Consumer Directed Health Plans (CDHPs)

Toys”R”Us offers you and your family a choice of CDHP options that provide comprehensive medical coverage and an available Health Savings Account (HSA)—an account that lets you save money, tax-free, to pay for out-of-pocket health care expenses now or in the future.  

Compare Your CDHP Medical Options

Most team members have CDHP medical options through Aetna. Team members in California also have access to a CDHP medical option through Kaiser.  All of the CDHP medical options provide comprehensive medical coverage, including coverage for preventive health, prescription drugs and protection against catastrophic claims. Review this table for a high-level, side-by-side comparison of the plans.

You can also review and print a more detailed comparison chart here: 

And make sure to check out the tools and videos to help you choose your benefits and become a better health care consumer. 

Important Considerations

  • In-network preventive care is covered at 100% for services such as routine physicals. 
  • You can choose in- and out-of-network coverage for all of the Aetna CDHP options. You must use in-network providers if you enroll in the Kaiser CDHP option.
  • When covering family members, CDHPs require you to meet the family deductible before you share expenses with the plan, even if only one person needs medical care.
  • Prescriptions are subject to the deductible (except for preventive medications). That means you pay the cost of your prescriptions up to your deductible. However, prescription copayments are held to certain maximum dollar limits to keep your out-of-pocket costs in check. After that, you pay coinsurance or copays for your medications.
Plan Option/Network Coverage“R”CDHP Gold“R”CDHP Silver“R”CDHP BronzeKaiser CDHP-CA
                                In- and Out-of-network coverage       In- and Out-of-network coverage     In- and Out-of-network coverage         Coverage for Kaiser providers only  
                       
2017-2018 Company HSA Contribution     TRU contribution + Wellness actions     TRU contribution + Wellness actions TRU contribution + Wellness actions            TRU contribution + Wellness actions    
Preventive Care       No cost In-network     No cost In-network       No cost In-network       No cost In-network  
Deductible In-/Out-of Network

Team member only coverage

2-person or family coverage                           
$1,500 / $3,000

$3,000 / $6,000    
$2,500 / $5,000

$5,000 / $10,000  
$4,000

$8,000  
$1,250

$2,500    
Coinsurance/Cost-Sharing (after you meet the deductible)                        You pay 20% In-network & 40% Out-of-network     You pay 30% In-network & 50% Out-of-network   You pay 30% In-network   You pay 20% In-network    
Prescription Drugs Retail*

Generic/Formulary Brand Name/Non-Formulary Brand Name          
You pay $10 / 30% / 40%   You pay $10 / 30% / 50%     You pay $10/50% /non-formulary brand not covered     You pay $10 generic / 30% brand    
Out-of-Pocket Maximum

Team member only coverage

2-person or family coverage

(includes deductible)       
$3,425 / $6,850

$10,000 / $20,000    
$6,350 / $12,700

$12,700 / $25,400    
$6,350

$12,700    
$4,000

$8,000    

 *Additional savings and convenience if you utilize mail order.

Tips for Choosing Your Medical Option

Here are other questions to ask yourself to help you select the right option for you:

  • Do you want smaller paycheck deductions? The Bronze option has smaller paycheck deductions, but higher deductibles. Your out-of-pocket costs could be high, depending on your health situation and how often you access care.
  • Would you rather have lower out-of-pocket costs? The Gold and Silver options have higher paycheck deductions, but lower deductibles so you’ll pay less out-of-pocket for medical care.
  • Do you want In- and Out-of-network coverage? Consider the Aetna CDHP options. The Kaiser options do not cover out-of-network providers except in emergencies.
  • Do you have maintenance prescriptions? Preventive care drugs are not subject to the deductible, but all other prescriptions are, including some maintenance prescriptions. Find out if your drugs are considered preventive .

Other things to think about:

  • A contribution from Toys“R”Us and your wellness actions can grow your HSA during the plan year! Learn more here. Watch for more information about the 2017-2018 wellness rebate coming later this year.
  • If you live in Hawaii or Puerto Rico, see the plans specific to your location.

Understand Your Prescription Drug Coverage

If you participate in one of the Aetna CDHP options your prescription drug coverage is provided by CVS Caremark. All specialty prescription drugs must be obtained through Caremark. If you are currently filling prescriptions for specialty drugs through your medical plan, you’ll be notified about how to transition to Caremark.

Caremark’s “Site of Care” program helps manage infusion therapies, and will be made available. Eligible participants for this program will be contacted by Caremark.

If you are covered by the Kaiser CDHP option, your prescription drug coverage is provided through Kaiser.

How CDHPs Work with the Health Savings Account

The Health Savings Account (HSA) is separate from the CDHP medical options sponsored by the Company. Like any savings or checking account, you own it. When you need care, you can use the money in your HSA to pay for medical expenses. Or, you can save it for the future.

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