Your health is important to us. We offer a comprehensive benefits program and resources to support healthy lifestyles for you and your family. Your coverage for health benefits is effective the first day of the month following 60 days of continuous full-time employment. If the 60th day is the first day of the month then coverage is effective on that day.
Important Note:
Eligibility and plan details may vary by line of business. Please talk to your recruiter for more information.
ScionHealth offers four Health Savings Account (HSA)-eligible plan options from which you can choose: the $1,500 Plan, the $2,500 Plan, the $4,500 Plan and the $6,550 Plan. Plan options will be offered through the following insurance carriers – Aetna/Meritain and UnitedHealthcare/UMR – depending on where you live. With the Aetna/Meritain and UnitedHealthcare/UMR plans, you receive prescription drug benefits administered by CVS Caremark.
Review the table below to see how the plans compare.
Note: If you live in California, you may also be eligible to enroll in an HMO though Kaiser. Please talk to your recruiter for more information.
| $1,500 Deductible Plan | $2,500 Deductible Plan | $4,500 Deductible Plan | $6,550 Deductible Plan | ||
|---|---|---|---|---|---|
| HSA eligible | Yes | Yes | Yes | Yes | |
| Your costs – In-Network | |||||
| Preventive healthcare visit | Covered at 100% in-network | Covered at 100% in-network | Covered at 100% in-network | Covered at 100% in-network | |
| Individual/family deductible |
$1,500/ $3,000 |
$2,500/ $5,000 |
$4,500/ $9,000 |
$6,550/ $13,100 |
|
| Individual/family out-of-pocket maximum |
$5,200/ $6,850 |
$6,200/ $6,850 |
$6,550/ $13,100 |
$6,550/ $13,100 |
|
| Plan coinsurance1 | 80% after deductible | 70% after deductible | 70% after deductible | 100% after deductible | |
| Office visit (Primary Care/Specialist) | 80% after deductible | 70% after deductible | 70% after deductible | 100% after deductible | |
| Retail Prescriptions (In-Network) - Short-term drugs and maintenance drugs up to first two fill3 (up to 30-day supply) |
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| Generic | 80% after deductible2 | 70% after deductible2 | 70% after deductible2 | 100% after deductible2 | |
| Preferred Brand4 | 80% after deductible2 | 70% after deductible2 | 70% after deductible2 | 100% after deductible2 | |
| Non-Preferred Brand4 | 60% after deductible2 | 50% after deductible2 | 50% after deductible2 | 100% after deductible2 | |
| Mail Order Prescriptions (up to 90-day supply) |
|||||
| Generic | 80% after deductible2 | 70% after deductible2 | 70% after deductible2 | 100% after deductible2 | |
| Preferred Brand4 | 80% after deductible2 | 70% after deductible2 | 70% after deductible2 | 100% after deductible2 | |
| Non-Preferred Brand4 | 60% after deductible2 | 50% after deductible2 | 50% after deductible2 | 100% after deductible2 | |
|
Specialty Drugs |
80% after deductible2 | 80% after deductible2 | 80% after deductible2 | 100% after deductible2 | |
1 $1,500 and $2,500 Deductible Plans—Family unit must meet family deductible before coinsurance is available. Each family member's covered expenses (medical and prescription drug expenses) count toward the family deductible. Once this family deductible is met, the Plan will pay benefits for all family members. The single deductible only applies to a member with no covered dependents. $4,500 and $6,550 Deductible Plans—Each member must meet the individual deductible, subject to the family maximum, before coinsurance is available.
2 Healthcare deductible waived for preventive medications. Under the $6,550 Deductible Plan, coinsurance of 70% generic, 70% preferred brand and 50% non-preferred brand applies to preventive medications and coinsurance of 80% applies to specialty preventive medications.
3 Maintenance drugs after two fills—plan pays 0%.
4 You will pay the difference between the brand and generic (does not count toward deductible or out-of-pocket maximum).
In addition, by participating in a healthcare plan, you have access to the following:
- Quantum Health
- Wellness Program
- Employee Assistance Program
- Telemedicine Program
The HSA allows employees who participate in an HSA-eligible plan to set aside pre-tax dollars to pay for eligible healthcare expenses.
Save money on your healthcare and/or dependent day care expenses by using a tax-advantaged Flexible Spending Account (FSA). The money you contribute to these accounts comes from your paycheck before it is taxed, and you withdraw it tax-free when you pay for eligible expenses, which reduces your annual taxable income.
You can take charge of your health and lower your medical coverage cost by participating in the Healthy Steps Wellness Program. The program gives you flexibility to choose how and when you earn incentive points. Earn points for engaging with Quantum Health, completing the Well-Being Assessment (WBA), getting your biometric screening and more!
By participating in the program you may qualify for the discounted Healthy Rewards Rate on your medical plan. If you enroll in a healthcare plan, depending on your medical plan effective date, there may be different steps for you and your covered spouse/partner to earn and retain the discounted rate. Log in to our benefits website after your hire date to learn about the program requirements.
Note: When enrolling, your specific benefits costs per pay period will be displayed as the Healthy Rewards Rate. For those with employee-only or employee + child(ren) coverage, if you do not earn the required points by each deadline, your medical rates will increase by $75 per month. For those with employee + spouse/partner or employee + family coverage, if neither you nor your spouse/partner earn the required points by each deadline, your medical rates will increase by $150 per month, and if only one of you earns the points (but the other does not), your increase will be $75 per month.
ScionHealth offers a choice of three comprehensive dental options, each offered through your choice of two insurance carriers – Cigna or Delta Dental.
Review the table below to see how the plans compare.
| Basic Dental Plan | Basic Plus Dental Plan | Enhanced Dental Plan | |
|---|---|---|---|
| In-network | |||
| Individual/family deductible (waived for preventive services) | $50/$150 | $50/$150 | $50/$150 |
| Annual maximum benefit | $750 | $1,000 | $2,000 |
|
Services Preventive Basic Major services |
Plan pays 90% Plan pays 70% Not covered |
Plan pays 100% Plan pays 70% Plan pays 50% |
Plan pays 100% Plan pays 80% Plan pays 50% |
| Orthodontia services | Not covered | Not covered | 50% |
|
Orthodontia coinsurance/ lifetime maximum |
Not covered | Not covered | $1,500 |
ScionHealth offers a choice of two vision options, each offered through your choice of two insurance carriers – Vision Service Plan (VSP) or UnitedHealthcare.
Review the table below to see how the plans compare.
| Standard Plan | Enhanced Plan | |||
|---|---|---|---|---|
| In-network | Copay | Frequency | Copay | Frequency |
| Exam | $10 | 1 per 12 months | $10 | 1 per 12 months |
| Lenses | $25 | 1 per 12 months | $10 | 1 per 12 months |
| Contact Lens Fitting | Not to exceed $60 | 1 per 12 months | Not to exceed $60 | 1 per 12 months |
| In-network | Retail Allowance | Frequency | Retail Allowance | Frequency |
| Frames | Up to $130 | 1 per 24 months | Up to $175 | 1 per 12 months |
| Contact Lenses (in lieu of Frames & Lenses) | Up to $130 | 1 per 12 months | Up to $175 | 1 per 12 months |
Designed to help protect you from unexpected financial stress if you or an eligible dependent has an accident, this coverage supplements your primary medical plan by providing cash benefits. You can use this money to help pay for medical expenses not paid by your medical plan (such as your deductible or coinsurance) or for anything else (such as everyday living expenses).
Based on your plan, you receive a cash benefit up to a specific amount for:
- Accidental death
- Dismemberment
- Dislocation or fracture
- Initial hospital confinement
- Intensive care
- Ambulance
- Medical expenses
- Outpatient physician’s treatment
The actual benefit amounts depend on the type of injury(ies) you have and the medical services you need.
When you are affected by a serious illness such as a heart attack or cancer, critical illness insurance provides financial support to help you and your eligible dependents through your difficult time.
If you experience a covered illness, you receive a lump-sum benefit payment to help cover out-of-pocket expenses for your treatment that are not covered by your medical plan. You also can use the money to take care of other expenses, such as housekeeping services, special transportation, and day care. Your full benefit may be paid up to twice per year. If you choose to cover your dependents, the covered spouse and covered children benefit amount is 50% of your benefit amount.
Even with your primary medical coverage, you still may be responsible for copays, deductibles, and other out-of-pocket costs. A hospital indemnity plan provides supplemental payments that you can use to cover expenses your medical plan doesn’t cover, such as hospital stays, ambulance service, surgery, and certain inpatient or outpatient treatments. Benefits are paid as cash payments. You can also cover dependents.