Medical Plan Options and Administrators

2024 Plan Information

Medical Plan

The Firm offers a choice of three Medical Plan options:

  • Options A and B are PPOs.
  • Option C is a Consumer-Driven Health Plan (also known as a High-Deductible Plan).

Employees who live in California or Hawaii, or who are US-based expats, have other medical plan options.

Regardless of which option you choose, you may elect one of two Medical Plan administrators – Cigna or UnitedHealthcare (UHC). Both:

  • Provide preventive care — including annual exams, immunizations and routine age-appropriate screenings — at no cost to you when you use in-network providers.
  • Cover the same services, like doctor visits, hospital care, lab work and X-rays.
  • Give you access to Cigna or UnitedHealthcare doctors, hospitals and other providers. Note: Although your paycheck contributions will be the same if you choose either administrator, you may pay less, on average, for medical services if you elect the preferred provider in your state.
  • Include prescription drug coverage, administered by Express Scripts.

Your Health Care Coverage When the COVID-19 Public Health Emergency Ends

The Firm’s Medical Plan will continue to provide comprehensive coverage for COVID-19 testing and treatment. The following services will be covered, subject to your applicable deductible and coinsurance:

  • Diagnostic COVID-19 PCR lab-based testing
  • COVID-19 treatment, including antivirals and therapeutics
  • Outpatient office visits and virtual care visits related to COVID-19

COVID-19 vaccines will be covered at 100% when obtained with an in-network provider. At-home COVID-19 tests will no longer be covered under the Medical Plan; however, you can purchase these tests using funds from your Health Care Flexible Spending Account or Health Savings Account.

Paycheck Contributions, Deductibles and Out-of-Pocket Maximums

When choosing a Medical Plan option, it’s important to consider your total costs because each option’s paycheck contributions (view 2023 and 2024 contributions), deductibles and out-of-pocket maximums differ. Making the right choice for you and dependents means understanding how the annual deductibles and out-of-pocket maximums work.

  • Your annual deductible is the fixed dollar amount you pay each year toward your medical expenses before the Medical Plan begins to cover a portion of the cost of your health care services. You pay the full cost of services (with some exceptions) until you meet the total deductible amount.
  • After meeting the annual deductible, you and the Plan share in the cost of services through coinsurance – you pay 20% of costs and the Plan pays the remaining 80%.
  • If the sum of your deductible and out-of-pocket costs reaches the annual out-of-pocket maximum, the Plan begins to pay 100% of the cost of in-network services and 100% of reasonable and customary cost for out-of-network services for the remainder of the year.

When comparing the three Medical Plan options, the higher the deductible and out-of-pocket maximum, the lower your paycheck contributions will be, and vice versa.

Option AOption BOption C
Your Paycheck Contributions

Highest

Moderate

Lowest
Consider funding a Health Savings Account (HSA) with the money you save in paycheck contributions

Annual Deductible

Lowest

Moderate

Highest
Combined medical and prescription drug deductible

Annual Out-of-Pocket Maximum

Lowest

Moderate

Highest
Combined medical and prescription drug out-of-pocket maximum

Save Money and Time with In-Network Services

In-network services lower your health care costs. The fees for in-network services are set by your medical plan administrator (Cigna or UnitedHealthcare) and typically offer you considerable savings over comparable out-of-network services. Additionally, the in-network deductible is generally half the amount of the out-of-network deductible and is waived for preventive care services received within your network. Finally, when using in-network services, the provider generally takes care of any required preauthorization and most paperwork, saving you time and money.

Check if Your Doctors Are In-Network

Before electing medical coverage through Cigna or UnitedHealthcare each year, you should check to see if the doctors and hospitals will continue to be in the same network for the coming year. Although infrequent, providers can change networks at any time during the year without notice.

CignaUnitedHealthcare

  • Go to Cigna’s website.

  • Choose Employer or School.

  • Enter your provider’s ZIP code.

  • Follow the prompts until it aks to Continue as guest. Then, enter ZIP code again if prompted.

  • When prompted to select a plan, choose Open Access Plus, OA plus or Choice Fund OA Plus.


  • Go to UHC’s website.

  • Choose Medical Directory or Behavioral Health, as needed.

  • Choose Employer and Individual Plans.

  • If prompted for the network, select Choice Plus.

  • Choose Change Location to enter your provider’s ZIP code.

What the Plan Pays When You Need Care

Here’s a look at the benefits provided under Options A, B and C. Note: Your deductible and out-of-pocket maximum reset each Plan year.

Option AOption BOption C
Note

The figures in the chart below reflect what the Plan pays, with the exception of deductibles and out-of-pocket maximums, which employees pay. CSP applies to cancer-related medical claim expenses only (does not include pharmacy-related expenses). A diagnosis of cancer and engagement with a CSP nurse is required.

Individual Annual Deductible

In-Network:
$600

Out-of-Network:
$1,200

In-Network:
$1,200

Out-of-Network:
$2,400

In-Network:
$2,300 (deductible includes prescription drugs, however CSP program does not apply to pharmacy-related expenses)

Out-of-Network:
$4,600 (deductible includes prescription drugs, however CSP program does not apply to pharmacy-related expenses)

Individual Out-of-Pocket Maximum

In-Network:
$2,000

Out-of-Network:
$4,000

In-Network:
$3,000

Out-of-Network:
$7,500

In-Network:
$5,500 (includes prescription drugs)

Out-of-Network:
$11,000 (includes prescription drugs)

Family Deductible

In-Network:
$1,250

Out-of-Network:
$2,500

In-Network:
$2,500

Out-of-Network:
$5,000

In-Network:
$4,600 (deductible includes prescription drugs, however CSP program does not apply to pharmacy-related expenses)

Out-of-Network:
$9,200 (deductible includes prescription drugs, however CSP program does not apply to pharmacy-related expenses)

Family Out-of-Pocket Maximum

In-Network:
$5,000

Out-of-Network:
$10,000

In-Network:
$7,500

Out-of-Network:
$15,000

In-Network:
$11,000 (includes prescription drugs)

Out-of-Network:
$20,000 (includes prescription drugs)

Diagnostic and Preventive Care

In-Network:
100% (no annual deductible)

Out-of-Network:
100% up to a maximum of $250 (no annual deductible) then 60% of eligible expenses (no annual deductible)

In-Network:
100% (no annual deductible)

Out-of-Network:
100% up to a maximum of $250 (no annual deductible) then 60% of eligible expenses (no annual deductible)

In-Network:
100% (no annual deductible)

Out-of-Network:
100% up to a maximum of $250 (no annual deductible) then 60% of eligible expenses (no annual deductible)

Most other services, including inpatient and outpatient hospital and specialist visits

In-Network:
80% after annual deductible

Prior proof of medical necessity may apply for certain services. Check with your health plan administrator to verify coverage and if preauthorization is required.

Out-of-Network:
60% of eligible expenses after annual deductible

Prior proof of medical necessity may apply for certain services. Check with your health plan administrator to verify coverage and if preauthorization is required.

In-Network:
80% after annual deductible

Prior proof of medical necessity may apply for certain services. Check with your health plan administrator to verify coverage and if preauthorization is required.

Out-of-Network:
60% of eligible expenses after annual deductible

Prior proof of medical necessity may apply for certain services. Check with your health plan administrator to verify coverage and if preauthorization is required.

In-Network:
80% after annual deductible

Prior proof of medical necessity may apply for certain services. Check with your health plan administrator to verify coverage and if preauthorization is required.

Out-of-Network:
60% of eligible expenses after annual deductible

Prior proof of medical necessity may apply for certain services. Check with your health plan administrator to verify coverage and if preauthorization is required.

Cancer Support Program

In-Network:
100% covered after annual deductible if enrolled in program within 60 days of diagnosis. Applies to cancer-related medical claim expenses only; diagnosis of cancer and engagement with CSP nurse required. 80% after annual deductible if not enrolled in program.

Out-of-Network:
60% after annual deductible

In-Network:
100% covered after annual deductible if enrolled in program within 60 days of diagnosis. 80% after annual deductible if not enrolled in program.

Out-of-Network:
60% after annual deductible

In-Network:
100% covered after annual deductible if enrolled in program within 60 days of diagnosis. 80% after annual deductible if not enrolled in program.

Out-of-Network:
60% after annual deductible

Bariatric Surgery

In-Network:
Cigna: 100% at Cigna Certified Hospitals for bariatric surgery; 80% after annual deductible at other in-network facilities.

UHC: Surgery must be received at a UHC designated Center of Excellence (COE) and will be covered at 100% no annual deductible; all other services related to the surgery covered at 80% after annual deductible.

Out-of-Network:
Cigna: 60% of eligible expenses after annual deductible

UHC: No coverage

In-Network:
Cigna: 100% at Cigna Certified Hospitals for bariatric surgery; 80% after annual deductible at other in-network facilities.

UHC: Surgery must be received at a UHC designated Center of Excellence (COE) and will be covered at 100% no annual deductible; all other services related to the surgery covered at 80% after annual deductible.

Out-of-Network:
Cigna: 60% of eligible expenses after annual deductible

UHC: No coverage

In-Network:
Cigna: 100% after annual deductible at Cigna Certified Hospitals for bariatric surgery; 80% after annual deductible at other in-network facilities.

UHC: Surgery must be received at a UHC designated Center of Excellence (COE) and will be covered at 100% no annual deductible; all other services related to the surgery covered at 80% after annual deductible.

Out-of-Network:
Cigna: 60% of eligible expenses after annual deductible

UHC: No coverage

Maternity

In-Network:
80% after annual deductible

Out-of-Network:
60% of eligible expenses after annual deductible

In-Network:
80% after annual deductible

Out-of-Network:
60% of eligible expenses after annual deductible

In-Network:
80% after annual deductible

Out-of-Network:
60% of eligible expenses after annual deductible

Fertility Coverage (includes cryopreservation, artificial insemination, IVF, GIFT and ZIFT)

In-Network:
Administered by Maven: 80% after annual deductible

Out-of-Network:
No coverage

In-Network:
Administered by Maven: 80% after annual deductible

Out-of-Network:
No coverage

In-Network:
Administered by Maven: 80% after annual deductible

Out-of-Network:
No coverage

Out-of-Network Reimbursements

Out-of-network reimbursements are based on eligible expenses as determined by the Plan administrator. You are responsible for any payments required to the provider in excess of the reasonable and customary amount.

Amounts paid to out-of-network providers count toward the in-network and out-of-network annual deductible. The amount you pay toward your annual deductible is included in your out-of-pocket maximum.

Non-Preventive Services

For non-preventive health care services, including office visits, coinsurance will apply after you have met your annual deductible. That means you will pay a percentage of the cost of services (coinsurance) rather than a flat fee (copay). The amount you pay in coinsurance plus the annual deductible during the year will not exceed your annual out-of-pocket maximum.

Cancer Support Program Coverage

Upon enrolling in the program within 60 days of a cancer diagnosis and meeting your annual in-network deductible, Morgan Stanley will cover 100% of the cost of cancer-related treatments and procedures provided by in-network doctors and facilities. This enhanced coverage applies to medical claim expenses only, which must indicate a cancer diagnosis. This does not apply to pharmacy claims. Regular engagement with a CSP nurse is required.

Fertility Coverage Lifetime Maximum

A lifetime maximum of $75,000 for fertility medical services and prescription drugs – combined with adoption and surrogacy reimbursements from the Firm and in- and out-of-network costs – applies to each household. The combined lifetime maximums apply across Plan administrators regardless of which carrier you choose, and include prior accumulation toward the fertility maximum and prior reimbursements from the Firm for adoption and surrogacy claims. Cryopreservation storage is limited to a 12-month period. Please contact Maven for further details.

Eligible Expenses

Eligible expenses, otherwise known as Reasonable and Customary (R&C) charges, are determined by the health plan administrator. If you receive services from an out-of-network provider, you may be responsible for the amount billed in excess of the eligible expense.

Tax-Advantaged Health Care Accounts: FSAs and HSAs

Another thing to consider when choosing between the three Medical Plan options is the type of tax-advantaged account/s you may contribute to save on health care costs:

Note: You may also contribute to a Dependent Day Care FSA, regardless of the Medical Plan option you elect – or if you do not take medical coverage through the Firm. Learn more.

Which Medical Plan Option Is Right for You?

If you’re not sure which Medical Plan option is right for you, see how the three options compare.

Primary Care with One Medical

New in 2022: Having a regular doctor is key to our ongoing health. Employees and their dependents enrolled in the Medical Plan through Cigna or UnitedHealthcare may take advantage of One Medical, a concierge medical practice that provides top-quality primary care to adults and children of all ages. Receive in-person care at 100+ locations across the US, or meet virtually with providers for non-emergency care 24/7. Morgan Stanley waives the membership fee to join One Medical. Standard in-network deductibles, coinsurance and out-of-pockets maximums apply. Most virtual care is free.

Resource and Support Programs for Specialized Medical Conditions

Understanding and working through a medical diagnosis, knowing the best facilities and doctors for your condition, or deciphering your doctor’s instructions can be challenging.

Employees and their family members enrolled in the Firm’s Medical Plan through Cigna or UnitedHealthcare have access to specialized programs and support for many conditions, which provide a single point of contact throughout your health care journey so you don’t have to go it alone. Most important, these programs help ensure you receive the best care and have the most successful outcome. These programs are available:

Hospital Partnerships

In addition, the Firm has established relationships with leading hospitals in the New York metro area. These programs are available to all employees and extended family members (you do not need to participate in the Firm’s Medical Plan):

Your State’s Preferred Medical Plan Administrator

If you enroll in Medical Plan Option A, B or C, your health care coverage will be administered by the Cigna Open Access Plus Network or UnitedHealth Choice Plus Network. Both networks cover the same services and have the same paycheck contributions — however, depending on where you live, either Cigna or UHC may have negotiated greater discounts with the providers in your state. That means you’ll pay less, on average, when you see providers in your state’s preferred network. Note: Some states are “neutral” and do not have a preferred provider.

Cigna Is the Preferred Administrator in These States

UHC Is the Preferred Administrator in These States

“Neutral” States That Have No Preferred Provider