Highlights

Plan benefits are offered through a network of participating healthcare providers (for example, doctors, hospitals, labs, and outpatient facilities).
Even though there is an out-of-network benefit available, JPMorganChase strongly encourages you to stay in-network. Selecting out-of-network providers and services cost more for all employees and JPMorganChase. Selecting in-network providers and services will reduce your out-of-pocket costs.
For in-network care:
For most routine services, such as primary care and specialist office visits, basic labs, urgent care, emergency room care, etc., you pay only the copay — a fixed dollar amount — associated with each covered service.
Less routine services, such as inpatient hospitalization or outpatient surgery, are subject to the annual deductible, then coinsurance.
You are not required to select or assign a Primary Care Physician.
You do not need referrals to see a specialist.
Important: In-network preventive care, including physical exams and recommended preventive screenings, is covered at 100% with no copays; and in-network primary care and mental healthcare office visits are covered after a $15 copayment.
Primary care providers include family practitioners, internists, pediatricians, OB/GYNs, nurse practitioners and Convenience Care Clinics. Internists must be contracted with Aetna or Cigna as a Primary Care Physician (PCP).
Mental healthcare providers include psychologists, therapists, psychiatrists, and social workers.
Go to My Health > My Medical Plan Website to search for in-network providers.

For employees living in Florida, Georgia, Louisiana and Oklahoma, go to My Health > Access Aetna/Cigna Medical Benefits through Included Health to search for in-network providers.
The plan's out-of-pocket maximum — your financial "safety net" — limits the total amount you are required to pay out-of-pocket each year. Note that there are separate out-of-pocket maximums for in-network and out-of-network charges. In addition, there is a separate out-of-pocket maximum for prescription drugs.
Out-of-network information:
Benefits for out-of-network care are subject to a separate, higher deductible and coinsurance.
You must meet an annual deductible before the coinsurance applies for most covered services.
There is a separate, higher out-of-pocket maximum for eligible out-of-network charges.
Benefits for out-of-network care are limited to reasonable and customary (R&C) charges after you meet the out-of-network deductible. These R&C charges are based on average claims data in your area and are determined by your healthcare company to be appropriate fees for medical services. You are responsible for any amount above the R&C charges. This can result in significant out-of-pocket expenses for you.
It's important to understand that if you are using out-of-network providers (doctors, facilities or other service providers), it is your responsibility to check with your healthcare company to see if there is a prior authorization or medical necessity requirement that you need to meet before receiving any out-of-network treatment, service or procedure. Otherwise, the treatment, service or procedure may not be covered by the Plan and you will be responsible for the full cost.
Prescription drug copays are based on the drug category and where you fill your prescription. Covered preventive generic and brand drugs are covered at 100% with no copay.
Plan Option 1 and Plan Option 2 are paired with a Medical Reimbursement Account (MRA) you can use to help pay for covered out-of-pocket medical and prescription drug expenses. The MRA is funded by JPMorganChase when you take action and complete designated wellness activities. Employees cannot contribute funds to an MRA.