The information on this page is for SelectTime employees. If you’re a seasonal employee, see which benefits you’re eligible for. If you’re a regular employee, visit the benefits site for you.

Medical

The Cigna Select PPO plan provides a range of benefits to cover your health care needs, including prescription drugs, immunizations, vaccines, and hospital stays.

If you live in Hawaii, you are eligible to enroll in the Kaiser Hawaii HMO medical plan.

Eligibility

SelectTime employees. Seasonal employees are included in a 12-month measurement period to determine health care benefit eligibility.

How It Works

How to Enroll

See how to enroll in benefits.

How to Get Started

Cigna Select PPO Summary of Benefits

Plan Feature Cigna Select PPO
In-Network
Cigna Select PPO
Out-of-Network

Plan-Year Deductible
(August 1–July 31)

$750 individual
$1,500 family

$1,500 individual1
$3,000 family

Plan-Year
Out-of-Pocket Maximum
(August 1–July 31)

$3,250 individual
$6,650 family

$6,500 individual2
$13,300 family

Coinsurance Plan pays 80% after deductible Plan pays 60% after deductible
Preventive Care Plan pays 100% $30 copay, then plan pays 60%
Office Visits
(PCP/specialist)
$30 copay, then plan pays 100% $30 copay, then plan pays 60%
Inpatient Care Plan pays 80% after deductible Plan pays 60% after deductible
Outpatient Care Plan pays 80% after deductible Plan pays 60% after deductible
Emergency Room
(waived if admitted)
$250 copay $250 copay

1 After each eligible member meets his or her individual deductible, covered expenses for that family member will be paid based on the benefit level that are within reasonable and customary charges. Or once the family deductible is met, covered expenses for each family member will be paid based on the benefit level that are within reasonable and customary charges.

2 After each eligible member meets his or her individual out-of-pocket maximum, the plan will pay 100% of their covered expenses that are within reasonable and customary charges. Or once the family out-of-pocket maximum is met, the plan will pay 100% of each eligible member’s covered expenses that are within reasonable and customary charges.

Cigna Select PPO Paycheck Deductions

Coverage Level Per-Paycheck Cost
Employee Only $69
Employee + Spouse/Domestic Partner $224
Employee + Children $172.25
Employee + Family $275.75

Kaiser Hawaii HMO Summary of Benefits

Plan Feature Kaiser Hawaii HMO
In-Network
Kaiser Hawaii HMO
Out-of-Network

Plan-Year Deductible
(August 1–July 31)

$0 individual
$0 family

Not Covered

Plan-Year
Out-of-Pocket Maximum1
(August 1–July 31)

$2,500 individual
$7,500 family

Not Covered

Coinsurance N/A Not Covered
Preventive Care No Charge Not Covered
Office Visits
(PCP/specialist)
$20 copay Not Covered
Inpatient Care Plan pays 90% Not Covered
Outpatient Care Plan pays 90% Not Covered
Emergency Room $100 copay Limited initial visit only. Must notify KP within 48 hours if admitted to a non-plan provider

1 After each eligible member meets his or her individual out-of-pocket maximum, the plan will pay 100% of their covered expenses. Or once the family out-of-pocket maximum is met, the plan will pay 100% of each eligible member’s covered expenses.

Kaiser Hawaii HMO Prescription Benefits

  Kaiser Hawaii HMO
Annual Out-of-Pocket Maximum Prescription amounts count toward medical plan out-of-pocket maximum
Retail (per 30-day supply)
Preferred Generic $10 copay
Preferred Brand $35 copay
Non-preferred Brand $35 copay
Mail Order (per 90-day supply)
Preferred Generic $20 copay
Preferred Brand $70 copay
Non-preferred Brand $70 copay

Kaiser Hawaii HMO Paycheck Deductions

Coverage Level Per-Paycheck Cost
Employee Only $12.75
Employee + Spouse/Domestic Partner $127.58
Employee + Children $104.62
Employee + Family $242.42

If you are a resident of Hawaii and you plan to waive coverage you must make the election to waive during your enrollment and you must complete the Form HC-5 Notification to Employer to waive coverage and submit to Employee Benefits.

Common Questions

How do I enroll in medical benefits?

Resources

Form HC-5 Notification to Employer to Waive Coverage

Where to Get Help

HR Connect
Phone 
1-800-819-1620
Visit website
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Cigna
Plan/Group Number 
#3331771
Phone 
1-800-244-6224
Visit website

Kaiser Hawaii HMO (Hawaii residents only)
Plan/Group Number 
10763
Phone 
1-808-432-5955
Visit website