Medical

Our benefits program includes medical plan options with a range of coverage levels and costs, so you can choose the one that’s best for you. These plans are administered by Blue Cross Blue Shield of Massachusetts. You can enroll as a new hire, during Open Enrollment, or if you have a qualifying life event. Otherwise, your next opportunity to change your benefits will be the next Open Enrollment period.

Qualifying life events include but are not limited to:

• Marriage
• Divorce or legal separation
• Birth or adoption of an eligible child
• Death of your spouse or covered child
• Loss or addition of other group coverage
• Change in your spouse’s work status (part time to full time or vice versa; taking or returning from an unpaid leave of absence)
• Change in your work status that affects your benefits
• Change in residence that affects your eligibility for coverage
• You or your covered dependent becomes eligible for Medicare

What to do if you experience a life event

If you need to make changes to your 2025 benefit elections as a result of a life event, visit the Aptia365 website or call a benefits counselor at 1-866-385-8032. Changes must be made within 30 days of your qualifying life event. Changes are effective as of the date of the event.

2025 medical plans

Here’s an overview of your medical plan options, showing coverage highlights for in-network care. Find complete cost and coverage details on the Aptia365 website.

Plan Name	Deductible (single/ family)	Spending Account	Perceptive contributions to spending account (single/family)	Flexible Spending Account (FSA)	Per Pay Period Deductions
$2,000 Deductible Plan	$2,000 / $4,000	Comes with a Health Savings Account with Perceptive contributions	$500 / $1,000	You may contribute to the Combination FSA up to $3,200* for dental and vision expenses.**	$$
$900 Deductible Plan	$900 / $1,800	Comes with a Health Reimbursement Account with Perceptive contributions	$400 / $800	You may contribute to a Health Care FSA up to $3,200* for eligible medical, prescription drug, dental, and vision expenses.	$$$

*The IRS may increase the contribution limit for the Health Care FSA and Combination FSA in 2025.
**Medical expenses can be covered by the Combination FSA after the deductible is met.

In-network costs

Here’s an overview of your medical plan options, showing coverage highlights for in-network care:

Medical plan options with Blue Cross Blue Shield of Massachusetts
Medical Coverage	$900 Deductible Plan	$2,000 Deductible Plan
Annual deductible (single/family)	$900 / $1,800	$2,000 / $4,000
Accompanying savings and spending account	Health Reimbursement Account	Health Savings Account
Annual Perceptive contribution to the savings and spending account (single/family)	$400 / $800	$500 / $1,000
FSA Eligibility*	Health Care FSA	Combination FSA
Plan coinsurance (for medical services other than office visits)	20%	20%
Doctor's office visits	20% after deductible	20% after deductible
Emergency room	20% after deductible	20% after deductible
Annual out-of-pocket maximum (single/family)	$3,000 / $6,000	$3,500 / $7,000

Prescription drug options
Prescription Drug Coverage	$900 Deductible Plan	$2,000 Deductible Plan	$900 Deductible Plan	$2,000 Deductible Plan
	Retail prescription drugs (30-day supply)		Mail-order prescription drugs (90-day supply)
Tier 1 & 2 (most generics)	30% (min $10 / max $20)	20% after deductible	30% (min $25/ max $50)	20% after deductible
Tier 3 (formulary)	30% (min $25/ max $50)	20% after deductible	30% (min $63/ max $125)	20% after deductible
Tier 4 & 5 (non-formulary)	45% (min $40 / max $80)	20% after deductible	45% (min $100 / max $200)	20% after deductible

*Members of the $900 Deductible Plan can also choose to open a Health Care FSA account to make pre-tax contributions to cover eligible medical, vision, and dental expenses, and $2,000 Deductible Plan members may also choose to enroll in the Combination FSA to cover certain dental and vision expenses, in addition to medical expenses once the deductible is reached. These FSA accounts may be opened in addition to the relevant HRA/HSA option. All employees are eligible to open a Dependent Care FSA. FSAs are employee-funded, and Perceptive does not make contributions to FSAs.

Out-of-network costs

Here’s an overview of your medical plan options, showing coverage highlights for out-of-network care.

Medical plan options with Blue Cross Blue Shield of Massachusetts
Medical Coverage	$900 Deductible Plan	$2,000 Deductible Plan
Annual deductible (single/family)	$3,000 / $6,000	$4,000 / $8,000
Plan coinsurance (for medical services other than office visits)	40%	40%
Doctor's office visits	40% after deductible	40% after deductible
Emergency room	20% after deductible	20% after deductible
Annual out-of-pocket maximum (single/family)	$6,000 / $12,000	$7,000 / $14,000

Prescription drug options
Prescription Drug Coverage	$900 Deductible Plan	$2,000 Deductible Plan	$900 Deductible Plan	$2,000 Deductible Plan
	Retail prescription drugs (30-day supply)		Mail-order prescription drugs (90-day supply)
Tier 1 & 2 (most generics)	Not covered	20% after deductible	Not covered	Not covered
Tier 3 (formulary)	Not covered)	20% after deductible	Not covered	Not covered
Tier 4 & 5 (non-formulary)	Not covered	Not covered	Not covered	Not covered

In the $900 Deductible Plan, you pay slightly higher out-of-pocket costs in exchange for lower premium contributions. Once you meet the deductible, you pay a percentage of the cost of care (coinsurance) — up to the out-of-pocket maximum. Coinsurance for prescriptions are subject to maximum amounts — you won’t pay more than the maximum. With this plan, you can see any provider you wish, but you will pay less when you stay in network.

How the $900 Deductible Plan works:

You pay the plan premium from your paycheck to have coverage.

Keep in mind: You pay nothing for in-network preventive care — it’s covered in full.

Use your $900 Deductible Plan wisely

Here are ways to make the most of your plan all year long.

• Track your stats. Log in to the Blue Cross Blue Shield of Massachusetts website to see how much of your deductible you’ve met, review claims, and more.
• Pair it with a Health Care Flexible Spending Account (FSA). If you enroll in the Health Care FSA, you can set aside before-tax dollars to help pay for your out-of-pocket costs. You will have a grace period that extends into the following year, allowing you extra time to use up your FSA funds. Eligible expenses incurred through March 15, 2026, may be submitted by March 31, 2026. After that, any unused money will be forfeited.
• Be cost-conscious. Visit the Blue Cross Blue Shield of Massachusetts website to search for in-network providers and use the tools to compare costs for medical services.

The $2,000 Deductible Plan pair low premium contribution rate, high-deductible coverage with a tax-free Health Savings Account (HSA) that helps you save up for future medical expenses. As an added bonus, Perceptive will contribute to your HSA — $500 for employee-only coverage and $1,000 for all other coverage levels. Money in your HSA can be carried forward from year to year and is always yours to keep. You can see any provider you wish, but you will pay less when you stay in network.

How the $2,000 Deductible Plan Works

You pay the plan premium from your paycheck to have coverage.

Keep in mind: You pay nothing for in-network preventive care — it’s covered in full.

Use your $2,000 Deductible Plan wisely

Here are ways to make the most of your plan all year long.

• Track your stats. Log in to the Blue Cross Blue Shield of MA website to see how much of your deductible you’ve met, review claims, use helpful tools, and more. Likewise, keep tabs on your HSA by logging in to the WEX website to view your balance, submit claims, and more.
• Think about your costs. You pay lower contribution rates in exchange for assuming more financial responsibility when you receive care, so it’s smart to plan ahead. Visit the Blue Cross Blue Shield of MA website to search for in-network providers and use the tools to compare costs for medical services. Try to contribute enough to your HSA to cover your expected out-of-pocket costs, such as your annual deductible and coinsurance.
• Change your HSA contributions anytime. Adjust your contributions as necessary during the year to keep your savings on track with your anticipated expenses. Note: You can only spend HSA contributions that have actually been deposited into your account.
• Look long term. You will never forfeit any money left in your HSA — it rolls over year after year. If you know about future expenses — or if you want to save for your health care costs in retirement — set aside a little extra each paycheck so your balance can grow over time.

When you enroll in a Perceptive medical plan, you automatically receive prescription drug benefits through Blue Cross Blue Shield of Massachusetts and CVS Caremark.

Drug tiers

The cost of your prescription drugs under each medical plan depends on the tier of the medication — Tier 1 & Tier 2 (most generics), Tier 3 (formulary), or Tier 4 and Tier 5 (non-formulary).

• Tier 1 & 2 (most generics) The prescription drug tier which consists of the lowest cost tier of prescription drugs (most are generic) and some medium-cost prescription drugs (some brand name).
• Tier 3 (formulary) consists of high-cost prescription drugs, most are brand-name prescription drugs.
• Tier 4 & 5 (non-formulary) consists of the higher-cost prescription drugs (mostly brand-name prescription drugs and some specialty drugs) and the highest-cost prescription drugs (most are specialty drugs).

Mail Order

If you regularly take medication to treat a chronic condition — such as an allergy, heart disease, high blood pressure, or diabetes — you can take advantage of the convenience and cost savings of using the mail order program to receive a three-month supply.

Why use mail order?

• No more waiting in line at the pharmacy – prescriptions are shipped to you for free!
• You save money with a reduced cost for a three-month supply.
• You can set up automatic refills.

Seeing in-network providers saves you money. Here’s how to find doctors in your medical plan network.

• Go to the Blue Cross Blue Shield of MA.
• Use the Find a Doctor / Drug / Facility link in the menu bar.
• Follow the prompts to look for providers, drugs, and facilities in the network.

Look up providers on the Aptia365 website

You can also use the Provider Lookup tool on the Aptia365 website to easily find in-network doctors.

• Click “Provider Lookup” above the medical plan options
• This link will open up a secondary window containing the Provider Search tool. You can search by zip code, provider’s name, type of procedures, facility, etc.

Teladoc is a convenient, low-cost telehealth service where you can see a therapist or board-certified doctor through a phone or video call or using the app. All of the medical plans include this valuable coverage. The full cost per visit is:

• Medical: $55
• Dermatology: $85
• Counseling: $85
• Psychologist: $180

You pay the full cost per visit until you meet your annual deductible. Once you meet the deductible, the amount you pay depends on the plan you enroll in:

• For the $900 Deductible Plan, you pay 20% of the cost.
• For the $2,000 Deductible Plan, you pay 20% of the cost.

If you enroll in a Perceptive medical plan for 2025, you may also choose to enroll in the Aptia365 HUB — a voluntary benefit that provides one-on-one health care advocacy support — online and by phone — to help you improve the quality and cost of your care.

Aptia365 HUB supports you as you take on a more active role as an involved, informed health care consumer. Perceptive will offer a subsidy toward the cost of this benefit. This benefit provides you with year-round access to personal health advocacy services, price comparison tools, physician performance ratings, expert medical opinions, and more.

Click the features below to learn more about 365+ HUB services.