Employee Benefits Guide 2026

2026 Medical Plan Updates

Michiana Eye Center is excited to provide a reduction to most premiums in 2026, while also reducing some deductibles and out of pocket maximums. When deciding on which plan to choose, it's important to consider these questions:

How much health care do I anticipate needing this plan year?
Will I need major treatments or hospital stays?
Do my family members or I have a chronic condition requiring regular provider visits or medication?
Do I value paying less per-paycheck for my coverage, or do I appreciate the piece of mind of less out-of-pocket costs?

New Medical Premiums

These premiums are withdrawn on a bi-weekly basis. For monthly employees, please multiply the below figures by 2.1667x

	$1000/$3000 PPO	$2000/$5000 PPO	$2500/$5000 HDHP
Individual	$138.46	$83.08	$46.15
Individual + Child(ren)	$290.77	$207.69	$126.92
Individual + Spouse	$353.08	$270.00	$161.54
Family	$463.85	$353.08	$230.77

If you are a Medicare A participant, enrolled in Tricare, or have any other medical coverage, you are not eligible for a Health Savings Account (HSA).

ALL PLANS OFFER:

100% Covered in-network preventive care

Access to the same providers via the Cigna network

Prescription drug coverage through CVS/ Caremark

THE MAIN DIFFERENCES:

	PPO	HDHP
How you pay for services	Copays for many services	Negotiated rate for services until you reach your deductible, then 20%
Prescription Drugs	Copays for prescription drugs	Negotiated rate for drugs until you reach your deductible, then 20%
HSA Eligibility	This plan makes you ineligible for a HSA	Self-contribute pre-tax $4,400 annually or $8,750 with family coverage

SWITCHING TO A HDHP PLAN CAN
SAVE YOU MORE THAN YOU THINK!

Invest these savings into a HSA and keep your hard earned money, or spend from the fund as you need to for qualified medical expenses

	Premium Savings vs $1000 PPO	Premium Savings vs $2000 PPO
Individual	$2,400 / year	$960 / year
Family	$6,060 / year	$3,180 / year

PLAN COMPARISON:

		$1000/$3000 PPO	$2000/$5000 PPO	$2500/$5000 HDHP
Preventive Care		100%, no deductible	100%, no deductible	100%, no deductible
Deductible	In-Network	$1,000 individual $3,000 embedded family	$2,000 individual $5,000 embedded family	$2,500 individual $5,000 aggregate family*
	Out-of-Network	$2,000 individual $6,000 embedded family	$4,000 individual $10,000 embedded family	$5,000 individual $20,000 aggregate family*
Coinsurance	In-Network	20% after deductible is reached	20% after deductible is reached	20% after deductible is reached
	Out-of-Network	40% after deductible is reached	40% after deductible is reached	40% after deductible is reached
Out of Pocket Max	In-Network	$3,500 individual $7,000 embedded family	$4,500 individual $9,000 embedded family	$5,000 individual $10,000 aggregate family*
	Out-of-Network	$7,000 individual $14,000 embedded family	$9,000 individual $18,000 embedded family	$10,000 individual $20,000 aggregate family*
Primary Care Copay	In-Network	$20 copay/office visit, deductible does not apply	$25 copay/visit, deductible does not apply	Cigna allowed amount, 20% coinsurance after deductible
	Out-of-Network	40% coinsurance after deductible	40% coinsurance after deductible	40% coinsurance after deductible
Specialist Copay	In-Network	$20 copay/visit, deductible does not apply	$25 copay/visit, deductible does not apply	Cigna allowed amount, 20% coinsurance after deductible
	Out-of-Network	40% coinsurance after deductible	40% coinsurance after deductible	40% coinsurance after deductible
ER Visit	In-Network	$250 copay	$250 copay	20% coinsurance after deductible

Prescription Drugs	Generic	$15 copay	$15 copay	CVS/Caremark allowed amount, 20% coinsurance after deductible
	Tier 2 / 3	$45 copay / $75 copay	$45 copay / $75 copay	CVS/Caremark allowed amount, 20% coinsurance after deductible

*aggregate family: Under the new aggregate-family deductible, the entire family works together toward one shared family deductible of $5,000. Once the total family deductible is met, all family members receive benefits. This structure allows us to offer a significantly lower family deductible while keeping the plan HSA-eligible.