Medical

Your health and well-being are important to your success both on the job and in your personal life. KPMG provides an array of programs aimed at balancing and enriching work and life.

Aetna Choice POS II Plan

As long as you live within a network area, you can participate in the Choice POS II Plan. The Choice POS II Plan is a network based plan with in-network and out-of-network benefits, which allows you to receive medical care from any provider you choose. If you receive care from an in-network provider you pay less out-of-pocket because the plan pays a higher percentage of covered expenses. You do not need to select a primary care provider or obtain a referral for specialist services.

Aetna HealthFund

As long as you live within a network area, you can participate in the Aetna HealthFund, a "consumer driven" health plan designed to give you and your family greater ability to manage your care. Your covered medical expenses are paid from a health fund and applied to your deductible. Once your fund is exhausted you will need to satisfy the balance of the deductible. When your deductible is met, Aetna HealthFund will reimburse covered expenses on a network basis, depending on if you choose an in-network or out-of-network provider.

MED 300*

This option, available if you live outside of a network area, is just as its name implies - a medical plan with a $300 annual individual deductible ($600 for all other family categories). With this benefit option, you pay 20 percent of covered expenses and the plan pays 80 percent after the annual deductible is met.

MED 1000*

The MED 1000 plan, available if you live outside of a network area, is a medical plan with a $1,000 annual individual deductible ($2,000 for all other family categories). With this benefit option, you pay 20 percent of covered expenses and the plan pays 80 percent after the annual deductible is met.

MED 5000*

The MED 5000 plan, available if you live in or outside of a network area, is a medical plan with a $5,000 annual individual deductible ($10,000 for all other family categories) and a preventive care benefit of $2,500 that is not subject to the deductible. With this benefit option, the plan pays 100 percent of covered expenses (including prescriptions) after the annual deductible is met. This high deductible plan enables you to set aside money tax-free in a savings vehicle known as a Health Savings Account.

MED 2900 and MED 5800*

Med 2900 is available for individual coverage and Med 5800 is available for Individual and child(ren), Individual and spouse, and Family coverage. Once you meet the plan's deductible, $2,900 or $5,800, covered expenses (including prescriptions) will be covered at 100 percent. This plan also provides a $2,500 preventive care benefit that is not subject to the deductible. If you elect one of these two high deductible plans, you may also set aside money tax-free in a savings vehicle known as a Health Savings Account.

Health Savings Accounts

KPMG offers high deductible health plans that are compatible with establishing a Health Savings Account (HSA). An HSA permits you to make tax-deductible contributions that may be accumulated over the years and distributed on a tax-free basis to pay for any medical expense qualified under Section 213(d) of the Code. You may establish an HSA with the vendor of your choice, however, you may not establish an account with a restricted entity.

HMO

HMOs are available in most locations and generally require that you select a primary care provider. Most HMOs only provide coverage if you receive care from a network provider.

Health Care Flexible Spending Account*

You may elect to have up to $5,000 (pretax) deducted from your pay to cover medical expenses not reimbursed through another source. The Health Care Flexible Spending Account includes an FSA Card that you may use to pay for expenses. Note: You are not eligible to contribute to a Health Savings Account (HSA) if you are enrolled in a Health Care Flexible Spending Account.

Prescription Drug Program Coverage*

Participants in the Choice POS II, Aetna HealthFund, MED 300 and MED 1000 plans are covered automatically under the prescription drug program. There are two aspects to the program: retail card and mail order. Prescription drugs for participants in MED 5000 and MED 2800/5900 are covered at 100% after you have satisfied your deductible and preventive drugs (based on Aetna's list of covered preventive drugs) are covered at 100% not subject to the deductible. Prescription coverage for HMO participants will vary by HMO.

Retail Card

You may purchase short-term prescriptions, up to a 30 day supply, through participating pharmacies. Co-pays are 10% for formulary generic drugs, 20% for formulary brand-name drugs, and 40% for drugs not listed on the formulary. Co-pays are subject to a minimum of $10 and a maximum of $50 per prescription. The combined retail and mail order out-of-pocket maximum you will have to pay is $1,250 per covered person.

Mail Order

You may purchase longer-term prescriptions by mail. Administered by Aetna Rx Home Delivery, a leading mail-order pharmacy, the service enables you to obtain prescriptions for up to 90 days. Co-pays are 10% for formulary generic drugs, 20% for formulary brand-name drugs, and 40% for drugs not listed on the formulary. Mail order co-pays are subject to a minimum of $10 and a maximum of $75 per prescription. The combined retail and mail order out-of-pocket maximum you will have to pay is $1,250 per covered person.

*Any reference to deductibles and out-of-pocket maximums are based on a calendar year.