Medical and Prescription Plans

Medical Health Insurance

It’s important to recognize that not everyone needs the same amount of care. So, Waters provides you with some options for different situations. You’ll have a choice of three Aetna health plans:

The Deductible $2,500/$6,250 Plan with an HSA or HRA
The Deductible $1,600/$3,700 Plan with an HSA or HRA
The Copay and Deductible Plan

With Aetna’s commitment to the health and wellbeing of the Waters family, you’ll have access to:

Aetna’s concierge health advocates
industry-leading technology that can help you navigate the complex world of health care
and help managing the best care for you and your family.

Additionally, both the Deductible $1,600/$3,700 plan and the Deductible $2,500/$6,250 plan come with the option for you to contribute to a special pre-tax account, called a Health Savings Account (HSA) , or HSA, to help pay for out-of-pocket medical costs.

All three plans have the same network, "Aetna Open Access Choice POS II", same Group # 870100-010-00001, same list of eligible covered expenses, and will 100% cover most in-network preventive care.

The Deductible $1,600/$3,700 medical plan is designed for you to pay more up front, from each paycheck, but with lower out-of-pocket costs over the year, if you have non-preventive medical and/or Rx services.

The Deductible $2,500/$6,250 medical plan costs less up front in premiums, saving you money on each paycheck (this is a good opportunity for you to put the pay check savings into your pre-tax HSA Account). The deductible is higher, your share of the coinsurance and the maximum potential out-of-pocket costs are more than the other deductible medical plan, the Deductible $1,600/$3,700 plan.

Note: if you do not qualify for an HSA, per IRS regulations, you can select a Health Reimbursement Account (HRA) , or HRA, instead.

The Copay and Deductible plan is designed to have a higher premium cost out of each pay check, but a lower out-of-pocket cost at the point of service. This plan may be a good choice if you expect to have high health care needs. Most employees don’t have health care utilization claims high enough to make this plan be the best choice. Most employees are likely to still be better off in one of the other two plan choices. This is because throughout the whole year, total cost, premium costs and out of pocket expenses during the year, this plan will be the most expensive.

Also, the Copay and Deductible plan does not qualify for an HSA or an HRA.

For prescriptions:

-Eligible preventive drugs are always covered at 100% in the two HSA/HRA eligible medical plans. The Copay and Deductible plan covers tier 1 and tier 2 eligible preventive drugs at no cost. Tier 3 drugs will still be subject to the plan’s copay in the Copay and Deductible Plan. Find the eligible Preventive Drug Lists under Quick Links on the home page of WatersBenefitsNow.com.

-the Deductible $1,600/$3,700 plan will cover your prescriptions at 100%, once you hit the deductible. No copays. No coinsurance.

-the Deductible $2,500/$6,250 plan will have 15% coinsurance for prescriptions, after the deductible, up to the out-of-pocket maximum. Then the prescriptions are covered 100%. No copays, ever.

-the Copay and Deductible plan charges a copay between $10 – $50, depending on the type of drug.

From day one, the Deductible $1,600/$3,700 Plan and the Deductible $2,500/$6,250 Plan will cover eligible preventive prescription drugs at 100%, without needing to hit the deductible. The Copay and Deductible Plan also covers tier 1 and tier 2 eligible preventive drugs at no cost, not even a copay. Tier 3 drugs will still be subject to the plan’s copay. Find the eligible preventive drug lists under the Learn – Resource Library on WatersBenefitsNow.com.

When going through enrollment, you don’t want to pick a more expensive plan than you need. But you also don’t want the reverse to happen, and pick too inexpensive a plan, just to end up paying too much out-of-pocket during the year. We’ll go over the key considerations you should make in the Choosing the Right Medical Plan section. But first, we should go over the details of each plan, so you know what you’re choosing between.

For Example

Hannah’s needs for medical care typically haven’t been high at all. So she actually saves money by choosing a plan that costs less each paycheck: the Deductible $2,500/$6,250 plan.

(Hannah takes advantage of the savings and sets them aside in her Health Savings Account, to help pay for any unexpected health care needs she might have down the road. If Hannah ends up not needing the funds this year, they’ll carry into next year, and she can even contribute more in the future—with an eye toward retirement.)

You also have the option of waiving coverage by choosing “I don’t want this benefit. (Waive).” (Be aware though that you will have to pay an IRS tax penalty if you aren’t covered by health insurance for at least 9 months of the year, so you should only waive Waters medical coverage if you’ll be getting it somewhere else.)

To help you decide, here are highlights of the features and costs for each.

The costs of your plan will depend on two factors:

Which plan you pick
Who you cover

To compare the costs of the three plans, click on the group describes you best to view that table:

Employee-Only

The below premiums show in-network pricing only, and do not reflect the potential Working Spouse/Partner surcharge if applicable to you. The full plan summary, including out-of-network coverage, is located in the Learn – Resource Library of WatersBenefitsNow.com.

	Deductible $2,500/$6,250 Plan	Deductible $1,600/$3,700 Plan	Copay and Deductible Plan
Premium	$23.40/paycheck (bi-weekly rate) ($608.40/yr) OR $25.35/paycheck (semi-monthly rate) ($608.40/yr)	$52.26/paycheck (bi-weekly rate) ($1358.76/yr) OR $56.62/paycheck (semi-monthly rate) ($1358.76/yr)	$76.44/paycheck (bi-weekly rate) ($1,987.44/yr) OR $82.81/paycheck (semi-monthly rate) ($1,987.44/yr)
Preventive Care	100% covered (even before hitting deductible)	100% covered (even before hitting deductible)	100% covered (even before hitting deductible)
Deductible	$2,500.00	$1,550.00	$750
Coinsurance	85%/15% (after deductible)**	90%/10% (after deductible)**	90%/10% (after deductible)**
Prescriptions To see what your specific prescription drugs cost, visit www.aetna.com	*Eligible Preventive Prescriptions covered 100%** (from day 1 of plan year) All other eligible prescriptions: Full, network-discount price, until you meet deductible 85%/15% coinsurance after deductible. 100% covered after out-of-pocket max	*Eligible Preventive Prescriptions covered 100%** (from day 1 of plan year) All other eligible prescriptions: Full, network-discount price, until you meet deductible 100% covered after deductible.	*Eligible Preventive Tier 1 and Tier 2 Prescriptions covered 100%** (from day 1 of plan year) All other eligible prescriptions: Subject to a set copay amount per tier Tier 1 Generic $10 copay Tier 2 Brand Name Preferred $30 Tier 3 Brand Name Non-Preferred $50
Out-of-Pocket Max	$6,750.00	$4,450.00	$3,000

* Eligible Preventive Prescriptions – you can find preventive drugs that are eligible in the Preventive Drug Lists, under the Quick Links or Learn – Resource Library Sections of WatersBenefitsNow.com

**For the two High Deductible Health Plans (HDHPs): Services received at CVS Minute Clinics, CVS Health Hubs, and Waters own on-site walk-in MedExpress clinic in the Milford office will be covered at 100% after your deductible is met. The plan will cover all eligible costs after you have met your annual deductible. For the Copay and Deductible Plan: Services received at CVS Minute Clinics, CVS Health Hubs, and Waters own on-site walk-in MedExpress clinic in the Milford office are covered at 100%. The plan will cover all eligible costs. Your annual deductible does not apply for these services.

Employee + Children

	Deductible $2,500/$6,250 Plan	Deductible $1,600/$3,700 Plan	Copay and Deductible Plan
Premium	$46.02/paycheck (bi-weekly rate) OR $49.86 (semi-monthly rate) ($1196.52/yr)	$100.62/paycheck (bi-weekly rate) OR $109.01 (semi-monthly rate) ($2616.12/yr)	$152.88/paycheck (bi-weekly rate) OR $165.62 (semi-monthly rate) ($3,974.88/yr)
Preventive Care	100% covered (even before hitting deductible)	100% covered (even before hitting deductible)	100% covered (even before hitting deductible)
Deductible	$6,250.00	$3,700.00	$1,500.00
Coinsurance	85%/15% (after deductible)**	90%/10% (after deductible)**	90%/10% (after deductible)**
Prescriptions To see what your specific prescription drugs cost, visit www.aetna.com	*Eligible Preventive Prescriptions covered 100%** (from day 1 of plan year) All other eligible prescriptions... Full, network-discount price, until you meet deductible 85%/15% coinsurance after deductible. 100% covered after out-of-pocket max	*Eligible Preventive Prescriptions covered 100%** (from day 1 of plan year) All other eligible prescriptions... Full, network-discount price, until you meet deductible 100% covered after deductible.	*Eligible Preventive Tier 1 and Tier 2 Prescriptions covered 100%** (from day 1 of plan year) All other eligible prescriptions... Subject to a set copay amount per tier Tier 1 Generic $10 copay Tier 2 Brand Name Preferred $30 Tier 3 Brand Name Non-Preferred $50
Out-of-Pocket Max	$13,500.00 ($6,750 for any one person)	$10,500.00 ($6,550 for any one person)	$6,000.00 ($3,000 for any one person)

Employee + Spouse/Partner

	Deductible $2,500/$6,250 Plan	Deductible $1,600/$3,700 Plan	Copay and Deductible Plan
Premium	$51.48/paycheck (bi-weekly rate) OR $55.77 (semi-monthly rate) ($1338.48/yr)	$116.22/paycheck (bi-weekly rate) OR $125.91 (semi-monthly rate) ($3021.72/yr)	$159.12/paycheck (bi-weekly rate) OR $172.38 (semi-monthly rate) ($4,137.12/yr)
Preventive Care	100% covered (even before hitting deductible)	100% covered (even before hitting deductible)	100% covered (even before hitting deductible)
Deductible	$6,250.00	$3,700.00	$1,500.00
Coinsurance	85%/15% (after deductible)**	90%/10% (after deductible)**	90%/10% (after deductible)**
Prescriptions To see what your specific prescription drugs cost, visit www.aetna.com	*Eligible Preventive Prescriptions covered 100%** (from day 1 of plan year) All other eligible prescriptions... Full, network-discount price, until you meet deductible 85%/15% coinsurance after deductible. 100% covered after out-of-pocket max	*Eligible Preventive Prescriptions covered 100%** (from day 1 of plan year) All other eligible prescriptions... Full, network-discount price, until you meet deductible 100% covered after deductible.	*Eligible Preventive Tier 1 and Tier 2 Prescriptions covered 100%** (from day 1 of plan year) All other eligible prescriptions... Subject to a set copay amount per tier Tier 1 Generic $10 copay Tier 2 Brand Name Preferred $30 Tier 3 Brand Name Non-Preferred $50
Out-of-Pocket Max	$13,500.00 ($6,750 for any one person)	$10,500.00 ($6,550 for any one person)	$6,000.00 ($3,000 for any one person)

Employee + Spouse/Partner + Any Children (Family)

	Deductible $2,500/$6,250 Plan	Deductible $1,600/$3,700 Plan	Copay and Deductible Plan
Premium	$74.88/paycheck (bi-weekly rate) OR $81.12 (semi-monthly rate) ($1946.88/yr)	$162.24/paycheck (bi-weekly rate) OR $175.76 (semi-monthly rate) ($4218.24/yr)	$243.36/paycheck (bi-weekly rate) OR $263.64 (semi-monthly rate) $6,327.36
Preventive Care	100% covered (even before hitting deductible)	100% covered (even before hitting deductible)	100% covered (even before hitting deductible)
Deductible	$6,250.00	$3,700.00	$1,500.00
Coinsurance	85%/15% (after deductible)**	90%/10% (after deductible)**	90%/10% (after deductible)**
Prescriptions To see what your specific prescription drugs cost, visit www.aetna.com	*Eligible Preventive Prescriptions covered 100%** (from day 1 of plan year) All other eligible prescriptions... Full, network-discount price, until you meet deductible 85%/15% coinsurance after deductible. 100% covered after out-of-pocket max	*Eligible Preventive Prescriptions covered 100%** (from day 1 of plan year) All other eligible prescriptions... Full, network-discount price, until you meet deductible 100% covered after deductible.	*Eligible Preventive Tier 1 and Tier 2 Prescriptions covered 100%** (from day 1 of plan year) All other eligible prescriptions... Subject to a set copay amount per tier Tier 1 Generic $10 copay Tier 2 Brand Name Preferred $30 Tier 3 Brand Name Non-Preferred $50
Out-of-Pocket Max	$13,500.00 ($6,750 for any one person)	$10,500.00 ($6,550 for any one person)	$6,000.00 ($3,000 for any one person)

If you go out of network under either the Deductible $1,600/$3,700 Plan or the Deductible $2,500/$6,250 Plan, the deductible is higher, your co-insurance responsibility is higher, and the out-of-network maximum is higher, so you’ll most likely end up paying a lot more for your care. For example, while preventive care is covered 100% in-network in both plans, it’s covered at just 70% out-of-network, in the Deductible $1,600/$3,700 Plan, and 65%, in the Deductible $2,500/$6,250 Plan. And that 70%/60% only applies after you’ve met your deductible. (Up until then, you’ll pay full price of the visit.)

For the Copay and Deductible Plan, you may have some out-of-network coverage, depending on the type of provider you see.

Check your plan details in the Learn – Resource Library section of this website, WatersBenefitsNow.com, for the full list of out-of-pocket costs.

You can make sure your providers are in your plan’s network (“Aetna’s Open Access Choice Point of Service II”) by:

Calling your doctor’s office directly
Calling an Aetna Concierge Health Advocate using 1-855-643-6143.
Going online, at: www.aetna.com, and entering your personal login information.

Spouse/Partner Surcharge for medical insurance

Waters has a working spouse/partner surcharge for medical insurance. This means that you will incur a surcharge ($650 annually) if your spouse or partner has access to subsidized group medical insurance through their own employer, but is enrolled in the Waters medical plan. If your spouse/partner doesn’t have access to subsidized group medical insurance through his/her own employer, you will not be assessed the surcharge.

The spousal/partner surcharge will be deducted from each paycheck. The surcharge is prorated and divided by the number of pay periods left in the year, and will be assessed on a pre-tax basis, for as long as the spouse or partner is covered under a Waters medical plan and is eligible for their own employer’s subsidized group medical insurance. If your partner or spouse happens to also work at Waters, this surcharge does not apply.

New Hire enrollment is your opportunity to evaluate and compare all of the options available from Waters and other sources, including your spouse/partner’s employer plans. You’ll want to compare payroll deductions and benefit levels including provisions such as deductible , copays , coinsurance , and out-of-pocket maximums .

Some employees may find the Waters plans best fit their needs; others may find a more suitable option elsewhere.
Some employees may keep all family members on one employer plan, while others may choose to split enrollment between the Waters plan and another employer plan.
Many employees may pay less in total payroll deductions if their spouse/partner is covered on the spouse/partner’s employer plan.

Waters hopes employees and their spouse or partners will take the time to thoroughly review all the options they have available and make the best decision for their situation.

Many Waters employees covering a family don’t realize that, if their spouse or partner were to pick up Employee-Only coverage at their employer, the Waters employee would drop down two tiers! And by switching from the Family tier to the Employee + Child(ren) tier, they’d pay a good amount less in premiums.

If you’re covering a family, and the surcharge applies, it makes sense to compare your two options:

The premium of the Family tier at Waters (with the surcharge)
The Employee-Plus-Child(ren) tier premium at Waters, plus the employee-only premium at your spouse’s or partner’s employer

Of course, a plan’s premium isn’t the only factor to consider. But it’s one to be aware of.

What you need to do:

As explained above, review options available from Waters and your spouse/partner’s employer to determine what works best for you and your family.
Make your elections in the WatersBenefitsNow.com platform before the end of your enrollment window.
Review your confirmation statement at the end of your enrollment, and your first pay stub of the new year, to ensure the surcharge was (or was not) processed correctly.

A Message From Waters

Why Waters has this Spouse/Partner Surcharge for medical insurance:

With Waters employee benefits, we strive to offer market competitive benefits to our employees while maintaining costs that will be sustainable over time and compliant with federal and state regulations. The cost of health care in the U.S. is expensive, and like most employers, Waters has to manage our costs carefully with the focus of offering varying benefit levels to meet the needs of our diverse population. When we benchmark our plans annually, we find that our plan costs and plan designs are market competitive or richer than norms. We review our plans annually and continue to offer a comprehensive benefits package to our U.S. employees, while maintaining a sustainable cost structure for the company. In order to do this, the company needs to keep up with industry trends and make adjustments periodically to manage costs and stay competitive.

A current trend is for employers to increase the cost for spouses/partners beyond the current premium rate structure. Waters has instead chosen to implement this cost sharing strategy for only those spouses/partners who have subsidized coverage available through another employer, and Waters has chosen a surcharge amount that is approximately half that of the national norms for this type of surcharge. Even with this surcharge added to the normal pay check deduction cost (premium), the employee cost is still very competitive, and Waters is still covering approximately 80% of the total premium cost.

Jump to this related content

Health Savings Account: Learn more about how Waters can set money aside and also how you can contribute your own pretax money in an HSA to pay medical costs throughout the year.
Health Reimbursement Account: Learn more about how waters can set money aside in an HRA to help pay for your medical costs throughout the year.
Health Advocacy: You and your family have access to a service to help you manage your health care and handle issues with things like pre-approvals, claims, and bills.
Medical Experts by Teladoc: Need a second opinion? This is a free service you can use to double-check your diagnosis.
Family and Medical Leave Act: If you need to leave work for illness, injury, or a new baby, the FMLA provides you with legal protection to keep your job.
Workers Compensation: Hurt on the job? Workers compensation can cover the costs of your care.
Medicaid and the Childrens Health Insurance Program (CHIP): If you or your children are eligible for both health coverage from Waters AND for Medicaid or CHIP, your State may have a premium assistance program that can help pay for coverage.