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 2022 PetSmart Benefits Guides  provide an overview of the medical plan offerings. 

As a part-time associate, you are not automatically eligible for health insurance. You must average 30 hours or more over a 12-month look-back period, as defined by the federal health care law, also called the Affordable Care Act (ACA) to be eligible. This look-back period is evaluated every fall and/or after you have completed one year of service. 

Part-time associates that are eligible for medical coverage will be contacted by the PetSmart Benefits Team regarding your enrollment window. Take time to consider your needs for the coming year and use the tools and resources described below to help make the right choice for you and your family.

Eligible Dependents

Your eligible dependents include:

  • your lawful spouse
  • your domestic partner who meets certain criteria (you’re required to submit an Affidavit of Domestic Partnership)
  • 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, children of your verified domestic partner and children for whom you have legal guardianship.  PetSmart requires proof of dependent eligibility for all dependents added to the health plans.

Domestic partners are eligible for healthcare benefits under the PetSmart Plan if they meet the eligibility criteria. A domestic partner refers to someone other than a husband or wife with whom you are in a committed, serious and usually permanent relationship. You will be asked to provide supporting documentation that confirms their eligibility. Eligibility is defined as:

  • Reside together in an exclusive commitment similar to marriage and intend to continue in the relationship indefinitely;
  • Have lived together for at least twelve (12) consecutive months, or twelve (12) consecutive months as of the effective date of coverage;
  • Are jointly responsible for basic living expenses;
  • Are at least 18 years old and mentally competent to consent to this affidavit; and
  • Are not related by blood to a degree of closeness that would prohibit legal marriage in the state where we legally reside;
  • Neither is legally married to, the civil union spouse of, or a domestic partner of any other person;
  • Both are capable of consenting to the domestic partnership and are not consenting to the partnership under force, duress, or fraud;
  • The relationship is not in violation of any laws applicable to the benefit;
  • There has been at least twelve months since the termination of a previous domestic partnership

Supporting documentation for any two of the following dated at least 12 months prior to the date of enrollment:

  • Copy of any declaration, affidavit, or similar document that establishes our relationship that has been filed with any governmental entity
  • Joint mortgage or joint tenancy on a residential lease
  • Joint bank account (e.g., statements; copies of cards or voided checks are not acceptable)
  • Joint liabilities (e.g., a credit card or car loan; utility bills are not acceptable)
  • Joint ownership of significant property (e.g., a car or a house)
  • Proof that you have named each other as primary beneficiary in wills, life insurance policies or retirement annuities.
  • A written agreement or contracts regarding your relationship showing mutual support obligations.
  • Named on the same car insurance policy.

PetSmart must be notified within forty-five (45) days of the termination of our domestic partnership by filing a Termination of Domestic Partnership with the Benefits Department. An associate cannot file a new domestic partnership for twelve (12) months following the filing of a Notice of Termination of Domestic Partnership.

The benefit premiums for a domestic partner who is not a tax dependent must be paid on federal after-tax basis and the IRS requires that the fair market value of health coverage extended to a domestic partner who is not a tax dependent must be reported as taxable income and is included in the employee’s gross income. This is the portion that PetSmart contributes and will be added as imputed income for tax calculation. This is not actual income, but it is included in the employee’s gross income in order to assess tax withholdings. If an employee has imputed income due to covering their non-dependent domestic partner, they will have a higher amount of their pay withheld in taxes than if they did not cover their non-dependent domestic partner.

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.

Surest, a UnitedHealthcare company

Bind is now Surest – new name, same great coverage. 

Surest is an innovative, personalized health plan where you pay a copay for all services, except covered preventive care, with no coinsurance or deductibles. Surest gives you transparent pricing, so you know what treatments cost up front. Surest lets you compare prices for providers in your area with the convenient Surest app which is available for download through the Apple or Google Play store. Learn more about this medical plan. 

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

When you enroll in Surest you will also have access to programs that support your personal health journey, such as healthy pregnancy/fertility support, smoking cessation and virtual visits. This quick reference guide provides an overview of the Surest medical plan and the programs available to members.  

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

2022 Medical Plan Comparison Chart

View the entire comparison chart and 2022 here. To learn more about medical spending account options available to you, when enrolled in a medical plan, please visit the Medical Spending Accounts page

  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 $3,650 (2022)2

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 $7,300 (2022)2

Annual Deductible
Individual: $1,250 $1,750 $0 $2,150
Family: $2,500 $3,500 $0 $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 $3,260/individual and $6,520/family (2022) 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.

2023 OPEN ENROLLMENT BEGINS OCTOBER 4TH. CLICK HERE TO LEARN MORE!