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 PlanCigna PPO $1,000 Deductible PlanCigna HDHP with HSA Plan
Coverage FeaturesIn-networkOut-of-networkIn-networkOut-of-networkIn-networkOut-of-network
Company HSA contributionNANA$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**
Coinsurance90%70%90%70%90%60%
Medical coverage
Preventive care0%30%0%30%0%40%
PCP Visits$25 copay30%*$35 copay30%*10%*40%*
Specialist visits$35 copay30%*$50 copay30%*10%*40%*
Outpatient surgery10%*30%*10%*30%*10%*40%*
Inpatient surgery (per stay)10%*30%*10%*30%*10%*40%*
Emergency room$250 copay$250 copay$250 copay$250 copay10%*40%*
Retail prescription drugs (30-day supply)
Generic$20 copay30%*$20 copay30%*10%*40%*
Brand formulary$50 copay30%*$50 copay30%*10%*40%*
Non-formulary$75 copay30%*$75 copay30%*10%*40%*
Mail-order prescription drugs (90-day supply)
Generic$40 copay30%*$40 copay30%*10%*40%*
Brand formulary$100 copay30%*$100 copay30%*10%*40%*
Non-formulary$150 copay30%*$150 copay30%*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 PlanPPO Premium Plan
Coverage FeaturesIn-networkOut-of-network In-NetworkOut-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 percentile80th percentile90th percentile90th percentile
Preventive/diagnostic services100%100%100%100%
Basic services60%60%80%80%
Major services50%50%60%60%
Orthodontia50% 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 FeaturesIn-Network You PayOut-of-Network You Pay
Exam (once every calendar year)$0 copayUp to $50
Frames (once every calendar year)$0 copay, $175 material allowance, 20% of balance over $175Up to $110
Retinal ImagingUp to $39NA
Hearing Care ( from Amplifon Hearing Network)40% off hearing exams and a low price guarantee on discounted hearing aidsNA
Prescription lenses (once every calendar year)
All prescription lenses - $20 copaySingle 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.