The JPMorgan Chase U.S. Medical Plan
This section is the summary plan description (SPD) and the plan document for the Medical Plan. Please retain this section for your records. Other sections and subsections of Your JPMC Benefits Guide may also constitute the complete SPD/plan document, including the Healthcare Participation and Plan Administration sections.
The JPMC U.S. Medical Plan (the Medical Plan or the Plan) provides comprehensive coverage for a broad range of healthcare services and prescription drugs. For many in-network routine services, including primary care and specialist office visits, basic lab services, urgent care, and emergency room visits there is no in-network deductible or coinsurance. Instead, there are fixed dollar copayments ("copays") for these covered services. Less routine services, such as inpatient hospital, outpatient surgery, radiology, etc., are subject to an annual deductible and coinsurance. And, if your deductible, coinsurance and copays add up to the out-of-pocket maximum in a plan year, the Plan pays 100% of your eligible in-network costs for the remainder of that year.
In addition to providing coverage in the event of illness, the Medical Plan offers coverage for eligible preventive care and eligible preventive prescription drugs (generic and brand) at 100% ($0 cost share), an integrated Wellness Program to help you and your family stay healthy and a Medical Reimbursement Account (MRA) to help you pay for eligible out-of-pocket medical and prescription drug costs. You can earn funds for your MRA when you participate in certain wellness incentive activities.
This section of the Guide will provide you with a better understanding of how your Medical Plan coverage works, including how and when benefits are paid.
Be sure to see important additional information about the Plan, in the sections titled About This Guide, What Happens If… and Plan Administration.
If you are an eligible U.S. employee living in California, your JPMorganChase medical coverage may include the Kaiser HMO option, described in the Kaiser HMO section.
If you are an eligible U.S. employee living in the Dallas-Fort Worth, Texas area, your JPMorganChase medical coverage may include the Centivo Select Plan option, described in the Centivo Select Plan section.
The Medical Plan offers two options: Plan Option 1 and Plan Option 2. Both options cover the same medically necessary services and supplies, including prescription drugs. In addition to choosing between the two options, you also choose whether your coverage is provided through Aetna or Cigna, both of which have broad networks of doctors and hospitals. The key differences between the two options is the level of payroll contributions, deductibles, copays and out-of-pocket maximums.
- Plan Option 1 has higher payroll contributions but lower annual deductibles, annual out-of-pocket maximums and generally lower copays.
- Plan Option 2 has lower payroll contributions but higher annual deductibles, annual out-of-pocket maximums and generally higher copays.
Both Aetna and Cigna have networks of selected healthcare providers and you are strongly encouraged to use in-network providers as this saves both you and JPMorganChase money. However, you have the option to use out-of-network providers if you choose. The Prescription Drug Plan is part of the Medical Plan and is administered by CVS Caremark — regardless of which option or healthcare company you choose.
Effective August 1, 2024, expanded services are available through Included Health for employees and their covered dependents enrolled in the JPMorganChase U.S. Medical Plan who live in Florida, Georgia, Louisiana and Oklahoma.
Included Health's Care Coordinators will help you and your covered dependents understand your healthcare benefits and support your healthcare needs. Included Health's care coordinators can help you:
- Understand your Aetna or Cigna health insurance coverage and cost
- Find solutions to healthcare insurance problems such as coordinating authorization for services, understanding medical bills and resolving billing errors
- Manage your health through care and disease management services for new and ongoing chronic conditions
- Find quality, in-network Aetna and Cigna providers, get treatment decision support and second medical opinions
- Get virtual primary care and urgent care services (subject to cost share based on the JPMorganChase Medical Plan)
Included Health's expanded services work in coordination with your JPMorganChase Medical Plan so you can get the most out of your healthcare. You'll still have the same access to your Aetna or Cigna network of providers, covered services and spending accounts. Your Medical ID card (from Aetna or Cigna) will have Included Health's contact information as their services replace Aetna and Cigna's call centers. Your healthcare company (Aetna or Cigna) is still responsible for authorizing services.
JPMorganChase has selected Aetna and Cigna to administer our Medical Plan. Both are large, established companies that offer broad nationwide provider networks.
They also offer strong, well-established clinical programs and provide tools and resources to help you research and understand your health treatment alternatives. You can choose to have either of these healthcare companies administer your Medical Plan, regardless of whether you choose Plan Option 1 or Plan Option 2.
You can easily check which healthcare providers participate in the various Medical Plan options by accessing your healthcare company's website at My Health, available at hr.jpmorganchase.com/hr on the JPMorganChase intranet or at myhealth.jpmorganchase.com if not on the JPMorganChase intranet.
Please Note: You should always check with your healthcare provider to ensure they plan to continue participating in the network of the Medical Plan option you choose. If your healthcare provider decides to leave the network, it does not qualify as an event that allows you to change your healthcare company during the year.
When you enroll in Plan Option 1 or Plan Option 2 through Aetna or Cigna, you will automatically be set up with a Medical Reimbursement Account (MRA). The MRA is a company-funded account that you can use to help pay for covered out-of-pocket medical and prescription drug expenses. You can earn Wellness funds for your MRA when you participate in certain wellness incentive activities.
For questions or concerns regarding the Medical Plan, please contact your healthcare company (Aetna or Cigna) or the Prescription Drug Plan administrator, CVS Caremark. For employees living in Florida, Georgia, Louisiana and Oklahoma, please contact Included Health for questions or concerns regarding the Medical Plan.
Included Health (for employees living in Florida, Georgia, Louisiana and Oklahoma)
(833) 938-9874
24/7
(833) 938-9874
24/7
For additional specialty resources, consult the Contacts section.
The JPMorgan Chase U.S. Benefits Program is available to most employees on a U.S. payroll who are regularly scheduled to work 20 hours or more a week and who are employed by JPMorgan Chase & Co. or one of its subsidiaries to the extent that such subsidiary has adopted the JPMorgan Chase U.S. Benefits Program. This information does not include all of the details contained in the applicable insurance contracts, plan documents and trust agreements. If there is any discrepancy between this information and the governing documents, the governing documents will control. JPMorgan Chase & Co. expressly reserves the right to amend, modify, reduce, change or terminate its benefits plans at any time. The JPMorgan Chase U.S. Benefits Program does not create a contract or guarantee of employment between JPMorganChase and any individual. JPMorganChase or you may terminate the employment relationship at any time.