Medical

We encourage our teammates to lead full, healthy lives—and offer medical benefits to support whatever choices you make for your care.

Eligibility

Medical benefits are available for teammates and their spouse/domestic partner and children.

Learn more about your benefits

Changes to benefits during the year are allowed only if you have a qualified life event.

Learn more about life event changes

Medical plan costs and other benefits

Get details about medical plan costs and other benefits options.

2024 medical premiums

Telehealth

Case Management Program

CarePlus Mobile Health

Virta: Diabetes reversal and weight loss

Family building benefits

Virtual physical therapy

Medical carriers

Choose a medical carrier that meets your needs. Depending on where you're located, TIH offers two medical plan carriers for teammates, spouses or domestic partners, and dependents.

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View carrier contact information to learn more
View 2024 carrier network Fast Facts (PDF) to learn more

For 2024

Aetna

Aetna has a broad provider network, which includes a large number of doctors, hospitals, and other providers across the country. It also has a lower-cost, narrow provider network available only in certain locations.

Find Aetna providers and review coverage

Kaiser Permanente

Kiser Permanente is a regional network available in certain locations that offers only in-network coverage. It’s available in:

  • California
  • Colorado
  • Georgia
  • Mid-Atlantic
  • Northwest
  • Washington
Learn about Kaiser plans and coverage

Other coverage

Teammates, spouses or domestic partners, and dependents covered by Aetna in 2024 are eligible to participate in the Case Management program, a free benefit that provides one-on-one support to individuals with complex health issues. Learn more about the Case Management program.

Teammates enrolled in a medical plan have 24/7 access to board-certified doctors, licensed nurses, and specialists through Teladoc.

Family building benefits from Ovia and Progyny provide resources to teammates who want to start or add to their family.

Medical plans

TIH offers these medical plans to our teammates:

  • a $500 preferred provider organization (PPO) with lower deductible
  • a $1,500 PPO with higher deductible (called Upfront Advantage)
  • a $250 accountable care organization (ACO) with a narrow network and lower deductible
  • a $2,500 HDHP with a health savings account (HSA)
  • a $4,000 HDHP with HSA
  • No-deductible exclusive provider organization (EPO)

Each plan has its own benefit features (like copays, deductibles, and other features). These features affect the costs you pay when you receive care.

All plans cover the same services, including prescription drugs. Plus, no matter which plan you choose, preventive care is covered at 100% (that’s no cost to you) when you stay in-network.

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2024 Aetna plans: What you pay

  $500 PPO $1,500 PPO $250 ACO $2,500 HDHP $4,000 HDHP
Providers In-network Out-of-network In-network Out-of-network In-network Out-of-network In-network Out-of-network In-network Out-of-network
Individual deductible $500 $1,000 $1,500 $3,000 $250 n/a $2,500 $5,000 $4,000 $8,000
Family deductible $1,000 $2,000 $3,000 $6,000 $500 n/a $5,000 $10,000 $4,000 individual in a family / $8,000 family $8,000 individual in a family / $16,000 family
Coinsurance after deductible: Your share / insurance share 10% / 90% 50%/ 50% 20% / 80% 50%/ 50% 0% / 100% n/a 20% / 80% 50% / 50% 20% / 80% 50% / 50%
Individual out-of-pocket maximum $1,500 $3,000 $2,500 $5,000 $1,250 n/a $4,000 $8,000 $5,500 $11,000
Family out-of-pocket maximum $3,000 $6,000 $5,000 $10,000 $2,500 n/a $8,000 $16,000 $5500 individual in a family / $11,000 family $11,000 individual in a family / $22,000 family
Primary care copay $30 50% 20% 50% $30 n/a 20% 50% 20% 50%
Specialist copay $40 50% 20% 50% $60 n/a 20% 50% 20% 50%
ER copay $150 $150 20% 20% $150 n/a 20% 20% 20%20%
Urgent care copay $40 50% 20% 50% $40 n/a 20% 50% 20% 50%

Medical premiums

Medical premiums are based on your Benefits Annual Rate (BAR). TIH offers premium lowering incentives through our Peak Health program. 

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View 2024 medical premiums for costs

Refer to your enrollment options in Workday to view eligible medical premiums.

Your medical premium cost could be offset by medical credits if you participate in and perform at the highest levels of the Peak Health program.

Understanding your benefit costs

Medical premiums, life insurance, and disability benefits are based on your Benefits Annual Rate (BAR). The BAR reflects your total annual cash compensation and your annual base pay.

Your BAR and other benefit premium costs will be shown in Workday.
Find it: View profile -> Actions -> Benefits -> View Benefits Annual Rate

Calculating BAR

Regular pay (annualized) as of September 30

+

Eligible cash bonuses, compensation, incentives, overtime, and premium pay from October 1 – September 30

=

BAR1

For new hires, your BAR is your base pay alone. 

Medical plan services

TIH offers a wide range of services that can be used with each of our medical plans: Services in the physician's office, wellness services, allergy injections, diabetic supplies, inpatient and outpatient hospital services, rehabilitation and therapy services, chemotherapy services, mental health and substance abuse services, and more. 

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The following summaries of benefits coverage show how you and the plan share the cost for covered services for common medical issues. For detailed coverage, see the full plan descriptions.

2024 summaries of benefits coverage

Prescription drugs

Prescription drug coverage for each of our medical plans is available to you in person or through mail order. 

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For 2024, Aetna plans include prescription drug coverage through CVS Caremark. Learn more.  Kaiser Permanente has its own exclusive pharmacy benefits.

Get assistance

If you have questions about a medical program, please contact your provider.

View providers for contact information
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1For active regular full-time or part-time exempt teammates

Your Benefits Annual Rate (BAR) equals your annual base pay as of Sept. 30, plus other cash payments received during the 12 months ending Sept. 30.

Cash payments include bonuses, incentives, overtime, and commissions. Cash payments don't  include equity (stock options, RSUs, etc.). A complete listing of payment types included in BAR is maintained by Payroll.

In the case of teammates in highly-incented positions (where more than 50% of compensation is expected to come from other than Base Salary), a special recalculation of BAR may be required.

If a highly-incented participant becomes eligible for a benefit (life or disability insurance) and less than 12 months of compensation history was included the last BAR calculation, BAR will be recalculated at the time of death or disability to determine the appropriate BAR by looking at actual earnings.  

Except as stated above, BAR is recalculated at Sept. 30 each year.

No personal or confidential teammate information is contained within benefits.tihinsurance.com.

Information contained within benefits.tihinsurance.com applies to eligible teammates residing in the United States, unless otherwise specified.

Not all subsidiaries and affiliates of TIH participate in the benefit programs and policies presented within benefits.tihinsurance.com.

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