Medical

At VMware we are proud to offer a comprehensive program of medical benefits. Our plans ensure you have the choice and flexibility you need to make smart and cost-effective healthcare decisions. All medical plans include prescription drug coverage and in-network preventive care services. Two of our plans are available to all benefit eligible employees, while the other two are offered to benefit eligible employees residing in either Northern California or Hawaii.

Our two PPO plans are administered by UnitedHealthcare (UHC) via the same Choice Plus network. If you reside in Maine, Massachusetts or New Hampshire you have access to both the Choice Plus network and UHC’s broader Harvard Pilgrim network. Both the HSA PPO and the Traditional PPO plans have the same network of doctors and hospitals. What is different about the two PPO plans is how they pay; the deductible is higher in the HSA PPO plan which qualifies it for a Health Savings Account or HSA plan. Also, the HSA PPO plan has VMware funding to your HSA that helps cover the higher deductible.

With the Kaiser HMO plans, you are restricted to using providers within the HMO network and the plans require that you select a Primary Care Physician (PCP) to coordinate all your health care needs, including arranging for hospitalization and referrals to specialists.

Other differences between the plans include the annual deductible, out-of-pocket maximum, employee contributions and VMware funding. Prescription drug coinsurance also varies by plan. Visit the Pharmacy page for more information. The comparison chart below provides more details.

2019 Medical Plan Comparison

HSA PPO1
In-Network
HSA PPO1
Out-of-Network
Traditional PPO1
In-Network
Traditional PPO1
Out-of-Network
Kaiser HMO N. CA Kaiser HMO HI
VMware Funding per
Quarter2
Individual: $187.50
Family: $375
Individual: $187.50
Family: $375
N/A N/A N/A N/A
Annual Deductible Individual: $1,500
Family: $3,000
Individual: $1,500
Family: $2,700
Individual: $500
Family: $1,500
Individual: $500
Family: $1,500
Individual: $250
Family: $500
None
Out-of-Pocket (OOP) Maximum3 Individual: $2,500
Family: $5,000
Individual: $6,000
Family: $12,000
Individual: $2,350
Family: $7,050
Individual: $6,250
Family: $18,750
Individual: $1,500
Family: $3,000
Individual: $2,500
Family: $7,500
Employee Coinsurance 10% after deductible 30% of UCR4,
after deductible
10% after deductible 30% of UCR4,
after deductible
10% after deductible Applies to certain
medical procedures
only
Preventive
(Annual Physicals &
Well Care Exams)
100% covered, not subject to deductible 30% of UCR4,
after deductible
100% covered,
not subject to deductible
30% of UCR4,
after deductible
100% covered,
not subject to deductible
100% covered, not
subject to co-pay
Physician Visit 10% after deductible 30% of UCR4,
after deductible
Primary Care: $20/visit
Specialist: $30/visit
30% of UCR4,
after deductible
Primary Care: $20/visit
Specialist: $30/visit
$15/visit
Lab and X-Ray 10% after deductible 30% of UCR4,
after deductible
10% after deductible 30% of UCR4,
after deductible
10% after deductible $10/visit; 20% coinsurance
for complex imaging
Emergency Room5 10% after deductible 10% after deductible $100/visit, then 10% $100/visit, then 10% 10% after deductible $100/visit
Ambulance 10% after deductible 10% after deductible 10% after deductible 10% after deductible 10% after deductible 20% coinsurance
Hospitalization 10% after deductible 30% of UCR4,
after deductible
10% after deductible 30% of UCR4,
after deductible
10% after deductible 10%
Chiropractic Care 10% after deductible
Up to 20 visits/year
30% after deductible
Up to 20 visits/year
$30/visit
Up to 20 visits/year
30% after deductible
Up to 20 visits/year
$15/visit
Up to 30 visits/year
$20/visit
Up to a combined
30 visits/year with
Acupuncture
Acupuncture 10% after deductible
Up to 20 visits/year
30% after deductible
Up to 20 visits/year
$30/visit
Up to 20 visits/year
30% after deductible
Up to 20 visits/year
$20/visit
Referral required
$20/visit
Up to a combined
30 visits/year with
Chiropractic
Massage 10% after deductible
Up to 20 visits/year
10% after deductible
Up to 20 visits/year
10% after deductible
Up to 20 visits/year
10% after deductible
Up to 20 visits/year
Not Applicable Not Applicable
Speech Therapy5 10% after deductible 30% after deductible $30/visit 30% after deductible $20 after deductible $15/visit;
short-term therapy
only
Infertility/Fertility
Preservation
10% after deductible
2 Smart Cycles/lifetime
Services through Progyny
(UHC Members Only)
Not Covered 10% after deductible
2 Smart Cycles/lifetime
Services through Progyny
(UHC Members Only)
Not Covered 50% coinsurance/visit
(does not include GIFT,
ZIFT or IVF)6
$15/visit; 20% IVF
(1 cycle/lifetime)

1 Individual deductible and OOP maximum only apply to employees enrolled in Individual tier. Members in dependent tiers must satisfy an aggregate deductible – the health plan doesn’t begin paying benefits until the entire family deductible has been met. Once the entirety of the family deductible has been met, by one family member or a combination of family members, then the cost sharing begins. Paid Interns are only eligible to enroll in the HSA PPO plan.
2 All existing employees enrolled in the HSA PPO as of January 1, 2019 will receive employer funding of $750/$1,500 (Individual/Family). All new hires as of January 1, 2019 will receive employer funding on a quarterly basis (divided by 4) based on coverage at the end of each quarter. Must be active on the last day of the quarter. Paid Interns are not eligible for VMware funding. HealthEquity accounts funded the pay period following the close of quarter.
3 OOP maximum includes Prescription Rx for all plans.
4 Usual, customary and reasonable charges.
5 Available to those with conditions of medical necessity.
6 GIFT is a gamete intrafallopian transfer. ZIFT is a zygote intrafallopian transfer. IVF is in-vitro fertilization.

Paying for Medical Coverage

Any premiums paid by you are on a pre-tax basis, other than for Domestic Partner coverage. By paying your premiums pre-tax (before federal, state and Social Security taxes are withheld), you reduce your taxable income, lower the amount of taxes you must pay and increase your net take-home pay. You must pay for coverage of a Domestic Partner and a Domestic Partner’s child(ren) on a post-tax basis, and the value of the Company subsidy is included in your taxable income. This is called “imputed income.” See the Domestic Partner Imputed Income Rate Table for details.

Employee Contributions for 2019

Per Paycheck1

Plan Employee Only Employee + Spouse/Domestic Partner Employee + Child(ren) Employee + Family
HSA PPO $0 $54.02 $38.90 $97.24
Traditional PPO $110.69 $249.04 $211.60 $359.73
Kaiser HMO N. CA $72.38 $159.23 $137.52 $231.61
Kaiser HMO HI $65.43 $130.86 $117.77 $196.29

1 Per paycheck contributions are 24 times per year. Contributions are pre-tax (except for Domestic Partner coverage).

Dependent Eligibility

  • Your spouse or domestic partner. Please note: after tax contributions and imputed income may apply when covering a domestic partner. See the Domestic Partner Imputed Income Rate Table for details
  • Your child(ren), your spouse’s / domestic partner’s child(ren), your foster child(ren) (UHC plans only), the minor(s) you have legal guardianship of are eligible for medical coverage until age 26, regardless of marital or student status.

Contact Us

HR Source
ASK HR [VMware network access required]
Phone: 1-888-VMWARE8, option ‘US Benefits’
Internal Phone: ext. 29200


Kaiser
Phone: 1-800-464-4000
Visit website


Progyny
Phone: 1-833-851-2238
Email: info@progyny.com
Visit website


UnitedHealthcare
Phone: 1-844-562-6290
Visit website

Resources

Benefit Byte Video: Health FSA Plans


Benefit Byte Video: Which Plan is Best for Me: HSA PPO vs Traditional PPO


Benefits Contact Quick Reference Guide


Domestic Partner Imputed Income Rate Table


Medical Plan Comparison Chart


Key Benefit Terms


Workday [VMware network access required]


Workday Quick Reference Guide: Change HSA Contribution [VMware network access
required
]