Live in California?

Your options will be different, depending on the insurance carrier you choose.

For starters, each insurance carrier in California can elect to offer each coverage level either as an option that offers in- and out-of-network benefits (e.g., a PPO) or an option that offers in-network benefits only (e.g., an HMO).

Also, insurance carriers can choose to offer either the standard Gold option or a Gold II option—not both. The Gold II option offers only in-network benefits.

Review the table below to see which insurance carriers offer out-of-network benefits for the coverage levels you're considering.

	Bronze	Bronze Plus	Silver	Gold	Gold II	Platinum
Aetna	In- and out-of-network	In- and out-of-network	In- and out-of-network	In- and out-of-network	N/A	In- and out-of-network
Anthem Blue Cross	In-network only	In-network only	In-network only	In-network only	N/A	In-network only
Cigna	In- and out-of-network	In- and out-of-network	In- and out-of-network	In- and out-of-network	N/A	In- and out-of-network
Health Net	In- and out-of-network	In- and out-of-network	In- and out-of-network	N/A	In-network only	In- and out-of-network
Kaiser Permanente	In-network only	In-network only	In-network only	N/A	In-network only	In-network only
United Healthcare	In- and out-of-network	In- and out-of-network	In- and out-of-network	In- and out-of-network	N/A	In- and out-of-network

Medical Coverage Level

	Bronze	Bronze Plus	Silver	Gold	Gold II	Platinum
Option type	High-deductible option with HSA	PPO	PPO	PPO	HMO	PPO that offers limited benefits for out-of-network care**
Paycheck contributions	$	$$	$$	$$$	$$$	$$$$

2024 Annual Deductible
In-network (individual / family)	$3,300 / $6,600	$2,300 / $4,600	$1,000 / $2,000	$800 / $1,600	N / A	$250 / $500
Out-of-network (individual / family)	$3,300 / $6,600	$4,600 / $9,200	$2,000 / $4,000	$1,600 / $3,200	N / A	$5,000 / $10,000
Traditional or true family?	Traditional	Traditional	Traditional	Traditional	N / A	Traditional

2024 Annual Out-of-Pocket Maximum
In-network (individual / family)	$6,400 / $12,800	$6,700 / $13,400	$5,300 / $10,600	$3,600 / $7,200	$5,400 / $10,800	$2,300 / $4,600
Out-of-network (individual / family)	$12,800 / $25,600	$13,400 / $26,800	$10,600 / $21,200	$7,200 / $14,400	N / A	$11,500 / $23,000
Traditional or true family?	Traditional	Traditional	Traditional	Traditional	Traditional	Traditional

2024 In-Network Benefits
Preventive care	Covered 100%, no deductible	Covered 100%, no deductible	Covered 100%, no deductible	Covered 100%, no deductible	Covered 100%	Covered 100%, no deductible
Doctor's office visit	You pay 25% after deductible	You pay $30 for PCP visit and $50 for specialist visit, no deductible	You pay $30 for PCP visit and $50 for specialist visit, no deductible	You pay $25 for PCP visit and $40 for specialist visit, no deductible	You pay $25 for PCP visit and $40 for specialist visit	You pay $25 for PCP visit and $40 for specialist visit, no deductible
Emergency room	You pay 25% after deductible	You pay $150, then 30% after deductible	You pay $150, then 30% after deductible	You pay $150, then 25% after deductible	You pay $150, then 30% after copay	You pay $150, then 15% after deductible
Urgent care	You pay 25% after deductible	You pay $50	You pay $50	You pay $40	You pay $40	You pay $25
Inpatient care	You pay 25% after deductible	You pay 30% after deductible	You pay 30% after deductible	You pay 25% after deductible	You pay 30%	If not an office visit, you pay 15% after deductible
Outpatient care	You pay 25% after deductible	If not an office visit, you pay 30% after deductible	If not an office visit, you pay 30% after deductible	If not an office visit, you pay 25% after deductible	If not an office visit, you pay 30%	If not an office visit, you pay 15% after deductible

Prescription Drug Coverage

	Bronze	Bronze Plus	Silver	Gold	Gold II	Platinum
Preventive drugs	You pay $0^**	You pay $0^**	You pay $0^**	You pay $0^**	You pay $0^**	You pay $0^**

30-Day Retail Supply
Tier 1 (generally lowest cost options)	You pay 100% until you've met the deductible, then you pay 25%	You pay $12	You pay $12	You pay $10	You pay $10	You pay $8
Tier 2 (generally medium cost options)	You pay 100% until you've met the deductible, then you pay 25%	You pay $60	You pay $50	You pay $40	You pay $40	You pay $30
Tier 3 (generally highest cost options)	You pay 100% until you've met the deductible, then you pay 25%	You pay $80	You pay $70	You pay $60	You pay $60	You pay $50

90-Day Mail Order Supply
Tier 1 (generally lowest cost options)	You pay 100% until you've met the deductible, then you pay 25%	You pay $30	You pay $30	You pay $25	You pay $25	You pay $20
Tier 2 (generally medium cost options)	You pay 100% until you've met the deductible, then you pay 25%	You pay $150	You pay $125	You pay $100	You pay $100	You pay $75
Tier 3 (generally highest cost options)	You pay 100% until you've met the deductible, then you pay 25%	You pay $200	You pay $175	You pay $150	You pay $150	You pay $125

These charts may not take into account how each coverage level covers any state-mandated benefits, its plan administration capabilities, or the approval from the state Department of Insurance of the benefits offered by the plan. If you have questions about a specific benefit, contact the insurance carrier for additional information. Individual carriers may offer coverage that differs slightly from the standard coverage reflected here. In the event that there is a discrepancy between this site and the official plan documents, the official plan documents will control.

These charts are a high-level listing of commonly covered benefits across carriers and coverage levels for the Aon Active Health Exchange. They are intended to provide you with a snapshot of benefits provided across coverage levels. In general, carriers have agreed to the majority of standardized plan benefits recommended by the exchange.

For a more detailed look at these and additional coverages, go to the PetSmart Benefits Portal at digital.alight.com/petsmart. It does account for any carrier adjustments to standardized plan benefits. To see summaries when you enroll online, check the boxes next to the options you want to review and click Compare. In order to get the most comprehensive information about any specific coverage, you will need to call the carrier directly.

Note: For additional comparison, you may find Summaries of Benefits and Coverage on the PetSmart Benefits Portal at digital.alight.com/petsmart.

Out-of-Area: Your specific options are based on your home zip code. If you live outside the service areas of all the insurance carriers, you can choose an out-of-area option at the Silver coverage level. Aetna will be the insurance carrier.

Choosing a Primary Care Physician: Certain options require you to choose a primary care physician. You may need to designate a primary care physician to coordinate your care if you choose Kaiser Permanente or Health Net as your insurance carrier.

Do You Take Any Prescription Drugs?

Your prescription drug coverage will be provided through your pharmacy benefit manager. The pharmacy benefit manager could be a separate prescription drug company. Associates who enroll under Aetna, Anthem Blue Cross, Cigna, or UnitedHealthcare will have their pharmacy benefits managed by CVS Caremark. All other carriers will manage their own prescription drug coverage.

While your coverage level will determine your coverage for prescription drugs, each pharmacy benefit manager has its own rules. You need to make sure you’re comfortable with how your family's medications will be covered. Get the details.

Questions?

Check out the Frequently Asked Questions (PDF) and the Glossary.

California Medical Coverage Level

Live in California?

Medical Coverage Level

Prescription Drug Coverage

Do You Take Any Prescription Drugs?

Questions?