Benefits – Medical
Overview
We know that our employees have different needs. That’s why we offer three medical plan options – PPO Plan, HSA 1600 or HSA 3200 – so you have the flexibility to choose the coverage that best fits your needs. All three medical plans are administered by Anthem and cover a broad range of medical services and include prescription drugs and vision coverage. The plans differ in the amounts that Anthem will pay and what you will pay:
How Our Plans Differ
The PPO Plan has lower out-of-pocket costs due to a lower deductible and coinsurance. While your costs are more predictable when you visit a provider, your payroll contribution is greater.
The HSA 1600 and the HSA 3200 are consumer-driven medical plans that give you more flexibility to manage your coverage with payroll contributions that are less than the PPO Plan. The HSA medical plans work differently because they combine a high deductible health plan with a special tax-advantaged Health Savings Account (HSA). You can use the funds in your HSA to pay for current or future qualified healthcare expenses for yourself, your spouse and your dependents. Cummins makes an annual contribution to your account are based on your coverage level and base annual salary (new hires receive a pro-rated amount based on their date of hire). You may also elect to fund your HSA with pre-tax payroll contributions.
What are the coverage levels?
You have four different coverage levels to choose from:
- Employee only
- Employee + spouse/domestic partner
- Employee + child(ren)
- Employee + family*
*Family includes employee, spouse/domestic partner and child(ren)/domestic partner’s child(ren).
You have the flexibility to elect medical coverage and waive dental coverage or vice versa. This allows you to choose only the coverage you want and need. So consider your situation and anticipated healthcare needs carefully and choose the options that are right for you.
2024 Insurance Premium Chart
Find Your Fit!
Life changes and so can your benefit needs. Before you decide to stick with what you currently have, get familiar with what’s offered, ask yourself some key questions and consider your choices. That way you’ll know you have the right fit, with the right combination of benefits and coverage for you and your family in the coming year.
Understand What’s Available
You have choices in your benefits – and an annual opportunity to consider choices for the following benefits:
- Medical ― Covers medical services and prescriptions, plus includes access to vision coverage and resources to help you get the care you need. You have several options available, including the PPO Plan, HSA 1600 and HSA 3200. You can choose the plan that best fits your needs and preference.
- Dental ― Covers a broad range of dental services, including preventive care, basic services, major services and orthodontia.
- Health Savings Account (HSA) ― Offers an opportunity to save tax-free for your qualified health care expenses if you are enrolled in the HSA 1600 or HSA 3200 plan. Annually, Cummins funds your HSA between $500 and $2,000 depending on your coverage level and your annual base salary. You can use the money in your account to help pay for care now or grow your account for your future health care needs.
- Flexible Spending Accounts (FSAs) ― Provides opportunities to save on taxes by paying yourself back for eligible health care and/or dependent day care expenses with tax-free dollars. Keep in mind that by law you will lose any amounts you don’t use during the year.
- Optional Life and Accident Insurance ― Additional protection you can purchase (beyond what you automatically receive as a Cummins employee) that offers financial benefits in case of serious injury or death. Coverage is also available for spouses/domestic partners and dependent children.
Remember that you have other benefits and resources you receive as a Cummins employee that are not part of Open Enrollment. Explore this site to learn more.
Ask Yourself Some Questions
Choosing the medical plan that’s right for you and your family is a big decision. You’ll want to consider your coverage needs, each plan’s features and costs of each plan to understand which will best meet your needs.
About your health
- How often do my family members and I use health care? Do I expect the same level of use in 2023?
- Do I have dependents who may require frequent visits for typical childhood illnesses like ear infections or the occasional urgent care visit?
- Does anyone in my family need prescription medication to manage a condition, such as diabetes or high blood pressure?
- Am I expecting to have any significant medical needs (e.g., surgery) or dental needs (e.g., braces)?
About your finances
- How much am I willing to spend per paycheck for coverage? How much am I willing to pay for care?
- How prepared am I to pay for medical or dental services if I or someone in my family needs significant care?
- Am I taking advantage of options to maximize my tax savings?
- How much life insurance do I need?
About your family
- Who do I need to cover under my Cummins benefits?
- Does anyone in my family have access to medical or dental benefits other than through Cummins?
- If so, how do those benefits compare in coverage and cost? Am I eligible to be covered under those plans?
Consider Your Choices
Keep in mind:
- The way you pay for medical: If you prefer to have lower employee premium contribution amounts for medical coverage deducted from your paycheck but have higher cost-sharing amounts apply (i.e., deductible and coinsurance) in the event you need medical care, consider a coverage option that’s paired with an HSA. If you’d rather pay more in employee premium contributions out of your paycheck to keep your potential cost-sharing amounts lower if/when you need medical care, consider the PPO Plan.
- Opportunities to maximize your health care savings. If you choose HSA 1600 or HSA 3200 medical coverage, consider taking full advantage of the Health Savings Account’s (HSA’s) triple-tax advantage. In addition to Cummins’ contribution to your HSA, you can contribute to the HSA and use the money to pay for eligible health care expenses now or in the future. The money you contribute is tax free, earns interest/investment returns that are also tax free and is withdrawn tax free if used for eligible health care expenses.
- Tax savings when you use the Flexible Spending Accounts (FSAs). You can use FSAs to pay yourself back with tax-free dollars for your eligible health care and/or dependent day care expenses. However, plan carefully if you decide to participate in the FSAs. By law, you’ll forfeit any money you don’t use for the year. Note: If you enroll in the HSA 1600 or HSA 3200 plan, you are not eligible to participate in the Health Care FSA. However, you can participate in the Dependent Care FSA.
- Additional life and accident financial protection. Understand the coverage you automatically receive from Cummins and the options you have to purchase additional protection. This includes added coverage for yourself, as well as optional coverage for your spouse/domestic partner and children (if applicable).
- Added benefits and resources included with medical coverage. When you enroll in medical coverage, you and your covered dependents automatically receive vision coverage. You also have access to a number of programs to help you get the care you need. This includes 24/7 medical advice through the Anthem NurseLine, LiveHealth Online Virtual Care, Anthem’s Inclusive Care program and Carrum Health to help you plan for a surgery. See more information below on these benefits!
What is the coverage for HSA 3200?
| Plan Feature | In-Network | Out-of-Network |
|---|---|---|
| Preventive Care | 100% | Not available |
| Annual Deductible |
Individual: $3,200
Family: $6,400 ($3,200 individual limit)
|
Individual: $6,400
Family: $12,800 ($6,400 individual limit)
|
| Cummins HSA Contribution |
|
|
| Employee HSA Contribution |
Maximum allowable contribution per IRS guidelines
Persons age 55 years or older may contribute an additional $1,000 per year
|
|
| Coinsurance (plan pays) | 80% after annual deductible | 50% of R&C after annual deductible |
| Annual Out-of-Pocket Maximum (includes annual deductible and coinsurance) Individual / Family* [Individual Limit] (based on annual base salary**) is: | ||
| ≤$50,000 | Individual: $3,500
Family: $7,000 ($3,500 individual limit)
|
Individual: $7,000
Family: $14,000 ($7,000 individual limit)
|
| $50,001 ‒ $60,000 | Individual: $4,000
Family: $8,000 ($4,000 individual limit)
|
Individual: $8,000
Family: $16,000 ($8,000 individual limit)
|
| $60,001 ‒ 70,000 | Individual: $4,500
Family: $9,000 ($4,500 individual limit)
|
Individual: $9,000
Family: $18,000 ($9,000 individual limit)
|
| $70,001 + | Individual: $5,500
Family: $11,000** ($5,500 individual limit)
|
Individual: $11,000
Family: $22,000 ($11,000 individual limit)
|
*With the HSA3200, the deductible and out-of-pocket maximum amounts are calculated under an embedded approach. Once one person meets the individual deductible (or out-of-pocket maximum amount), the plan begins to pay its share for that person. When another family member, or combination of family members, reach the second half of the deductible (meeting the full family deductible), the plan begins paying coinsurance for all covered family members.
**The salary calculation includes commissions.
2024 SBC HSA 3200 $50000 or Less
2024 SBC HSA 3200 $50001-$60000
2024 SBC HSA 3200 $60001-$70000
2024 SBC HSA 3200 $70000+
What is the coverage for HSA 1600?
| Plan Feature | In-Network | Out-of-Network |
|---|---|---|
| Preventive Care |
100%
|
Not available
|
| Annual Deductible |
Individual: $1,600
Family: $3,200 (NO individual limit)
|
Individual: $3,200
Family: $6,400 (NO individual limit)
|
| Cummins HSA Contribution |
|
|
| Employee HSA Contribution |
Maximum allowable contribution per IRS guidelines
Persons age 55 years or older may contribute an additional $1,000 per year
|
|
| Coinsurance (plan pays) |
80% after annual deductible
|
50% of R&C after annual deductible
|
| Annual Out-of-Pocket Maximum (includes annual deductible and coinsurance) if annual base salary* is: | ||
| ≤$50,000 | Individual: $2,000
Family: $4,000 (NO individual limit)
|
Individual: $4,000
Family: $8,000 (NO individual limit)
|
| $50,001 ‒ $60,000 | Individual: $2,500
Family: $5,000 (NO individual limit)
|
Individual: $5,000
Family: $10,000 (NO individual limit)
|
| $60,001 ‒ $70,000 | Individual: $3,500
Family: $7,000 (NO individual limit)
|
Individual: $7,000
Family: $14,000 (NO individual limit)
|
| $70,001 + | Individual: $4,500
Family: $9,000 ($6,850 individual limit)
|
Individual: $9,000
Family: $18,000 (NO individual limit)
|
*Under the HSA 1600, the plan considers all enrolled family members together (not individually). If you cover yourself and any other person, the full family in-network deductible of $3,200 must be met before expenses are eligible for coinsurance.
**The salary calculation for the lower out-of-pocket contribution includes commissions.
2024 SBC HSA 1600 $50000 or Less
2024 SBC HSA 1600 $50001-$60000
2024 SBC HSA 1600 $60001-$70000
2024 SBC HSA 1600 $70000+.
What is the coverage for PPO Plan?
| Plan Feature | In-Network | Out-of-Network |
|---|---|---|
| Preventive Care | 100% | Not available |
| Annual Deductible Individual / Family* |
$750 / $1,500 | $1,500 / $3,000 |
| Cummins HSA Contribution | Not available | |
| Employee HSA Contribution | Not available | |
| Coinsurance (plan pays) | 80% after annual deductible | 50% of R&C after annual deductible |
| Annual Out-of-Pocket Maximum** (includes annual deductible and coinsurance) Individual / Family | ||
| All annual base salary levels | $3,250 / $6,500 | $6,500 / $13,000 |
| Copays | ||
| Primary Care Provider Visit | $25 | 50% coinsurance |
| Specialist Visit | $40 | 50% coinsurance |
| Urgent Care | $50 | 50% coinsurance |
| Emergency Room (waived if admitted directly to hospital) |
$150 | Covered as in-network |
*Each covered person needs to meet only the individual deductible before the plan begins paying its share of eligible expenses for that person.
**Prescription drug expenses are not counted toward the calendar-year deductible but are counted toward the calendar-year out-of-pocket maximum.
2024 SBC PPO Medical Plan
Transparency in Coverage
Transparency in Coverage (TIC) regulations require health insurers and group health plans to make Machine Readable Files (MRFs) publicly available that contain the negotiated rates for in-network providers and allowed amounts for out-of-network providers. The MRFs are formatted to allow researchers, regulators, and application developers to more easily access and analyze data. Anthem is responsible for publishing and maintaining the MRFs for our Cummins plans. These files will be published on anthem.com and will be updated monthly.
Users can view the Anthem machine readable files at: https://www.anthem.com/machine-readable-file/search/. These files are identified by the Cummins Employer Identification Number (EIN): 35-0257090.
What are the preventive care benefits?
Regardless of the medical plan you select, eligible preventive care services are covered at 100% with no deductible when you use in-network providers. Preventive care benefits include:
- Physical exams
- Well-child care
- Immunizations
- Mammograms
- Pap smears
- Colonoscopy
- Women’s contraceptives
- Breast pumps
- Other preventive care tests connected to the physical exam
For additional information, please refer to the Preventive Services List or contact the Anthem 866-251-1779 or visit the website.