Overview
At SPARC, we value your and your family’s health and wellness, which is why we offer a benefits program designed to help prevent illness, maintain health, and provide access to the information and care you need.
Medical benefits from SPARC help you maintain your well-being through preventive care and access to an extensive network of high-quality, lower-cost providers, as well as affordable prescription medication.
Your medical plan options include a range of coverage levels and costs, so you can choose the one that’s best for you. You can enroll as a new hire, during Annual Enrollment, or if you have a qualifying life event.
Key features
All of our medical plans provide:
Comprehensive, affordable coverage
for a wide range of health care services.
Preventive care,
covered at 100%, such as your annual physical exam and preventive screenings.
Doctor visits
available both in-office and virtual.
Prescription drug coverage
provided by Express Scripts (Anthem plans) or Kaiser Permanente (Kaiser HMO plan).
Emergency Room coverage
for your medical needs.
The cost of coverage (your payroll deductions) and the cost of care (the amount you pay for health care services when you receive them) will be different depending on which option and coverage level you choose. SPARC pays the majority of your cost of coverage, regardless of which medical plan you select.
2024 medical plans
Essential CDHP
May be a fit if your medical care is usually limited to preventive care, you rarely see specialists, and typically take only preventive medication.
Standard PPO
May be a fit if your medical care is usually not extensive, but you want a higher level of coverage than the CDHP, and possibly take non-preferred medications.
Premium PPO
May be a fit if your medical care is more extensive, you need to see specialists, and take non-formulary or specialty medications.
Kaiser HMO (CA Only)
Only available to employees in California. May be a fit if you want your care coordinated by a primary care provider (PCP).
How much does SPARC medical coverage cost?
SPARC pays a majority of the cost of your medical coverage. You’ll pay the remaining amount through premiums from your paycheck. The amount you pay will depend on which plan you choose, your annual salary, and whether you cover just yourself or family members, too. To learn more about eligible dependents, click here*.
*Please note as you view the rate sheet, there is an additional salary band. The three salary bands ensure that all benefit-eligible employees contribute a similar percentage of their salary to the cost of benefit premiums.
What else the company contributes
In addition to paying a significant portion of the medical plan premium costs, SPARC makes an annual contribution to either your HSA or HRA, depending on which medical plan you elect. Please see the HSA and HRA pages for contribution amounts. Note that the HSA employer contributions will be split into quarterly installments.
For information on plan premiums and contributions click here.
SMOKER/TOBACCO SURCHARGE: Non-tobacco users receive discounted contribution rates. The tobacco user surcharge is an additional $12.50 weekly or $25.00 bi-weekly. Effective January 1, 2024, the tobacco user surcharge applies to all covered members of the plan who are tobacco users. This means that if either one or multiple covered members of the plan are tobacco users, the flat tobacco user surcharge will apply. The surcharge is not compounded for multiple tobacco users. Tobacco users include smokers and users of other types of tobacco or nicotine products such as pipes, e-cigarettes, and chewing tobacco.
Tobacco cessation program
Need help quitting the tobacco habit? LiveHealth Online can help you do it through the new Tobacco Free program. Complete the Tobacco Free program to get healthy and earn the discounted rate of up to $600 per year. The Tobacco Free program is available at no cost to you and your family (dependents must be 18+) on the Anthem Health Plan.
Using LiveHealth Online, you can meet with a health coach through live video or phone. Your coach can teach you ways to overcome cravings and give you tools to support your new tobacco-free lifestyle, like shipping nicotine replacement therapy right to your home. Getting started is easy! Go to www.livehealthonline.com/sparc or call 1-888-LiveHealth (888-548-3432) to sign up.
Plan Comparison
Use this interactive side-by-side plan comparison to understand key differences between the plans.
2024 plan differences
| Essential CDHP | Standard PPO | Premium PPO | Kaiser HMO (CA Only) | |
|---|---|---|---|---|
| Annual deductible (individual/family) | ||||
| In-network | $2,000/$4,000 | $1,000/$2,000 | $400/$800 | N/A |
| Out-of-network | $4,000/$8,000 | $2,000/$4,000 | $1,200/$2,400 | N/A |
| Out-of-Pocket Maximum (OOPM)* (individual/family) | ||||
| In-network | $6,000/$12,000 | $4,000/$8,000 | $3,000/$6,000 | $3,000/$6,000 |
| Out-of-network | $12,000/$24,000 | $8,000/$16,000 | $6,000/$12,000 | N/A |
| Coinsurance | ||||
| In-network | 80%/20% | 80%/20% | 90%/10% | N/A |
| Out-of-network | 50%/50% | 50%/50% | 50%/50% | N/A |
| Health care visits | ||||
| Preventive care (in- network) |
No charge | No charge | No charge | No charge |
Preventive care |
50% after deductible |
50% after deductible | 50% after deductible | N/A |
Primary care visit |
80%/20% | 80%/20% | $25/visit No deductible | $30 copay |
Primary care visit |
50%/50% | 50%/50% | 50%/50% | N/A |
Specialist visit |
80%/20% | 80%/20% | $50/visit No deductible |
$50 copay |
Specialist visit |
50%/50% | 50%/50% | 50%/50% | N/A |
X-rays/lab |
80%/20% | 80%/20% | 90%/10% | $10 per encounter |
X-rays/lab |
50%/50% | 50%/50% | 90%/10% | N/A |
Ambulance services |
80%/20% | 80%/20% | 90%/10% | $150 per trip |
Ambulance services |
80%/20% | 80%/20% | 90%/10% | N/A |
Emergency room |
80%/20% | 80%/20% | $250 copay No deductible | $200 per visit |
Emergency room |
80%/20% | 80%/20% | $250 copay No deductible | N/A |
Prescription Drug Coverage
To learn about prescription drug coverage, click here.
Use this interactive side-by-side plan comparison to understand key differences between the plans.
| Essential CDHP | Standard PPO | Premium PPO | Kaiser HMO (CA Only) | |
|---|---|---|---|---|
| Annual deductible (individual/family) | ||||
| In-network | $2,000/$4,000 | $1,000/$2,000 | $400/$800 | N/A |
| Out-of-network | $4,000/$8,000 | $2,000/$4,000 | $1,200/$2,400 | N/A |
| Rx coinsurance | ||||
| In-network | After deductible Generic Rx: You pay 20% | Generic Rx: You pay 20% | Generic Rx: You pay 10% | Generic Rx: $15 copay retail, $30 copay mail order (for a 100-day supply) |
| Preferred & Non-Preferred Brand Rx: You pay 20% | Preferred & Non-Preferred Brand Rx: You pay 20% | Preferred & Non-Preferred Brand Rx: You pay 10% | Preferred & Non-Preferred Brand Rx: $35 copay retail, $70 copay mail order (for a 100-day supply) | |
| Specialty Rx: 30% to a $500 maximum | Specialty Rx: 30% to a $500 maximum | Specialty Rx: 30% to a $500 maximum | Specialty RX: 20% coinsurance (not to exceed $100) for up to a 30-day supply | |
| Out-of-network | N/A | N/A | N/A | N/A |
| Rx out-of-pocket maximum | ||||
| In-network | Accrues to the medical plan OOPM |
$2,200 Individual $4,400 Family |
$2,200 Individual $4,400 Family |
N/A |
| Out-of-network | N/A | N/A | N/A | N/A |
Essential CDHP
Plan features of the Essential CDHP:
- Preventive care is covered at 100% in-network
- Certain medications are covered in full
- Access to the HSA and the highest level of company contribution
- You may also elect to enroll in a Limited Purpose FSA (LPFSA) account, which may be used in conjunction with an HSA and allows you to contribute pre-tax dollars to use for eligible dental and vision post-deductible expenses
- Highest deductible, offset by the company’s and your voluntary pre-tax HSA contributions
- Expenses are capped by the out-of-pocket maximum
- Lowest payroll deductions
How the Essential CDHP plan works
Plan premiums are automatically deducted from your paycheck. When you receive in-network preventive care, you pay nothing — it’s covered in full! If you need non-preventive care, it works like this:
Use your HSA to save money and plan ahead!
Contributing to your HSA is a great way to budget for deductibles and other out-of-pocket expenses while also saving money — your HSA contributions are tax-free!*
Keep in mind:
- The Essential CDHP costs you less from your paycheck, so you may have extra money to put in your HSA.
- You can only spend HSA money already deposited into your account; this includes the quarterly Company contribution. If you don’t have enough money in your HSA when you need it, you can pay another way and reimburse yourself later to take full advantage of your HSA’s tax savings.
- You will never forfeit any money left in your HSA — it rolls over each year. To save for your health care costs in retirement or prepare for future expenses, set aside a little extra each paycheck to grow your balance.
- You can pair your HSA with a tax-free Limited Purpose Flexible Spending Account (FSA) to save even more.
- You can change your HSA contribution amount throughout the year if needed.
*HSA contributions are not subject to federal income tax, but are currently subject to state income tax in CA and NJ. Consult with your tax advisor to understand the potential tax implications of enrolling in an HSA. Money in an HSA can be withdrawn tax-free as long as it is used to pay for qualified health-related expenses. If money is used for ineligible expenses, you will pay ordinary income tax on the amount withdrawn, plus a 20% penalty tax if you withdraw the money before age 65.
Standard PPO
Plan features of the Standard PPO:
- Preventive care is covered at 100% in-network
- You will receive a contribution from the company into an HRA
- You can use a Health Care FSA to set aside pre-tax dollars through bi-weekly contributions to help pay for eligible out-of-pocket medical, dental, prescription drug, and vision expenses
- Lower deductible
- Expenses are capped by the out-of-pocket maximum
- Mid-tier payroll deductions
How the Standard PPO works
Plan premiums are automatically deducted from your paycheck. When you receive in-network preventive care, you pay nothing — it’s covered in full! If you need non-preventive care, it works like this:
Premium PPO
Plan features of the Premium PPO:
- Preventive care is covered at 100% in-network
- Lowest deductible
- You can use a Health Care FSA to set aside pre-tax dollars through bi-weekly contributions to help pay for eligible out-of-pocket medical, dental, prescription drug, and vision expenses
- Expenses are capped by the out-of-pocket maximum
- Highest payroll deductions
How the Premium PPO works
Plan premiums are automatically deducted from your paycheck. When you receive in-network preventive care, you pay nothing — it’s covered in full! If you need non-preventive care, it works like this:
Kaiser HMO (CA Only)
Plan features of the Kaiser HMO (CA Only):
- Providers only within the Kaiser Permanente network
- Only available for employees in California
- Preventive care is covered at 100% in-network
- High payroll deductions
- No deductibles to meet
- Copays at point of service
- You can use a Health Care FSA to set aside pre-tax dollars through bi-weekly contributions to help pay for eligible out-of-pocket medical, dental, prescription drug, and vision expenses
- Prescriptions paid through copays
How the Kaiser HMO (CA Only) works
Plan premiums are automatically deducted from your paycheck. When you receive in-network preventive care, you pay nothing — it’s covered in full! If you need non-preventive care and visit a Kaiser Permanente provider, it works like this:
Virtual Care
LiveHealth Online
At home or on the go, you can see a doctor or therapist with Anthem’s LiveHealth Online through a private video visit on your smartphone, tablet, or computer.
By using LiveHealth Online, you can:
- See a board-certified doctor in just a few minutes with no appointment. Doctors are available 24/7 to assess your condition, and, if needed, they can send a prescription to your local pharmacy.
- When your own doctor isn’t available, use LiveHealth Online if you have pinkeye, a cold, the flu, a fever, allergies, a sinus infection, or another common health condition.
- Make an appointment with a licensed therapist in four days or less. You can have a video visit with a therapist from home, at work, or on the go—evenings and weekend appointments are available too. Appointments can be scheduled online or over the phone at 1-888-548-3432 from 7 a.m. to 7 p.m. EST, seven days a week. You can get help for anxiety, depression, grief, panic attacks, and more.
What will a visit cost under the Essential CDHP, Standard PPO or Premium PPO?
Your Anthem plan includes benefits for video visits using LiveHealth Online, so you’ll just pay your share of the costs, which is usually $49 or less for medical doctor visits or the same price as an office visit for a 45-minute therapy session.
Sign up for LiveHealth Online at livehealthonline.com or download the app to your phone or tablet.
Cost by plan and comparison table
| Essential CDHP | Standard PPO | Premium PPO | |
|---|---|---|---|
| Cost | 80% after deductible | 80% after deductible | $25 |
Do you have the Kaiser HMO (CA Only) plan?
If you're enrolled in the Kaiser HMO (CA Only), you have many convenient ways to get care. You can schedule an e-visit, video visit, phone appointment, or even email your doctor.
Sign in to kp.org, use the Kaiser Permanente app, or call 1-833-574-2273 to make an appointment.
Virtual Primary Care
We know it can be hard to get appointments with your doctor. To make it easier to connect with a primary care provider, use Anthem’s Sydney Health app. This comprehensive primary care solution makes it easy for you to access:
- Comprehensive virtual primary care, coordinated by a care team.
- Preventive care through wellness check-ins and lab screenings.
- A personalized care plan and follow-ups, including automated reminders and check-ins.
- Unlimited access to care, including prescription refills and referrals.
- 24/7, on-demand urgent care support.
Sydney: Anthem’s New Mobile App
Sydney is a simple, smart, personalized app that helps you find everything you need to know about your Anthem benefits all in one place. With the Sydney app, you can easily:
- View and use digital ID cards
- Find a doctor
- Check costs of care
- View claims
- Use the 24/7 chatbot and get answers quickly
- Set health reminders to help you reach your unique health goals
Download Sydney today! The app is available for iPhone and Android, and it’s free.
The importance of primary care
A primary care provider (PCP) serves as your main doctor and is your first stop when you need care. When you see the same doctor over time, they can:
- See the full picture of your health and connect the dots if you face a health issue.
- Save you time and money and stay healthy with preventive care and helping to manage chronic conditions.
- Coordinate your care, ensure tests are needed, check that your medications work well together, and help other doctors understand your health needs.
- Help you avoid costly visits to the emergency room for colds, minor injuries, or flare-ups of chronic conditions.
- Advise you where to go for care when you need it.