| 2024 BENEFIT PLAN OVERVIEW | |||||||
| MONTHLY COST | |||||||
| MEDICAL COVERAGE | Employee | Employee + Child(ren) | Employee + Spouse | Employee + Family | |||
| Kaiser HMO Socal 2024 Kaiser HMO SoCal Plan Chart 2024 Kaiser HMO SoCal Summary of Benefits and Coverage | When you enroll in the Kaiser Permanente HMO, you must receive all your care from doctors and hospitals affiliated with Kaiser. Unlike other HMOs, you do not have to choose a primary care doctor. However, you must get a referral to specialists. The only exceptions are emergency room visits OR urgent care visits when you are outside Kaiser’s service area. To find Kaiser locations, visit my.kp.org/caltech. | $152 | $321 | $369 | $574 | ||
| Kaiser HMO Washington 2024 Kaiser HMO Washington Plan Chart 2024 Kaiser HMO Washington Summary of Benefits and Coverage Kaiser Nondiscrimination Notice (WA) | When you enroll in the Kaiser Permanente HMO, you must receive all your care from doctors and hospitals affiliated with Kaiser. Unlike other HMOs, you do not have to choose a primary care doctor. However, you must get a referral to specialists. The only exceptions are emergency room visits OR urgent care visits when you are outside Kaiser’s service area. To find Kaiser locations, visit my.kp.org/caltech. | $152 | $321 | $369 | $574 | ||
| Hawaii HMSA 730 CompMED with Vision Plan 2024 Hawaii Medical Service Association Plan Chart (HMSA) | January 1, 2024, employees living and working in the state of Hawaii, will be offered the CompMED 730 with Vision plan to comply with Hawaii state law requirements. Employees located in Hawaii with employee only coverage, will be offered this medical plan at zero cost. Employees with dependents will be responsible for an employee cost share of the monthly premium – see chart below for more details. The CompMED 730 plan includes vision coverage, as such, a separate enrollment in the VSP plan is not needed. If you enroll in an Anthem PPO plan, HMSA utilizes the same Anthem Blue Cross/Blue Shield network of providers. You can search for providers by visiting www.hmsa.com/search/providers and selecting CompMED from the Medical Plan selection menu. | $0 | $369 | $369 | $574 | ||
| Anthem HMO 2024 Anthem HMO Plan Chart 2024 Anthem HMO Summary of Benefits and Coverage | When you enroll in the Anthem HMO, you choose a Participating Medical Group (PMG) and a Primary Care Physician (PCP). You must be referred by your PCP to specialists and receive authorization from your assigned PMG for any medical services. If you need urgent care services and you are inside the HMO’s service area, contact your PMG to find the contracted urgent care you should use. The only exceptions are emergency room visits OR urgent care visits when you are outside the HMO’s service area. You can find Anthem HMO providers at www.anthem.com/ca/caltech (search in the Advantage HMO network) | $186 | $394 | $456 | $707 | ||
| Anthem HDHP 3200 (With HSA) 2024 Anthem HDHP 3200 Plan Chart 2024 Anthem HDHP 3200 Summary of Benefits and Coverage | When you enroll in the HDHP 3000 plan, there is a per person deductible of $3,200 and a family maximum of $6,400. You can see any doctor or provider you want, but you pay more when you see providers outside the Anthem Blue Cross PPO network. If you visit an out-of-network provider, you will be responsible for paying any amounts in excess of the “eligible charges” based on the customary and reasonable rate as determined by the plan. You can find Anthem Blue Cross PPO providers at www.anthem.com/ca/caltech. | $59 | $123 | $140 | $220 | ||
| Anthem HDHP 1800 (With HSA) 2024 Anthem HDHP 1800 Plan Chart 2024 Anthem HDHP 1800 Summary of Benefits and Coverage | When you enroll in the Anthem HDHP 1800 plan, if you are covering one or more dependent(s) in the family deductible of $3,600 must be met prior to the insurance paying claims for non-preventive visits. If you cover yourself only, the deductible is $1,800. You can see any doctor or provider you want, but you pay more when you see providers outside the Anthem Blue Cross PPO network. If you visit an out-of-network provider, you will be responsible for paying any amounts in excess of the “eligible charges” based on the customary and reasonable rate as determined by the plan. You can find Anthem Blue Cross PPO providers at www.anthem.com/ca/caltech. | $165 | $348 | $395 | $623 | ||
| Anthem Blue Card PPO 2024 Anthem BlueCard Plan Chart 2024 Anthem HDHP Bluecard PPO Summary of Benefits and Coverage | You must be an Institute employee who is assigned to work at an Institute location outside of California at the request of the Institute, you and your Dependents may be able to enroll in coverage under the Blue Card PPO Plan with Anthem Blue Cross. Before you leave, contact the JPL Benefits Office for further details. | $152 | $321 | $369 | $574 | ||
| Delta Dental PPO (Standard) 2024 Delta Dental Comparison Chart 2024 Delta Dental Plan Chart (Standard) | With the Delta Dental PPO (Standard) plan, you can choose to see any licensed dentist, but to maximize your savings, visit a dentist in the PPO network. These dentists have agreed to reduced fees, and you will not get charged more than your expected share of the bill. If you cannot find a PPO dentist, Delta Dental Premier dentists offer the next best opportunity to save. Unlike non-Delta Dental dentists, they have agreed to set fees, and you will not get charged more than your expected share of the bill. To find a participating dentist, visit www.deltadentalins.com/caltech. | $13 | $28 | $32 | $51 | ||
| Delta Dental PPO (Enhanced) 2024 Delta Dental Comparison Chart 2024 Delta Dental Plan Chart (Enhanced) | With the Delta Dental PPO (Enhanced) plan, you have the same great benefits and network access as the “Standard” Delta Dental PPO, but with a higher annual benefit maximum, higher in-network coverage for basic and major services, and more orthodontia coverage with a higher lifetime maximum that also includes adult coverage. To find a participating dentist, visit www.deltadentalins.com/caltech. | $17 | $36 | $41 | $65 | ||
| Metlife DHMO 2024 MetLife DHMO Dental Plan Chart MetLife Schedule of Benefits | With the MetLife DHMO, you must choose your dentist from the MetLife DHMO directory. Each family member may choose a different dentist. If necessary, your dentist will refer you to a specialist for certain types of care, such as endodontics, periodontics, oral surgery or orthodontia. Except for some emergency situations, you will not receive a benefit for out-of-network services. | $2 | $4 | $5 | $10 | ||
| Vision Service Plan (VSP) 2024 VSP Plan Chart | You can receive eye services and supplies from any vision care provider you choose, but you save money when you use a VSP Choice network provider. VSP provides coverage for eye exams and glasses (frames and lenses) or contact lenses. To search for a VSP Choice network provider, visit www.vsp.com. | $2.28 | $3.42 | $3.44 | $6.70 | ||
| HEALTH SAVINGS ACCOUNT (HSA) | |||||||
| Health Savings Account (HSA) | You can enroll in the HSA if you are enrolled in either of the Anthem Blue Cross High Deductible PPO plans. | Contribute up to the maximums listed below in 2024 for qualified health care expenses: Employee Only HDHP Coverage: $4,150 (up to $5,150 if age 55 or older in 2024) Family HDHP Coverage: $8,300 (up to $9,300 if age 55 or older in 2024) | |||||
| FLEXIBLE SPENDING ACCOUNTS | |||||||
| Healthcare Flexible Spending Account (HFSA) | Set aside pre-tax money for you and your dependents to pay for eligible medical, dental, vision and prescription drug expenses. For information on your current balance, how to seek reimbursement, or any other HFSA questions, please visit https://healthequity.com/ or contact HealthEquity Member Services at 866-346-5800. For a list of eligible HFSA expenses, visit https://www.healthequity.com/fsa-qme. | You can contribute $120 - $3,050 for the 2024 calendar year to the HFSA. | |||||
| Dependent Day Care Flexible Spending Account (DCFSA) | Set aside pre-tax money to pay for eligible dependent care expenses, while you and your spouse or domestic partner work or go to school. | You can contribute $120 to $5,000* ($2,500 if married and filing tax returns separately) for the 2024 calendar year to the DCFSA *There will be a contribution limit of $3,500 for Highly Compensated Employees (HCEs). In 2024, an HCE would be an employee who earned $150,000 or more from Caltech/JPL in 2023 and an employee hired in 2024 with an anticipated annual 2024 salary of $150,000 or more from Caltech/JPL. This is required by Section 129 of the IRS Code. | |||||
| LIFE AND ACCIDENT INSURANCE | |||||||
| Basic Life | Provides a benefit equal to one times your annual salary, up to a maximum of $50,000, in the event of your death. | Cost is fully paid for by the Institute. | |||||
| Supplemental Employee Life | Provides a benefit equal to 1, 2, 3, 4 or 5 times your annual salary (rounded to the next higher $10,000), in the event of your death. Maximum coverage amount is $1 million. | Monthly cost is based on your coverage amount and age as of January 1, and is automatically calculated in Workday. | |||||
| Supplemental Spouse/ Domestic Partner Life | Choose any $10,000 increment from $10,000 up to $200,000. Spouse life coverage amounts cannot exceed 100% of your own combined Basic and Supplemental Life Insurance coverage. | Monthly cost is based on your coverage amount and your spouse/domestic partner’s age as of January 1, and is automatically calculated in Workday. | |||||
| Supplemental Child Life | Provides a benefit of $10,000 for eligible dependent children up to age 26. | Monthly cost is $0.655, regardless of how many children you have. | |||||
| Personal Accident Insurance (PAI) | The PAI plan provides a benefit to you if you suffer a serious injury due to an accident (e.g., loss of a limb, eyesight, speech or hearing) or to your beneficiary if you die because of an accident. You may purchase PAI Insurance at a minimum of $10,000 in coverage up to a maximum of $500,000 in coverage in increments of $25,000. If you elect more than $150,000 in coverage, your benefit cannot be more than 10 times your annual salary. | Cost varies by coverage amount and whether you choose to cover eligible, and is automatically calculated in Workday. | |||||
| DISABILITY INSURANCE | |||||||
| Basic Long Term Disability (LTD) | Long-term disability (LTD) insurance protects you against the loss of income that can accompany a long-term leave due to illness or injury after six months of disability. Basic LTD coverage provides a benefit equal to 40% of your regular salary (Basic Monthly Earnings), up to a maximum of $10,000 per month. | Cost is fully paid for by the Institute. | |||||
| Supplemental Long Term Disability (LTD) | If you enroll and have been approved for participation in the Supplemental LTD Plan, your combined basic and supplemental plan benefits provide you with 60% of your basic monthly earnings, minus other income benefits, to a maximum monthly benefit of $17,500. Supplemental LTD coverage is voluntary and employee-paid with after-tax contributions. | Monthly cost is $0.137 for each $100 of your Basic Monthly Earnings. | |||||
| VOLUNTARY BENEFITS | |||||||
| Unum Accident Insurance Unum Plan Summary and Schedule of Benefits | Accident Insurance can pay a set benefit amount based on the type of injury you have and the type of treatment you need. It covers accidents that occur on and off the job. And it includes a range of incidents, from common injuries to more serious events. It can help you with out-of-pocket costs that your medical plan doesn’t cover, like copays, deductibles and coinsurance. | Cost:
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| Unum Hospital Indemnity Insurance Unum Hospital Indemnity Insurance Plan Summary | Hospital Indemnity Insurance helps covered employees and their families cope with the financial impacts of a hospitalization. You can receive benefits when you’re admitted to the hospital for a covered accident, illness or childbirth. The plan pays $1,500 for a hospital admission once per calendar year and $100 per day while hospitalized up to 365 days per calendar year. | Cost:
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| Unum Critical Illness Insurance Unum Critical Illness Insurance Plan Summary | Critical Illness Insurance can help protect your finances from the expense of a serious health problem, such as cancer, a stroke or heart attack. This plan provides a lump-sum benefit directly to you — not to a doctor or health care provider —at the first diagnosis of a covered condition. You can choose coverage levels of $10,000 or $20,000. Your spouse/domestic partner can receive 100% of your coverage amount as long as you have purchased coverage for yourself. Your eligible child(ren) from birth until the end of the month in which they reach age 26 are automatically covered at no extra cost. Their coverage amount is 100% of yours. | Monthly cost is based on coverage amount and age as of January 1 and is automatically calculated in Workday. | |||||
| LegalShield Legal Services LegalShield Legal Services Plan Summary | LegalShield’s network of law firms in each state provides personal legal services in all areas of the law. The plan provides access to professional advice to help you deal with legal matters impacting your family, home, finances, estate planning and more. Most legal services are unlimited and include services such as: consultation, contract and document review, traffic ticket representation, and will and durable power of attorney preparation. Members also receive estate planning, civil trial defense and IRS audit assistance. The Legal Services plan covers all of your eligible dependents when you enroll at no additional cost. | Cost:
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| IDShield Identity Theft Protection Services IDShield Identity Theft Protection Services Plan Summary | With IDShield, you get proactive identity and credit monitoring, along with full-service restoration if your identity is stolen, backed by a $1 million dollar identity fraud protection plan. Coverage includes unlimited consultation with identity theft specialists, monitoring of credit, financial accounts, social media, passport, medical ID, and email addresses. | Cost:
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| Medical Evacuation and Repatriation (MER) | The MER Plan provides medical and travel assistance when you are more than 100 miles away from your home. For more information, visit the ISOS Website. | Cost is fully paid for by the Institute. | |||||
| Included Health | Included Health provides all employees and dependent(s) enrolled in a Caltech medical plan a second medical opinion, help selecting doctors and more Learn more by visiting https://includedhealth.com/microsite/caltech/ | Cost is fully paid for by the Institute. | |||||
| WELLNESS PROGRAMS | |||||||
| Sonic Boom Wellness | The Sonic Boom wellness site (available via desktop or app) can help you develop healthy habits — centered around nutrition, physical activity, weight management, stress reduction and more. Sonic Boom offers fun and/or educational challenges each quarter. Try one — or all —of them. Not only will you learn healthier habits, but you’ll also stay connected with your colleagues. And, you may even earn recognition and 25,000 Boomin’ Bucks, which you can redeem for prizes. | Cost is fully paid for by JPL. | |||||
| MyLifeMatters Employee Assistance Program (EAP) | MyLifeMatters is JPL’s free and confidential Employee Assistance Program (EAP), which is available to you and your family — at no cost — whenever help is needed. Contact MyLifeMatters at (800) 367-7474 or go to mylifematters.com (enter company password JPL) at any time, day or night. You can also download the MyLifeMatters app for on-the-go access. 5 free counseling sessions with a local counselor or virtually are available, per covered person, per issue. | Cost is fully paid for by the Institute. | |||||
| Learn to Live | Learn to Live is a free and confidential interactive online option for employees and their family members (age 13 and over) who struggle with stress, depression, sleeplessness, social anxiety or substance use to receive help in the privacy of their own home, at any time. The programs offered by Learn to Live are based on the principles of Cognitive Behavioral Therapy (CBT) and provide effective tools to help you understand how your mind works and change your behavior patterns -- to help you live your best life. | Cost is fully paid for by JPL. | |||||