Medical coverage, for your benefit
We understand that our Benesch team has different health care needs and preferences, so we give you a choice of two types of medical plans. With both plans, you have access to Anthem’s vast network of providers (Blue Access OH I) and receive prescription coverage from Optum Rx.
Please note: If you enroll in coverage, it is effective on the first of the month following your hire date.
Health Care Savings Medical Plan
- Higher deductible in exchange for lower premium
- Opportunity to save pre-tax dollars in a Health Savings Account (HSA) for qualified medical expenses
- Earn a firm-provided HSA contribution of $600 employee/$1,200 family, paid in two increments (Jan. 15 pay and July 15 pay) by completing wellness activities.
Preferred Provider Organization Plan (PPO)
- Lower deductible in exchange for higher premium
- Predictability of costs—you know before you go because there are set copays for services
Discover the best medical plan for you and your family with our online  medical cost calculator! This easy-to-use tool helps you find the right fit for your unique healthcare needs.
Health Care Savings Medical Plan
This medical plan has higher deductibles but lower premiums. Once you reach your annual deductible, copays will apply. You have access to the same network of providers and high level of care. Note: in-network preventive care is paid at 100% and the deductible does not apply.
Important Note: Prescriptions are applied to the deductible first. Once you meet your deductible, a copay will apply.
By enrolling in this medical plan, you are eligible to enroll in a Health Savings Account (HSA) that provides a triple-tax advantage. The funds you contribute to your HSA are yours to keep and can be used not only for medical expenses (including certain over-the-counter medical items), but for retirement health care expenses as well.
If you enroll in an HSA, you will receive a firm-provided contribution of $600 employee/$1,200 family for the first 12 months enrolled and then after, you will be able to earn the firm-provided contribution by completing wellness activities. The firm-provided contribution will be paid in two increments (Jan. 15 pay and July 15 pay).
If you have an HSA, you are also eligible to contribute to a Limited Purpose Flexible Spending Account, (LFSA), which can be used to cover dental and vision expenses. It also provides an additional level of tax advantage with pre-tax contributions.
Health Care Savings Medical Plan Overview
| In-Network | Out-of-Network | |
|---|---|---|
| Costs for Primary Services | ||
| Deductible | $3,500 individual / $7,000 family | $4,000 individual / $8,000 family |
| Maximum Out-of-Pocket | $4,000 individual / $8,000 family | $8,000 individual / $16,000 family |
| Primary Care and Mental Health and Substance Abuse Disorder Services Visits |
$25 copay after deductible | 50% after deductible |
| Preventive Care | No charge | 50% after deductible |
| Specialist Visits | $35 copay after deductible | 50% after deductible |
| Emergency Room | $250 copay and 20% after deductible | $250 copay and 20% after deductible |
| Urgent Care | $75 copay after deductible | 50% after deductible |
| Rx Retail Copays | ||
| Generic | $20 copay after deductible | 50% coinsurance after deductible |
| Preferred Formulary | $40 copay after deductible | |
| Non-Preferred Formulary/Specialty | $60 copay after deductible | |
| GLP-1 Weight Loss Medication | $200 copay after deductible* | |
| Maintenance Rx (90-Day Supply) | ||
| Generic | $40 copay after deductible | Not covered |
| Preferred Formulary | $80 copay after deductible | |
| Non-Preferred Formulary/Specialty | $120 copay after deductible | |
| GLP-1 Weight Loss Medication | $400 copay after deductible* | |
| Home Delivery (90-Day Supply) | ||
| Generic | $40 copay after deductible | Not covered |
| Preferred Formulary | $80 copay after deductible | |
| Non-Preferred Formulary/Specialty | $120 copay after deductible | |
| GLP-1 Weight Loss Medication | $400 copay after deductible* | |
*The Benesch Medical Plan will apply a $20,000 lifetime maximum for GLP-1 medications prescribed for weight loss. Each participant’s plan-paid expenses for GLP-1 medications incurred on or after January 1, 2024 will count toward this lifetime maximum. Once the $20,000 lifetime maximum is reached, the plan will no longer provide coverage for GLP-1 medications in the weight-loss category.
Health Care Savings Medical Plan Monthly Rates
| Coverage | Employee | Equity Partner |
|---|---|---|
| Employee | $177 | $1,058 |
| Employee + Spouse | $390 | $2,329 |
| Employee + Child(ren) | $332 | $2,011 |
| Employee + Family | $561 | $3,386 |
PPO Medical Plan
This medical plan allows you to visit any physician or healthcare provider you wish without first requiring a referral from a primary care physician. No matter which healthcare provider you choose, in-network healthcare services will be covered at a higher benefit level than out-of-network services. It's important to check if your provider accepts your health plan so you receive the highest level of benefit coverage. For a list of in-network doctors, click here.
For most services, a deductible will apply. Once you've met your deductible, a copay will apply thereafter.
Prescriptions are covered at a copay. In-network pharmacies will be covered at a higher level of benefit than out-of-network pharmacies.
You are also eligible to contribute to the Medical Flexible Spending Account (FSA) that provides tax advantages and can be used to cover the costs of your deductible and copays.
PPO Medical Plan Overview
| In-Network | Out-of-Network | |
|---|---|---|
| Costs for Primary Services | ||
| Deductible | $750 individual / $1,500 family | $3,000 individual / $6,000 family |
| Maximum Out-of-Pocket | $3,000 individual / $6,000 family | $6,000 individual / $12,000 family |
| Primary Care and Mental Health and Substance Abuse Disorder Services Visits |
$35 copay | 50% after deductible |
| Preventive Care | No copay | 50% after deductible |
| Specialist Visits | $50 copay | 50% after deductible |
| Emergency Room | $250 copay | $250 copay |
| Urgent Care | $85 copay | 50% after deductible |
| Rx Retail Copays | ||
| Generic | $20 copay | 50% coinsurance |
| Preferred Formulary | $40 copay | |
| Non-Preferred Formulary/Specialty | $60 copay | |
| GLP-1 Weight Loss Medication | $200 copay after deductible* | |
| Maintenance Rx (90-Day Supply) | ||
| Generic | $40 copay | Not covered |
| Preferred Formulary | $80 copay | |
| Non-Preferred Formulary/Specialty | $120 copay | |
| GLP-1 Weight Loss Medication | $400 copay after deductible* | |
| Home Delivery (90-Day Supply) | ||
| Generic | $40 copay | Not covered |
| Preferred Formulary | $80 copay | |
| Non-Preferred Formulary/Specialty | $120 copay | |
| GLP-1 Weight Loss Medication | $400 copay after deductible* | |
*The Benesch Medical Plan will apply a $20,000 lifetime maximum for GLP-1 medications prescribed for weight loss. Each participant’s plan-paid expenses for GLP-1 medications incurred on or after January 1, 2024 will count toward this lifetime maximum. Once the $20,000 lifetime maximum is reached, the plan will no longer provide coverage for GLP-1 medications in the weight-loss category.
PPO Medical Plan Monthly Rates
| Coverage | Employee | Equity Partner |
|---|---|---|
| Employee | $366 | $1,247 |
| Employee + Spouse | $803 | $2,742 |
| Employee + Child(ren) | $689 | $2,368 |
| Employee + Family | $1,164 | $3,989 |
My Health Dashboard
Download the Sydney Health App and use your Anthem login to find everything you need to know about your medical and wellness benefits all in one place.
In addition to being able to find a doctor matched to your preferences and manage your medical/pharmacy care, you have access to My Health Dashboard (under the Menu on the app) for personalized health and wellness tools. You can sync your devices and find resources and programs that interest you, including:
- Health Risk Assessment to help build an action plan based on your personalized needs
- Action Plans to help you reduce stress, sleep better, increase energy, get active, eat healthy, or achieve a healthy weight—all outlined with easy steps to begin implementing
- Well-being Coach with digital and phone coaching programs to transform your health
- Emotional Wellbeing Resources, including digital tools and programs to improve emotional well-being
- Weight Management Center with a digital playbook to lose weight
- ConditionCare  programs specifically for those with cancer, diabetes, asthma or heart disease