PPO Health Plan Change from Cigna to Moda FAQ

Why is the County making this change? 
Last year, the County selected a new vendor for its self-insured Preferred Provider Organization (PPO) and partnered with CIGNA for benefits administration. This decision was made after a long and thorough competitive bidding process. We fully anticipated encountering and working through any issues, as we would under any new arrangement. However, our experience in being unable to resolve issues with CIGNA over the last nine months has caused us to rethink continuing this partnership.

We continue to hear from many employees who have struggled with customer service, including the pre-authorization process, ensuring their providers were covered by the plan (this is particularly true with behavioral health providers), and many other issues. This change should not impact those who are on Kaiser plans. 

Our goal is to provide excellent insurance coverage for County employees and we believe this step will help us achieve that.

When will the change be effective?
January 1, 2023. 

Will this change be part of Open Enrollment for next year? 
Yes, if you are currently on a Cigna plan and not moving to Kaiser, the change from Cigna to Moda will happen automatically for you. If you move from Kaiser to Moda, the change will be effective January 1, 2023. However, we strongly encourage you to review your benefits every year and finalize your Open Enrollment event in Workday to confirm all of your enrollments. 

Will our medical plans be changing?
Moda will offer the same plans we have with Cigna. There may be some minor changes in how they administer a specific area of coverage, but the same overall level of benefits will be maintained. 

Will Moda also provide pharmacy benefits?
No, pharmacy benefits will remain with WellDyne. 

Will my dental plan with Delta Dental and my vision plan with Vision Service Plan (VSP) change? 
No, the dental and vision plans will stay with Delta Dental and VSP. 

Will I receive new ID cards? When?
Yes, if you will have Moda medical coverage in 2023, you should receive your new member cards from Moda on or before 1/1/2023, which will be used for medical and pharmacy benefits. Remember that VSP does not have ID cards; your provider confirms coverage with your personal information. 

Are my providers in-network with Moda?
Remember, you must use providers within Moda’s network to receive the highest level of benefits under your plan for most services. Moda has a very robust network called Connexus. 

Can I look up my providers today in Moda’s network?
You can go online to the Moda provider directory and search by network, choose “Connexus.” You can search for a specific provider by name, or narrow results by selecting type, specialty, location, etc. to find a provider. If you find your provider in the provider directory, then they are in the network.

Does my deductible start over again on 1/1 of each new year?
In moving from Cigna to Moda, deductible amounts applied in the last quarter of 2022 will carry over to help satisfy the 2023 deductible. This is true each year, not just for the transition from Cigna to Moda. 

How can I get more information? 
We will be updating this page with more information as it becomes available. Full details about this change and updated rates will be provided prior to Open Enrollment.

Who can I contact with questions/concerns about this change? If I have issues with Cigna? 
The benefits team is here to help you! Contact us at employee.benefits@multco.us. You can also leave us a message at 503-988-3477. Or, come by our office at 501 SE Hawthorne - Suite 300. We’re in the office from 7:30am to 5:00pm Tuesday, Wednesday and Thursday.

How will my out-of-state dependent child access in-network providers?
Moda has contracted with Aetna to provide out-of-state dependent children with access to a national network of providers. If your dependent child lives outside of the Moda Oregon and SW Washington service district, you can provide Moda with your child's out-of-state address to gain access to Moda's national network of providers through Aetna. Please reference the Moda Out-of-State Dependents brochure for details about notifying Moda of your child's out-of-state address and accessing the Aetna national network. 
 

I am a retiree who lives outside the Moda Oregon and SW Washington service district. How will I access in-network providers?
Moda has contracted with Aetna to provide members who live outside of the Moda service district with access to a national network of providers. Access to the national network is contingent on having an address on file that is outside of the Moda Oregon and SW Washington service district. Please reference the  Moda Retiree National Network Brochure (220.62 KB) for details about accessing the Aetna national network. 

What is the difference between Moda’s national network of providers and the Moda travel network?
Moda’s national network of providers through Aetna is only available to employees, retirees, Cobra participants and out-of-state dependent children who reside outside of the Moda Oregon and SW Washington service district. The national network provides these individuals with access to a countrywide network of doctors, pharmacies and facilities through Aetna, so they can continue to receive in-network care while living outside of Oregon and SW Washington. In contrast, the Moda Health travel network allows you to receive urgent and emergent care outside of your primary service area while traveling. If you live in Idaho or Alaska, you must seek care from Connexus or PHCS providers for in-network care while traveling. If you live in another state, you must seek care from an Aetna PPO provider while traveling. The Moda Health travel network is not an alternative primary network. Members must seek in-network services whenever possible, and pre-authorization is required for inpatient services.