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Health & well-being
Liberty Mutual offers a comprehensive, competitive benefits program that supports the overall health and well-being of you and your family.
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Liberty Mutual offers three health plan options for employees to choose from: two Consumer Directed Health Plan (CDHP) options – which come with a Health Savings Account (HSA) – and the Exclusive Provider Organization (EPO) Option – which they can pair with a Health Care Flexible Spending Account (FSA).
The new EPO Option was designed in response to employee feedback. It offers more predictable out-of-pocket health care costs.
How the health plan options compare
Liberty offers three health plan options. Two Consumer Directed Health Plan (CDHP) options — CDHP Option 1 and CDHP Option 2 — and the EPO Option — for all U.S. employees outside of Hawaii.1 All three cover the same services and are administered by UnitedHealthcare, but there are important differences as outlined in the chart below:
CDHP Option 1 | CDHP Option 2 |
EPO Option |
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Administrator | UnitedHealthcare | ||||
Eligibility | Eligible for Health Savings Account (HSA) |
Eligible for Health Care Flexible Spending Account (FSA) Note: EPO Option participants can’t participate in a Health Savings Account, per IRS regulations, but they can use funds in an HSA if they have an existing account. |
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Liberty contribution to health spending or savings accounts |
Individual: $600 Family: $1,200 |
None | |||
In-network preventive care | Covered at 100% | ||||
Annual deductible |
Medical and prescription drugs In-network: $1,500 individual/$3,000 family1, 2 Out-of-network: $3,000 individual/$6,000 family1, 2 |
Medical and prescription drugs In-network: $2,000 individual/$4,000 family1, 2 Out-of-network: $4,000 individual/$8,000 family (2 or more members)2 |
Medical only In-network: $600 Individual/$1,200 family Out-of-network: No coverage, except for emergency care. |
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Copays | N/A |
Note: Copays do not apply to the deductible, but do apply to the out-of-pocket. In locations where Tier 1 doctors are not available, you will pay the Tier 1 co-pay for any in-network provider.
*Additional cost sharing will apply to tests and procedures completed at the emergency room, subject to deductible and co-insurance.
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Virtual visits3 (Teladoc, Doctor on Demand, AmWell) | 15% coinsurance after deductible is met | 25% coinsurance after deductible is met | $0 | ||
Coinsurance |
In-network: 15% After meeting the deductible, the plan pays for coverage minus the amount of coinsurance, up until the out-of-pocket maximum |
In-network: 25% After meeting the deductible, the plan pays for coverage minus the amount of coinsurance, up until the out-of-pocket maximum |
In-network: 15% + copays
Out-of-network: N/A – there is no out-of-network coverage except emergency care services. Coinsurance for the EPO Option applies when employees receive additional treatment during an office visit or other services separate from an office visit, such as lab work or outpatient surgery.
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Out-of-Pocket Maximum Includes deductible, prescription drugs, and for the EPO Option: copay Once you meet the out-of-pocket maximum, the plan pays 100% for the rest of the calendar year. |
Employee pays less out-of-pocket when they receive care In-network: $4,000 individual/$8,0004 family Out-of-network: $8,000 individual/ $16,000 family |
Employee pays more out-of-pocket when they receive care In-network: $6,650 individual/$13,3004 family Out-of-network: $13,300 individual/$26,600 family |
In-network: $3,500 individual/$7,000 family
Out-of-network: N/A – there is no out-of-network coverage except for emergency care services. |
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Emergency Room | Deductible and coinsurance apply. | Deductible $250 copay and coinsurance apply. | |||
Prescription Drugs |
Administered by CVS Caremark® Generic maintenance drugs: $0 before deductible Generic drugs: Employees pay 20% per script retail; $60 maximum retail5 / $120 max mail order Preferred brand drugs: Employees pay pay 30% per script; $70 maximum retail / $140 max mail order Non-preferred brand drugs: Employees pay pay 50% per script retail; $100 maximum retail / $200 max mail order Note: Coinsurance applies after employees meet the deductible.
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Administered though the CVS Proximity-based network.* Generic maintenance drugs: $0 Generic drugs: Employees pay 20% per script; $60 maximum retail / $120 max mail order Preferred brand drugs: Employees pay 30% per script; $70 maximum retail / $140 max mail order Non-preferred brand drugs: Employees pay 50% per script; $100 maximum retail / $200 max mail order If employees live within 5 miles of a CVS, they’ll have coverage at CVS-retail stores only. Otherwise, they’ll have access to a national network of retail pharmacies.
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Note: This is only a summary of coverage under these health plan options. To learn more about benefits, limitations and exclusions, read the Summary Plan Description or call the Liberty Benefits Center at 1-800-758-4460 (Option 1), Monday – Friday, 8:30 a.m. – 8 p.m. ET. |
Employees who live in Hawaii can find health plan information about the Hawaii Preferred Provider Organization (PPO) in the Hawaii Benefit Summary and the Hawaii Pharmacy Benefit Summary.
1Family coverage refers to coverage levels that include employee and one or more dependents (spouse/domestic partner, child).
2Every family member's medical and prescription drug costs counts toward the family deductible — there is no individual deductible.
3Virtual visits are only covered with UHC providers: Teladoc, Doc on Demand and AmWell
4If employees have family coverage and the employee or a family member reaches $7,350 in out-of-pocket costs for in-network care during the calendar year, the plan pays 100 percent coverage for that individual for the rest of the year. All other family members will continue to pay coinsurance until the full family out-of-pocket maximum is met.
5Certain generic maintenance drugs will be $0 out-of-pocket with no deductible or coinsurance.
Refer to the 2021 Premium costs for health, dental and vision rates.
Eligibility and enrollment
An employee is eligible if the employee is: | A U.S. employee scheduled to work 20 or more hours per week |
An employee can cover these family members: |
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Employees can enroll in the Liberty Mutual Health Plan:
- During annual enrollment each fall
- Within 30 days of hire
- Generally within 30 days of experiencing a qualified status change (e.g., getting married)
2022 premium costs
2022 Per pay period premium costs
Note: there are 26 pay periods in 2022.
Plan |
Employee only | Employee + Spouse/domestic partner | Employee + child(ren) | Employee + family | ||||
Full-time |
Part-time |
Full-time |
Part-time |
Full-time |
Part-time |
Full-time |
Part-time |
|
Medical | ||||||||
---|---|---|---|---|---|---|---|---|
CDHP Option 1 |
$67.72 |
$142.35 |
$155.75 |
$327.41 |
$121.90 |
$256.23 |
$223.47 |
$469.76 |
CDHP Option 2 |
$51.08 |
$125.05 |
$117.49 |
$287.61 |
$91.96 |
$225.08 |
$168.58 |
$412.65 |
EPO Option |
$79.60 |
$146.31 |
$183.06 |
$336.51 |
$143.26 |
$263.36 |
$262.65 |
$482.81 |
Dental | ||||||||
Basic Plan |
$4.06 |
$6.63 |
$8.10 |
$13.22 |
$8.51 |
$13.89 |
$13.38 |
$4.06 |
Plus Plan |
$12.51 |
$15.08 |
$24.54 |
$29.66 |
$26.27 |
$31.65 |
$41.28 |
$12.51 |
Vision | ||||||||
Eyewear + Exam Plan |
$4.03 |
$8.06 |
$7.66 | $10.25 |
Employees who live in Hawaii can find health plan information about the Hawaii Preferred Provider Organization (PPO) in the Hawaii Benefit Summary and the Hawaii Pharmacy Benefit Summary.
Preventive care coverage
Preventive care is a type of medical care that focuses on both disease prevention and health maintenance. Under the CDHP options and EPO health plan, in-network preventive care and certain preventive drugs (e.g., generic contraceptives) are covered at 100% before the deductible is met. This means an employee pays nothing out of pocket. For certain maintenance drugs (such as those for managing blood pressure), employees don't need to meet the deductible, but coinsurance still applies. Covered in-network preventive care services include:
- Adult physical exams and well-child visits
- Age- and gender-appropriate preventive services, including pap tests, colonoscopies and mammograms*
- Immunizations
- Prenatal visits and screenings
How the CDHP works
1. The employee pays 100% of their health care services and most prescription drugs until they meet the deductible.
2. Once the deductible is met, the plan and the employee pay coinsurance until the employee reaches the out-of-pocket maximum.
3. Once the employee reaches their out-of-pocket maximum, the plan pays 100% of covered services for the remainder of the calendar year.
Here are some highlights of the CDHP options:
Preventive care is covered at 100% | Non-preventive care costs go toward deductible | CDHP Option 1 and 2 are paired with an HSA |
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How the CDHP and EPO work for family coverage
For CDHP Option 1 and 2:
For employees who cover themselves and one or more family members under either CDHP option, both the family deductible and family out-of-pocket maximum apply. Here's how they work:
Family deductible | Family out-of-pocket maximum |
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Important! Each family member's out-of-pocket costs apply toward the family maximum. However, if an employee or their family member reaches $7,350 in out-of-pocket costs for in-network care during the calendar year, the plan pays 100% coverage for that individual for the rest of the year. All other family members will continue to pay coinsurance until the full family out-of-pocket maximum is met.
For the EPO:
Each family member has their own deductible and the family has a separate deductible. The individual deductible is embedded in the family deductible, so no one family member can contribute more than their individual amount toward the family deductible. The out-of-pocket costs that a family member pays to reach their individual deductible also count towards meeting the family deductible.
Unlike with the CDHP, the EPO Option has copayments, which do not apply to the deductible (but do count towards your out-of-pocket maximum).
In addition, if one person in the family meets their individual deductible, the plan starts to pay for that family member. If the family deductible hasn’t also been met, the other family members’ deductibles still apply. When the family deductible is met, the plan starts paying for all family members, less 15% coinsurance. For the EPO Option, the family deductible is $1,200 and the individual deductible is $600.
For example, let’s say an employee gets X-rays that cost $600. They meet their individual deductible and the plan pays for care from here on out, less 15% coinsurance.
Plus, that $600 goes toward their family deductible, so when their spouse and child both need lab work that costs $300 each, they’ll meet your family deductible of $1200. Now, the plan will pay for their care, minus coinsurance, so: 85% for covered services.
About the UnitedHealthcare network
Employees can search for in-network health care and behavioral health providers by logging onto myuhc.com or contacting UnitedHealthcare member services at 1-844-LIB-MUT4 (1-844-542-6884), Monday – Friday, from 8 a.m. – 8 p.m. (all time zones) for more information.
- If an employee lives in Massachusetts, Maine or New Hampshire, they can search for networks on myuhc.com using “United Healthcare Choice (EPO) or Choice Plus (CDHP) with Harvard Pilgrim Plan.” An employee's plan ID card will include the Harvard Pilgrim Healthcare logo, which indicates that they have access to Harvard Pilgrim’s provider and facility network at in-network rates.
- If an employee lives in any other state, they can search for networks on myuhc.com using “UnitedHealthcare Choice Plus Plan.”
Note that for employees who live in Buffalo, New York, or certain areas of Pennsylvania, additional provider options may be available. Employees can contact UnitedHealthcare member services for more information.
Premium designation: Providers listed as part of UnitedHealthcare’s premium designation program have been evaluated for quality and cost efficiency based on national industry, evidence-based and medical specialty society standards, as well as market and specialty benchmarks. For the EPO Option, premium designation (known as “Tier 1 doctors”) have lower copays in most areas. You can find out if your doctor is a Tier 1 doctor by going to myuhc.com and looking for the blue dot next to your provider’s name.
For help finding an in-network provider, contact UnitedHealthcare member services at 1-844-LIB-MUT4 (1-844-542-6884), Monday – Friday, 8 a.m. – 8 p.m. (all time zones).
Keep in mind: Employees in the CDHP options can still see out-of-network providers, but their cost for services will be higher.
Centers of Excellence for bariatric surgery visits
Liberty Health Plan participants seeking bariatric surgery must receive care through one of the more than 320 nationwide UnitedHealthcare bariatric Centers of Excellence (COEs); otherwise, there will be no coverage under the Health Plan.
Providers and centers that belong to the UnitedHealthcare bariatric Centers of Excellence (COEs) program perform more successful bariatric procedures than many other facilities.
Centers of Excellence for fertility solutions
Centers of Excellence for fertility solutions offers education, treatment options and guidance throughout the treatment process, plus help identifying a superior facility. Covered services are only available when received at a Center of Excellence (COE) and are paid at the in-network level. Benefits are not available at a non-COE in-network or out-of-network facility. For members who do not have access to a Fertility Solutions COE within 60 miles from their home, the member’s Fertility Solutions case manager will assist in finding a quality network provider. This is considered a “gap” exception and conditional on the member enrolling in Fertility Solutions; however, the member will still qualify for the fertility benefit. Employees should call Liberty Mutual health support at 1-844-542-6884 for details.
Liberty Mutual health support
UnitedHealthcare offers specialized health support from skilled and caring nurses. All services are confidential and provided at no additional cost to employees and their covered family members. For more information, call 1-844-542-6884.
Cancer support program
CDHP participants can work with experienced cancer nurses who will help explain a diagnosis, review treatment options, find the right provider and give employees the support they need to manage their condition.
Maternity support program
Experienced maternity nurses are here to help employees prepare for a smooth pregnancy and delivery. Employees can turn to them anytime they have questions or concerns during pregnancy, delivery and after the baby is born. They’ll work with the same nurse throughout their entire pregnancy (and up to six weeks after delivery). When employees enroll, they’ll receive a welcome kit that contains helpful things for themselves and the baby, including a massager, onesie and milestone stickers, to name a few
Fertility solutions
CDHP participants can receive education, treatment options and guidance throughout the treatment process, plus identify a superior facility that's right for them. They'll access the fertility Centers of Excellence (COE) network and a nurse consultant who is specially trained in reproductive health. Covered services are only available when received at a COE and are paid at the in-network level. Call Liberty Mutual Health Support for details.
Orthopedic health support program
Employees can receive information and support to relieve pain in their back, neck, shoulder, hip or knee. A nurse will help employees understand treatment options; offer coaching to support behavior change; provide estimated treatment costs and see how they could save money; help them learn to manage their pain or understand medications; assist in learning more about a certain diagnosis and treatment options; refer them to top providers, including Centers of Excellence; and help prepare for surgery and recovery, if surgery is needed. Whether an employee just started experiencing pain or has had it for a long time, an Orthopedic Health Support nurse is here to help.
Behavioral health support
The health plan covers behavioral health. Employees can call UnitedHealthcare to find a provider in their network. Employees can also receive specialized guidance for certain conditions: They can talk to an autism care advocate specialist, who can guide them to in-network care for children diagnosed with autism spectrum disorder. If addiction is a concern, employees can talk to a substance use treatment advocate who can educate them on treatment options and help employees identify preferred providers that meet the plan’s quality standards.
Prescription drug coverage
Prescription drug coverage, administered by CVS Caremark®, is automatically provided as part of the Liberty Mutual Health Plan. CVS Caremark® offers a large, national pharmacy network. For the EPO plan, you must fill prescriptions at a CVS pharmacy if one is available within 5 miles of your home zip code. Otherwise, you can use any in-network pharmacy. In addition, employees can:
- Pay the lower mail-order price when they fill a 90-day maintenance prescription at a CVS retail pharmacy.
- Receive a 20% discount on CVS brand health-related items at CVS retail stores using the CVS ExtraCare® card.
For the CDHP 1 or 2: | For the EPO: |
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CDHP participants must meet the annual deductible before coinsurance applies. That means you pay the full cost of most prescriptions until you reach your deductible. At that point, the plan begins to share the cost and you pay coinsurance. There are some exceptions:
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If an employee lives within 5 miles of a CVS, they’ll have coverage at CVS retail stores only. Otherwise, you’ll have access to a national network of retail pharmacies. |
Have a question about participating pharmacies or other prescription drug program topics? Employees can contact a CVS Caremark® Customer Care representative any day, any time, at 1-888-562-3784.
Retail 30-day supply | Employee pays: Generic drugs: 20% per script; $60 maximum Preferred brand drugs: 30% per script; $70 maximum Non-preferred brand drugs: 50% per script; $100 maximum |
Mail order maintenance 90-day supply | Employee pays: Generic drugs: 20% per script; $120 maximum Preferred brand drugs: 30% per script; $140 maximum Non-preferred brand drugs: 50% per script; $200 maximum |
Retail maintenance 90-day supply | Employee pays: Same price as 90-day mail order supply if filled at a CVS retail pharmacy |
Certain preventive medications |
Generic drugs covered at 100%; not subject to the annual deductible or coinsurance Preferred and non-preferred brand drugs not subject to deductible; however, coinsurance will apply. |
You can access the current preventive and maintenance medication list by clicking here.
Authorization required for select medications
If a medication isn’t a preferred drug on the CVS Caremark® formulary list, it may require prior authorization. Call CVS Caremark® at 1-855-240-0536 to confirm if prior authorization is needed before you fill your prescription.
Drug cost estimator
Liberty aims to maintain the quality of the prescription drug program while keeping costs as low as possible. Generic and preferred brand name drugs cost less than non-preferred brand drugs. To help manage drug costs, check out prices and explore lower cost alternatives using the CVS Caremark® drug cost estimator.
Related Topics
Virtual visits
Watch this video to see how to “visit” a doctor or behavioral health specialist virtually, for non-emergencies, from a mobile device or computer without an appointment.
Make HSA funds go further
Watch this video to learn how Health Savings Accounts (HSA) can help save for medical expenses now and in the future.
Your well-being and more on Castlight
Find well-being programs that can help employees manage stress, lose weight, fit in a quick workout, get a better night’s sleep, quit smoking, and more. Liberty Mutual Health Plan participants can also use Castlight to choose high-quality doctors and understand health care costs.