There are no design changes to the medical plans offered for 2020. As a reminder, there are four national plans, all administered by Anthem, Cigna and Aetna*:
|$400 Deductible Plan||A plan that offers greater predictability of costs through copays for doctor’s visits and prescriptions, along with a low deductible and has the highest per-paycheck contributions.|
|$900 Deductible Plan||The $900 Deductible Plan offers slightly lower out-of-pocket costs in exchange for higher per-paycheck contributions. With this plan, your costs are more predictable, but you’ll likely still have out-of-pocket expenses. You can see any provider you wish, but you will pay less when you stay in network.|
|$1,850 Deductible Plan**||A consumer-directed plan that puts you in charge of your spending through lower per-paycheck contributions, higher deductibles, and a tax-free Health Savings Account (HSA). Pearson will make a contribution in 2020 of up to $500 if you cover yourself only and up to $1,000 if you cover yourself and dependents.|
|$2,850 Deductible Plan||Another consumer-directed plan that puts you in charge of your spending through the lowest per-paycheck contributions, higher deductibles, and a tax-free Health Savings Account (HSA). Pearson will make a contribution in 2020 of up to $500 if you cover yourself only and up to $1,000 if you cover yourself and dependents.|
*Aetna provides a narrower network than Anthem and Cigna but comes with lower per paycheck contributions and out-of-pocket costs. It is only available in certain states.
Anthem BCBS Members Will Receive New ID Cards With a New Group Number:
Due to a migration to a new claims platform, all Anthem enrolees will receive a new ID card with a new Group Number (270096) for 2020. New ID cards will be mailed to your address in Fusion before the beginning of the year.
Are Consumer-Directed Health Plans an option you want to consider in 2020?
Pearson offered Consumer Directed Health Plans ($1,850 and $2,850 Deductible Plans) for the first time in 2019. In case you still have questions about these plan options, here’s a snapshot of how they work:
- Lower paycheck costs — allowing you to keep control over more of your money.
- You pay 100% of your medical and prescription drug costs until you meet the annual deductible.
- After meeting the deductible, you and the plan share the cost of covered medical care and prescriptions, with the plan paying the majority.
- You’re protected by an annual limit on costs — the out-of-pocket maximum. Once you hit it, the plan pays 100% of any further eligible expenses for the rest of the year.
- Enrolling in and contributing to a Health Savings Account (HSA) helps you pay your deductible and other out-of-pocket costs.
- These plans use the same networks that other plans offer, and you pay nothing for in-network preventive care — it’s covered in full.
The site Consumer-Directed Health Plans provides a more in-depth review of these types of plans.
Did you know?
As an enrollee in the $1,850 or $2,850 plan you can access the Consumer-Directed Health Plan Preventive Drug List? This is a list of medications that are not subject to the deductible. This means that you don’t have to meet the deductible before the plan pays 80% (or 70% if enrolled in the $2,850 plan) of the cost.
A Note About the $1,850 Deductible Plan
If you enroll in the $1,850 Deductible Plan and cover dependents, the full family deductible must be met before the Plan pays benefits for any family member. Any covered family member can contribute to the family deductible. The individual deductible only applies if you elect the employee-only coverage tier. In addition, the full family out-of-pocket maximum must be met before the Plan pays benefits at 100% for any family member. Any covered family member can contribute to the family out-of-pocket maximum. The individual out-of-pocket max only applies if you elect the employee-only coverage tier. Please call the Pearson Benefits Marketplace at 855-237-6421 if you have any questions.
Like the national plans, there are no changes to the Kaiser HMO (California), Triple-S (Puerto Rico) and HMSA (Hawaii) options for 2020. Coverage information for these offerings can be found here.
Supplemental Medical Options
Pearson offers supplemental medical options* — Accident, Critical Illness and Hospital Indemnity Insurance — that provide cash payments in the event of a significant unexpected medical expense. You pay the full cost of coverage through after-tax payroll deductions. Be sure to consider your anticipated medical needs for the coming year — for example, a major surgery — when deciding if supplemental coverage is right for you.
It’s important to note that you can only enroll in supplemental medical coverage during open enrollment unless you experience a qualifying life event. However, you will be able to cancel your coverage anytime. You will not be required to provide evidence of insurability when you enroll in coverage during open enrollment. You do not need to be enrolled in a Pearson medical plan to enroll in supplemental medical coverage.
*Supplemental Medical coverage is not available to residents of Puerto Rico.
Pearson will continue to offer two dental options. There are no changes and employees can select between the Delta Dental PPO and the Cigna DHMO (Cigna Dental Care). Each of the dental options offer free in-network preventive care and ortho coverage for children and adults.