What are my Options?
For full plan details, including costs, download the Benefits Guide from ADP and see the Featured Documents tile or the 2022 Employee Benefits Knowledge Library in Workplace.
Medical Benefits
Here’s what you can expect from your medical benefits:
Cigna $500
Deductible Plan
- The out-of-pocket maximum is $2,000 individual and $4,000 family for network coverage.
- ER copay is $250.
- Brand formulary copay is $50.
- Non-formulary copay is $75.
Cigna $1,000
Deductible Plan
- The out-of-pocket maximum is $4,000 individual and $8,000 family for network coverage.
- ER copay is $250.
- Brand formulary copay is $50.
- Non-formulary copay is $75.
Cigna High Deductible
Plan (HDHP) with HSA
- The deductible is $2,500 individual and$5,000 family.
- The out-of-pocket maximum is $5,000 individual and $10,000 family.
- Members’ coinsurance is pay 10%.
Kaiser HMO and
DHMO Plans
- Only employees in California are eligible.
- Two Kaiser plans will continue to be offered, alongside Cigna, for employees in California.
- For details on the Kaiser plan review the Benefits Guide, page 6.
Cigna PPO $500 Deductible Plan | Cigna PPO $1,000 Deductible Plan | Cigna HDHP with HSA Plan | ||||
---|---|---|---|---|---|---|
Coverage Features | In-network | Out-of-network | In-network | Out-of-network | In-network | Out-of-network |
Company HSA contribution | NA | NA | $500 employee only $1,000 family (prorated based on enrollment date) |
|||
Annual deductible | ||||||
Per person/per family | $500/ $1,000 | $1,000/ $2,000 | $1,000/ $2,000 | $2,000/ $4,000 | $2,500/ $5,000 | $5,000/ $10,000 |
Embedded** | Embedded** | Embedded** | Embedded** | Aggregate** | Aggregate** | |
Out-of-pocket maximum | ||||||
Per person/per family | $2,000/ $4,000 | $4,000/ $8,000 | $4,000/ $8,000 | $8,000/ $16,000 | $5,000/ $10,000 | $10,000/ $20,000 |
Embedded** | Embedded** | Embedded** | Embedded** | Aggregate** | Aggregate** | |
Coinsurance | 90% | 70% | 90% | 70% | 90% | 60% |
Medical coverage | ||||||
Preventive care | 0% | 30% | 0% | 30% | 0% | 40% |
PCP Visits | $25 copay | 30%* | $35 copay | 30%* | 10%* | 40%* |
Specialist visits | $35 copay | 30%* | $50 copay | 30%* | 10%* | 40%* |
Outpatient surgery | 10%* | 30%* | 10%* | 30%* | 10%* | 40%* |
Inpatient surgery (per stay) | 10%* | 30%* | 10%* | 30%* | 10%* | 40%* |
Emergency room | $250 copay | $250 copay | $250 copay | $250 copay | 10%* | 40%* |
Retail prescription drugs (30-day supply) | ||||||
Generic | $20 copay | 30%* | $20 copay | 30%* | 10%* | 40%* |
Brand formulary | $50 copay | 30%* | $50 copay | 30%* | 10%* | 40%* |
Non-formulary | $75 copay | 30%* | $75 copay | 30%* | 10%* | 40%* |
Mail-order prescription drugs (90-day supply) | ||||||
Generic | $40 copay | 30%* | $40 copay | 30%* | 10%* | 40%* |
Brand formulary | $100 copay | 30%* | $100 copay | 30%* | 10%* | 40%* |
Non-formulary | $150 copay | 30%* | $150 copay | 30%* | 10%* | 40%* |
*Employee coinsurance percentage after the deductible has been met.
**Learn about the difference between aggregate and embedded deductibles here.
Dental
Dental coverage is through Cigna. Here’s what you can expect from your dental benefits:
Preventive Plan | PPO Premium Plan | |||
---|---|---|---|---|
Coverage Features | In-network | Out-of-network | In-Network | Out-of-network |
Annual deductible | $50 Individual / $150 Family | $50 Individual / $150 Family | $50 Individual / $150 Family | $50 Individual / $150 Family |
Calendar-year maximum | $1,000 | $1,000 | $2,000 | $2,000 |
Reasonable and customary limit (R&C) percentile | 80th percentile | 80th percentile | 90th percentile | 90th percentile |
Preventive/diagnostic services | 100% | 100% | 100% | 100% |
Basic services | 60% | 60% | 80% | 80% |
Major services | 50% | 50% | 60% | 60% |
Orthodontia | 50% Adults and Children up to age 26. Lifetime max of $1,000. | 50% Adults and Children up to age 26. Lifetime max of $2,000. |
Vision Benefits
Having vision coverage allows you to save money on eligible eye care expenses, such as periodic eye exams, eyeglasses, contact lenses, and more for yourself and your covered dependents. Vision Insurance is provided by EyeMed Vision Care.
Coverage Features | In-Network You Pay | Out-of-Network You Pay |
---|---|---|
Exam (once every calendar year) | $0 copay | Up to $50 |
Frames (once every calendar year) | $0 copay, $175 material allowance, 20% of balance over $175 | Up to $110 |
Retinal Imaging | Up to $39 | NA |
Hearing Care ( from Amplifon Hearing Network) | 40% off hearing exams and a low price guarantee on discounted hearing aids | NA |
Prescription lenses (once every calendar year) | All prescription lenses - $20 copay | Single vision - up to $42 Bifocal - up to $78 Trifocal - up to $130 Lenticular - up to $130 |
Contact lenses fit and follow-up (once every calendar year) | Standard - up to $40 Premium - 10% off retail | NA |
Contact lenses materials (once every calendar year) | $0 copay; $175 allowance; 85% of charge over $175 | Conventional: up to $140 Disposable up to $140 Medical necessary: up to $210 |
Laser Vision Correction (Lasik or PRK from U.S. Laser Network) | 15% of the retail price or 5% off the promotional price | NA |
Life Insurance
Employee Term Life and AD&D Insurance
United Site Services provides you with term life insurance through Cigna so that you can protect those you love from the unexpected. You are automatically enrolled for this benefit, and there is no cost to you for coverage. The standard benefit amount is 1x your base annual salary, up to $500,000 maximum for both basic life and basic accidental death and dismemberment (AD&D).
Employee Optional Life and AD&D Insurance
If you want additional protection, you can purchase extra supplemental life and/or AD&D insurance for yourself. You may elect additional life coverage equal to 1x, 2x, 3x, 4x, or 5x your base pay, up to $750,000 maximum. You can purchase an amount of optional AD&D that matches your optional life insurance election.
Dependent Voluntary Life Insurance
You may also purchase optional life insurance for your spouse or domestic partner in increments of $10,000, up to a maximum of $100,000. Optional child life insurance is available, too:
- Ages 15 days to six months: $1,000.
- Ages six months to 26: $10,000.
Disability Insurance
Short-Term Disability Summary
All United Site Services employees will be covered under Short-Term Disability at a coverage level of 66.67% of their weekly salary, with no weekly maximum benefit.
Long-Term Disability Summary Classes
This includes all active, full-time employees regularly working a minimum of 30 hours per week in the United States, who are citizens or permanent resident aliens of the United States.
401(k) Savings
The United Site Services 401(k) savings plan provides advantages you may not get with other types of savings plans and helps you meet one of life’s important goals — saving for a financially secure retirement. New hires are eligible to enroll in the USS 401(k) plan on the first day of the month following one month of service. Visit www.empowermyretirement.com or by calling 1-844-465-4455.