Medical Benefits
OVERVIEW

Medical

Nothing is more important than your overall health and wellbeing. That’s why our benefits program offers plans to help keep you and your family healthy and also provide important protection in the event of illness or injury.
Informatica offers a choice of medical insurance so you can select the coverage that’s best for you and your family. You can choose from the following options:

  • Aetna Saver Plan, a consumer directed health plan that provides coverage for in- and out-of-network care and comes with the option of a Health Savings Account (HSA). This plan is available nationwide.
  • Aetna PPO Plan, a preferred provider organization that provides coverage for in- and out-of-network care. This plan is available nationwide.
  • Kaiser HMO Plan, a health maintenance organization, provides coverage for in-network care. This plan is available for California and Hawaii residents only.



Compare medical plans

The chart below provides a comparison of key coverage features and costs for each medical plan available to you. Carefully consider your health care needs for the coming year when evaluating your options.

Coverage

Aetna Saver with HSA

Aetna PPO

Kaiser HMO
(CA Only)

Kaiser HMO
(Hawaii Only)

In-Network

Out-of-Network

In-Network

Out-of-Network

In-Network Only

In-Network Only

Annual deductible

Individual

$1,600

$3,200

$500

$1,000

None

None

Family

$3,200

$6,400

$1,200

$2,400

None

None

Out-of-pocket maximum (includes deductible & copays)

Individual

$3,000

$6,000

$2,700

$4,000

$1,500

$2,500

Family

$6,000

$12,000

$5,300

$7,800

$3,000

$7,500

Annual HSA contribution (from Informatica)

Individual

$400

Not Applicable

Not Applicable

Not Applicable

Family

$800

Not Applicable

Not Applicable

Not Applicable

Medical coverage

PCP office visits

You pay 10%,
after deductible

You pay 30%,
after deductible

$20

You pay 30%,
after deductible

$20

$15

Specialist visits

You pay 10%,
after deductible

You pay 30%,
after deductible

$30

You pay 30%,
after deductible

$20

$15

Preventive care

Covered 100%

You pay 30%,
after deductible

Covered 100%

You pay 30%,
after deductible

Covered 100%

Covered 100%

Telemedicine
(In-network only)

You pay 10%, after deductible

$30

No Cost

Copay, if
applicable.
depends on service

Telemedicine
(In-network only)
Behavioral Health

You pay 10%, after deductible

You pay $30 per visit

No Cost

Copay, if
applicable.
depends on service

Emergency room

You pay 10%, after deductible

You pay 10%, after a $150 copay

No Cost

You pay $100 per
visit

Prescriptions

When you enroll in an Informatica medical plan, you automatically receive the following prescription drug coverage:

Coverage

Aetna Saver with HSA
(CVS Caremark) Coverage

Aetna PPO
(CVS Caremark)

Kaiser HMO
(CA Only)

Kaiser HMO
(Hawaii Only)

In-Network

Out-of-Network

In-Network

Out-of-Network

In-Network Only

In-Network Only

Retail drugs (30-day supply)

Generic

$10

$10 + 50%
of the Rx cost

$10

$3 maintenance;
$10 all others

Brand-Name

You pay 10%,
after deductible

You pay 30%,
after deductible

$35

$35 + 50%
of the Rx cost

$35

$35

Non-formulary

$50

$50 + 50%
of the Rx cost

$35 Specialty

Not applicable
Specialty Drugs:
$200

Mail-order drugs (90-day supply)

Generic

$20

$20

$6 maintenance;
$20 all others

Brand-Name

You pay 10%,
after deductible

Not Covered

$70

Not Covered

$70

$70

Non-formulary

$100

$70 Specialty

Not applicable
Specialty Drugs: $400

All Non-Specialty
Drugs

You may fill 90-day supplies of (non-specialty) medication through
any retail location. You will need a 90-day prescription from your provider
and you will pay 3X the applicable 30-day supply cost.

Cost to Employee

Per Pay Period

Plan

Employee Only

Employee + Spouse

Employee + Child(ren)

Employee + Family

Aetna Saver Plan

$15.00

$90.50

$77.50

$137.00

Aetna PPO

$48.00

$157.50

$133.00

$232.00

Kaiser HMO (CA)

$31.00

$115.00

$102.00

$168.50

Kaiser HMO (HI)

$28.50

$106.50

$94.00

$155.50

Supplemental Medical

Even with comprehensive coverage from your medical plan, you will still have some out-of-pocket expenses if you get critically ill or are seriously injured. While it doesn’t replace your medical coverage, supplemental insurance offers additional protection to help you pay expenses not covered by your plan.

Accident insurance

Coverage is provided by Aetna.

The voluntary accident plan provides a financial cushion for life’s unexpected events by helping you pay for costs that aren’t covered by your medical plan if you or a covered dependent suffers an accident. The plan provides you with a lump-sum benefit payment that you can use however you like, use it to pay for health care costs not covered by your medical plan, or use it for mortgage or rent payments or groceries. This type of insurance serves to supplement your regular medical insurance; it does not replace it.

Cost to Employee

Monthly

Plan

Employee
Only

Employee +
Spouse

Employee +
Child(ren)

Employee +
Family

$11.71

$20.27

$22.31

$30.53

Critical illness insurance

Coverage is provided by Aetna.

Critical Illness insurance helps protect you from the financial impact of certain illnesses. Depending on the level of benefit you choose, the plan will provide you with a lump-sum payment of either $10,000, $20,000, $30,000 or $50,000 in the event you experience one of the covered medical conditions, including cancer, heart-related conditions, major organ transplants, and kidney failure. You can also elect coverage for your dependents in the amount of 100% of the employee benefit election. You can choose from four coverage levels: Employee Only, Employee and Spouse, Employee and Children, or Family. A Recurrence Benefit is available if an illness/condition returns, and you are also eligible for an annual health screening benefit of $50.

You may use your benefit payment as you see fit, including copays, deductibles, out-of-network treatment, child care, and mortgage and other costs not covered by other types of insurance. Keep in mind:

  • Critical illness insurance helps supplement your regular medical insurance; it does not replace it.
  • If you sign up for critical illness insurance during your initial enrollment period, you will not be required to provide evidence of your good health.

Cost to Employee

Monthly

Coverage Level

$10,000

$20,000

$30,000

$50,000

Age

Employee Only
or Employee +
Children

Employee +
Spouse or
Family

Employee Only
or Employee +
Children

Employee +
Spouse or
Family

Employee Only
or Employee +
Children

Employee +
Spouse or
Family

Employee Only
or Employee +
Children

Employee +
Spouse or
Family

<20

$2.67

$5.75

$4.24

$9.20

$5.81

$12.65

$8.95

$19.54

20 – 24

$3.08

$6.57

$5.05

$10.84

$7.03

$15.10

$10.99

$23.64

25 – 29

$3.65

$7.72

$6.20

$13.14

$8.76

$18.55

$13.86

$29.39

30 – 34

$4.45

$9.32

$7.80

$16.34

$11.15

$23.35

$17.86

$37.39

35 – 39

$5.71

$11.84

$10.31

$21.37

$14.92

$30.91

$24.14

$49.97

40 – 44

$7.91

$16.26

$14.73

$30.21

$21.55

$44.17

$35.19

$72.08

45 – 49

$11.48

$23.39

$21.86

$44.48

$32.24

$65.57

$53.01

$107.75

50 – 54

$17.24

$34.93

$33.39

$67.56

$49.54

$100.19

$81.84

$165.44

55 – 59

$25.36

$51.18

$49.63

$100.05

$73.90

$148.92

$122.43

$246.67

60 – 64

$35.76

$71.98

$70.42

$141.65

$105.08

$211.33

$174.41

$350.67

65 – 69

$48.69

$97.85

$96.28

$193.39

$143.87

$288.94

$239.05

$480.02

70+

$61.08

$122.65

$121.07

$243.00

$181.06

$363.35

$301.03

$604.04

How the Plans work with HSA

Triple tax-advantaged savings account
Money is tax-free when it goes in, tax-free as it grows, and tax-free when used to pay for eligible health care costs. And remember, you can roll over unused HSA funds from year to year with no limit.

Important Things to Consider When Seeking Care

Urgent care vs ER