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Contact the BSC at 866-481-4922
Monday-Thursday 8:00-6:00 ET / Friday 8:00-5:00 ET

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Puerto Rico Health Plan

Eligible Mohawk and Dal-Tile employees residing in Puerto Rico have the option of enrolling themselves and eligible dependent(s) in the new Cigna Indemnity Plan.

Plan features
  • See any provider on the island—no directory
  • Digital ID card
  • Coinsurance is 80/20% after deductible.
  • Preventive care (annual check-ups, age-appropriate screenings, immunizations)—no cost
  • Allowable maximums for: Regular mammograms, 3D mammograms, CT scans and MRIs
Includes Pharmacy benefits through Express Scripts
  • 90-day supply mail order home delivery
  • 30-day supply retail pharmacy
  • Brand name diabetic medications — $50 per 30 days
  • Generic and maintenance medication – no cost
  • Weight loss medications excluded—no coverage
  • Prescription costs count towards out-of-pocket maximum
  • Coinsurance—80/20% after deductible

Please note: Health plan members will pay the cost of the visit, procedure, medications, etc and file a claim for reimbursement. 

Plan details

PuertoRico Plan 2024

2021 Peach Line

Plan Rates

PuertoRico Plan Rates 2024

Healthcare Flexible Spending Account

Employees enrolled the Puerto Rico Indemnity Plan are eligible to enroll in a Healthcare Flexible spending account to pay for health-related expenses. 

Please find more information here.

Plan Documents

pdf button Summary of Benefits and Coverage (SBC)

pdf button Medical Indemnity Plan Flyer [Eng | Sp]

pdf button Pharmacy Claim Form (ESI)

pdf button Medical Caim Form

Questions?

Contact the Benefits Service Center at 866-481-4922 if you have questions about your health plan.