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Cigna Simple Choice 9100 - 73943NC0070045 Health Insurance Plan

Cigna HealthCare of North Carolina, Inc. health insurance plan with the Plan ID 73943NC0070045. The plan is called Cigna Simple Choice 9100.

Based on the AV Calculator by CMS.gov, the plan has an actuarial value of 59.86% (we converted the output of AV Calculator to percentage to compare with data provided by Issuer, it shows the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 40.14% of the costs of all covered benefits (according to the AV Calculator by CMS.gov). More information about AV Calculator methodology.

Field Data
Health Insurance Plan ID73943NC0070045
Health Insurance Plan Year2023
StateNorth Carolina
Health Insurance IssuerCigna HealthCare of North Carolina, Inc.
Plan Formulary Description URLFormulary URL
Plan Marketing Materials URLMarketing URL
Last Plan Update DateThu, 23 Feb 2023 00:00 GMT
Last Import DateSun, 01 Oct 2023 10:53 GMT
Health Insurance Plan Variant73943NC0070045-00
 
Available Variants of the Health Plan

73943NC0070045-00

73943NC0070045-01

73943NC0070045-02

73943NC0070045-03

Cigna Simple Choice 9100 Health Insurance Plan Variant 73943NC0070045-00 Attributes

Plan Attribute Value
AV Calculator Output Number0.598552346
Begin Primary Care Cost-Sharing After Number Of Visits0
Begin Primary Care Deductible Coinsurance After Number Of Copays0
Business Year2023
Child-Only OfferingAllows Adult and Child-Only
Composite Rating OfferedNo
CSR Variation TypeStandard Bronze Off Exchange Plan
Dental Only PlanNo
Design TypeDesign 1
Disease Management Programs OfferedAsthma, Heart Disease, Diabetes, High Blood Pressure & High Cholesterol, Pregnancy
EHB Percent of Total Premium 1
First Tier Utilization100%
Formulary IDNCF015
Formulary URLURL
HIOS Product ID73943NC007
Import Date2/23/2023 1:01
Limited Cost Sharing Plan Variation - Estimated Advanced Payment$0.00
Inpatient Copayment Maximum Days0
HSA EligibleNo
New/Existing PlanNew
Notice Required for PregnancyNo
Is a Referral Required for Specialist?No
Issuer ID73943
Issuer Marketplace Marketing NameCigna Healthcare
Market CoverageIndividual
Medical Drug Deductibles IntegratedYes
Medical Drug Maximum Out of Pocket IntegratedYes
Metal LevelBronze
Multiple In Network TiersNo
National NetworkNo
Network IDNCN001
Out of Country CoverageYes
Out of Country Coverage DescriptionEmergency Services Only
Out of Service Area CoverageYes
Out of Service Area Coverage DescriptionEmergency Services Only
Plan BrochureURL
Plan Effective Date1/1/2023
Plan Expiration Date12/31/2023
Plan ID (Standard Component ID with Variant) 73943NC0070045-00
Plan Marketing NameCigna Simple Choice 9100
Plan TypeHMO
Plan Variant Marketing NameCigna Simple Choice 9100
QHP/Non QHPBoth
SBC Scenario, Having a Baby, Coinsurance$0
SBC Scenario, Having a Baby, Copayment$0
SBC Scenario, Having a Baby, Deductible$9,100
SBC Scenario, Having a Baby, Limit$60
SBC Scenario, Having Diabetes, Coinsurance$0
SBC Scenario, Having Diabetes, Copayment$0
SBC Scenario, Having Diabetes, Deductible$5,400
SBC Scenario, Having Diabetes, Limit$20
SBC Scenario, Treatment of a Simple Fracture, Coinsurance$0
SBC Scenario, Treatment of a Simple Fracture, Copayment$0
SBC Scenario, Treatment of a Simple Fracture, Deductible$2,400
SBC Scenario, Treatment of a Simple Fracture, Limit$0
Service Area IDNCS001
Source NameHIOS
Plan ID73943NC0070045
State CodeNC
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Groupper group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Personper person not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, IndividualNot Applicable
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Groupper group not applicable
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Personper person not applicable
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, IndividualNot Applicable
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance0.00%
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Group$18200 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person$9100 per person
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual$9,100
TEHBDedOutOfNetFamilyPerGroupper group not applicable
TEHBDedOutOfNetFamilyPerPersonper person not applicable
Combined Medical and Drug EHB Deductible, Out of Network, IndividualNot Applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group$18200 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person$9100 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual$9,100
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Groupper group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Personper person not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, IndividualNot Applicable
Unique Plan DesignNo
URL for Enrollment PaymentURL
URL for Summary of Benefits & CoverageURL
Wellness Program OfferedNo

Copay & Coinsurance of Cigna Simple Choice 9100 Health Insurance Plan, 73943NC0070045

Drug Tier Pharmacy Type Copay amount Copay option Coinsurance rate Coinsurance option Mail Order

Frequently Asked Questions(FAQ) about Cigna Simple Choice 9100, 73943NC0070045 Health Insurance Plan, 73943NC0070045

Does Cigna Simple Choice 9100 Health Insurance Plan, 73943NC0070045 support Mail Ordering?

Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.

Does (73943NC0070045) Health Insurance Plan, Variant (73943NC0070045-00) offer Disease Management Programs?

Yes, and here is the list of available programs: Asthma, Heart Disease, Diabetes, High Blood Pressure & High Cholesterol, Pregnancy

Does (73943NC0070045) Health Insurance Plan, Variant (73943NC0070045-00) have Out Of Country Coverage?

Yes. Details: Emergency Services Only

Does (73943NC0070045) Health Insurance Plan, Variant (73943NC0070045-00) have Out of Service Area Coverage?

Yes. Details: Emergency Services Only

Does (73943NC0070045) Health Insurance Plan, Variant (73943NC0070045-00) offer Disease Management Programs?

Yes, and here is the list of available programs: Asthma, Heart Disease, Diabetes, High Blood Pressure & High Cholesterol, Pregnancy

Does Cigna Simple Choice 9100 Health Insurance Plan, Variant (73943NC0070045-00) offer Disease Management Programs for Asthma?

Yes, the Cigna Simple Choice 9100 Health Insurance Plan Variant 73943NC0070045-00 offers Disease Management Program for Asthma.

Does Cigna Simple Choice 9100 Health Insurance Plan, Variant (73943NC0070045-00) offer Disease Management Programs for Heart disease?

Yes, the Cigna Simple Choice 9100 Health Insurance Plan Variant 73943NC0070045-00 offers Disease Management Program for Heart disease.

Does Cigna Simple Choice 9100 Health Insurance Plan, Variant (73943NC0070045-00) offer Disease Management Programs for Diabetes?

Yes, the Cigna Simple Choice 9100 Health Insurance Plan Variant 73943NC0070045-00 offers Disease Management Program for Diabetes.

Does Cigna Simple Choice 9100 Health Insurance Plan, Variant (73943NC0070045-00) offer Disease Management Programs for High blood pressure & high cholesterol?

Yes, the Cigna Simple Choice 9100 Health Insurance Plan Variant 73943NC0070045-00 offers Disease Management Program for High blood pressure & high cholesterol.

Does Cigna Simple Choice 9100 Health Insurance Plan, Variant (73943NC0070045-00) offer Disease Management Programs for Pregnancy?

Yes, the Cigna Simple Choice 9100 Health Insurance Plan Variant 73943NC0070045-00 offers Disease Management Program for Pregnancy.

 

Disclaimer: This is based on the import(Date: Sun, 01 Oct 2023 10:53 GMT) of the data from Healthcare Issuers listed by CMS. While we make every effort to ensure that data is accurate, you should assume all results are unvalidated. Source: CMS.gov, HealthPorta HEALTHCARE MRF API