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Medical and Rx

Asurion provides a range of medical coverage options so you can choose the one that best meets the needs of your health and wallet. When you elect Asurion medical coverage, prescription coverage is included.

Medical options

The Bronze Plus option may be the right choice for you if:

You want low per-paycheck contributions, i.e. premiums.

and

You don’t want to save money in a Health Savings Account to meet your deductible.

and

You like predictability—to know exactly what you’ll pay when you see a provider or fill a prescription, i.e. copayments (copays).

Before you make a final decision, however, we encourage you to examine the Bronze Plus option closely and think carefully about your healthcare needs.

Your cost

How much you’ll pay for a medical option is a three-component equation:

1

What you pay to have coverage

2

What you pay when you need care

3

What you save for future healthcare needs

Monthly premiums

Copayments (Copays)

Deductible

Healthcare savings

Varies depending on ZIP code and coverage level

Primary: $30
Specialist: $50

Employee only: $2,300
Family: $4,600

Flexible spending account
contribution limit:
Employee only: $3,050
  • Your per-paycheck cost
  • How much you pay when you see a provider
  • Copayments do not count toward your deductible
  • Deductible: The amount you have to reach before the option shares the cost of your care
  • Coinsurance: 30%
    Your percentage of the cost of care that is shared with the option after you meet the deductible
  • Pretax payroll contributions
  • How you can cover your out-of-pocket costs, including medical and prescription copayments; your deductible and coinsurance; and other planned and unplanned out-of-pocket healthcare needs

How does the Bronze Plus option work for Caroline1?

January

Health event: Preventive exam (i.e. annual physical)

  Deductible Expense Non-deductible Expense
Preventive visit $ 0 $ 0
Over-the-counter (OTC) allergy meds   $ 20
Total Caroline spent this month   $ 20
Year-to-date total Caroline spent $20

March

Health event: Sinus infection diagnosis

  Deductible Expense Non-deductible Expense
Provider visit   $ 30
Rx: Tier 1 antibiotic   $ 12
Over-the-counter (OTC) allergy meds   $ 20
Total Caroline spent this month   $ 62
Year-to-date total Caroline spent $82

May

Health Event: Abnormal test follow up for diagnostic exam

  Deductible Expense Non-deductible Expense
Specialist visit   $ 50
Lab test $ 150  
Over-the-counter (OTC) allergy meds   $ 20
Total Caroline spent this month   $ 220
Year-to-date total Caroline spent $302

July

Health Event: Cyst diagnosis and outpatient surgery

  Deductible Expense Non-deductible Expense
Provider outpatient hospital facility visits $ 1,250  
Rx: Tier 2 post-surgical narcotic   $ 60
Over-the-counter (OTC) allergy meds   $ 20
Total Caroline spent this month   $ 1,330
Year-to-date total Caroline spent $1,632

September

Health Event: Bicycle accident

  Deductible Expense Non-deductible Expense
Provider and urgent care center visits $ 875  
Rx: Tier 2 antibiotics   $ 60
Physical therapy   $ 800
Over-the-counter (OTC) allergy meds   $ 20
Total Caroline spent this month   $ 1,755
Year-to-date total Caroline spent $3,387

November

Health Event: Strep throat

  Deductible Expense Non-deductible Expense
Telemedicine consultation   $ 30
Rx: Tier 1 antibiotics   $ 12
Over-the-counter (OTC) allergy meds   $ 20
Total Caroline spent this month   $ 62
Year-to-date total Caroline spent $3,449
$0
January 1
$0 $2,300
$6,700
December 31
Deductible: You Pay 100%
Coinsurance: You Pay 30%, Plan Pays 70%
Plan pays: 100%
Out-of-pocket Maximum $6,700
I Fictional example. Any similarity to a real individual is unintended. Assumes Employee only coverage; in-network care only.

Smart considerations

A flexible spending account may be a smart way to manage your out-of-pocket healthcare expenses for the year. Just remember that you have to use the balance in your FSA annually or you forfeit the remainder. The Bronze Plus option offers you the same doctors as the Gold option, but with lower premiums and a higher deductible.

The Silver option may be the right choice for you if:

You want low per-paycheck contributions, i.e. premiums.

and

You don’t expect to use a lot of medical services, or you can easily afford an expense like an unexpected doctor’s visit or prescription.

and

You want to save money for healthcare expenses—including your deductible and coinsurance, as well as future needs—in a pretax Health Savings Account.

Before you make a final decision, however, we encourage you to examine the Silver option closely and think carefully about your healthcare needs.

Your cost

How much you’ll pay for a medical option is a three-component equation:

1

What you pay to have coverage

2

What you pay when you need care

3

What you save for future healthcare needs

Monthly premiums

Copayments (Copays)

Deductible

Healthcare savings

Varies depending on ZIP code and coverage level

You must pay the total cost of your service until you reach the deductible

Employee only: $1,600
Family: $3,200

Health Savings Account
contribution limit1:
Employee only: $4,100
Family: $8,450
  • Your per-paycheck cost
  
  • Deductible: The amount you have to reach before the option shares the cost of your care
  • Coinsurance: 25%
    Your percentage of the cost of care that is shared with the option after you meet the deductible
  • Pretax payroll contributions
  • How you can cover your out-of-pocket costs, including your deductible and coinsurance, and unplanned healthcare needs
  • Use it now, save for later, reinvest a portion or roll over the balance until retirement
  1. A Dental and Vision FSA is also available

You might be wondering if the Silver option will serve your needs well if you have a lot of medical and prescription expenses. It will—when you maximize your HSA savings. Consider the example below, showing someone with $5,000 of medical expenses in a year under the Gold and Silver options.

Comparison of $5,000 Annual Expenses

How does the Silver option work for Caroline1?

January

Health event: Preventive exam (i.e. annual physical)

  Deductible Expense Non-deductible Expense
Preventive visit $ 0 $ 0
Over-the-counter (OTC) allergy meds   $ 20
Total Caroline spent this month   $ 20
Year-to-date total Caroline spent $20

March

Health event: Sinus infection diagnosis

  Deductible Expense Non-deductible Expense
Provider visit $ 150  
Rx: Tier 1 antibiotic $ 45  
Over-the-counter (OTC) allergy meds   $ 20
Total Caroline spent this month   $ 215
Year-to-date total Caroline spent $235

May

Health Event: Abnormal test follow up for diagnostic exam

  Deductible Expense Non-deductible Expense
Specialist visit $ 250  
Lab test $ 150  
Over-the-counter (OTC) allergy meds   $ 20
Total Caroline spent this month   $ 420
Year-to-date total Caroline spent $655

July

Health Event: Cyst diagnosis and outpatient surgery

  Deductible Expense Non-deductible Expense
Provider outpatient hospital facility visits $ 905  
25% coinsurance on remaining $345 $ 86.25  
Rx: Tier 2 post-surgical narcotic $ 18.75  
Over-the-counter (OTC) allergy meds   $ 20
Total Caroline spent this month   $ 1,030
Year-to-date total Caroline spent $1,685

September

Health Event: Bicycle accident

  Deductible Expense Non-deductible Expense
Provider and urgent care center visits $ 218.75  
Rx: Tier 2 antibiotics $ 18.75  
Physical therapy $ 250  
Over-the-counter (OTC) allergy meds   $ 20
Total Caroline spent this month   $ 508
Year-to-date total Caroline spent $2,193

November

Health Event: Strep throat

  Deductible Expense Non-deductible Expense
Telemedicine consultation   $ 30
Rx: Tier 1 antibiotics $ 6.25  
Over-the-counter (OTC) allergy meds   $ 20
Total Caroline spent this month   $ 56.25
Year-to-date total Caroline spent $2,248.75
$0
January 1
$0 $1,600
$3,800
December 31
Deductible: You Pay 100%
Coinsurance: You Pay 25%, Plan Pays 75%
Plan pays: 100%
Out-of-pocket Maximum $3,800
I Fictional example. Any similarity to a real individual is unintended. Assumes employee only coverage; in-network care only.

 

Silver option features a “True Family” deductible. If you enroll in any coverage other than Employee only, the “Family” deductible must be met before cost-sharing begins for any covered individual.

Smart considerations

A Health Savings Account is available only with the Silver option because it is a high-deductible health plan (HDHP).

CONTRIBUTIONS
are pretax (so your gross pay is lower for tax purposes, too)

INTEREST
accrues untaxed

EXPENDITURES
for qualified expenses are tax-free

Bottom line: If you need predictability in cost or don’t want to save money in an HSA, the Silver option probably will not be a good fit.

The Gold option may be the right choice for you if:

You want a low annual deductible in exchange for higher premiums.

and

You don’t want to save money in a Health Savings Account to meet your deductible.

and

You like predictability—to know exactly what you’ll pay when you see a provider or fill a prescription, i.e. copayments (copays).

Before you make a final decision, however, we encourage you to examine the Gold option closely and think carefully about your healthcare needs.

Your cost

How much you’ll pay for a medical option is a three-component equation:

1

What you pay to have coverage

2

What you pay when you need care

3

What you save for future healthcare needs

Monthly premiums

Copayments (Copays)

Deductible

Healthcare savings

Varies depending on ZIP code and coverage level

Primary: $25
Specialist: $40

Employee only: $800
Family: $1,600

Flexible spending account
2023 contribution limit:
Employee only: $2,850
  • Your per-paycheck cost
  • How much you pay when you see a provider
  • Copayments do not count toward your deductible
  • Deductible: The amount you have to reach before the option shares the cost of your care
  • Coinsurance: 25%
    Your percentage of the cost of care that is shared with the option after you meet the deductible
  • Pretax payroll contributions
  • How you can cover your out-of-pocket costs, including: medical and prescription copayments; your deductible and coinsurance; and other planned and unplanned out-of-pocket healthcare needs

How does the Gold option work for Caroline1?

January

Health event: Preventive exam (i.e. annual physical)

  Deductible Expense Non-deductible Expense
Preventive visit $ 0 $ 0
Over-the-counter (OTC) allergy meds   $ 20
Total Caroline spent this month   $ 20
Year-to-date total Caroline spent $20

March

Health event: Sinus infection diagnosis

  Deductible Expense Non-deductible Expense
Provider visit   $ 25
Rx: Tier 1 antibiotic   $ 10
Over-the-counter (OTC) allergy meds   $ 20
Total Caroline spent this month   $ 55
Year-to-date total Caroline spent $75

May

Health Event: Abnormal test follow up for diagnostic exam

  Deductible Expense Non-deductible Expense
Specialist visit   $ 40
Lab test $ 150  
Over-the-counter (OTC) allergy meds   $ 20
Total Caroline spent this month   $ 210
Year-to-date total Caroline spent $285

July

Health Event: Cyst diagnosis and outpatient surgery

  Deductible Expense Non-deductible Expense
Provider outpatient hospital facility visits $ 1,250  
Rx: Tier 2 post-surgical narcotic   $ 40
Over-the-counter (OTC) allergy meds   $ 20
Total Caroline spent this month   $ 1,310
Year-to-date total Caroline spent $1,595

September

Health Event: Bicycle accident

  Deductible Expense Non-deductible Expense
Provider and urgent care center visits $ 875  
Rx: Tier 2 antibiotics   $ 40
Physical therapy   $ 640
Over-the-counter (OTC) allergy meds   $ 20
Total Caroline spent this month   $ 1,575
Year-to-date total Caroline spent $3,170

November

Health Event: Strep throat

  Deductible Expense Non-deductible Expense
Telemedicine consultation   $ 30
Rx: Tier 1 antibiotics   $ 10
Over-the-counter (OTC) allergy meds   $ 20
Total Caroline spent this month   $ 60
Year-to-date total Caroline spent $3,230
$0
January 1
$0 $800
$3,600
December 31
Deductible:
You Pay 100%
Coinsurance: You Pay 25%, Plan Pays 75%
Plan pays: 100%
Out-of-pocket Maximum $3,600
I Fictional example. Any similarity to a real individual is unintended. Assumes employee only coverage; in-network care only.

Smart considerations

A flexible spending account may be a smart way to manage your out-of-pocket healthcare expenses for the year. Just remember that you have to use the balance in your FSA annually or you forfeit the remainder.

Gold vs. Gold II—California

California has two Gold options. The Gold II option is an HMO with only in-network benefits.

 

Gold

Gold II

PREVENTIVE CARE

100% covered

100% covered

COPAYMENT (COPAY)
Primary physician / Specialist

$25 / $40

$25 / $40

DEDUCTIBLE
Employee only / Family

$800 / $1,600

None

COINSURANCE

25%

30%

out-of-pocket maximum

$3,600 / $7,200

$5,400 / $10,800

HEALTHCARE ACCOUNT

Flexible spending account optional
Health Savings Account not available

Flexible spending account optional
Health Savings Account not available

PRESCRIPTION

    

Tier 1
Tier 2
Tier 3

$10
$40
$60

$10
$40
$60

MEDICAL OPTION

Preferred Provider Organization (PPO)

Health Maintenance Organization (HMO)
Only in-network benefits

Notes: In-network rates shown only. PCP is your primary care physician. Deductible and out-of-pocket maximum listed as Employee only / Family.

The Platinum option may be the right choice for you if:

You don’t mind paying the highest premiums.

and

You don’t want to save money in a Health Savings Account for current or future healthcare needs.

and

You like the predictability of copayments when you see a provider or fill a prescription.

Before you decide, please carefully compare the premiums of all the metallic coverage options. For example, the money you’d save in premiums between the Platinum and Silver options could go into an HSA that lowers your taxable gross income and offers an investment opportunity.

Your cost

How much you’ll pay for a medical option is a three-component equation:

1

What you pay to have coverage

2

What you pay when you need care

3

What you save for future healthcare needs

Monthly premiums

Copayments (Copays)

Deductible

Healthcare savings

Varies depending on ZIP code and coverage level

Primary: $25
Specialist: $40

Employee only: $250
Family: $500

Flexible spending account
2023 contribution limit:
Employee only: $2,850
  • Your per-paycheck cost
  • How much you pay when you see a provider
  • Copayments do not count toward your deductible
  • Deductible: The amount you have to reach before the option shares the cost of your care
  • Coinsurance: 15%
    Your percentage of the cost of care that is shared with the option after you meet the deductible
  • Pretax payroll contributions
  • How you can cover your out-of-pocket costs, including: medical and prescription copayments; your deductible and coinsurance; and other planned and unplanned out-of-pocket healthcare needs

Smart considerations

A flexible spending account may be a smart way to manage your out-of-pocket healthcare expenses for the year. Just remember that you have to use the balance in your FSA annually or you forfeit the remainder.

 

 

What to know about prescriptions

  • Prescription coverage is included with your medical option.
  • If you’re enrolled in the Silver option, prescriptions are subject to the medical plan deductible—meaning you will pay the full cost of non-preventive medications until you reach the annual deductible under the medical plan.
  • You can use your HSA to pay for prescription drugs.
  • Maintenance medications must be filled with a 90-day supply at the pharmacy to avoid paying the full cost of the medication.
  • If you are not currently prescribed a 90-day supply, you can receive up to two 30-day courtesy fills at any network retail pharmacy.
  • If either you or your doctor requests a brand-name medicine when a generic is available, you will pay the brand copay, plus the difference in cost between the brand and generic medicine.
  • Generics, if available, will be substituted for brand medicines unless your doctor indicates “Dispense as Written” on the prescription, or you request to receive only the brand medicine.

 

 

 

Comparing plans

 

BRONZE PLUS

SILVER

GOLD

PLATINUM

PREVENTIVE CARE

100% covered

100% covered

100% covered

100% covered

PREMIUMS
Rates depend on ZIP code and coverage level

$

$

$$

$$$

COPAYMENT
PCP / Specialist

$30 / $50

You pay the cost of visit until deductible is met

$25 / $40

$25 / $40

URGENT CARE

$50

None

$40

$25

DEDUCTIBLE
Employee only / Family

$2,300 / $4,600

$1,600 / $3,200

$800 / $1,600

$250 / $500

COINSURANCE

30%

25%

25%

15%

Out-of-pocket maximum

$6,700 / $13,400

$3,800 / $7,600

$3,600 / $7,200

$2,300 / $4,600

HEALTHCARE ACCOUNTS
Flexible spending
account (FSA)
Health Savings Account (HSA)

FSA optional
HSA not available

Dental and vision FSA optional
HSA available

FSA optional
HSA not available

FSA optional
HSA not available

PRESCRIPTION Copayment

      

Tier 1
Tier 2
Tier 3

$12
$60
$80

No copayments
25% after deductible

$10
$40
$60

$8
$30
$50
  • In-network rates shown only.
  • Deductible and out-of-pocket maximum listed as Employee only / Family.
  • Silver option features a “True Family” deductible, which means that under Family coverage you must meet the full deductible before the option begins sharing cost for any covered person.
  • Notes for CA employees: Certain carriers in California may be an exception, depending on ZIP code. California has an additional Gold option. See comparison of Gold and Gold II.

Comparing costs

$-$$$ = Costs low to high

HOW OPTIONS
DIFFER

BRONZE PLUS

SILVER

GOLD

PLATINUM

PAY NOW OR PAY LATER?

$     Monthly premium
$$   Coinsurance
$$   Copayment
$$$ Deductible
$$$ Out-of-pocket maximum
$$   Rx

$    Monthly premium
$    Coinsurance
…..Copayment: You pay 100%
…..until you reach
…..the deductible
$$  Deductible
$$  Out-of-pocket maximum
….. Rx2

$$ Monthly premium
$   Coinsurance
$   Copayment
$   Deductible
$$ Out-of-pocket maximum
$$ Rx

$$$ Monthly premium
….._Coinsurance: None
$     Copayment
….._Deductible: None
$     Out-of-pocket maximum
$      Rx

HEALTHCARE SAVINGS ACCOUNTS?
Flexible spending account is available with all metallic levels

Medical, prescription, dental and vision expenses

  • Pretax contributions
  • IRS-defined contribution limit
  • Use annually

Dental and vision expenses only

  • Pretax contributions
  • IRS-defined contribution limit
  • Use annually

Medical, prescription, dental and vision expenses

  • Pretax contributions
  • IRS-defined contribution limit
  • Use annually

Medical, prescription, dental and vision expenses

  • Pretax contributions
  • IRS-defined contribution limit
  • Use annually

HSA (Health Savings Account) is available with Silver option

No HSA

All of the above and:
Medical, prescription, dental and vision expenses

  • Balance rolls over year to year
  • Accrues interest
  • Take it with you if you change jobs
  • Can be invested

No HSA

No HSA

PREDICTABILITY?
  • Know how much you’ll pay in copayments to see your doctor or a specialist
  • Copayments do not count toward the deductible
  • You’ll pay 100% of the cost until you meet the deductible
  • Costs often vary among providers
  • Know how much you’ll pay in copayments to see your doctor or a specialist
  • Copayments do not count toward the deductible
  • Know how much you’ll pay in copayments to see your doctor or a specialist

NETWORK?
  • Insurance carrier options depend on your ZIP code
  • In- and out-of-network deductibles add up separately
  • Insurance carrier options depend on your ZIP code
  • In- and out-of-network deductibles add up separately
  • Insurance carrier options depend on your ZIP code
  • In- and out-of-network deductibles add up separately
  • Network availability depends on your ZIP code
  1. In the Silver option:
    • You don’t pay a copay when you see a doctor. Instead, you are responsible for your share of the cost, which varies, depending on whether you’ve met your annual deductible.
    • Prescriptions are paid like every other medical expense: covered individual pays 100% of the cost until the deductible is met, which means your Rx cost will initially be higher, then prescriptions are subject to coinsurance.