2020 Open Enrollment Guide - Dec. 2 to 15, 2019 Open enrollment is - Petco Benefits for Healthy Living
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SALARIED PARTNERS
2020 Open
Enrollment
Guide
Open enrollment is
Dec. 2 to 15, 2019
ACTION REQUIRED!
! You must actively enroll during Open Enrollment to have
most benefits in 2020. Read this guide for the paw-ticulars.
2020 Open Enrollment checklist
Use this checklist to help you enroll in your 2020 benefits
by December 15.
Bury your nose in this Open Enrollment Guide
• Get an overview of benefit changes for 2020 and what you need to
do to enroll.
Access other resources to learn about your 2020 benefits
• Review the resources available on the Benefitfocus website. Go to
www.mypetcobenefits.com and click on the Login Here button.
• Get information about the new medical and dental plans administered
by Collective Health at http://join.collectivehealth.com/petco or call
844-516-3836 starting December 2 to speak to a Member Advocate.
Enroll in your 2020 benefits from December 2 to 15
• Go to www.mypetcobenefits.com and click on the Login Here button to
enroll in your 2020 benefits using Benefitfocus.
• Call the Petco Benefits Service Center at 855-847-6067 to enroll in your
2020 benefits over the phone or get answers to your benefit questions.
Representatives are available Monday-Friday from 8 a.m. to 8 p.m. ET.
ACTION REQUIRED!
You must enroll in the following plans to have coverage beginning
February 1, 2020. If you don’t enroll, coverage in these plans will
end on January 31, 2020.
• Medical, dental and vision
• Health savings account (HSA)
• Flexible spending accounts (FSA)
• Voluntary critical illness, accident and hospital indemnity insurance
See page 4 for more information about the default benefits that will
apply if you miss the December 15 enrollment deadline.
Inside
Welcome to Open Enrollment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Take paws and find out what’s new for 2020 . . . . . . . . . . . . . . . . . . . . . . . . . 1
2020 Open Enrollment action items . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Enroll in your 2020 benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Default benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Medical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Prescription drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Teladoc . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Health savings account . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Flexible spending accounts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Vision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Dental . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Life & AD&D insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Disability insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Legal assistance plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Voluntary benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Petco preventive care and Petco insurance . . . . . . . . . . . . . . . . . . . . . . . . . 18
Dependent eligibility reminders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Other valuable benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Sign-up for
text message alerts!
Sign-up for text message alerts on your smartphone
to receive notifications from Petco about benefit program
deadlines and events. Petco does not charge for text message
alerts sent to you. You may incur charges from your wireless carrier
for text messages. Check with your wireless carrier for
possible charges.
To sign up, text BENE9 to 31996.
To stop, text STOP to 31996.
i
Welcome to Open Enrollment
You talked. We listened.
We’re making exciting changes to our benefits in 2020, many of which are in response to your
feedback and the results of the benefits satisfaction survey completed earlier this year.
You told us you needed more affordable medical plans with easier access to care. We heard you and
Petco is making a significant investment in the health plans to lower your costs and make it easier to
get the care you and your family need. You also told us you want better tools and resources to make
it easier to understand and use your healthcare benefits. We are putting healthcare resources right at
your fingertips that you can access 24/7 from your smartphone or computer.
• Affordable premiums – ALL medical plans have lower premiums in 2020 – that means you’ll
have more left in your paycheck for other important things in your life
• Affordable care – we’re adding low-cost copays for the basics like doctor visits and prescriptions
• Accessible care – all Collective Health PPO Plan participants will have access to Teladoc for
$0 copay (and $49/visit for HSA participants until the deductible is met) – that’s right, a doctor
is just a click away on your smartphone or computer at no cost to you
• Simpler care – transparency tools and other great features are coming your way in 2020 under
the Collective Health Plans – these tools take the guesswork out of finding the best quality care
at the lowest price and it’s easy to use on the Collective Health app or website
This guide will walk you through what you need to know about your 2020 benefit choices. With
new medical and dental options starting Feb. 1, 2020, you must act and enroll in your benefits by
December 15, 2019. If you miss the enrollment deadline, most benefits will end on January 31, 2020.
Take paws and find out what’s new for 2020
We’re making some important changes and enhancements to our benefits program for 2020 to simplify your
healthcare experience and raise the bar in how we support our partners.
Telemedicine through Teladoc with
option to have $0 copay for doctor visits
Lower medical plan
When you enroll in a Collective Health medical plan,
premiums in 2020 you can use Teladoc, giving you convenient 24/7 video access to
In response to your doctors who can diagnose, treat and write prescriptions to your
feedback, all Petco local pharmacy for most non-emergency conditions. You’ll have
medical plans will have a $0 copay for doctor visits if you enroll in the Enhanced or Value
lower premiums in 2020. PPO plans. If you enroll in the HSA Plan, you will pay $45 per visit
until you satisfy your deductible, and then doctor visits are offered
at no charge. To learn more about Teladoc, see page 9.
1
New medical and dental plan options
through Collective Health
HRA ends on January 31, 2020
We are partnering with Collective
Beginning February 1, 2020, Petco will no
Health as the administrator of our new
longer provide a health reimbursement
medical and dental plans replacing
account (HRA) for employees enrolled in
the Anthem Blue Cross medical plans
a Petco medical plan. You may continue to
and the Cigna dental plans. With
submit expenses for reimbursement through
Collective Health, you’ll have access to
April 30, 2020 for eligible expenses incurred
enhanced tools and valuable resources
by January 31, 2020.
to help you understand your benefits and make smart
enrollment choices. For medical, see page 5. For In lieu of an HRA, Petco has redesigned the
dental, see page 14. medical plans to provide affordable access
to healthcare by lowering medical plan
Save more money with a premiums and introducing affordable copays
for visits to a doctor or urgent care center.
health savings account
If you enroll in the HSA plan, Petco
contributes to your HSA up to
$250 ($62.50 every quarter) for
New voluntary benefits
employee-only coverage and up to $500
through Transamerica
($125 every quarter) if you cover at least one dependent.
You can contribute pre-tax dollars up to $3,300 for Voluntary critical illness, accident
employee only and $6,600 for employee + dependents and hospital indemnity will be
coverage. If you are age 55 or older in 2020, you can offered through Transamerica. You can enroll during
contribute an additional $1,000 to your HSA. See page this year’s Open Enrollment without evidence of
11 for more information about the HSA. insurability. See page 17 for more information about
voluntary benefits.
Healthcare FSA maximum
is increasing Grand Rounds medical expert
second opinion service
In 2020, you can set aside up to
$2,750 in a healthcare FSA or a If you enroll in a Collective Health medical plan, you
limited use FSA. If you are enrolled will have access to Grand Rounds at no additional
in the CDHP with HSA, you can open a limited use FSA charge. Grand Rounds can help you get a second
to pay for eligible dental and vision expenses only. See opinion or personalized care plan for any diagnosis
page 12 for more information about the FSAs. from a world-leading expert. See page 6 for more
information about Grand Rounds.
Get Care price
transparency tool
Go to mypetcobenefits.com Collective Health members have access to the Get
and click on Login Here to Care price transparency tool making it simple to make
view medical plan premiums value-based care decisions by finding high-quality, cost
for the 2020 plan year. effective facilities and doctors in their area.
Walmart and Sam’s Club
added to the VSP network
Starting February 1, 2020, you have network coverage
for your vision needs at Walmart and Sam’s Club. See
page 13 for more information about vision benefits.
2
2020 Open Enrollment action items
If you don’t take action during Open Enrollment, you cannot make changes to most benefits until the next
Open Enrollment (for 2021), unless you have a life event change during the year such as a marriage or the
birth or adoption of a child.
Required Elections During Open Enrollment
If you are eligible, you must enroll in these benefits during Open Enrollment if you want coverage
in 2020:
Medical Health savings account Accident
Dental Flexible spending accounts Hospital Indemnity
Vision Critical Illness
Can Change/Enroll Only During Open Enrollment
If you are eligible, you can add or change these benefits during Open Enrollment or continue current
coverage in 2020:
Voluntary employee and dependent life Short-term disability
Voluntary accidental death & dismemberment Long-term disability
Legal assistance plan
Can Change/Enroll at Anytime*
If you are eligible, you can elect or change these benefits at any time:
401(k) Plan Petco preventive care
Auto & home insurance Petco insurance
* After eligibility effective date.
3
Enroll in your 2020 benefits
Enroll online Call the Petco Benefits
The easiest way to choose your benefits for Service Center
2020 is through the Benefitfocus website. You can call the Petco Benefits Service
Center to enroll in your benefits or get
• Go to mypetcobenefits.com and click on
answers to your benefit questions.
Login Here
• Call 855-847-6067 M-F from 8 a.m.
• For new users, follow the onscreen
to 8 p.m. ET
instructions to create an account on the
Benefitfocus website
Default benefits
If you do not take action during Open Enrollment, you will not have medical,
dental, vision, health savings account, flexible spending accounts or
voluntary benefits (critical illness, accident, hospital indemnity) effective
February 1, 2020.
If you miss the enrollment deadline, your benefits effective February 1, 2020 will
default to the coverages shown here.
2020 Default Benefits
BENEFIT DEFAULT COVERAGE
Basic life and AD&D
• Salaried partners & Directors 1X annual earnings, max $250,000 paid by Petco
• Officers 3X annual earnings, max $1,000,000 paid by Petco
Voluntary employee and dependent life Current coverage
Voluntary AD&D Current coverage
Basic short-term disability
• Salaried partners 60% of earnings, max $500 per week, paid by Petco
• Directors 60% of earnings, max $2,000 per week, paid by Petco
• Officers 67% of earnings, max $3,500 per week, paid by Petco
Buy-up short-term disability Current coverage
• Salaried partners
Basic long-term disability
• Salaried partners & Directors 60% of earnings, max $11,500 per month, paid by Petco
• Officers 67% of earnings, max $22,000 per month, paid by Petco
Buy-up long-term disability
• Salaried partners Current coverage
Petco preventive care Current coverage
Petco insurance Current coverage
Legal assistance plan Current coverage
Employee Assistance Program Covered
4
Medical
Petco has completely redesigned the medical plans for 2020 reducing premiums across the board, and partnering
with Collective Health to bring innovation and an improved experience to understanding and using healthcare.
Here’s what you need to know about our new plans.
If you live in CA, CO, DC, GA, MD, OR, VA or WA, you have three additional medical plans through Kaiser
Permanente. Your eligibility to select a Kaiser Permanente plan is determined by your home zip code.
Enhanced PPO Plan HSA Plan
• Highest premiums • Premiums in-between Enhanced and
• Lowest deductible Value PPO plans
•C
opays for doctor visits, urgent care and
• High deductible
generic drugs
•T
elemedicine doctor visit through Teladoc • M ust meet the deductible before the
has a $0 copay plan begins to pay for services other
than preventive care. After you’ve met
the deductible, you’ll pay 20% for most
covered services
Value PPO Plan • Telemedicine doctor visit through Teladoc
has a $45 copay before the deductible is
• Lowest premiums
met and a $0 copay after the deductible
• Highest deductible is met
•C
opays for doctor visits, urgent care and
• Petco will make quarterly contributions
generic drugs
into your HSA up to $250 per plan
•T
elemedicine doctor visit through Teladoc year for employee only coverage and
has a $0 copay up to $500 per year for employee +
dependent(s)
Note: While the HSA plan may be a good
Transition of care choice for someone who is a low utilizer of
healthcare and has predictable expenses,
If you are currently receiving care for an ongoing
it might not be the right plan for everyone.
medical condition (including pregnancy) from an
Contact a Collective Health Member
Anthem Blue Cross provider who is not in the Blue
Advocate at 844-516-3836 for assistance
Shield network, you may be eligible for transition
evaluating the medical plans available to
assistance for a limited period of time. Contact
make the best choice for you.
Collective Health on or after Dec. 2, 2019 at
844-516-3836 and speak to a Member Advocate
who can assist you.
Nicotine Use Surcharge
Smoking is the leading preventable cause of serious
disease. If you make the healthy choice not to use
nicotine, you can avoid a $15 per pay period nicotine
use surcharge on your medical contribution. You will
be required to state your nicotine use status when
you make your enrollment elections. This applies to
partners and eligible dependents.
5
Collective Health
Effective February 1, 2020, Collective
Health will replace Anthem Blue Cross and
CIGNA as the administrator for Petco’s
Contact Collective Health
medical and dental plans. Collective Health
utilizes the Blue Shield medical provider
Beginning Dec. 2, 2019
network and the Delta Dental provider
network.
http://join.collectivehealth.com/petco
Why Collective Health? help@collectivehealth.com
Collective Health is passionate about
delivering an exceptional overall
844-516-3836
experience when it comes to managing
M-F, 6 a.m.-6 p.m. PST
your healthcare. They combine technology
and industry expertise to help members Search for the Collective Health
better understand their benefits and mobile app on the App Store or
navigate through their healthcare needs. Goggle Play
With Collective Health’s unique platform,
you will be able to view your medical,
pharmacy and dental claims all in one Member Advocates
place (excluding Kaiser plans and the Collective Health’s Member Advocates can:
dental HMO). You can work online or with
a Member Advocate to ask questions, • Help you understand your coverage
submit claims, or use their transparency • Give
you a single place to review your
tool to find providers who are highly- claims history
ranked among their peers for delivering
• Answer your questions
quality healthcare. These tools can
also help you compare costs between • Connect
you to programs that meet your unique
providers and/or procedures in your area needs including mental health support, health
to help you make the most effective coaching, expert medical advice and more.
decision for your health and your wallet.
Finding Blue Shield network providers
Blue Shield has an extensive provider network with significant overlap of
in-network providers with Anthem Blue Cross. To find out if your provider
is part of the Blue Shield network or to find a new in-network provider, use
the Collective Health online portal above and go to “Find Care.” If you
have questions or need assistance finding in-network providers, contact
Collective Health by phone or email noted above.
6
use the text and tables on pages 7
and 8 here in the BAB magazine
medical tables comparison pages.
2020 medical plans at-a-glance
Collective Health Medical Plans: See the Collective Health Summary of Benefits & Coverage (SBC) for the applicable
medical plan available on the Benefitfocus website for details on Collective Health medical plan benefits.
Collective Health Medical Plans
Plan Feature Enhanced PPO Plan Value PPO Plan HSA Plan
Plan Year Deductible
• Employee $1,000 $4,000 $2,000
• Family $2,000 $8,000 $4,0001
Petco Contribution to HSA
• Employee n/a n/a $250 ($62.50 quarterly)5
• Family n/a n/a $500 ($125 quarterly)5
Plan Year Out-of-Pocket Max
• Employee $6,000 $6,000 $4,000
• Family $12,000 $12,000 $8,000
In-Network In-Network In-Network
YOU PAY YOU PAY YOU PAY
Preventive Care $03 $03 $03
Telemedicine Virtual Doctor Visit $03 $03 $45 (until plan year deductible is met)
through Teladoc $0 (after plan year deductible is met)
Office Visit
• PCP $25 copay $40 copay 20%2
• Specialist $50 copay $80 copay 20%2
Urgent Care $100 copay $100 copay 20%2
Emergency Room 20%2 30%2 20%2
Diagnostic Testing 20%2 30%2 20%2
Outpatient X-Ray and Lab 20%2 30%2 20%2
Hospitalization
• Inpatient Semi-Private Room 20%2 30%2 20%2
• Inpatient Physician 20%2 30%2 20%2
Outpatient Treatment (PT, OT, ST) 20%2 30%2 20%2
Mental Health/Substance Abuse
• Inpatient 20%2 30%2 20%2
• Outpatient 20%2 30%2 20%2
Pharmacy Retail 30-day supply 30-day supply 30-day supply
• Specified Preventive Drugs4 100% covered3 100% covered3 100% covered3
• Generic $10 copay $10 copay 20%2
• Brand Formulary 20%3 30% 3 20%2
• Brand Non-Formulary 30%3 30% 3 20%2
Pharmacy Mail Service 90-day supply 90-day supply 90-day supply
• Specified Preventive Drugs4 100% covered3 100% covered3 100% covered3
• Generic $20 copay $20 copay 20%2
• Brand Formulary 20%3 30% 3 20%2
• Brand Non-Formulary 30%3 30% 3 20%2
1) The
family deductible must be met before any person receives benefits.
2) Coinsurance you pay after you meet the plan year deductible unless otherwise noted.
3) Plan year deductible waived.
4) As specified in essential drug list.
5) Beginning 02/01/2020.
72020 medical plans at-a-glance
Kaiser Permanente Medical Plans: You must live in a Kaiser Permanente service area in CA, CO, DC, GA, MD, OR,
VA or WA. You must use Kaiser network providers only except for certain emergency situations. Benefits in RED are
for California residents only. See the Kaiser Summary of Benefits & Coverage (SBC) for your state available on the
Benefitfocus website for details on Kaiser medical plan benefits.
Kaiser Permanente Medical Plans
Plan Feature Enhanced Plan Value Plan HSA Plan
Plan Year Deductible
• Employee $1,000 $4,000 $2,000
• Family $2,000 $8,000 $4,0001 ($2,8002 CA)
Petco Contribution to HSA
• Employee n/a n/a $250 ($62.50 quarterly) 6
• Family n/a n/a $500 ($125 quarterly) 6
Plan Year Out-of-Pocket Max
• Employee $6,000 $6,000 $4,000
• Family $12,000 $12,000 $8,000
Kaiser Network Providers Kaiser Network Providers Kaiser Network Providers
YOU PAY YOU PAY YOU PAY
Preventive Care $04 $04 $04
Telemedicine Virtual Doctor Visit $04 $04 $0
through Kaiser
Office Visit
• PCP $25 copay $40 copay 20% 3
• Specialist $50 copay $80 copay ($50 copay CA) 20% 3
Urgent Care $100 copay ($25 copay CA) $100 copay ($40 copay CA) 20% 3
Emergency Room 20% 3 30%2 20% 3
Diagnostic Testing 20% 3 30% 3 20% 3
Outpatient X-Ray and Lab 20% 3 30% 3 20% 3
Hospitalization
• Inpatient Semi-Private Room 20% 3 30% 3 20% 3
• Inpatient Physician 20% 3 30% 3 20% 3
Outpatient Treatment (PT, OT, ST) 20% 3 30% 3 20% 3
Mental Health/Substance Abuse
• Inpatient 20% 3 30% 3 20% 3
• Outpatient 20% 3 30% 3 20% 3
Pharmacy Retail 30-day supply 30-day supply 30-day supply
• Specified Preventive Drugs5 100% covered4 100% covered4 100% covered4
• Generic $10 copay $10 copay 20% 3 ($50 max CA)
• Brand Formulary 20%4 ($100 max CA) 30% 4 ($100 max CA) 20% 3 ($100 max CA)
• Brand Non-Formulary 30% 4 (20%, 3 $100 max CA) 30% 4 ($100 max CA) 20% 3 ($100 max CA)
Pharmacy Mail Service 90-day supply 90-day supply 90-day supply
• Specified Preventive Drugs5 100% covered4 100% covered4 100% covered4
• Generic $20 copay $20 copay 20% 3 ($50 max CA)
• Brand Formulary 20%4 ($100 max CA) 30% 4 ($100 max CA) 20% 3 ($100 max CA)
• Brand Non-Formulary 30% 4 (20%, 3 $100 max CA) 30% 4 ($100 max CA) 20% 3 ($100 max CA)
1) The
family deductible must be met before any person receives benefits.
2) In CA, a covered family member needs to meet a $2,800 plan year deductible before the plan starts sharing costs for that family member under the HSA Plan.
3) Coinsurance or copay you pay after you meet the plan year deductible unless otherwise noted.
4) Plan year deductible waived.
5) As specified in essential drug list.
6) Beginning 02/01/2020. 8Prescription drugs
All medical plans include prescription drug coverage.
Prescription drugs with a Collective Health medical plan
When you enroll in a medical plan administered by Collective Health, you automatically receive prescription drug
coverage through CVS. The CVS pharmacy network has more than 68,000 pharmacies nationwide, including
9,900 CVS pharmacies plus many national and independent retail pharmacies.
Specified Preventive Generic Drugs Brand Non-Formulary
Drugs Generic drugs have the lowest Brand name drugs not on
Certain generic preventive costs and are considered the brand formulary have the
medications (like birth control) identical to their brand name highest copays. When you
are covered at no cost and not equivalents by the FDA in fill a prescription, you can
subject to annual deductibles terms of efficacy and safety. ask the pharmacist whether
provided certain requirements a generic or brand formulary
are met. drug of your medication
is available. If you or your
provider choose a brand non-
formulary medication when
Brand Formulary
a generic is available, you’ll
Drugs on the brand formulary are designated as preferred based on
pay the difference in cost
their cost effectiveness and, in some cases, efficacy. If you or your
between the generic and the
provider choose a brand formulary medication when a generic is
brand nonformulary drug.
available, you’ll pay the difference in cost between the generic and
the brand formulary drug.
Prescription drugs with a Kaiser Permanente medical plan
When you enroll in the Kaiser medical plan, you automatically receive prescription drug coverage through Kaiser.
Many Kaiser Permanente facilities have pharmacies in the building. You can refill prescriptions in person, online
or by phone.
Refill in person: Bring your prescription to a Kaiser pharmacy.
Online: Visit kp.org/rxrefill to order your prescription refills online after you register
at kp.org/registernow.
Phone: Call the pharmacy refill phone number highlighted on your prescription label.
9Feel good all
over with FREE
doctor visits
from Teladoc.
Get started using Teladoc
beginning Feb. 1, 2020
Once you receive your Collective
Health medical ID card, set up an
account at teladoc.com.
Teladoc
Illness doesn’t always happen from 9 to 5 or when
you’re close to home. Teladoc provides you with 24/7
access to a national network of U.S. board certified
doctors when you are enrolled in a Collective Health Complete your medical history.
medical plan. And depending on your medical plan
enrollment, the service may be free.
You can connect with a Teladoc physician from
anywhere—home, work or on the road. Teladoc
doctors diagnose non-emergency medical problems,
recommend treatment, and can even call in any
necessary prescriptions to your pharmacy.
Request a consultation with a Teladoc
Teladoc doctors can treat a range of conditions doctor and a board-certified physician
including: will call or video chat with you.
• Respiratory infections • Allergies
• Ear infections • Cold and flu
• Urinary tract infections • Sore throat
2020 Medical Plan Your Cost Per Visit
Enhanced PPO Plan $0
If you are enrolled in the Enhanced or
Value PPO Plan, you pay $0. If you are
Value PPO Plan $0
enrolled in the HSA Plan, you pay $45
until your deductible is met, and
Before deductible: $45
HSA Plan $0 after your deductible is met.
After deductible: $0
10Medical ID cards Dental ID cards
If you enroll in a Collective Health medical If you enroll in the Standard or Enhanced
plan, you will receive a new medical/ Dental Plan administered by Collective
prescription drug ID card in January 2020. Health, you will receive a new dental ID card
in January 2020.
If you enroll in a Kaiser Permanente medical
plan for the first time in 2020, you will If you enroll in the Delta Dental HMO, you
receive a new medical/prescription drug ID will receive a new dental ID card directly
in January 2020 from Kaiser. from Delta Dental in January 2020.
HRA ends on January 31, 2020
See page 2 for information about the HRA ending on January 31, 2020.
Health savings account
If you enroll in the HSA Plan through Collective Health or Kaiser, you have the option to contribute to a health
savings account (HSA). The HSA offers tax savings and can be used to cover eligible medical, pharmacy,
dental and vision expenses now or in the future. Unlike money in an FSA, the funds in your HSA roll over each
year and continue to build. Your HSA funds are also portable, so if you leave Petco, you can take your account
balance with you.
Key things to know about a health savings account
Petco contributes to your In 2020, you can contribute You can use your HSA to pay
HSA up to $250 ($62.50 per pre-tax dollars up to $3,300 for eligible medical, dental and
quarter) for employee-only for employee only and up to vision expenses.
coverage and up to $500 $6,600 if you cover at least
($125 per quarter) if you cover one dependent. If you are
at least one dependent. 55 or older in 2020, you can You can adjust your HSA payroll
contribute an additional $1,000. contributions at any time during
the year.
You decide when to spend (or You can contribute to an HSA if Your HSA earns interest, and
save) your HSA dollars. Any your are enrolled in the HSA Plan once the balance reaches
unused money remaining in and you are not covered by any a certain amount (typically
your account at the end of the other medical plan, Medicare, $2,000), you can choose
plan year rolls over for you to Medicaid, TRICARE or a to invest the amount above
use to pay for eligible expenses healthcare FSA. Also you cannot $2,000 similar to how the
now or save for the future. be claimed as a dependent on 401(k) plan works.
another person’s tax return.
11Flexible spending accounts
Healthcare flexible Healthcare Flexible Spending Account
spending account
Annual maximum Up to $2,750 in 2020
A healthcare FSA gives
contribution
you a tax break on many medical, dental and vision
expenses that are not covered by other plans. Eligible expenses Medical, dental and vision care
By anticipating your expenses and arranging for expenses not paid by your health
deductions to be made from your paycheck each insurance and on the IRS list of
pay period, you lower your tax bill. You can set aside approved expenses.
up to $2,750 in 2020 on a pre-tax basis to cover Pairs with Enhanced or Value PPO Plan
eligible medical, dental and vision expenses
If you don’t use it Up to $500 carry over to
next year and any additional
Limited use flexible funds will be forfeited
spending account
If you enroll in the HSA Plan and open a health
savings account, you can open a limited use FSA Limited Use Flexible Spending Account
to set aside a portion of your earnings on a pre-tax Annual maximum Up to $2,750 in 2020
basis to pay for dental and vision expenses only. contribution
You can set aside up to $2,750 in 2020 on a pre-tax
basis to cover eligible dental and vision expenses Eligible expenses Dental and vision care expenses
not paid by your health insurance
not reimbursed by any other health plan.
or reimbursed through a health
savings account
Dependent daycare flexible Pairs with HSA Plan
spending account
A dependent daycare FSA allows you If you don’t use it Up to $500 carry over to
next year and any additional
to pay for eligible day care or elder care expenses
funds will be forfeited
while you are working. You can set aside up to
$5,000 each plan year on a pre-tax basis to cover
the cost of dependent day care expenses. Dependent daycare
The amount you contribute to a dependent daycare Flexible Spending Account
FSA cannot be greater than your income or your Annual maximum Up to $5,000 in 2020 per
spouse’s income, whichever is less. If your spouse contribution married couple filing jointly
contributes to a dependent care FSA through his or ($2,500 max for married, filing
her employer, your combined contributions may not separately.)
exceed $5,000.
Eligible expenses Dependent day care expenses
that make it possible for you to
work
If you don’t use it Any funds remaining at the end
of the plan year are forfeited
12Vision
Vision benefits provided through Vision Service Plan (VSP) are designed to help reduce the cost of eyeglasses,
contact lenses and other vision services.
You have two options available: VSP Standard Vision and VSP Enhanced Vision.
Your benefits are highest when you visit a VSP provider. If you see a non-VSP provider, you’ll have to file your
own claim forms and you’ll likely pay more out-of-pocket. The benefits shown in the table below are from VSP
network providers.
Vision Benefits At-a-Glance
VSP Standard Vision VSP Enhanced Vision
Benefit Feature Using VSP Provider Using VSP Provider
Eye Exam (Once each plan year) Covered in full with $10 copay Covered in full with $10 copay
Frames Once every other plan year Once every plan year
Covered up to a $130 Covered up to a $175
retail allowance; plus 20% off retail allowance; plus 20% off
any out-of-pocket costs any out-of-pocket costs
Lenses (Once each plan year)
• Single vision, lined bifocal, lined trifocal Covered in full with $25 copay Covered in full with $10 copay
Lens Options 20% to 25% off retail cost 20% to 25% off retail cost
Scratch resistant coating, ultraviolet coating,
tint, standard polycarbonate, anti-reflective
coating, other add-ons and services
Contact Lenses (Once each plan year in lieu
of frames and lenses)
• Contact lens exam (fitting and evaluation) Covered in full with copay Covered in full with copay
not to exceed $60 not to exceed $60
• Contact lenses Covered up to $130 allowance Covered up to $175 allowance
To find VSP providers
in your area, call VSP
at 800-877-7195 or
visit vsp.com.
13Dental
Standard and Enhanced Dental Plans
Collective Health administers the Standard and Enhanced Dental Plans through Delta Dental. Both plans give you
access to Delta Dental’s network of preferred dentists. If you use a Delta Dental network dentist, your preventive
care is covered at 100% and you’ll pay less out-of-pocket costs for other services because network dentists provide
services at pre-negotiated rates.
The main differences between the Standard and Enhanced Dental Plans are a higher plan year maximum
($1,500 vs. $2,000) and orthodontia coverage is only available with the Enhanced Dental Plan.
To find Delta Dental network dentists, go to http://join.collectivehealth.com/petco and click on “Find Care.”
You can also call Collective Health at 844-516-3836 for assistance.
Delta Dental HMO Plan
The Delta Dental HMO Plan requires you to visit your selected primary care dentist in order to receive benefits.
You must choose a dentist for each covered family member. Preventive services are covered at no charge. You pay
a fixed copay for other dental services. To find a DeltaCare USA dentist, go to www.deltadentalins.com and click
on Find a Dentist.
Dental Benefits At-a-Glance
Collective Health Dental Plans Delta Dental
Benefit Feature Standard Dental Plan Enhanced Dental Plan Delta Dental HMO
Plan Year Deductible $50 per person, $50 per person, None
$150 per family $150 per family
Plan Year Maximum Benefit $1,500 $2,000 No Maximum Benefit
Diagnostic/Preventive Services
• Preventive Care No charge, no deductible No charge, no deductible No charge1,2
• Oral Exams, X-rays No charge, no deductible No charge, no deductible No charge
Basic Services
• Oral Surgery 20% after deductible 20% after deductible $12—$125 copay
• Restorative (fillings) 20% after deductible 20% after deductible $0—$115 copay
• Endodontics (root canals) 20% after deductible 20% after deductible Up to $430 copay
Major Services
• Crowns 50% after deductible 50% after deductible Up to $500 per unit
• Dentures 50% after deductible 50% after deductible $525—$715 copay
Orthodontia
• Adolescent Benefit (to age 19) Not covered 50% after deductible $1,530—$2,505 copay
• Adult Benefit up to $1,500 lifetime max
Not covered Not covered $1,730—$2,705 copay
1) $12 copay per tooth for sealants and a $170 copay for space maintainers.
2) $30 copay (child) or $45 copay (Adult) for prophylaxis beyond the limit of 2 per year with no copay.
3) Additional charges for evaluation, treatment plan, banding (placement of braces) and retention.
14Life and AD&D insurance
Basic life and accidental death & dismemberment (AD&D)
You receive basic life and AD&D as shown in the table below. Life insurance pays benefits upon your death. AD&D
insurance pays benefits if your death is the result of a covered accident. If you die from an accidental injury, your
beneficiary will receive both the life and AD&D benefit. Basic life and AD&D will decrease to 65% of the original
coverage amount at age 65 and 50% of the original coverage amount at age 70.
Coverage Coverage Amount
• Salaried partners & Directors 1X annual earnings, max $250,000 paid by Petco
• Officers 3X annual earnings, max $1,000,000 paid by Petco
Voluntary life insurance for you and your dependents
You can purchase voluntary life to increase your own coverage or add coverage for your spouse/domestic
partner or children. Voluntary life for yourself or your spouse/domestic partner will decrease to 65% of the
original coverage amount at age 65 and 50% of the original coverage amount at age 70.
Guaranteed Issue
Coverage Coverage Amount Maximum (if enrolling when first eligible)
Voluntary Employee Life
• Salaried partners & Directors 1X to 5X annual earnings $500,000 Lesser of 3X annual earnings or $500,000
• Officers 1X to 5X annual earnings $1,000,000 Lesser of 3X annual earnings or $750,000
Voluntary Spouse/Domestic $10,000 to $250,000 Lesser of $30,000 if enrolling when first eligible
Partner Life $250,000 or
You must elect voluntary 100% of your
employee life in order to elect voluntary
coverage for your spouse/ employee life
domestic partner. amount
Voluntary Child Life $5,000, $10,000, $15,000 $20,000 $20,000
You must elect voluntary or $20,000
employee life in order to elect
coverage for your child(ren).
Voluntary AD&D insurance for you and your dependents
You may also purchase voluntary AD&D for yourself and your family. If your death is the result of a covered
accident, your beneficiaries receive the full amount of your voluntary AD&D Insurance. If you are seriously
injured in a covered accident, all or part of your voluntary AD&D benefit is paid to you. The amount payable
depends on the nature of the injury. If you select an option that includes coverage for your family, coverage for
family members is a percentage of your coverage.
Coverage for Coverage Amount
You $10,000 to $500,000 in $10,000 increments
Family members
• Spouse/domestic partner only • 50% of your coverage amount
• Child(ren) only • 15% of your coverage amount
• Spouse/domestic partner and child(ren) •S pouse/domestic partner: 40% of your coverage amount
child(ren): 10% of your coverage amount
15Disability insurance
Short-term disability insurance
Basic short-term disability: Petco provides basic short-term disability (STD) equal to 60% of your eligible earnings
up to $500 per week1 . Benefits begin on the 8th day for illness and the 1st day for accidents and continue up to
180 days. Partners in California, Hawaii, New Jersey, New York and Rhode Island are also covered under a state
disability plan. Short-term disability benefits from Petco are reduced by payments you receive from state plans.
Buy-up short-term disability: You can purchase additional coverage equal to 67% of your eligible earnings up to
$1,500 per week. Officers and Directors are not eligible for Buy-up coverage.
Long-term disability insurance
Basic long-term disability: Petco also provides you with basic long-term disability (LTD) equal to 60% of your
eligible earnings up to $11,500 per month2 . Benefits begin after 180 days of disability and continue until you are no
longer disabled or reach age 65 (if you become disabled at age 60 or younger). If you become disabled after age
60, benefits continue according to a schedule. Refer to the Summary Plan Description for more information.
Buy-up long-term disability: You can purchase additional coverage equal to 67% of your eligible earnings up to
$11,500 per month. Officers and Directors are not eligible for Buy-up coverage.
1. Up to $2,000 per week for Directors and up to $3,500 per week for Officers.
2 For Officers, basic LTD is equal to 67% of eligible earnings up to $22,000 per month.
Legal assistance plan
Hyatt Legal Plans provides access to a national network of more than 12,000 attorneys. If you prefer, you may use
your own attorney and be reimbursed according to a set fee schedule.
The attorney fees for covered services are fully paid when you use a network attorney. There are no limits on the
number of times you may use the plan, and there are no dollar limits on your use of a plan attorney for covered
services. Services provided to you, your spouse/domestic partner and children under the age of 26 include:
• Wills and estate planning • Personal bankruptcy
• Traffic ticket defense • Juvenile court proceedings
• Power of attorney • Purchase or sale of home
• Consumer protection • IRS audit
16Voluntary benefits
The voluntary plans offered through Transamerica provide additional financial protection with premiums paid
through the convenience of payroll deduction. During this year’s Open Enrollment, evidence of insurability
requirements for critical illness insurance are waived.
Benefit Plan or Coverage Option
Critical Illness Pays a one-time lump sum benefit amount upon the diagnosis of a covered disease
You pay the cost with or illness such as a heart attack, stroke, cancer, major organ transplant, coronary
after-tax contributions. bypass surgery and more. You can use the money for any purpose.
• Coverage for you: $5,000, $10,000 or $20,000
•C
overage for your spouse or domestic partner: 50% of your coverage amount
• Coverage for your child(ren): 50% of your coverage amount
Accident Pays a specified benefit for specific injuries resulting from a covered accident.
You pay the cost with You can choose from two coverage options. The amount the plan pays depends
after-tax contributions. on the type of injury. Examples include:
• Fractures: $280 to $4,000
• H ospital confinement: $225 per day up to 365 days
• Burns: $300 to $6,000
• Coverage is available for yourself and your eligible family members.
Hospital Indemnity Pays a cash benefit of $150 each day you are confined to a hospital up to
You pay the cost with 31 days maximum. Optional riders include $150 per day cash benefit if you
after-tax contributions. are confined to an intensive care unit up to 30 days and a $1,500 additional
hospital confinement, one day per calendar year. How you use the money is
up to you—groceries, rent bills or whatever you need. Coverage is available for
yourself and your eligible family members.
Additional information about each voluntary plan including costs and coverage options
is included on the Benefitfocus website.
If you currently have a voluntary benefits policy through Voya, payroll deductions
will end January 31, 2020. If you wish to keep your Voya coverage, contact Voya at
877-236-7564 to find out if you can set up direct billing arrangements.
17Petco preventive care
The Petco preventive care plan pays you back for routine exams, tests, vaccinations and basic treatments.
Annual Services Value
Monthly price $20 per pet
(max: 5 pets)*
Benefits total value Up to $600**
Benefits overview Max. reimbursement
Two routine vet checkups $50
Blood test $50
Vaccination or titer testing $50
Microchipping $40
Health certificate $40
Behavioral exam $30
Heartworm or FeLV/FIC test $30
Urine test $25
Deworming $25
Fecal test $20
Additional perks
Unlimited Ask-a-Vet online consultation $150 value
Flea, tick and heartworm care $60
Wellness welcome kit $30
* Applies to dogs and cats only.
** Based on annual average of the aggregate total of all services.
Petco insurance
With Petco insurance, you’ll enjoy the peace of mind that your furry family members are protected, and money
won’t be the first concern when your pet is in the exam room. Pet insurance covers unexpected accidents, illness
and costly veterinary bills. You can customize your coverage for a fit that’s right for you.
Have questions?
Contact customer support by phone at 833-898-7387 or send an email to
support.wellness@petco.com.
To enroll, go to mypetcobenefits.com and click on the Login Here button.
18Dependent Eligibility Reminders
You are responsible for making sure your
covered dependents are eligible.
Spouse/domestic partner
Your eligible dependents are your: surcharge
• Legal spouse Petco partners who cover a spouse
• Same-sex domestic partner (opposite-sex domestic or eligible domestic partner on a
partners are eligible if one partner is at least 62 years old) Petco medical plan—when he or
she is eligible for medical coverage
• Child* under age 26 or disabled, dependent child incapable
outside of Petco’s plan (other
of self-support due to mental or physical disability, if the
than coverage through Medicare
child becomes disabled prior to reaching age 26
or Medicaid)—must pay a $50
Your eligible children include: surcharge per pay period.
• Natural born child The surcharge is in addition to
• Stepchild, legally adopted child or child for whom you have normal payroll contributions for
been appointed legal guardianship by a court of law medical coverage. If you are adding
a spouse or domestic partner to
• Child for whom the Plan has received a Qualified Domestic your coverage, you will be required
Child Support Order. to state whether your spouse
or domestic partner is eligible
*F
or Voluntary Child Life and family coverage under Voluntary AD&D, children for medical coverage outside of
are eligible up to age 19, or age 26 if a full-time student.
Petco’s plan when you make your
enrollment elections.
19Other valuable benefits
There’s more to your benefits than medical, dental and vision. As a valued Petco partner, here are a few other great
benefits to take advantage of:
Petco 401(k) Plan
The Petco 401(k) Plan helps you build financial security for your future. You become eligible to
participate on the first day of month following 6 months of service during which you worked at least
500 hours. You must be age 21 to participate.
You can contribute up to $19,500 in 2020 to your 401(k) account1 . If you are age 50 or older in 2020,
you can contribute up to an additional $6,500 under the catch-up provision.
Below Directors: Petco matches 100% of the first 1% that you contribute plus 50% of the next 5%.
So if you earn $30,000 annually and contribute 6% to your 401(k) account, you’ll receive a $1,050
matching contribution from Petco.
Directors and Officers: Petco matches 100% of the first 1% that you contribute plus 50% of the next 2%.
So if you earn $125,000 annually and contribute 3% to your 401(k) account, you’ll receive a $2,500
matching contribution from Petco.
Contact Fidelity to get started at 800-835-5095. The plan number is 49089.
Employee Assistance Program
When the going gets tough, turn to the Employee Assistance Program (EAP). Administered by
ComPsych and paid by Petco, the EAP offers up to five 50-minute confidential counseling sessions
and referrals.
Get help with drug or alcohol dependency, emotional problems, stress, relationship issues, legal or
financial concerns and more. Other services include health and wellness articles and resources, and
child and elder care referrals. All Petco partners and family members are eligible and can access EAP
services by calling 877-EAP-4PET (TDD: 800-697-0353), or by visiting guidanceresources.com.
Store discount
As a valuable member of the Petco team, you and your eligible family members receive a discount
on in-store purchase when you present a Partner Discount card. Cards are available from your Store
Leader (store partners), Hiring Manager (regional partners) or Human Resources (distribution and
support center partners).
Example discounts include:
• 40% discount on select premium and alternate food brands
• 20% discount on other merchandise and services.
• 20% discount on Petco private brand items, salon and Vetco (all services).
• Free puppy and basic dog training for Petco partners (20% discount for eligible family members).
20% discount on intermediate dog training courses.
1 Contributions for highly compensated partners (as defined by the IRS) may be lower due to IRS testing.
20PRESORTED
FIRST-CLASS
US POSTAGE
Petco Carmel Mountain 0581
PAID
111 60 Rancho C armel Dr. ACTION MAIL
San Diego, C A 92 128
Sam Sample
1234 Anywhere St.
San Diego, CA 00000
2020 Open
Enrollment
Get hopping!
2020 Petco benefits Open Enrollment
is Dec. 2 to 15, 2019.
———————————————— 2020 Open Enrollment Key Dates ————————————————
Dec. 2 to 15, 2019 Jan. 2020 Jan. 31, 2020 Feb. 1, 2020
Annual Open •A
ll partners enrolled in a Collective Health If you did not take Your 2020 benefit
Enrollment period medical or dental plan will receive new ID action during Open elections begin.
for 2020. To enroll cards in the mail. Enrollment, your
or make changes to medical, dental,
• If you enroll in the Delta Dental HMO, you
your benefits, go to vision, health savings
will receive a new dental ID card in the mail
mypetcobenefits.com account, flexible
from Delta Dental.
or call 855-847-6067. spending accounts
• If you are a new HSA or FSA participant, and certain voluntary
you will receive a new debit card in the mail. benefits will end.
This guide provides an overview of some of the benefit plans offered by Petco. It is not intended to be all inclusive. In the event of any conflict
between this guide and the official plan documents and contracts, the official plan documents and contracts will govern. Petco reserves the
right to change or modify its benefit plans as appropriate without advance notice. This guide does not represent a contract of employment.
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