Medical Plans

PetSmart offers two consumer-driven Preferred Provider Organization (PPO) medical plan options, one High-Deductible Health Plan (HDHP) with a Health Savings Account (HSA) through UnitedHealthcare, and the new Bind medical plan. The 2021 or 2022 PetSmart Benefits Guides  provide an overview of the medical plan offerings. 

Part-time associates, may be eligible for medical coverage if you work an average of 30 hours per week, as defined by the federal health care law, also called the Affordable Care Act (ACA). Part-time associates that are eligible for medical coverage will be contacted by the PetSmart Benefits Team regarding your enrollment. 

Eligible Dependents

Your eligible dependents include your lawful spouse or your dependent children up to age 26, or who are age 26 or older with a physical or mental disability as defined by the Social Security Administration.

Eligible children include your natural children, legally adopted children, stepchildren who reside with you the majority of the time, and children for whom you have legal guardianship.

PPO1 and PPO2

The consumer-driven PPO options provide comprehensive medical coverage. You have the freedom to see any provider, the annual out-of-pocket maximum protects you against high or unexpected medical bills, and in-network preventive care is always 100% covered.

High Deductible Health Plan (HDHP) with Prescription

An HDHP is a lot like a regular medical plan, but with a few twists. It covers office visits, preventive care, drugs, lab tests, X-rays, and more. You can use any doctor, lab, hospital, or other provider, but you’ll pay less if you stay in-network. You’ll have a combined deductible where both medical and prescription drug expenses count toward it.

No prescription drug copays. You pay the full discounted cost for medications – including generic and brand-name drugs, until you reach your deductible. Note: You’ll pay the coinsurance amount for the generic preventive medications on the HDHP preventive drug list,  even if you haven’t met your deductible.

Bind

Bind is an innovative, personalized health plan where you pay a copay for all services, except covered preventive care, with no coinsurance or deductibles. Bind gives you transparent pricing, so you know what treatments cost up front. Bind lets you compare prices for providers in your area with the convenient MyBind app which is available for download through the Apple or Google Play store. Visit ChooseBind.com/petsmart (access code: petsmart2021) to learn more about this medical plan. 

Most in-network preventive care costs are priced at $0 additional expense to you. Bind gives you all the information you need to make the right choices for your family and more opportunities to save.

HMSA (Hawaii Medical Service Association)

PetSmart offers medical insurance to our eligible associates in Hawaii. Get the details here.

Spousal Surcharge

PetSmart continues to offer medical coverage to your lawful spouse. However, if you decide to cover a spouse who has other medical coverage options available (such as through his/her employer), you will pay a spousal surcharge in addition to your medical cost

The spousal surcharge is $20 per week ($1,040 a year). In addition to the cost of medical coverage, the surcharge is deducted from your pay before taxes.

The spousal surcharge does not apply if your spouse is:

  • Also a PetSmart associate
  • Not employed
  • Employed but not eligible for benefits through his/her current employer
  • Eligible for Medicare or Medicaid

Note: PetSmart conducts periodic audits to ensure that dependents enrolled in the plans meet the eligibility criteria for coverage. Any misrepresentation or falsification of information regarding eligibility for coverage or benefits may result in (i) termination of your PetSmart benefits, (ii) termination of your employment with PetSmart, and (iii) reimbursement to PetSmart of benefits that were improperly obtained.

Hearing

Our medical plans cover preventive screening services, hearing device fittings, testing and hearing aids.

Prescription

When you enroll in a PetSmart medical plan, you automatically receive prescription drug coverage through the CVS Caremark® prescription benefit program. You can use your CVS Caremark prescription benefit ID card at participating pharmacies or when ordering prescriptions through the CVS Caremark Mail Service Program. Go mobile with the CVS/Caremark App for access to your ID card, to view prescription history, and to track your mail order.

The amount you pay may vary depending on the type of drug you need and the method in which you fill your prescription. The medical plan comparison chart below will illustrate some of those differences. For more information about the CVS Caremark® prescription benefit program, call the Customer Care team at 1-800-966-5772

PPO1, PPO2, Bind HDHP

Retail Generic

$7 Copay Ded/Coins

Retail Brand Formulary

$25 Min/$150 Max; 25% Coins Ded/Coins

Retail Nonformulary

$50 Min/$250 Max; 40% Coins Ded/Coins

Mail Generic (90-day)

$18 Copay Ded/Coins

Mail Brand Formulary (90-day)

$75 Copay Ded/Coins

Mail Nonformulary (90-day)

$400 Copay Ded/Coins

Specialty

$0/30% Coins – through Prudent Rx Ded/Coins

Some medications are covered by the no cost preventive services list, and with a prescription will be covered with a $0 copayment. This list may be amended or changed based on rules of the Affordable Care Act (ACA). For more information about the prescription drug options, see the Prescription section.

Members who are experiencing chronic or complex conditions may be eligible for the PrudentRX Copay Program. To learn more, contact Caremark Specialty Pharmacy at 1-800-237-2767.

Mandatory Maintenance Choice

Mandatory Maintenance Choice offers you savings when it comes to filling long-term prescriptions. The plan will cover long-term maintenance medications only if you have 90-day supplies filled through CVS mail service or at CVS or Target pharmacy. Maintenance medications are drugs you take for regular daily use or for ongoing conditions such as diabetes, high cholesterol, allergies, high blood pressure, etc. How do you move your current 30-day prescription to Maintenance Choice? Simply request your physician to provide a new prescription written for up to a 90-day supply with 3 refills to cover a 12-month period. Submit the new prescription to any CVS or target retail pharmacy and receive your medication for the same low mail service copay. 

Explore the prescription plan and digital tools you can use to find out if your medication is covered, cost, and where to fill. These helpful tools can be found at Caremark.com. 

2021 Medical Plan Comparison Chart

View the entire comparison chart here.

  PPO1 PPO2 BIND HDHP
Weekly cost. Contributions are deducted from weekly pay before taxes. Salaried associates: To calculate your biweekly contribution, multiply weekly contribution by 52 and divide by 26.
Associate Only $61.45 $44.11 $22.17 $22.17
Associate & Spouse $146.62 $112.06 $84.87 $84.87
Associate & Child(ren) $126.98 $96.85 $73.21 $73.21
Associate & Family $218.71 $167.88 $127.65 $127.65
  PPO1
(in-network)
PPO2
(in-network)
BIND
(in-network)
HDHP
(in-network)
Health Reimbursement Account (HRA)
(money from PetSmart to help you pay for eligible medical and prescription drug expenses, like copays, deductibles and coinsurance)
Individual: N/A $250 N/A N/A
Family1: N/A $500 N/A N/A
Health Savings Account (HSA)
(money both from PetSmart and that you may contribute to for health care expenses that can be used today or saved for the future)
Individual: N/A N/A N/A

PetSmart Contribution:
$390/$7.50 per week*
*Prorated annual contribution based on plan start date

Associate Contribution:
You decide how much to contribute, up to $3,6002

Family: N/A N/A N/A

PetSmart Contribution:
$780/$15 per week*
*Prorated annual contribution based on plan start date

Associate Contribution:
You decide how much to contribute, up to $7,2002

Annual Deductible
Individual: $1,250 $1,750 N/A $2,150
Family: $2,500 $3,500 N/A $4,250
Annual Medical Out-of-Pocket (OOP) Maximum
(including copays, coinsurance and deductible)
Individual: $3,250 $3,500 $6,000 $3,375
Family: $6,500 $7,000 $12,000 $6,750
Annual Prescription Drug Out-of-Pocket (OOP) Maximum3
Individual: $1,500 $1,500 $1,500 Combined with medical OOP maximum
Family: $3,000 $3,000 $3,000 Combined with medical OOP maximum
Preventive Care4
(including annual wellness exams and screenings, labs, X-rays, gynecological exams, well-child care, and immunizations if for preventive purposes only)
In-Network: Plan pays 100%
(no copay or deductible)
Plan pays 100%
(no copay or deductible)
Plan pays 100%
(no copay or deductible)
Plan pays 100%
(no copay or deductible)
Out-of-Network: Not covered Not covered $300 Not covered
Physician Services (office visits)
Primary Care Physician (PCP): $25 copay $25 copay $60-$240 copay (combined with PCP/SCP) 80%5
Specialist Care Physician (SCP)
(including mental health and substance abuse):
$50 copay $50 copay Most common: PCP/SCP: $130/$220 80%5
Inpatient Hospitalization
Associate: You pay 20% after deductible is met You pay 20% after deductible is met You pay
$4,0006
You pay
20% after deductible is met
Maternity Care
Associate:

$25 copay for first office visit only

After you pay deductible, plan pays 80% for physician, delivery and hospital charges

$25 copay for first office visit only

After you pay deductible, plan pays 80% for physician, delivery and hospital charges

Prenatal:
You pay $0 copay

Delivery:
You pay
$3,000-$5,000 copay

After you pay deductible, plan pays 80% for physician, delivery and hospital charges

1 “Family” includes “Associate plus spouse,” ”Associate plus child(ren),” and “Associate plus family” coverage levels.

2 Amount shown is the total IRS limit for the calendar year. Associate contributions are capped at $3,210/individual and $6,420/family as they receive employer contributions bringing the total to the IRS maximum. The IRS allows an additional $1,000 contribution if you are age 55 or older.

3 There is a separate out-of-pocket (OOP) maximum for prescription drug expenses administered by CVS/caremark®. Once this OOP maximum is reached, the plan pays 100% of eligible prescription drug expenses.

4 Your health plan now offers certain preventive service benefits at no cost to you. This means you don’t have to pay a copay or coinsurance, even if you haven’t met your deductible. These no-cost benefits are part of the Affordable Care Act (ACA).

5 After you meet your annual deductible.

6 Inpatient hospitalizations may vary, $4,000 is the most common copay.

2022 Open Enrollment begins October 5th. Click here to learn more!