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Important Information
- 2025 Summary of Benefits - Medical 1500
- Allegiance Summary Plan Description
- $1,500 individual deductible, $3000 deductible for a family
- Cigna Network
- University of Utah, Mountain Star, and CommonSpirit hospitals included
- Deductible waived for in-network and out-of-network mental health office visits
- Accidental injury: first $1,000 paid
- Pharmacy: Kroger
- HealthJoy app: online telemedicine, virtual benefits wallet, and other features!
Resources
- Overview of Your Allegiance Plan
- Utah Cigna Hospital Map.pdf PDF
- Allegiance Healthcare Bluebook PDF
- Coordination of Benefits
- Home Health Services and DME
- Member Portal Walkthrough Video
Open Access Plus, OA Plus, Choice Fund OA Plus
Cigna is our national network, with providers located throughout the United States. This network is available if you have selected the Medical 750 Plan or Medical 1500 Plan.
Medical Rates
| 2025 | Full Time 30+ Hours/Week | Part Time 20–29 Hours/Week | Surcharge for Tobacco Use |
| Medical 1500 Plan (Cost Per Month) | |||
| Employee | $56 | $112 | +$90 |
| Employee + 1 Child | $119 | $238 | +$90 |
| Employee + Spouse | $119 | $238 | +$90 |
| Employee + Children | $172 | $344 | +$90 |
| Employee + Family | $172 | $344 | +$90 |
Medical Plans
| 2025 | Medical 1500 | ||
| Type of Service | Network Providers | Non-Network Providers | |
| Calendar Year Deductible | $1,500 per individual / $3,000 per family | ||
| Coinsurance | 75% insurance / 25% member | 55% insurance / 45% member | |
| Calendar Year Out of Pocket Maximum (Includes deductible, coinsurance, copayments, and pharmacy) | $5,000 per individual / $10,000 per family | ||
| Lifetime Maximum | Unlimited | ||
COBRA Rates
| 2025 | |
| Medical 1500 Plan (Cost Per Month) | |
| Employee | $571 |
| Employee + 1 Child | $1,215 |
| Employee + Spouse | $1,215 |
| Employee + Children | $1,752 |
| Employee + Family | $1,752 |
| Family Health Clinic | |
| Employee | $267 |
| Employee + 1 Child | $531 |
| Employee + Spouse | $531 |
| Employee + Children | $799 |
| Employee + Family | $799 |
