Your medical plan options

When it comes to your health, choice matters. Dolby provides multiple medical plan options to ensure you can select the plan that is right for you and your family.

Comparing medical plan features

The table below shows in-network coverage only. For the OAP and HSA Compatible PPO out-of-network details, visit Dolby.BenefitSpot.com.

Scroll table to see more

Plan Feature
Cigna Open Access Plus (OAP)
Cigna HSA Compatible Preferred Provider Organization (PPO)
Cigna Health Maintenance Organization (HMO)
Kaiser Health Maintenance Organization
(HMO - CA Only)
Includes Health Savings Account (HSA)?
No
Yes. Dolby contributes $1,000 for employee-only and $2,000 for employee + dependent coverage
No
No
Includes Out-of-Network coverage?
Yes, but you'll save more by staying in-network
Yes, but you'll save more by staying in-network
No
No
Coinsurance
10%
10%
Copays may apply
Copays may apply
Preventive Visits
No charge; not subject to copay or deductible
No charge; not subject to deductible or coinsurance
No charge; in-network only
No charge; in-network only
Deductible
$400 individual/$1,200 family
$2,000 individual/$4,000 family
$0
$0
Prescription Drug (Retail)
30 day fill: $15/$30/$50
30 day fill: 30%/40%/50% after deductible
30 day fill: $15/$30/$50
30 day fill: $15/$30
Prescription Drug (Mail Order)
90 day fill: $30/$60/$100
90 day fill: 30%/40%/50% after deductible
90 day fill:$30/$60/$100
90 day fill:$30/$60
Office Visit
$25
You pay 10% after deductible
$20
$20
Fertility Benefit*
10% after deductible
10% after deductible
Coverage varies based on place of service
Plan covers three fertility cycles per lifetime to treat diagnosed infertility
Annual Out-of-Pocket Max
$2,500 individual/$5,000 family
$3,000 individual/$6,000 family
$2,000 individual/$4,000 family
$2,000 individual/$4,000 family

*For details on covered fertility services, check with your medical plan carrier and/or plan documents.

Back
What's new & changing?
Tax-advantaged accounts
Next
Amplify your health. Enroll May 21 – June 4.
I'm Ready to EnrollI Have a Question

This website is an overview and does not provide a complete description of all benefit provisions. Please refer to your plan benefit booklets or summary plan descriptions (SPDs) for more detailed information. The plan benefit booklets determine how all benefits are paid.