Each network tier has a different cost-sharing arrangement. You and your covered family members choose which tier to use each time you seek care:
Intermountain Health Peaks region (SCL Health Tier 1)
So what is a Tier 1 provider?
For our Cigna plans, Tier 1 is essentially our legacy SCL Health providers, hospitals, and medical centers. It also includes Children’s Hospital Colorado and select providers and facilities who partner with us to deliver care. For Kaiser EPO participants (Front Range only), Tier 1 is providers and facilities within the Kaiser Permanente of Colorado network.
You will save the most when you receive care or services from the Tier 1 Network. We are in the healthcare business, so we can deliver both exceptional care and a better ability to control cost. This means you receive the highest level of benefits when you use Tier 1 providers and facilities. Some of these features include lower copays for physician/specialist oﬃce visits (when applicable), lower deductibles, lower coinsurance, and lower out-of-pocket maximums.
"Find Care" at myCigna.com online or via the myCigna app. To access this updated search platform that shows the Tier 1 designation, offers improved quality and a better customer experience, login to your myCigna.com account and click on "Find Care".
Note: Kaiser members, Tier 1 applies to select SCL Health Hospitals/Facilities.
Network (Tier 2)
For Cigna members the Open Access Plus network of providers and facilities have agreed to our plan’s negotiated rates. Your deductible, coinsurance, and copays are lower than when using an out-of-network provider.
For Kaiser members, you must stay within the exclusive network of providers offered through Kaiser to receive any network benefit.
Out-of-Network (Tier 3)
For Cigna members, if you receive care from a provider who is not a part of the networks described above, your services may not be discounted, and you could be billed the difference between what the SCL Health plan pays and what the provider chooses to charge. Seeing providers outside of the Tier 1 and Cigna networks will cost you the most out-of-pocket.
For Kaiser members, there is no out-of-network coverage available, and you will be charged 100% of the billed rate that the provider charges for services sought.