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.

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	Up to 100 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