Page 4 - Benefits Guide TeleSign 2020
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Benefits at A Glance
BENEFIT CHOICES
Medical and Prescription Drugs • HMO: No deductible, $20 PCP, $40 specialist, $250 hospital, prescription drugs
Anthem Blue Cross • PPO: $250/$750 deductible, $20 PCP, $40 specialist, 20% hospital, prescription drugs
• HSA PPO: $1,500/$3,000 deductible, 20% PCP/specialist, 20% hospital, prescription
drugs
Health Savings Account • IRS Annual Maximum Contribution Limit: $3,550 Individual / $7,100 Family
Health Equity • TeleSign’s Annual Contribution: up to $750 Individual / $1,500 Family
Flexible Spending Accounts • Health Care Account: Up to $2,750 per year
Discovery Benefits • Limited Health Care Account: Up to $2,750 per year
• Dependent Care Account: Up to $5,000 per year
Dental • PPO: $2,500 calendar year maximum benefit, $50/$150 deductible, no charge
Anthem Blue Cross preventive, 10% basic, 40% major, ortho for children 50% with $1,500 lifetime
benefit maximum
Vision • PPO: $10 exam copay, $10 materials copay, $130 frames benefit, $130 contact lens
Anthem Blue Cross benefit (cosmetic/elective/disposable)
Basic Life/AD&D • 2x your annual salary to a maximum benefit of $500,000
Anthem Blue Cross
Long Term Disability • 60% of your pre-disability earnings to a monthly maximum of $10,000
Anthem Blue Cross
Voluntary Life/AD&D • Employee: $10,000 increments to a maximum benefit of $300,000
Anthem Blue Cross • Spouse or Domestic Partner: $5,000 increments to a maximum benefit of $150,000
• Child(ren): Flat $5,000 or $10,000
Commuter Benefits • Transit and vanpooling: Up to $270 per year
Discovery Benefits • Parking: Up to $270 per year
Employee Assistance Program • 24/7 unlimited phone consultations
Anthem Blue Cross • Access to legal and financial counseling
Travel Assistance Program • Emergency medical assistance, pre-trip information, repatriation and more when
Anthem Blue Cross traveling 100+ miles away from home or work
Value-Added Programs • Future Moms
Anthem Blue Cross • ConditionCare
• Estimate Your Cost
• PayForward Program
Pet Insurance • 5% discount on premiums
Nationwide • Helps pay for medical treatment costs for pet’s accidents, illnesses, and routine
medical care, including surgeries, prescriptions, hospitalization, diagnostic tests,
and office visits
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