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Get The Most From Your Benefits

Benefits only create value when people understand how to use them. So this isn't a filing cabinet — it's a guide, and there's a real person at the end of every phone number on this page.

Section 02

Understanding Your Benefits

Six things worth ten minutes of your time. Knowing how these work is the difference between a $20 copay and a $2,000 bill.

The one-paragraph version. You're on a self-funded plan using the Cigna nationwide PPO network. Securus is your care team and the name on your ID card. DisclosedRx handles prescriptions. In network, preventive care and virtual care are $0. Most other care is either a flat copay or coinsurance after you meet your deductible. Out of network costs roughly double — so the single most valuable habit you can build is checking the network before you book.

Medical Coverage

Your deductible, out-of-pocket maximum, and what every service costs — for all eight PPO plans. Pick your plan and the page adjusts to you.

See my plan summary

Prescription Coverage

Four retail tiers starting at a $15 generic copay, plus mail order for anything you take regularly. DisclosedRx at 888-589-3340 — ask for a Prescription Navigator if a price looks high. Ask the Plan Assistant whether a specific medication is on the formulary — it can tell you the tier and whether prior authorization applies.

  • 2026 Premier Formulary — check your drug's tier
  • Mail order & Retail 90 for maintenance meds
  • Specialty pharmacy & copay card assistance
Open the formulary

Preventive Care

$0 in network on every plan, and you don't have to meet your deductible first. Annual physicals, screenings, immunizations. This is the cheapest care you'll ever get — use it.

What counts as preventive

Mental Health

Outpatient therapy is covered at the same cost as a regular office visit on most plans — a flat copay, not a percentage. Inpatient behavioral health is covered as coinsurance after deductible.

See mental health costs

Virtual Care

$0, every plan, 24/7/365. Powered by Evo by Fabric — and it covers more than urgent care: talk therapy and mental health medication management too, for adults and children. Reach it through the Securus Member Portal.

Open virtual care

External Programs

Fertility pharmacy, GLP-1 weight-loss medication and clinical weight loss are offered by outside organizations alongside the plan — not through Triad, and not automatically available. Check with HR before you start.

See wellbeing programs

What Counts As Preventive Care

"Preventive care" has a specific legal meaning here — it isn't a judgment call your provider makes. This plan is intended to comply with the Affordable Care Act's requirement to cover certain preventive services without cost-sharing: no copay, no coinsurance, and no need to meet your deductible first. What qualifies comes from national recommendations published by the U.S. Preventive Services Task Force, the Health Resources and Services Administration, and the Centers for Disease Control and Prevention — not from the plan.

What The Law Requires The Plan To Cover

  • Evidence-based items or services rated A or B in the U.S. Preventive Services Task Force recommendations
  • Immunizations recommended by the Advisory Committee on Immunization Practices and adopted by the Director of the CDC
  • HRSA comprehensive guidelines for infants, children and adolescents
  • HRSA comprehensive guidelines for women

Because these lists are updated nationally, what counts as preventive can change from year to year without your plan design changing at all.

Covered At No Cost To You

  • Annual routine physical
  • Annual well woman exam — including screenings, contraceptive methods, breastfeeding support, supplies and counseling
  • Pediatric exams and routine immunizations
  • Vision exams for dependents under age 19

Adult routine vision: members age 21 and over are covered for one routine exam per year, at whatever your plan design applies — a copay or the deductible. Note that Cigna uses the EyeMed network for routine vision exams, so check that your provider participates. Your Summary Plan Description has the full detail.

See preventive care on your plan

One thing worth knowing before you go: a visit that starts as preventive can pick up charges if your provider treats something in the same appointment. If you want it billed as preventive, say so when you book and ask the office to confirm the service is on the preventive list.

The Official Recommendations And Guidelines

These are the source lists the plan follows. If you want to know whether a specific screening is covered at no cost, this is where to look.

Section 03

Save Money On Healthcare

On a self-funded plan, the money saved is your money — it stays in the plan and holds your rates down next year. These are the seven levers you personally control.

1

Stay in the Cigna network

The biggest one by far. Out of network your deductible roughly doubles, coinsurance jumps to 40–50% after deductible, and the provider can bill you for whatever the plan doesn't allow. Two minutes in the directory saves four figures.

2

Use $0 virtual care first

Virtual care is $0 on every plan, 24/7/365. Urgent care runs $40–$100 and the ER is coinsurance after deductible. For anything that doesn't need hands on you, start virtual.

3

Urgent care instead of the ER

The emergency room is for emergencies. For a sprain, a cut, or a fever at 9pm, urgent care is a flat copay while the ER is a percentage of a much larger bill. If you're unsure, call Securus at 877-420-0785 and ask.

4

Ask for the generic, every time

Retail Tier 1 is $15 on every plan. Tier 3 runs $85–$100 and Tier 4 is 50% coinsurance. Ask your prescriber directly: "is there a generic or a Tier 1 option?"

5

Move maintenance meds to mail order

Anything you take every month should be on mail order or Retail 90 through DisclosedRx or PPS Rx. Fewer trips, and on the PPO $5000 HSA plan Tier 1 mail order drops to $30.

6

Call a Prescription Navigator before you accept a high price

This is the most underused benefit on the plan. DisclosedRx at 888-589-3340 has people whose entire job is finding a covered alternative, a copay card, or a manufacturer program. Call before you pay.

7

Shop imaging and labs — the price range is enormous

An MRI can vary by thousands of dollars between two in-network facilities a few miles apart, for the identical scan. Before you book complex imaging, call Securus and ask where the lower-cost in-network option is.

8

Take your free preventive care

$0, no deductible, every plan. Annual physicals, screenings and immunizations catch expensive problems while they're still cheap ones. Skipping them is the most costly saving there is.

Not sure which applies to your situation? Ask the Plan Assistant or call the Securus care team at 877-420-0785.

The DisclosedRx Savings Program

If you take an expensive brand-name or specialty medication, this is the call to make. DisclosedRx runs a savings program with three routes to a lower price, and a person — called a Savings Advocate — who stays with you rather than handing you off. They do the paperwork chasing, including contacting your prescriber. Reach them at 480-690-5091, Monday to Friday 8am–8pm Eastern, or savings@disclosedrx.com.

1 · Patient Assistance Programs

Manufacturer-sponsored programs that provide the medication at no cost if you qualify — including drugs your plan doesn't cover. DisclosedRx guides the application and handles the provider paperwork. Expect to supply things like photo ID, tax documents, a signed application and a release of information.

If you're eligible, this is the first stop — it saves the most, for you and the plan, so the program checks here first.

2 · Alternative Sourcing

The same brand-name medication obtained through licensed international and 340B domestic pharmacies at a much lower cost. You pay $0 — no copay, no deductible — and it is delivered to your door. DisclosedRx manages the prescription, refills, ordering and shipment tracking.

Nothing from this route is added to your deductible or out-of-pocket maximum, because the plan's saving covers the drug in full.

3 · Manufacturer Copay Cards

If your medication has a copay card, DisclosedRx finds it, helps you enroll, contacts the pharmacy, and makes sure it is applied every time rather than just the first fill. You can also get a card yourself from the manufacturer's website — the Savings Advocates will help you locate it.

Before You Enroll — The Practical Details

Who Qualifies For Alternative Sourcing

You need to have been taking an approved brand or specialty medication for at least 30 days, and the first fill must come from a domestic pharmacy — new prescriptions aren't eligible. A medication already denied by the DisclosedRx clinical review team can't be routed through this program.

What Enrollment Takes

A copy of the front and back of your unexpired photo ID, and for some cold-chain medications a signed enrollment form. That's it — DisclosedRx handles the rest. If shipping to your home won't work, they'll help you find another way.

You Keep Control

You can opt out at any time, and in an emergency you can always fill at a domestic pharmacy. Switching to a new pharmacy benefit manager? If you already hold an approved prior authorization, DisclosedRx can extend a grace period of up to 60 days while they obtain the paperwork, so your fills don't stop.

Eligible medications are typically high-cost brand and specialty drugs — the member letter gives examples, and DisclosedRx confirms whether yours qualifies. Medications sourced internationally come from licensed pharmacies in countries the FDA recognizes as having equivalent regulatory standards, in manufacturer-sealed packaging.

Savings Program brochure Read the full FAQ

Section 05

Wellness & Wellbeing

Two of these come with your plan. The rest are separate organizations offering programs alongside it — read the difference before you assume something is available to you.

Included With Your Plan

Available to every member on the Triad program, at the cost shown. Nothing to sign up for.

External Programs — Not Part Of Triad

These are separate organizations, not Triad programs. They are offered alongside the health plan, not through it, which means they are not automatically available to you. Whether you can use one depends on what your employer has arranged. Eligibility, pricing and terms are set by each organization rather than by the plan, and using one is not a plan benefit and does not run as a claim. Check with your HR team or your Benefit Consultant before starting with any of them.

If something on this list isn't confirmed for your employer, it may not be open to you and the plan can't extend it. Ask HR before you start an intake — that's a faster answer than finding out at the end of one.

Section 06

Frequently Asked Questions

Organized by what you're actually trying to do. If your question isn't here, the Plan Assistant in the corner can probably route you — and if it can't, it'll tell you rather than guess.

Eligibility

Can I join the plan in the middle of the year?
Only with a qualifying life event. There are four accepted reasons: loss of other coverage, Medicaid or Medicare ineligibility, legal mandate, and a move from part-time to full-time. If you qualify through one of these, you do not serve the new-hire waiting period. Start with your HR team.
When does my coverage start as a new hire?
New hires serve a waiting period set by your employer. The length of that waiting period and your exact effective date both come from your employer — confirm them with your HR team. We won't guess at your date here.
What is the plan year?
It depends on your employer. Each employer sets its own plan year when it joins the program, and a plan year can begin on the first of any month — so plan years vary from one employer to the next. Ask your HR team for your dates.

What matters for you: deductibles and out-of-pocket maximums reset at the start of your plan year. If you've already met your deductible and you're planning a procedure, finishing it before your reset date usually costs you less.
If I start mid-month, what comes out of my paycheck?
That's set by your employer, not by the plan. How much is deducted and which paycheck it starts on follow your employer's payroll schedule and how they've set up benefit deductions. Ask your HR or payroll team — they can tell you the exact amount and timing for your first deduction.

Claims

My claim was denied. What do I do?
Call the Securus care team at 877-420-0785 first — a large share of denials are coding or processing errors they can correct directly. If that doesn't resolve it, contact your employer's Benefit Consultant — they escalate denials on your behalf. A denial is not always final.
Do I need prior authorization before a procedure?
Some services do. Medical precertification runs through Cigna at 866-494-4872 and is usually initiated by your provider — but confirm it happened before your appointment. Prescription prior authorizations go through DisclosedRx at 888-589-3340.
What happens if I go out of network?
Your deductible roughly doubles, coinsurance rises to 40–50% after deductible, virtual care isn't covered at all, and the provider can bill you for the difference between their charge and what the plan allows. The one exception is the emergency room, which is covered at the in-network level wherever you go.
How do I know what a service will cost before I get it?
Check the plan summary for your plan's copay or coinsurance, then call Securus at 877-420-0785 and ask for an estimate at the specific facility. Prices for the same in-network service vary a lot between facilities — especially imaging and labs — so it's worth asking where the lower-cost option is.

Prescriptions

Who manages my prescriptions?
DisclosedRx is the pharmacy benefit manager. Member Services: 888-589-3340 or care@disclosedrx.com. They handle mail order, Retail 90, specialty pharmacy, prior authorizations and copay card assistance.
Is my medication covered?
Check the 2026 Premier Formulary. If your drug isn't listed, call 888-589-3340 and ask for a Prescription Navigator — their job is finding a covered alternative or a lower price.
What are the prescription copays?
Retail Tier 1 is $15 on every plan. Tier 2 is $45 or $65 depending on plan, Tier 3 is $85 or $100, and Tier 4 is 50% coinsurance. On the two HSA plans, all tiers apply after you meet your deductible. Mail Order Tier 4 is not covered on any plan. See your exact tiers.
How do I get a 90-day supply delivered?
Use mail order through DisclosedRx or Postal Prescription Services (PPS Rx), a Kroger company and the preferred mail-order pharmacy for maintenance medications. Call 888-589-3340 to set it up.
My specialty medication is unaffordable. Is there help?
Yes, and this is worth a call before you pay anything. Ask about the DisclosedRx Savings Program — patient assistance programs, alternative sourcing and copay cards. Call a Savings Advocate on 480-690-5091, weekdays 8am–8pm Eastern. If you're still stuck after that, your Benefit Consultant can escalate.

Dependents

How do I add a new baby, spouse or child?
A birth, adoption or marriage is a qualifying life event. Tell your HR team as soon as you can and complete the Enrollment & Change Form. Don't wait — qualifying-event windows are limited.
Are my children's dental and vision covered?
Children's eye exams are $0 in network. Children's eyeglasses and children's dental check-ups are not covered under the medical plan on any of the eight plans. Ask your HR team whether your employer offers separate dental or vision coverage.
How do I remove a dependent?
Through your HR team using the Enrollment & Change Form, tied to a qualifying life event. Coverage termination timing follows the plan's rules — Securus at 877-420-0785 can confirm the exact date coverage ends.

Open Enrollment

When is open enrollment?
Open enrollment dates are set with your employer each year. Your HR team will announce yours — and the plan provides the communication materials they send you. If you haven't heard anything and the plan year is approaching, ask HR or email us.
What should I actually think about when picking a plan?
Three questions. One: what did you actually spend on care last year? Two: do you take regular prescriptions, and what tier are they? Three: would you rather pay more monthly and less when you use care, or the reverse? The plan summary lets you compare all eight side by side, and your Apex team will walk through it with you.
What's the difference between the HSA plans and the others?
On the PPO $3500 HSA and PPO $5000 HSA, copays apply only after you meet your deductible — that's what makes them HSA-qualified and lets you pair them with a health savings account. On the other six plans, most copays apply immediately.

Billing

I got a bill I don't understand.
Don't pay it yet. Call Securus at 877-420-0785 with the bill in front of you and ask them to compare it against how the claim processed. If the bill and the claim don't match — or the provider is billing you the balance — take it to your employer's Benefit Consultant to escalate.
What's an EOB and is it a bill?
An Explanation of Benefits is not a bill. It's the plan showing you what was billed, what the plan allowed, what it paid, and what portion is yours. Compare every provider bill against the matching EOB — that's how you catch errors.
Who do I call about my premium deduction?
Your HR or payroll team — premium deductions come out of payroll, not through Securus. If the deduction doesn't match your elected coverage, HR can trace it, and Apex can help reconcile it if needed.

Section 07

Who's Who In Your Health Plan

Five names show up across your ID card, your bills and your explanations of benefits. Each one does a specific job, and only one of them is your first call.

One call. Securus Benefits will handle the rest. Securus administers your health plan and is your first point of contact for anything health-related. If they can't answer it directly, they connect you with the right partner — you don't have to work out who owns the problem. Reach them at 877-420-0785, in the Securus Member Portal, or by email at support@securusbenefits.com.

Your first call

Securus Benefits

  • Eligibility and benefit verification
  • Claim questions and explanations
  • Billing questions and general enquiries
  • COBRA administration
  • Case coordination and vendor support
Need a doctor, or have a question about a medical claim? Call Securus.
PPO network

Cigna

  • Provider network access
  • Medical claim submission
  • Claims repricing and contracted discounts
  • Precertification review
Looking for an in-network provider? Search the Cigna directory.
Pharmacy benefits

DisclosedRx

  • Pharmacy network
  • Prescription claims processing
  • Prior authorizations for medications
  • Formulary management and coverage rules
Questions about a prescription? Call DisclosedRx at 888-589-3340.
Virtual care

Evo by Fabric

  • 24/7/365 everyday and urgent care
  • Talk therapy
  • Mental health medication management
  • Care for adults and children
Need virtual care? Sign in to the Securus Member Portal and follow the link to Evo.
Technology platform

Yuzu

  • Claims processing system
  • Member and provider portals
  • Tracks claims, EOBs and accumulators
Powers the plan behind the scenes. You never need to contact Yuzu.

Virtual care availability can vary by state and by plan.

Three Things Worth Knowing

Precertification Comes First

When a service requires precertification, it has to be obtained through Cigna before the service happens — not after. Your provider normally starts it, but confirm it went through before your appointment rather than finding out on the bill.

Providers Verify With Securus

If a provider's office says they can't find your coverage, tell them to verify benefits with Securus Benefits. They may look for Cigna because of the network name on your card, and that is the wrong place to check eligibility.

In-Network Is On You To Check

You are always responsible for confirming your provider is in-network with Cigna before you go. A referral is not a guarantee, and the cost difference between in and out of network is the single biggest one on your plan.

How A Claim Actually Moves

Useful when a bill looks wrong — it tells you which step to ask about.

1

You receive care

You visit a provider or have a service.

2

Claim goes to Cigna

The provider submits the claim to Cigna.

3

Cigna processes it

Cigna applies the PPO discount and reviews for accuracy.

4

Securus applies your plan

Using Yuzu's platform, Securus applies your plan's benefits.

5

Decision made

Benefits are applied and payment is issued.

6

You get an EOB

The explanation of benefits shows what the plan paid and what you owe.

An explanation of benefits is not a bill. It tells you how the claim was processed. If the provider's bill doesn't match the EOB, that's the moment to call Securus — before you pay it.

Download the one-page Who's Who

Section 08

Contact & Support

Every number below reaches a person. Start at the top and work down — most things are resolved in the first call.

Start here — members

Securus Care Team

Your dedicated care guides and the plan's administrator. Claims, eligibility, ID cards, benefit questions, and help finding care. This is the name on your ID card.

24/7/365 — $0 on every plan

Virtual Urgent Care

Everyday and urgent care by video or phone, any hour of any day, powered by Evo by Fabric — and it also covers talk therapy and mental health medication management. Start here before urgent care or the ER for anything that doesn't need hands on you.

Prescriptions

DisclosedRx

Coverage and tiers, prior authorizations, mail order, specialty pharmacy, and copay assistance. Ask for a Prescription Navigator if a price looks high — that's what they're there for.

Finding care

Cigna PPO Network

Search for in-network doctors, hospitals and facilities. Enter your ZIP and select "Continue as Guest" — you're not a direct Cigna member. For a routine adult vision exam, Cigna redirects you to EyeMed.

Prior authorization

Cigna Precertification

Approvals required before certain procedures, imaging and hospital stays. Your provider normally initiates it — but call to confirm it went through before your appointment rather than after.

When you've hit a wall

Your Benefit Consultant

Denials, disputes, specialty drug access, provider navigation. If you have already made the calls and it is not resolved, this is the escalation. Have your name, employer, what happened and any claim number ready.

See your enrollment materialsOr ask your HR team who to contact