01/01/2026 ASO Open Access Plus HDHPQ - HDHPQ 3500 Proclaim - 37302326 - V 33 - 10/20/25 05:17 PM ET 13 of 17 ©Cigna 2025 Additional Information One Guide Available by phone or through myCigna mobile application. One Guide helps you navigate the health care system and make the most of your health benefits and programs. Premium Personal Health Team The Premium Personal Health Team is a designated and integrated service delivery approach using a one health advocate model. Core functions include: Case Management - Short term and complex Inpatient Advocacy Pre Admission Outreach Post Discharge Outreach 24 hour Health Information Line Outreach Care Facility - N/A Pre-Certification - Continued Stay Review - Preferred Care Management Inpatient - required for all inpatient admissions In-Network: Coordinated by your physician Out-of-Network: Customer is responsible for contacting Cigna Healthcare. Subject to penalty/reduction or denial for non-compliance. $750 penalty applied to hospital inpatient charges for failure to contact Cigna Healthcare to precertify admission. Benefits are denied for any admission reviewed by Cigna Healthcare and not certified. Benefits are denied for any additional days not certified by Cigna Healthcare. Pre-Certification - Preferred Care Management Outpatient Prior Authorization - required for selected outpatient procedures and diagnostic testing In-Network: Coordinated by your physician Out-of-Network: Customer is responsible for contacting Cigna Healthcare. Subject to penalty/reduction or denial for non-compliance. $750 penalty applied to outpatient procedures/diagnostic testing charges for failure to contact Cigna Healthcare and to precertify admission. Benefits are denied for any outpatient procedures/diagnostic testing reviewed by Cigna Healthcare and not certified. Pre-Existing Condition Limitation (PCL) does not apply. Treatment Decision Support Treatment decision support for common health conditions. Cigna health advocates provide unbiased information and education on treatment options for common health conditions, including: back pain, coronary artery disease, osteoarthritis of the hip and knee, benign uterine conditions, breast cancer and prostate cancer. Included Well-Being Solution: Core Plus Health assessment Device/app integration Personalized online content and data-driven actions Social connections/challenges Incentive administration
2026 Cigna Health Plan Benefit Summary HDHP 3500 Page 12 Page 14