaches, therapists, and psychiatrists work as a team to coordinate the best, personalized care right from your smartphone, whenever you need it. It’s like a virtual clinic without the waiting room. Headspace Care's mental health services are in-network and accessible through your behavioral health benefits.
  
  What is Headspace Care?  Headspace Care offers confidential mental healthcare through behavioral health coaching via text-based chats, self-guided learning activities and content, and, if needed, video-based therapy and psychiatry. Support is available anytime (24/7/365), anywhere (we go where your phone goes), for a variety of mental health challenges you may be struggling with—all from the privacy of your smartphone.
  
  How do I begin chatting with a Headspace Care behavioral health coach?  Download the Headspace Care emotional support app from your smartphone. Follow the instructions sent to your email. Enter your: First name, last name, date of birth and your Member ID number to verify your eligibility. Then, answer a few questions, and you’re ready to get started! Choose to schedule an appointment with your coach at a time that works best for you, or chat right away.
  
  What kinds of things can a Headspace Care coach help me with?  With a behavioral health coach, anyone can get personalized support to help overcome life challenges and reach goals in their moment of need. Coaches can help with any issue you’re struggling with such as stress, anxiety, depression, issues with work, relationships, sleep, and more.
  
  

  To learn more about Headspace Care and to get started, visit myCigna.com.

• Provider and Facility Network Tiers

  Provider and Facility Network Tiers

  Depending on which provider(s) and facilities are used when a patient receives services, and on the associated network tier, costs will vary. This guide is intended to help explain the medical plans’ service network tiers and costs.

  The OAP and the OAP High Deductible Health Plans have two network tiers, and each tier has a different cost structure based on negotiated prices. The out-of-network cost structure is higher than the in-network tier.

  Note: Providers listed in each network are subject to change; mycigna.com is the best source for updates.

  Tier 1: In-Network
  Tier 2: Out-of-Network - All providers and facilities not a part of the first tier are considered out-of-network.

• Additional Programs and Resources Through Cigna

  The Patient Assurance Program
  Managing diabetes is not easy, but this new program helps control the cost of eligible insulin products, making them more affordable. A 30-day (or one month) supply costs no more than $25 and a 90-day (or three month) supply costs no more than $75. The program includes Basaglar, Humulin, Humalog and Levemir. Additional insulin products may be included in the program. Members currently taking an insulin that is not included in the program should talk with their doctor about whether taking an insulin covered under the program is right for them.

  Cigna Clinical Management Programs

  • Your Health Matters Chronic Condition Management – Members who have a chronic health condition can develop a one-on-one relationship with a dedicated health advocate to help them manage chronic conditions ranging from asthma and low back pain to depression and coronary artery disease, among many others. The dedicated health advocate will help:
    • Obtain information and resources about their condition
    • Create a plan to help improve health (based on the member’s goals) 
    • Understand medications and doctor’s orders 
    • Make more educated decisions about their health and treatment options 

  To initiate a confidential, one-one-one conversation, call 800-244-6224 or visit mycigna.com.

  • Cancer Support Program - Members who have cancer—or are cancer survivors—can get one-on-one support to help with everything from understanding their diagnosis to discussing their health care provider’s treatment to celebrating survivorship. The personal nurse advocate will help:
    • Address immediate needs and concerns
    • Understand their diagnosis, medications, and treatment options
    • Coordinate follow-up care and screenings
    • Understand health plan benefits and find quality providers in their area
    • Find quality local support groups and facilities
    • Manage post-cancer care and support

  For additional information, call 800-615-2909 or visit mycigna.com.

  • Healthy Babies Program - Cigna’s Healthy Babies prenatal care and education materials provide information and support that work—from prenatal to post-delivery. Pregnant members can get help throughout their pregnancy:
    • Maternity specialists are available over the phone 24/7 to help with everything from morning sickness to maternity benefits.
    • Support is available from a case manager if the member is hospitalized during pregnancy or if their baby is in the NICU.

  Download the Cigna Healthy Pregnancy app to track and learn about pregnancy. The app also provides support for the baby’s first two years. For additional information, call the number on the back of the Cigna ID card.

  Resources

  • Cancer Support Program Oncology
  • Cancer Support Program Customer Brochure
  • Healthy Babies
  • Patient Assurance Program (Diabetes Medication)
  • Patient Assurance Drug List
  • SO LONG Tobacco, hello Healthy Life
  • Overview of Cigna Smoking Cessation Program
  • My Personal Champion - Gender Affirmation

• Lifestyle Management

  Cigna Lifestyle Management Program
  Cigna lifestyle management programs can help members lose weight, quit tobacco, or lower stress levels – and at no additional cost! Each program is easy to use and available where and when needed. Members can use each program online or over the phone—or both. To sign up for any of the lifestyle management programs, visit mycigna.com or call 800-Cigna24.

  • Weight Management - Create a personal healthy-living plan that will help you build confidence, be more active, and eat healthier.
  • Tobacco Cessation - Create a personal quit plan with a realistic quit date. Participants receive free over-the-counter nicotine replacement therapy (patch or gum).
  • Stress Management - Learn what causes stress and develop a personal stress management plan.