Cigna OAP

The OAP plan allows you and your family to receive care from any provider or hospital, and you must first pay a deductible before the plan pays.

Video walkthrough

Coming soon for Cigna OAP

Plan Details

Premiums

Coverage Details

DFW Contributions - Per Individual
Network
N/A
Non-Network
N/A
DFW Contributions - Per Family
Network
N/A
Non-Network
N/A
Annual Deductible (Excludes Prescription Copayments) - Per Individual
Network
$600
Non-Network
$1,200
Annual Deductible (Excludes Prescription Copayments) - Per Family
Network
$1,200
Non-Network
$2,400
Annual Out-of-Pocket Limit (Includes the Deductible, Copays, and Coinsurance) - Per Individual
Network
$2,600
Non-Network
$5,200
Annual Out-of-Pocket Limit (Includes the Deductible, Copays, and Coinsurance) - Per Family
Network
$5,200
Non-Network
$10,400
Coinsurance/Copayments - Preventive Care
Network
100% covered
Non-Network
40%*
Coinsurance/Copayments - LW Clinic Visit
Network
100% covered
Non-Network
N/A
Coinsurance/Copayments - Office Visits
Network
20%*
Non-Network
40%*
Coinsurance/Copayments - Specialist Office Visits
Network
20%*
Non-Network
40%*
Coinsurance/Copayments - Outpatient Surgery
Network
20%*
Non-Network
40%*
Coinsurance/Copayments - Hospitalization and Inpatient Surgery
Network
20%*
Non-Network
40%*
Coinsurance/Copayments - Mental Health (Inpatient/Outpatient)
Network
20%*
Non-Network
40%*
Coinsurance/Copayments - Virtual visits powered by MDLive Medical and Behavioral Mental Health
Network
$0 copayment
Non-Network
N/A
Coinsurance/Copayments - Urgent Care Facility
Network
20%*
Non-Network
40%*
Coinsurance/Copayments - Emergency Room
Network
20%*
Non-Network
20%*
Coinsurance/Copayments - Ambulance
Network
20%*
Non-Network
20%*

Benefit	Network	Non-Network
DFW Contributions - Per Individual	N/A	N/A
DFW Contributions - Per Family	N/A	N/A
Annual Deductible (Excludes Prescription Copayments) - Per Individual	$600	$1,200
Annual Deductible (Excludes Prescription Copayments) - Per Family	$1,200	$2,400
Annual Out-of-Pocket Limit (Includes the Deductible, Copays, and Coinsurance) - Per Individual	$2,600	$5,200
Annual Out-of-Pocket Limit (Includes the Deductible, Copays, and Coinsurance) - Per Family	$5,200	$10,400
Coinsurance/Copayments - Preventive Care	100% covered	40%*
Coinsurance/Copayments - LW Clinic Visit	100% covered	N/A
Coinsurance/Copayments - Office Visits	20%*	40%*
Coinsurance/Copayments - Specialist Office Visits	20%*	40%*
Coinsurance/Copayments - Outpatient Surgery	20%*	40%*
Coinsurance/Copayments - Hospitalization and Inpatient Surgery	20%*	40%*
Coinsurance/Copayments - Mental Health (Inpatient/Outpatient)	20%*	40%*
Coinsurance/Copayments - Virtual visits powered by MDLive Medical and Behavioral Mental Health	$0 copayment	N/A
Coinsurance/Copayments - Urgent Care Facility	20%*	40%*
Coinsurance/Copayments - Emergency Room	20%*	20%*
Coinsurance/Copayments - Ambulance	20%*	20%*

* After deductible
New enrollments are not allowed for the 2026 plan year. If you're currently enrolled in the OAP plan, you can keep your coverage for 2026 — your enrollment will automatically carry over unless you make a change.

Pharmacy Benefits

Retail Rx (up to 30-day supply)
You Pay
Retail Rx - Tier 1 Generic Drugs
You Pay
$5 copayment
Retail Rx - Tier 2 Brand-name drugs (on the Preferred Drug List)
You Pay
$30 copayment
Retail Rx - Tier 3 Brand-name drugs (not on the Preferred Drug List)
You Pay
$60 copayment
Retail Rx - Tier 4 Specialty retail drugs (injection, infused or oral)
You Pay
$100 copayment (30-day supply)
Mail Order Rx (31 to 90-day supply)
You Pay
Mail Order Rx - Tier 1 Generic Drugs
You Pay
$10 copayment
Mail Order Rx - Tier 2 Brand-name drugs (on the Preferred Drug List)
You Pay
$60 copayment
Mail Order Rx - Tier 3 Brand-name drugs (not on the Preferred Drug List)
You Pay
$120 copayment
Mail Order Rx - Tier 4 Specialty mail order drugs (injection, infused or oral)
You Pay
$100 copayment (30-day supply)

Tier	You Pay
Retail Rx (up to 30-day supply)
Retail Rx - Tier 1 Generic Drugs	$5 copayment
Retail Rx - Tier 2 Brand-name drugs (on the Preferred Drug List)	$30 copayment
Retail Rx - Tier 3 Brand-name drugs (not on the Preferred Drug List)	$60 copayment
Retail Rx - Tier 4 Specialty retail drugs (injection, infused or oral)	$100 copayment (30-day supply)
Mail Order Rx (31 to 90-day supply)
Mail Order Rx - Tier 1 Generic Drugs	$10 copayment
Mail Order Rx - Tier 2 Brand-name drugs (on the Preferred Drug List)	$60 copayment
Mail Order Rx - Tier 3 Brand-name drugs (not on the Preferred Drug List)	$120 copayment
Mail Order Rx - Tier 4 Specialty mail order drugs (injection, infused or oral)	$100 copayment (30-day supply)

DFW’s plan is a mandatory generic plan. If you choose a brand-name drug when a generic is available, you will pay the difference in cost between the generic and brand-name drug plus the applicable brand copayment.

Prescription drug coverage is administered through Cigna and Express Scripts.
Preventive medications are available at a $0 copayment.
Maintenance medications can be delivered to your home through Express Scripts Pharmacy (800-835-3784).