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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 01
Start Here
The five things members need most. Everything else on this page builds on these.
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 summaryPrescription 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
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 preventiveMental 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 costsVirtual 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 careExternal 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 programsWhat 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 planOne 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.
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.
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.
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.
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?"
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.
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.
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.
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.
Section 04
When You Hit A Roadblock
Denied, billed wrong, or bounced between phone numbers? Start with the Securus care team — they can resolve most of it directly. If it's still not right after that, your employer's Benefit Consultant takes it from there and escalates on your behalf. Here is what gets escalated.
Claims Issues
A claim processed wrong, applied to the wrong deductible, or denied for a reason that doesn't hold up. It gets reprocessed.
Billing Disputes
A bill that doesn't match what the plan says it should be, or a provider billing you for the balance. Don't pay it — get it reviewed first.
Prior Authorizations
A denied authorization for a procedure or medication your doctor says you need. A denial is not always the end of it — it can be appealed.
Specialty Medications
High-cost specialty drugs where access or affordability is the barrier. Copay programs, formulary placement and appeals all get worked before you pay full price.
Provider Navigation
You need a specialist, a second opinion, or a high-quality low-cost facility and don't know where to start. Securus can help you find it.
Start With Securus 877-420-0785 See All Contacts
Whoever you contact, have this ready: your name, your employer, what happened, and any claim or reference number. That is usually enough to start working it the same day. Your Benefit Consultant's contact details are in your enrollment materials — ask your HR team if you don't have them.
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.
Mental Health Support
Outpatient therapy and psychiatry are covered under your medical plan — on most plans at the same flat copay as a regular office visit, not a percentage. Inpatient behavioral health is covered as coinsurance after deductible.
See what therapy costs24/7 Virtual Care
$0 on every plan, any hour, any day. Powered by Evo by Fabric — everyday and urgent care, plus talk therapy and mental health medication management. Call 855-636-3669, or sign in to the Securus Member Portal and follow the link to Evo.
Open virtual careExternal 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.
Alto Pharmacy — Fertility
A fertility-specialist pharmacy that coordinates medication timing and delivery directly with your clinic. Hands-on, not a call center.
- 800-874-5881
- Medication delivery & coordination
Good Life Direct — GLP-1
Affordable access to GLP-1 weight-loss medications. Start with an online medical intake questionnaire, then manage care through the patient portal.
- Online intake — no office visit to start
- Ongoing care via patient portal
Awaken180° Weightloss
A coached, medication-free clinical weight loss program. For members who'd rather change the inputs than add a prescription.
- 844-346-1800
- Clinical coaching, no medication
Fitness, EAP & More
Fitness access, an employee assistance program, financial wellness and chronic condition management are arranged separately by employers. None of them come through Triad, so what's available to you — if anything — depends entirely on your employer.
Ask your HR team which are activeIf 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?
When does my coverage start as a new hire?
What is the plan year?
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?
Claims
My claim was denied. What do I do?
Do I need prior authorization before a procedure?
What happens if I go out of network?
How do I know what a service will cost before I get it?
Prescriptions
Who manages my prescriptions?
Is my medication covered?
What are the prescription copays?
How do I get a 90-day supply delivered?
My specialty medication is unaffordable. Is there help?
Dependents
How do I add a new baby, spouse or child?
Are my children's dental and vision covered?
How do I remove a dependent?
Open Enrollment
When is open enrollment?
What should I actually think about when picking a plan?
What's the difference between the HSA plans and the others?
Billing
I got a bill I don't understand.
What's an EOB and is it a bill?
Who do I call about my premium deduction?
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.
Securus Benefits
- Eligibility and benefit verification
- Claim questions and explanations
- Billing questions and general enquiries
- COBRA administration
- Case coordination and vendor support
Cigna
- Provider network access
- Medical claim submission
- Claims repricing and contracted discounts
- Precertification review
DisclosedRx
- Pharmacy network
- Prescription claims processing
- Prior authorizations for medications
- Formulary management and coverage rules
Evo by Fabric
- 24/7/365 everyday and urgent care
- Talk therapy
- Mental health medication management
- Care for adults and children
Yuzu
- Claims processing system
- Member and provider portals
- Tracks claims, EOBs and accumulators
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.
You receive care
You visit a provider or have a service.
Claim goes to Cigna
The provider submits the claim to Cigna.
Cigna processes it
Cigna applies the PPO discount and reviews for accuracy.
Securus applies your plan
Using Yuzu's platform, Securus applies your plan's benefits.
Decision made
Benefits are applied and payment is issued.
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.
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.
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.
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.
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.
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.
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.
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.