Medical Plans Overview

Medical Plans Overview

To support your health and financial wellness, Pearson provides benefits that help you and your family stay healthy and live a meaningful life. We want you to feel confident in your choices so you can make the most of your benefits. So, we’ll provide you with information about what is available and give you the freedom to choose the benefits that work best for you.

Which plan is right for you?

Pearson Benefits Marketplace shows the costs and coverage for each plan, making it easy to decide. And, if you answer a few simple questions, you’ll see which plan may be a “best match” for your needs and preferences.

View the 2019 Medical Plans Chart for a PDF, print-out version of these charts below.

National Plan Comparison

$400 Deductible Plan $900 Deductible Plan $1850 Deductible Plan $2850 Deductible Plan
HSA-eligible No No Yes Yes
Company contribution to HSA N/A N/A $500 for employee-only coverage; $1,000 for family coverage $500 for employee-only coverage;
$1,000 for family coverage
In-network care: Your costs
Preventive care Covered at 100% in-network, so you pay nothing
Deductible (individual/
family)
$400/$800 $900/$1,800 $1,850/$3,700 $2,850/$5,700
Out-of-pocket maximum (individual/
family)
$2,200/$4,400 $3,000/$6,000 $3,500/$6,500 $5,500/$11,000
You pay 20%, plan pays 80% You pay 20%, plan pays 80% You pay 20%, plan pays 80% You pay 30%, plan pays 70%
Office visit (primary care/specialist) You pay $20/$40 You pay $40/$80 You pay 20% after deductible You pay 30% after deductible
MDLIVE  visit You pay $10 You pay $10 You pay $40, or $10 after you have met your deductible You pay $40, or $10 after you have met your deductible
Emergency room visit You pay $150, then 20% after deductible You pay 20% after deductible You pay 20% after deductible You pay 30% after deductible

A word about the $1,850 Deductible Plan

If you enroll in the $1,850 Deductible Plan and cover any dependents, the full family deductible must be met before the Plan pays benefits for any family member. Any covered family member can contribute to the family deductible. The individual deductible only applies if you elect the employee-only coverage tier. Please call the Pearson Benefits Marketplace at 855-237-6421 if you have any questions.

Location-Based Plans  

Kaiser HMO Medium Plan – California HMSA Preferred Provider Plan – Hawaii Triple-S Platinum Plan – Puerto Rico
In-network care: Your costs
Preventive care Covered at 100% in-network, so you pay nothing
Deductible (individual/family) $500/$1,000 No deductible No deductible
Out-of-pocket maximum (individual/
family)
$1,500/$3,000 $2,500 / $7,500 (medical)
$3,600 / $4,200 (pharmacy)
$6,350/$12,700
Major Medical: $2,000/$6,000
Coinsurance You pay 10%, plan pays 90% Varies by service Varies by service
Office visit (primary care/specialist) You pay $25/$40 copay You pay $12 copay You pay $10/$15 copay
Emergency room visit You pay $150 copay You pay 20%, plan pays 80% You pay $75 copay / $35 if recommended by Teleconsulta (Triage)