Medical
Whether you have a chronic condition like high cholesterol or asthma, or your child comes down with the flu, your medical benefits have you covered.
To keep you and your family healthy, ZOLL offers two great medical plan options:
- Saver Plan with HSA
- PPO90
Most ZOLL employees will receive medical coverage through UnitedHealthcare. Cardiac Management Solutions employees who live in and around Pittsburgh, PA will receive the same coverage through Aetna.
Hawaii Employees – Hawaii employees have access to all of ZOLL’s U.S. benefits, with medical coverage provided through HMSA. Contact your local HR Benefit Advocate with questions.
How the Plan Works
Both plans provide:
- The same comprehensive medical coverage as well as Mental Health, Substance Use, and Fertility benefits. Remember, you will pay less when you use in-network providers.
- Prescription Drug benefits through OptumRx.
- Preventive Care at 100% when you stay in network.
The plans differ in your cost of coverage, tax-advantaged account eligibility and how the deductible and out-of-pocket costs are determined.
| Saver Plan with HSA | PPO90 | |
|---|---|---|
| Your Cost of Coverage each paycheck | Lower | Higher |
| Annual Deductible | Higher | Lower |
| When you’re enrolled in Employee + One or Family Coverage | The entire family deductible must be met before the plan begins to pay benefits at 90% coinsurance for any family member. The individual deductible is waived. |
The plan pays 90% for any family member once they meet their individual deductible. Once the maximum family deductible is met by any family members, the plan pays 90% for all covered members, even those who have not met their individual deductible. |
| Out-of-Pocket Maximum | Higher | Lower |
| When you’re enrolled in Employee + One or Family Coverage | The entire family out-of-pocket maximum must be met before the plan pays 100% for any family member. The individual out-of-pocket maximum is waived. |
The plan pays 100% for any family member once they meet their individual out-of-pocket maximum. Once the family out-of-pocket maximum is met by any family members, the plan pays 100% for all covered members, even those who have not met their individual out-of-pocket maximum. |
| Best for employees who | …are actively engaged in decisions about their benefits. …are looking for short- and long-term savings opportunities. |
…want a plan design based on a copay/coinsurance structure, and don’t mind paying higher premiums. |
| Tax Advantaged Accounts | Health Savings Account (HSA) Limited Purpose Flexible Spending Account (FSA) |
Health Care Flexible Spending Account (FSA) |
| ZOLL HSA Contribution | Employee Only – $650 Employee + One or Family Coverage – $1,300 |
N/A |
Learn More about HSAs.
When you are not feeling well, it’s important to Know Where to Go for Care.
Medical Plan Comparison
| Medical Plan Highlights | ||
|---|---|---|
| Saver Plan with HSA In-Network* |
PPO90 Plan In-Network* |
|
| Calendar year deductible | $1,600 Individual $3,200 Family |
$1,000 Individual $2,000 Family |
| Calendar year out-of-pocket maximum |
$3,000 Individual $6,000 Family |
$2,000 Individual $4,000 Family |
| Annual HSA funding by ZOLL |
$650 Employee $1,300 Employee + 1 $1,300 Family |
N/A |
| Office visits Preventive care Diagnosis treatment Specialist |
Covered at 100%, no deductible 10% after deductible 10% after deductible |
Covered at 100%, no deductible $25 copay, no deductible $40 copay, no deductible |
| Telemedicine – $ | Covered at 100% after Deductible | $15 copay |
| Urgent Care – $$ | 10% after deductible | $25 copay |
| Emergency room – $$$ | 10% after deductible | 10% after deductible |
| Inpatient care (includes physician/surgeon fees and maternity care) |
10% after deductible | 10% after deductible |
| Outpatient care (includes physician/surgeon fees and maternity care) |
10% after deductible | Covered at 100% after $150 copay per procedure |
| Hospital and other day surgical facility services | 10% after deductible | Inpatient: 10% after deductible Outpatient: $150 per admission, no deductible |
| Fertility Treatment (in-network coverage only) |
10% after deductible | 10% after deductible |
| Hearing Benefit | Every 36 months UHC: $2,000 allowance per ear Aetna: $4,000 allowance |
Every 36 months UHC: $2,000 allowance per ear Aetna: $4,000 allowance |
| CT scans, MRIs, PET scans and other high-end imaging | 10% after deductible | 10% after deductible |
| Diagnostic X-ray and lab | 10% after deductible | 10% after deductible |
| Mental hospital or substance abuse facility |
10% after deductible | 10% after deductible |
| Short-term rehabilitation therapy, PT, and OT (up to 40 visits per calendar year) |
10% after deductible | PCP: $25 copay, no deductible Specialist: $40 copay, no deductible |
| Best for Employees who… | …are actively engaged in decisions about their benefits. …are looking for short- and long-term savings opportunities. |
…want a plan design based on a copay/coinsurance structure, and don’t mind paying higher premiums. |
* The benefits outlined above are provided when you see in-network providers. Please refer to the UnitedHealthcare and Aetna summaries for a more detailed description of in-network and out-of-network coverage.
The Saver Plan with HSA
The Saver Plan with HSA is a Consumer Driven Health Plan (CDHP) that comes with a Health Savings Account so you can pay for eligible expenses now, or in the future. The Saver Plan works in three steps:
- Meet Your Annual Deductible – You are responsible for meeting your annual deductible for in-network and out-of-network medical care and most prescription drug coverage before the plan will start to pay. In-network preventive care, like your annual physical, is covered at 100%. Preventive care is not subject to the deductible. Check out the Preventive Drug List for Consumer Driven Health Plans to see if your preventive drug is subject to copay instead of deductible!
- Share the Cost of the Plan – Once you and your dependents meet the annual deductible, you and the plan share the cost. The plan pays 90% after the deductible for all in-network medical care is met. It’s important to keep in mind that if you are enrolled in employee + one or family coverage, the individual deductible for each member is waived. This means you and your covered dependents are sharing costs to meet the deductible.
- Reach the Out-of-Pocket Maximum – If you and your dependents meet the out-of-pocket maximum before the plan year ends, the plan will pay 100% of your medical care and prescription drug cost for the rest of the plan year. The individual out-of-pocket maximum is waived if you are enrolled in employee + one or family coverage. This means you and your covered dependents are sharing costs to meet the out-of-pocket maximum.
PPO90 Plan
The PPO90 is a traditional Preferred Provider Organization Plan (PPO) that pays 90% coverage when you visit an in-network provider. When you enroll in a PPO you:
- Contribute more money toward your medical premium each paycheck
- Pay co-pays for most office visits, except for preventive care, like your annual physical, which is covered at 100%
- Have a lower out-of-pocket cost when utilizing in-network providers, but also have coverage for out-of-network providers
Fitness and Weight Loss Reimbursement Program
ZOLL offers you and your covered dependents up to $300 annually for expenses related to Qualified Health Club Memberships and Weight Loss Programs:
- The Reimbursements are offered per household, per calendar year for employees and/or their dependents enrolled in a ZOLL Medical Plan.
- Up to $150 can be reimbursed for each program per calendar year. This is up to $300 in reimbursable savings!
- The Fitness Reimbursement can be used for Qualified Health Club Memberships, which must have both cardiovascular (i.e., treadmills, bikes, elliptical machines) and strength training (i.e. free weights, weight machines) exercise equipment.
- Examples of Qualified Health Clubs can include YMCA, YWCA, LA Fitness, Bally’s, Lifetime Fitness, Boost Fitness, Best Fitness, community Fitness Centers, virtual fitness programs (i.e., Peloton), Crossfit, Yoga, Spin, and Barre.
- The Weight Loss Reimbursement can be used for Weight Watchers Traditional and Online programs, hospital-based weight loss programs (offered by and held at licensed hospitals) and other online weight loss programs such as NOOM and My Fitness Pal.
Click here for the Aetna Fitness and Weight Loss Reimbursement Form.
Aetna is available to employees located in the greater Pittsburgh, PA area only*
How to Submit Reimbursement Forms
- The best way to submit your UHC Fitness and/or Weight loss Reimbursement Forms is in your MyUHC.com member portal. Not sure how? Click here for a step-by-step job aid that will show you.
- If you choose to mail your form to UHC’s P.O. Box, please retain a copy for your records. Processing times may vary. If you do not receive your reimbursement within 90 days after mailing it in, please contact your local HR Benefit Advocate
- Employees with Aetna may submit their form via fax or upload it to the Aetna Member Portal:
- Fax: 866-474-4040 (Attn: Claims)
- Portal – Go to messages and upload documents
Check These Out!
UHC offers a variety of health and wellness presentations and articles designed to support healthier habits for you and your family throughout the year. Check out the Health and Wellness Resource Calendar to learn more.
New to ZOLL? Visit WhyUHC to compare our plan options and costs, and to check if your doctors and medications are in the UHC network.
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