CARING FOR THE TOTAL YOU - CHOOSE YOUR 2021 BENEFITS OCT. 19-NOV. 6 2021 OPEN ENROLLMENT GUIDE - MYPETCOBENEFITS BENEFITS ...

Page created by Lawrence Howard
 
CONTINUE READING
CARING FOR THE TOTAL YOU - CHOOSE YOUR 2021 BENEFITS OCT. 19-NOV. 6 2021 OPEN ENROLLMENT GUIDE - MYPETCOBENEFITS BENEFITS ...
HOURLY PARTNERS

CARING FOR THE
TOTAL YOU.
Choose Your 2021 Benefits
Oct. 19—Nov. 6

2021 Open Enrollment Guide
CARING FOR THE TOTAL YOU - CHOOSE YOUR 2021 BENEFITS OCT. 19-NOV. 6 2021 OPEN ENROLLMENT GUIDE - MYPETCOBENEFITS BENEFITS ...
Looking for information
            about your benefits?
            Check out the enhancements
            to our benefits website at
            www.mypetcobenefits.com.

Open Enrollment in 3 easy steps
1 REVIEW              your choices explained in this Open Enrollment Guide.

		     •	Access additional resources such as plan summaries, FAQs, and videos
          on the MyPetcoBenefits website. Go to www.mypetcobenefits.com.

		     •	Get information about the medical and dental plans administered by
          Collective Health at http://join.collectivehealth.com/petco or call
          844-516-3836 to speak to a Member Advocate.

2 CHOOSE               the coverage you want for 2021.

3 ENROLL

                      online or call the Petco Benefits Service Center.
       •	Go to www.mypetcobenefits.com and click on the Login Here button
          to enroll in your 2021 benefits using Benefitfocus.

		     •	Call the Petco Benefits Service Center at 855-847-6067 to enroll in your
          2021 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.

     Passive enrollment process
     For 2021, you will be automatically re-enrolled in the coverage you have today,
     except for flexible spending accounts, which must be elected each year.

     Take action by November 6, 2020 to enroll in a new plan, make changes to
     your current coverage, or enroll in a flexible spending account.
CARING FOR THE TOTAL YOU - CHOOSE YOUR 2021 BENEFITS OCT. 19-NOV. 6 2021 OPEN ENROLLMENT GUIDE - MYPETCOBENEFITS BENEFITS ...
Inside
Caring for the total you                                           2
2021 Open Enrollment – what you need to know                       2
Plans included in Open Enrollment                                  3
Enroll in your 2021 benefits                                      4
Dependent eligibility reminder                                    4
Medical                                                            5
Tax savings accounts                                              11
Vision                                                            13
Dental                                                            14
2021 medical, dental and vision per pay period rates              15
Life and AD&D insurance                                           16
Disability insurance                                              16
Legal assistance plan                                             17
Voluntary benefits                                                17
Petco preventive care and Petco insurance                         18
Other valuable benefits                                           19
Important contact information                                     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. Check with your wireless carrier for possible charges for
 text messages.

 To sign up, text BENE9 to 31996. To stop, text STOP to 31996.

                                       1
CARING FOR THE TOTAL YOU - CHOOSE YOUR 2021 BENEFITS OCT. 19-NOV. 6 2021 OPEN ENROLLMENT GUIDE - MYPETCOBENEFITS BENEFITS ...
CARING FOR THE TOTAL YOU.
We believe that serving our partners by investing in their health and wellbeing is non-negotiable.
This means we take care in designing Petco’s Total Rewards with affordable benefits that help
support and protect you, your family, your health, and financial goals.

Here are some of the ways our health benefits are caring for the total you:

•	Telemedicine: Quick and convenient video visits with a healthcare provider for non-emergency
    medical care at no cost with Collective Health PPO plans. See page 10 for details.

•	Behavioral health: Video visits also available with behavioral health professionals at no cost for
    anxiety, grief, depression, and more with Collective Health PPO plans. See page 10 for details.

•	Preventive care: If you’re covered by a Petco medical plan, certain preventive care is covered at
    100% when you use in-network providers. Age and frequency limitations apply.

•	Affordable care: Collective Health PPO plans have affordable copays for doctor visits and
    prescriptions to save you money.

•	Expert Second Opinion Service: If you are enrolled in a Collective Health medical plan, you
    have access to a free second opinion service from nationally recognized doctors if you are
    contemplating surgery or have questions about a treatment plan for serious health conditions.

                                               2021 Open Enrollment
                                               October 19 – November 6, 2020

                                               Open Enrollment is your annual opportunity
                                               to make changes to your benefits and to add
                                               or drop coverage for eligible family members.

What you need to know for 2021
Petco continues to invest to make our benefits inclusive, diverse, and affordable, and to make it easy for
you and your family to get the care you need. Here are a few things you should know about for 2021:

3	Same plans and coverage options in 2021 that are available today.
3	No increase in health plan contributions in 2021. See page 15 for 2021 medical, vision and dental
   plan rates.

3	Decrease in health plan contributions if you cover eligible family members under a Collective
   Health medical plan.

                                                    2
CARING FOR THE TOTAL YOU - CHOOSE YOUR 2021 BENEFITS OCT. 19-NOV. 6 2021 OPEN ENROLLMENT GUIDE - MYPETCOBENEFITS BENEFITS ...
Plans included in Open Enrollment
You can enroll or make changes to the benefits shown below during Open Enrollment. Outside of
Open Enrollment, you can only make changes to these benefits if you have a qualifying life event
during the year such as a marriage or the birth or adoption of a child.

Go to www.mypetcobenefits.com for more information on qualifying life events.

  • Medical          • Flexible Spending Account               •	Accident Insurance

  • Dental           •	Short and Long-term Disability         •	Hospital Indemnity Insurance

  • Vision           •	Critical Illness Insurance             •	Legal Assistance Plan

Plans you can enroll in at anytime during the year

  Once you become eligible, you can enroll or change these benefits at any time:

  • 401(k) Plan                     • Pet Preventive Care          •	Commuter Benefits Program
  • Health Savings Account          • Petco Pet Insurance          •	Auto & Home Insurance

                                                     3
CARING FOR THE TOTAL YOU - CHOOSE YOUR 2021 BENEFITS OCT. 19-NOV. 6 2021 OPEN ENROLLMENT GUIDE - MYPETCOBENEFITS BENEFITS ...
Enroll in your 2021 benefits
            Enroll online                                        Call the Petco Benefits
            The easiest way to choose your benefits for          Service Center
            2021 is through the Benefitfocus website.            You can also call the Petco
                                                                 Benefits Service Center to enroll
            •	Go to mypetcobenefits.com and click on
                                                                 in your benefits or get answers
               Benefits Enrollment at the top of any page
                                                                 to your benefit questions.
            •	For new users, follow the onscreen
                                                                 •	Call 855-847-6067 M-F from
               instructions to create an account on the
                                                                    8 a.m. to 8 p.m. ET
               Benefitfocus website

Dependent eligibility reminders
You are responsible for making sure your
covered dependents are eligible.
                                                            Spouse/domestic
Your eligible dependents are your:                          partner surcharge
• Legal spouse                                              Petco partners who cover a spouse
                                                            or eligible domestic partner on a
•	Same-sex domestic partner
                                                            Petco medical plan—when he or
                                                            she is eligible for medical coverage
•	Child under age 26 or disabled, dependent
                                                            outside of Petco’s plan (other
   child incapable of self-support due to mental or
                                                            than coverage through Medicare
   physical disability, if the child becomes disabled
                                                            or Medicaid)—must pay a $50
   prior to reaching age 26                                 surcharge per pay period.

Your eligible children include:                             The surcharge is in addition to
                                                            normal payroll contributions for
• Natural born child                                        medical coverage. If you are adding
                                                            a spouse or domestic partner to
•	Stepchild, legally adopted child or child
                                                            your coverage, you will be required
   for whom you have been appointed legal                   to state whether your spouse or
   guardianship by a court of law                           domestic partner is eligible for
                                                            medical coverage outside of Petco’s
•	Child for whom the Plan has received a Qualified
                                                            plan when you make your enrollment
   Domestic Child Support Order                             elections.

                                                     4
CARING FOR THE TOTAL YOU - CHOOSE YOUR 2021 BENEFITS OCT. 19-NOV. 6 2021 OPEN ENROLLMENT GUIDE - MYPETCOBENEFITS BENEFITS ...
Medical
Here’s what you need to know about our 2021 medical plans.

                                                             HSA Plan
   Enhanced PPO Plan                                         •P
                                                               remiums in-between Enhanced and
   • Highest premiums                                         Value PPO plans
   • Lowest deductible                                       • High deductible
   •C
     opays for doctor visits, urgent care and
                                                             • You must meet the deductible before
    generic drugs
                                                               the plan begins to pay for services other
   •T
     elemedicine doctor visit through Teladoc has             than preventive care. After you’ve met
    a $0 copay (Collective Health medical plan)                the deductible, you’ll pay 20% for most
                                                               in-network covered services
                                                             •T
                                                               elemedicine doctor visits through
                                                              Teladoc has a $45 copay before the
                                                              deductible is met and a $0 copay after
   Value PPO Plan                                             the deductible is met (Collective Health
                                                              medical plan)
   • Lowest premiums
                                                             •P
                                                               etco will make quarterly contributions
   • Highest deductible
                                                              into your HSA up to $250 per plan
   •C
     opays for doctor visits, urgent care and                year for employee only coverage and
    generic drugs                                             up to $500 per year for employee +
   •T
     elemedicine doctor visit through Teladoc has            dependent(s)
    a $0 copay (Collective Health medical plan)
                                                             Note: While the HSA plan may be a good
                                                             choice for someone who is a low utilizer of
                                                             healthcare and has predictable expenses,
                                                             it might not be the right plan for everyone.
Plans available through Kaiser                               Call the Petco Benefits Service Center at
If you live in a Kaiser Permanente service area in CA,       855-847-6067 for assistance evaluating
CO, DC, GA, MD, OR, VA or WA, you may be able to             the medical plans available to make the
elect a Kaiser HMO or HSA medical plan. See page 7           best choice for you.
for more information.

                                                         5
CARING FOR THE TOTAL YOU - CHOOSE YOUR 2021 BENEFITS OCT. 19-NOV. 6 2021 OPEN ENROLLMENT GUIDE - MYPETCOBENEFITS BENEFITS ...
2021 medical plans at-a-glance
Collective Health Medical Plans: Review the Collective Health Summary of Benefits & Coverage (SBC) for
the plans below at www.mypetcobenefits.com.

                                                                          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)
 • Family                                                     n/a                            n/a                     $500 ($125 quarterly)
 Plan Year Out-of-Pocket Max
 • Employee                                                $6,000                          $6,000                             $4,000
 • Family                                                  $12,000                         $12,000                            $8,0005
                                                         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.                    4) As specified in essential drug list.
 2) Coinsurance you pay after you meet the plan year deductible unless otherwise noted.       5) T
                                                                                                  he family out-of-pocket maximum must be met before
 3) Plan year deductible waived.                                                                 benefits are paid at 100% for any person.

                                                                            6
CARING FOR THE TOTAL YOU - CHOOSE YOUR 2021 BENEFITS OCT. 19-NOV. 6 2021 OPEN ENROLLMENT GUIDE - MYPETCOBENEFITS BENEFITS ...
2021 medical plans at-a-glance
Kaiser Permanente Medical Plans: If you live in a Kaiser Permanente service area in CA, CO, DC, GA, MD,
OR, VA or WA, you may be able to elect a Kaiser Permanente HMO or HSA medical plan. 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
www.mypetcobenefits.com for details on Kaiser medical plan benefits.

                                                                           Kaiser Permanente Medical Plans
 Plan Feature                                        Enhanced HMO Plan                     Value HMO 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)
 • Family                                                        n/a                                n/a                    $500 ($125 quarterly)
 Plan Year Out-of-Pocket Max
 • Employee                                                   $6,000                             $6,000                             $4,000
 • Family                                                     $12,000                            $12,000                            $8,000 6
                                                   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                                20% 3
 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.            4) Plan year deductible waived.
 2)	In CA, a covered family member needs to meet a $2,800 plan year deductible        5) As specified in essential drug list.
     before the plan starts sharing costs for that family member under the HSA Plan.   6)	The family out-of-pocket maximum must be met before benefits
 3)	Coinsurance or copay you pay after you meet the plan year deductible unless           are paid at 100% for any person.
     otherwise noted.
                                                                                7
CARING FOR THE TOTAL YOU - CHOOSE YOUR 2021 BENEFITS OCT. 19-NOV. 6 2021 OPEN ENROLLMENT GUIDE - MYPETCOBENEFITS BENEFITS ...
Prescription drugs
All Petco 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 70,000 pharmacies nationwide.

  Specified Preventive                      Generic Drugs                       Brand Non-Formulary
  Drugs                                     Generic drugs have the              Brand name drugs not on
  Certain generic preventive                lowest costs and are                the brand formulary have
  medications (like birth control)          considered identical                the highest copays. When
  are covered at no cost and not            to their brand name                 you fill a prescription, you
  subject to annual deductibles             equivalents by the FDA              can ask the pharmacist
  provided certain requirements             in terms of efficacy and            whether a generic or
  are met.                                  safety.                             brand formulary drug
                                                                                of your medication is
                                                                                available. If you or your
                                                                                provider choose a brand
  Brand Formulary
                                                                                non-formulary medication
  Drugs on the brand formulary are designated as preferred
                                                                                when a generic is available,
  based on their cost effectiveness and, in some cases, efficacy.
                                                                                you’ll pay the difference
  If you or your provider choose a brand formulary medication
                                                                                in cost between the
  when a generic is available, you’ll pay the difference in cost
  between the generic and the brand formulary drug.                             generic and the brand
                                                                                nonformulary drug.

Prescription drugs with a Kaiser Permanente medical plan
When you enroll in a Kaiser HMO or HSA 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: Take 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.

                                                        8
Collective Health
Collective Health is the administrator for Petco’s Enhanced PPO, Value PPO and HSA medical
plans. Collective Health is also the administrator for the Standard Dental and Enhanced Dental
plans. Collective Health utilizes the Blue Shield medical provider network and the Delta Dental
provider network.

Why Collective Health?
Collective Health combines technology and industry expertise to help members better understand
their benefits and navigate through their healthcare needs.

With Collective Health’s unique platform, you will be able to view your medical, pharmacy and
dental claims all in one place (excluding Kaiser plans and the dental HMO). You can work online
to manage your healthcare claims and access tools that help you find care and compare costs for
services and procedures in your geographic area. You can also speak to a Member Advocate by
phone to ask questions about your coverage
and for help submitting claims. Collective
Health makes it simple for you to make the
most effective decisions for your health               Contact Collective Health
and your wallet.
                                                          http://join.collectivehealth.com/petco
Member Advocates
Collective Health’s Member Advocates can:                 help@collectivehealth.com
• Help you understand your coverage
•	Give you a single place to review your                 844-516-3836
   claims history                                         Mon-Fri, 4 a.m. to 6 p.m. PT
                                                          Sat 7 a.m. to 11 a.m. PT
• Answer your questions
•	Connect you to programs that meet your                 Search for the Collective Health
   unique needs including mental health                   mobile app on the App Store or
   support, expert medical advice, and more.              Goggle Play

How to find network providers
Access the Collective Health online portal 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.

                                                   9
Teladoc
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 medical plan.

You can connect with a Teladoc physician from
                                                                                   Your Cost
anywhere—home, work or on the road. Teladoc
                                                                                 for Medical or
doctors diagnose non-emergency medical                     2021 Medical            Behavioral
problems, recommend treatment, and can even                Plan                   Health Visits
call in certain prescriptions to your pharmacy.
                                                           Enhanced PPO Plan            $0

  Behavioral health visits through Teladoc are             Value PPO Plan               $0
  also available with a psychiatrist, psychologist,
  social worker or licensed therapist for anxiety,                             Subject to deductible;
                                                           HSA Plan             $0 after deductible
  grief, depression and more.
                                                                                       is met

Grand Rounds
Connect with nationally recognized medical doctors from the comfort of your home. If you are
enrolled in a Collective Health medical plan, you can connect with board-certified doctors for an
expert second opinion via phone or video all within a matter of days and at no cost to you!

Get expert advice when you or a covered family member has questions about:

• A new or existing diagnosis         • A chronic condition
• Treatment plan                      • Your medication
• Possible surgery

  Petco spine program requirement
  If you or a family member is enrolled in a Collective Health medical plan, you must complete
  an Expert Opinion with Grand Rounds prior to spine surgery. Failure to get a second opinion
  may lead to an additional $500 copay.

                                                      10
Tax savings accounts
HealthyEquity is the new administrator for Petco’s tax savings accounts
HealthEquity is the new administrator for the health savings account (HSA), flexible spending accounts (FSA), and
commuter benefits program. HealthEquity is an industry leader offering partners enhanced customer service,
claims processing, simple tools, and and online services to get the most from your account(s).

 HealthEquity                              • Live service 24/7/365: Get the same service at 2 a.m. or 2 p.m.
                                              from knowledgeable, US-based HealthEquity Member
 https://learn.healthequity.com/petco         Service specialists.
                                           •E
                                             asy-to-use online account access: Access claims, pay bills, get
 844-341-4934
                                            reimbursements, and more—all from a single, easy-to-use
 Available 24/7,                            online portal.
 365 days a year!                          •H
                                             ealthyEquity educational and informational resources:
                                            Watch videos, user interactive tools including contribution
                                            calculators and access links to other useful websites.

Health savings account (HSA)
If you enroll in the HSA Plan through Collective Health or Kaiser, you have the option to contribute to a
health savings account (HSA). 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.

 Transferring your HSA to HealthEquity: If you currently have an HSA with BenefitFocus, you can transfer
 your account balance as of 12/31/2020 to HealthEquity at no cost. Refer to the instructions on how to
 transfer your HSA balance to HealthEquity on the Open Enrollment page on www.mypetcobenefits.com.

Key things to know about a health savings account

 Petco contributes to your              In 2021, you can contribute            You can use your HSA to pay
 HSA up to $250 ($62.50                 pre-tax dollars up to $3,350           for eligible medical, dental
 per quarter) for employee-             for employee only and up               and vision expenses.
 only coverage and up to                to $6,700 if you cover at
 $500 ($125 per quarter)                least one dependent. If you
 if you cover at least one              are 55 or older in 2021, you           You can adjust your HSA
 dependent.                             can contribute an additional           payroll contributions at any
                                        $1,000.                                time during the year.

 You decide when to                     You can contribute to an HSA if        Your HSA earns interest,
 spend (or save) your HSA               your are enrolled in the HSA Plan      and once the balance
 dollars. Any unused money              and you are not covered by a           reaches $2,000, you can
 remaining in your account at           non-HSA medical plan, Medicare,        choose to invest the
 the end of the plan year rolls         Medicaid, TRICARE, or a                amount over $2,000 —
 over for you to use to pay             healthcare FSA. Also you cannot        similar to how the 401(k)
 for eligible expenses now or           be claimed as a dependent on           plan works.
 save for the future.                   another person’s tax return.

                                                       11
Tax savings accounts (continued)
Healthcare flexible                                           Healthcare Flexible Spending Account
spending account                                            Annual maximum        Up to $2,750 in 2021
A healthcare FSA gives you a tax break on                   contribution
many medical, dental and vision expenses that
are not covered by other plans. By anticipating             Eligible expenses     Medical, dental and vision care
                                                                                  expenses not paid by your health
your expenses and arranging for deductions to
                                                                                  insurance and on the IRS list of
be made from your paycheck each pay period,                                       approved expenses.
you lower your tax bill. You can set aside up
to $2,750 in 2021 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 $550 carry over to
                                                                                  next year and any additional

Limited use flexible                                                              funds will be forfeited

spending account                                              Limited Use Flexible Spending Account
If you enroll in the HSA Plan and open a health
savings account, you can open a limited use FSA             Annual maximum        Up to $2,750 in 2021
to set aside a portion of your earnings on a pre-tax        contribution
basis to pay for dental and vision expenses only.
                                                            Eligible expenses     Dental and vision care expenses
You can set aside up to $2,750 in 2021 on a pre-tax                               not paid by your health insurance
basis to cover eligible dental and vision expenses                                or reimbursed through a health
not reimbursed by any other health plan.                                          savings account

                                                            Pairs with            HSA Plan
Dependent care flexible                                     If you don’t use it   Up to $550 carry over to
spending account                                                                  next year and any additional
                                                                                  funds will be forfeited
A dependent care FSA allows you to pay for
eligible day care or elder care expenses while you
are working. You can set aside up to $5,000 each                              Dependent Care
plan year on a pre-tax basis to cover the cost of                        Flexible Spending Account
dependent care expenses.
                                                            Annual maximum        Up to $5,000 in 2021 per married
The amount you contribute to a dependent care               contribution          couple filing jointly ($2,500 max
FSA cannot be greater than your income or your                                    for married, filing separately.)
spouse’s income, whichever is less. If your spouse
contributes to a dependent care FSA through his             Eligible expenses     Dependent care expenses that
or her employer, your combined contributions                                      make it possible for you to work

may not exceed $5,000.                                      If you don’t use it   Any funds remaining at the end
                                                                                  of the plan year are forfeited

Commuter benefits program
Set aside pre-tax dollars for transportation and
                                                                      Commuter Benefits Program
parking. Use the commuter benefits program
administered by HealthEquity to save money on               2021 Transit Maximum        $270 per month
commuting expenses.
                                                            2021 Parking Maximum        $270 per month

                                                       12
Vision
Standard and Enhanced Vision Plans
The Standard and Enhanced Vision Plans are offered through VSP. Both plans provide discounts on
exams, eyeglasses or contacts, and other vision services.

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
apply to in-network services and providers.

                                 2021 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

                                                         13
Dental
Standard and Enhanced Dental PPO Plans
Collective Health administers the Standard and Enhanced Dental PPO 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.

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.

                                   2021 Dental Benefits At-a-Glance
                                                  Collective Health Dental Plans                            Delta Dental
Benefit Feature                              Standard Dental PPO                Enhanced Dental PPO         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 copay3
                                                                               up to $1,500 lifetime max
• Adult Benefit                                    Not covered                         Not covered         $1,730—$2,705 copay3

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.

                                                                       14
2021 medical, vision and dental rates
Medical (costs shown are per pay period)
                                            Employee                  Employee +                  Employee +
 Option                                       Only                    Spouse/DP1                   Child(ren)                   Family

 Enhanced PPO Plan                           $94.80                     $285.51                     $190.16                   $326.30
 Value PPO Plan                               $39.30                    $130.26                      $85.67                      $175.11
 HSA Plan                                     $62.43                   $202.30                      $137.58                    $259.66
 Kaiser Enhanced       Plan2                   $71.01                    $217.64                    $144.32                   $290.96
 Kaiser Value   Plan2                         $34.87                    $109.24                      $72.06                    $146.42
 Kaiser HSA    Plan2                          $47.96                     $148.51                     $98.24                    $198.78

   Spouse/Domestic Partner Surcharge: A $50 surcharge is added to your medical rate each pay period if you
   cover a spouse or domestic partner on a Petco medical plan when he or she is eligible for medical coverage
   through their own employer (other than coverage through Medicare or Medicaid).

   Nicotine Surcharge: A $15 surcharge is added to your medical rate each pay period if you and/or your covered
   spouse currently uses nicotine and is not currently participating in a tobacco cessation program. The maximum
   nicotine surcharge is $30 ($15 for the Petco Partner and $15 for the covered spouse).

Vision (costs shown are per pay period)
                                           Employee                  Employee +                 Employee +
 Option                                      Only                    Spouse/DP1                  Child(ren)                    Family

 VSP Enhanced Vision                          $3.66                      $7.30                       $7.77                       $12.43
 VSP Standard Vision                           $2.31                     $4.58                      $4.88                         $7.80

Dental (costs shown are per pay period)
                                            Employee                  Employee +                  Employee +
 Option                                       Only                    Spouse/DP1                   Child(ren)                   Family

 Enhanced Dental PPO                           $13.61                       $27.23                   $29.66                     $42.78
 Standard Dental PPO                           $10.21                    $20.42                      $22.85                     $32.09
 Delta Dental HMO                              $6.36                        $11.65                    $12.71                     $16.95

 1) D
     omestic partner: If you cover a domestic partner under a Petco medical, dental or vision plan, the portion of the premium that applies to
    dependent coverage is taxable.
 2) You must live in a Kaiser Permanente service area in CA, CO, DC, GA, MD, OR, VA or WA to enroll in a Kaiser Permanente medical plan.

                                                                       15
Life and AD&D insurance
Basic life and accidental death & dismemberment (AD&D)
Petco provides company-paid life and AD&D coverage to all salaried partners. Under most circumstances,
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 may 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 (Company Paid)                                       Coverage Amount

Hourly partners                                            $25,000 paid by Petco

Disability insurance
Disability insurance ensures that you have a financial safety net in place should you become unable to
work. Petco pays for basic short and long-term disability. You pay for buy-up coverage.

Short-term disability insurance
Short-term disability pays a portion of your earnings while you are temporarily disabled. 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.

   Coverage (Partner Paid)        Waiting Period                    Coverage Amount                          Paid By

Voluntary short-term disability       7 days       60% of eligible weekly earnings up to $500 per week        You

Long-term disability insurance
Long-term disability provides financial protection in the event you are unable to work for an extended
period of time. 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.

   Coverage (Partner Paid)        Waiting Period                    Coverage Amount                          Paid By

Voluntary long-term disability1      180 days      60% of eligible monthly earnings up to $2,000 per month    You

                                                         16
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      •   Power of attorney
• Personal bankruptcy            •   Purchase or sale of home
• Traffic ticket defense         •   Consumer protection
• Juvenile court proceedings     •   IRS audit

Voluntary benefits
The voluntary plans offered through Transamerica provide additional financial protection with
premiums paid through the convenience of payroll deduction.

 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.

More information about the voluntary benefits is available on www.mypetcobenefits.com. The cost for
coverage is included on the Benefitfocus enrollment website.

                                                      17
Petco preventive care (for pets)
The Petco preventive care plan pays you back for routine exams, tests, vaccinations and basic treatments
for your covered pets.

 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 (for pets)
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 Benefits Enrollment link at the
    top of any page..

                                                                      18
Other valuable benefits
Petco’s Total Rewards program is designed to care for the total you. This means that in addition
to healthcare, life and disability insurance, we care about your financial health and emotional
well-being too. Here are a few plans that add value to the Total Rewards you have access to as
a Petco partner.

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 2021 to your 401(k) account1. If you are age 50 or older in
2021, you can contribute up to an additional $6,500 under the catch-up provision.

Petco matches 100% of the first 1% that you contribute plus 50% of the next 5%.

Contact Fidelity to get started at 800-835-5095. The plan number is 49089.

Employee Assistance Program
Petco’s Employee Assistance Program (EAP) is available to all partners and their family
members. The EAP provides access to in-person or telephonic counseling for a variety of issues.
Administered by ComPsych and paid by Petco, the EAP offers up to five 50-minute confidential
counseling sessions per issue per plan year as well as 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 877-327-4738 (TDD: 800-697-0353), or by visiting guidanceresources.com. To
register on the website, use EAP4PET for the organization web ID.

   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.

                                                        19
Important benefit contacts
Here is a list of contacts to help you get the most out of your benefits.

 Benefit                                        Group Number          Telephone                   Website
 Petco Benefits Service Center                 NA*               855-847-6067     NA*
 Petco Benefits Website                        NA*               NA*              www.mypetcobenefits.com
 Petco Payroll                                 NA*               NA*              payroll@petco.com
 Medical
 Collective Health                             Group #:          844-516-3836     http://join.collectivehealth.com/petco
 •	Enhanced PPO, Standard PPO &               W0070147
    HSA Plan
    — Telemedicine
 		 Teladoc                                    NA*               800-835-2362     www.teladoc.com
    — Expert Second Opinion
    		 Grand Rounds                            NA*               855-543-5186     www.grandrounds.com/petco

 Kaiser Permanente                                                                kp.org/thrive
 • Enhanced, Standard and HSA Plan
 		Kaiser Permanente—No CA                     Group #: 606363   800-464-4000
 		 Kaiser Permanente—So CA                    Group #: 234494   800-464-4000
 		 Kaiser Permanente—CO                       Group #: 47076    800-632-9700
 		 Kaiser Permanente—GA                       Group #: 10463    888-865-5813
 		 Kaiser Permanente—DC, MD, VA               Group #:28717     800-777-7902
 		 Kaiser Permanente—OR                       Group #: 19862    800-813-2000
 		 Kaiser Permanente—WA                       Group #: 19862    888-901-4636
 Prescription Drugs
 CVS (Collective Health Plans)                 Group #: RX1172   844-294-0389     caremark.com
 Rx Savings Solutions                          NA*               NA*              rxsavingssolutions.com
 (Collective Health Plans)
 Vision                                        Group #:          800-877-7195     vsp.com
 Vision Service Plan (VSP)                     30043528
 • VSP Standard Vision
 • VSP Enhanced Vision
 Dental
 Collective Health                             Group #: 20421    844-516-3836     http://join.collectivehealth.com/petco
 • Standard Dental Plan
 • Enhanced Dental Plan

 Delta Dental                                  Group #: 79267    800-422-4234     www.deltadentalins.com
 • Delta Dental HMO Plan
 Flexible Spending Accounts (FSAs)             NA*               844-341-4934     https://learn.healthequity.com/petco
 Health Savings Account (HSA)                                                     www.healthequity.com
 Commuter Benefits Program
 HealthEquity
 Basic Life and AD&D Insurance                 Group #:          888-787-2129     https://www.mylincolnportal.com
 Liberty Mutual                                40-444824                          (Company code: PETCO)
 Disability                                    Group #:          800-320-7585     https://www.mylincolnportal.com
 Lincoln Financial Group                       40-444824                          (Company code: PETCO)
 • Short and Long-term Disability
 Voluntary Plans
 •	Transamerica Critical Illness, Accident,   NA*               855-244-8318     mypetcobenefits.com
    & Hospital Indemnity
 Petco Insurance                               NA*               833-898-7387     Email: support.wellness@petco.com
 Petco Preventive Care                         NA*               833-898-7387     Email: support.wellness@petco.com
 Auto and Home Insurance                       NA*               800-GET-MET8     metlife.com/mybenefits
 MetLife                                                         (800-438-6388)
 Legal Assistance                              Plan code:        800-821-6400     legalplans.com
 Hyatt Legal Plans                             6090656
 Employee Assistance Program (EAP)             NA*               877-EAP-4PET     guidanceresources.com
 ComPsych/Guidance Resources                                     (877-327-4738)   (To register, use EAP4PET for
                                                                                  organization web ID)
 401(k) Plan                                   Plan #: 49089     800-835-5095     401k.com
 Fidelity Investments                                                             Use your SSN to log in and create
                                                                                  Personal Identification Number (PIN)
 * Not applicable
                                                                 20
21
HOURLY PARTNERS

                                                           PRE-SORTED
                                                           FIRST CLASS
Location Name & Number                                     U.S. POSTAGE
                                                                PAID
Street Address
                                                           ACTION MAIL
City, State Zip

                     Sam Sample
                     1234 Anywhere Street
                     San Diego, CA 00000

 2021 OPEN ENROLLMENT
 Choose your benefits
 October 19—November 6, 2020
 Open Enrollment is your annual opportunity to make
 changes to your benefits and to add or drop coverage
 for eligible family members.

 Passive Enrollment Process
 For 2021, you will be automatically re-enrolled in the
 coverage you have today, except for flexible spending
 accounts, which must be elected each year.

 If you would like to enroll in a new plan, need to make
 changes to your current coverage, or wish to enroll in
 a flexible spending account, be sure to take action by
 November 6, 2020.
You can also read