Health Insurance

This is the policy for the US offices.

Questions

If you have questions regarding your health insurance, please email benefits@thoughtbot.com.

Eligibility

All employees working 30 or more hours per week are eligible to enroll in a health plan immediately upon starting with thoughtbot. Your effective date is your start date.

Medical Insurance

We pay 100% of the medical insurance premiums for individuals and up to 90% for their families. Family plans cover spouses and/or children.

2019 Medical Benefits

thoughtbot offers Blue Cross Blue Shield Preferred Blue PPO (BCBS) to all full-time US team members. Additionally, in California we also offer Kaiser Permanente Platinum 90 HMO 0/15. Our plan years run on a calendar year cycle: January 1st to December 31st.

Blue Cross Blue Shield Preferred Blue PPO (BCBS)

The BCBS plan has a deductible of $500 for individuals and $1000 for families for in-network or out-of-network care. Please note that the in-network deductible and out-of-network deductible are two separate deductibles.

With the PPO plan, you do not need to get a referral from a primary care doctor before seeing a specialist. But you should make sure all providers you see are in-network. In-network providers will get approval from BCBS before a procedure. It is your responsibility to get approval from BCBS before a procedure if you see an out-of-network provider. Services requiring pre approval are noted under Limitations & Exceptions in the Summary of Benefits & Coverage.

In-network coverage is fully covered or requires a modest co-pay ($20 for Primary care doctor/specialists/Urgent Care visits-$150 for the ER) or deductible. Out-of-network coverage requires you pay 20% co-insurance.

Create a log-in at MyBlue Member to see if your doctor is in-network, view claims, review benefits, request an ID card, etc, etc.

The BCBS Preferred Blue PPO gives members the opportunity to be reimbursed for up to 3 months of gym memberships or weight-loss program fees. Members can also participate in Healthy Actions where you are able to earn money for simply getting a physical. Information on these programs as well as request forms can be found in the Blue Cross Blue Shield Dropbox folder.

Because we cover 100% of premiums for individuals, your monthly contribution is $0 on an individual plan. On a family plan your monthly contribution varies by coverage.

2019 BCBS Medical Plans Employee Pays
Employee only $0.00
Employee + spouse $83.49/month ($38.53/payroll)
Employee + child(ren) $68.31/month ($31.53/payroll)
Employee + family $151.80/month ($70.06/payroll)

Kaiser Permanente Platinum 90 HMO 0/15

With an HMO plan you will need to get referral from your Plan Physician before you are able to see a specialist. There is a $0 deductible on this plan, but there are modest co-pays ($15 for primary doctor/Urgent Care, $30 for a specialist, and $150 for ER visit) There is no out-of-network coverage.

Create a login on the Kaiser Permanente website to find a doctor, schedule/cancel appointments, manage prescriptions, etc.

Information on the plan can also be found on the Kaiser Permanente summary of benefits & coverage

thoughtbot covers 100% of premiums for individuals, your monthly contribution is $0 on an individual plan. The Kaiser rates are based on age, so costs for adding a dependent will vary with thoughtbot covering 90%.

Please email benefits@thoughtbot.com with questions.

Flexible Spending Account

We provide access to a Flexible Spending Account - which allows you to put aside up to $2,700 per year in 2019, pre-tax to pay for eligible medical expenses. The 2018 yearly limit was $2,650. The FSA has a minimum election of $500. The IRS allows up to $500 to rollover to the next plan year. There is a 90 day grace period at the end of the year to submit receipts for expenses incurred during the plan year. Any funds over $500 that are not claimed during the 90 day grace period will be lost.

Our FSA is administered by WageWorks. You will receive a FSA debit card from WageWorks if you enroll. You may order additional cards for your dependents on the WageWorks website. Your account will show the full balance of your elected yearly contribution immediately, and this amount can be used to pay for expenses immediately. The account will be funded in even payroll withdrawals throughout the year. Please see the WageWorks FSA guide for details on using your account.

FSA funds can only be used for expenses incurred while you are employed at thoughtbot. You cannot take unused funds with you when your employment ends.

Wage Works Balances & Claims

You can check the balance of your WageWorks accounts (FSA, DCA, Parking & Transit), file claims, request a replacement card and update your address on the WageWorks website. Additionally, you can enroll and change your elections for Parking and Transit on the website.

To request a replacement card- login into your account and select Card Center at the top of the screen.

Dependent Care Account

A Dependent Care Account (DCA) allows you to contribute to pre-tax dollars via payroll deductions and use those funds for custodial care of dependents while you are at work. This can include daycare, preschool, summer day camp, babysitting while you are at work, adult daycare and more for children and adult dependents.

The DCA plan year runs on a calendar year basis. Funds must be used for expenses incurred during the calendar year or the first 2.5 months of the following year (grace period.) Claims must be filed within 90 days of the end of the plan year.

The maximum contribution per household is $5,000 if you are single, or you are married and filing a joint tax return, or $2,500 if you are married, filing separate tax returns. Money is deposited into your account each time it is deducted from your paycheck.

Our FSA is administered by WageWorks. WageWorks does not issue debit cards for the DCA. Claims must be submitted online or by mail.

Funds can only be used for expenses incurred while you are employed at thoughtbot. You cannot take unused funds with you when your employment ends.

Dental Insurance

Dental Insurance is through Principal Financial Group. Our plan years run on a calendar year cycle: January 1st to December 31st. We cover 100% of the premium for the preventative Core Plan for employees and their families.

You can also choose to upgrade your Dental coverage to the Enhanced plan. If you opt in you are responsible for the difference in the coverage cost. Compare the plans and view the entire Enhanced plan description in the Dental folder. The cost for dental coverage had not increased, therefore the cost remains the same in 2019 as it was in 2018.

2019 Dental Plans Employee Pays
Core Plan, Employee only $0.00
Core plan, Employee + family $0.00
Enhanced plan, Employee $37.49/month ($17.30/payroll)
Enhanced Plan, Employee + family $94.77/month ($43.74/payroll)

Find a dentist in your area.

Additionally, our dental plan offers discounts on eye exams, corrective lenses and more through the VSP Access Plan.

Vision Coverage

We pay 100% of the vision coverage premiums for both families and individuals. Our plan years run on a calendar year cycle: January 1st to December 31st.

2019 Vision coverage is though Principal via the VSP network. If you enroll in vision overage it will be listed on the same ID card as your Dental card.

2018 Vision coverage is through [Cigna Vision][cigna-vision-summary]. If you enroll in vision coverage, it will be listed on the same ID card as your Cigna medical insurance.

Changing Information

You have 30 days to make changes after life events (marriage, child birth, etc). Otherwise changes must be made during the open enrollment period.

To change your enrollment following a life event, visit the benefits section in Namely. It’s located just above the paystub link on your homepage.

We may follow up with you to collect additional information necessary to make the requested change.

Termination

Unless otherwise stated, upon termination, your medical benefits will remain in effect until the last day of the month in which you are terminated.

Upon termination you may be entitled to continuation or conversion of the group medical insurance plan in accordance with the terms of the policy and/or applicable state and federal law. For more information, contact benefits@thoughtbot.com.