The Simplified Medical Plan
This section is the summary plan description (SPD) and the plan document for the Simplified 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 Health Care Participation Plan Administration and sections.
If you are a benefits eligible employee living in Arizona or Ohio, the JPMorgan Chase Medical Plan coverage for you is available via the Simplified Medical Plan.
- If you are a U.S. benefits-eligible employee residing anywhere in the U.S. other than Arizona or Ohio, the JPMorgan Chase Medical Plan coverage for you is available via the Core Medical Plan. For details on the Core Medical Plan, see that section of Your JPMC Benefits Guide.
The Simplified Medical Plan has no in-network deductible or coinsurance. Instead, there are fixed copayments for covered services. This health care "menu" approach allows you to learn about and understand your out-of-pocket costs prior to receiving care. And, if your copayments ("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 Simplified Medical Plan offers coverage for eligible preventive care and eligible preventive generic prescription drugs for free ($0 cost share), along with an integrated Simplified 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 costs. You can earn funds for your MRA when you (and your covered spouse/domestic partner) participate in certain wellness activities.
This section of the Guide will provide you with a better understanding of how your Simplified 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 a U.S. benefits-eligible employee living anywhere but Arizona or Ohio, your JPMorgan Chase medical coverage is available via the Core Medical Plan, not the Simplified Medical Plan. For details, see the Core Medical Plan section. If you are an eligible U.S. employee living in California, your JPMorgan Chase medical coverage includes the Kaiser HMO option, described in the Kaiser HMO section.
The Simplified Medical Plan offers two options, Simplified Option 1 and Simplified Option 2. Both options offer the same coverage for 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, copays and out-of-pocket maximums.
- Option 1 has higher payroll contributions but a lower annual out-of-pocket maximum and generally lower copays.
- Option 2 has lower payroll contributions but a higher annual out-of-pocket maximum and generally higher copays.
Both Aetna and Cigna have networks of selected health care providers, and you are strongly encouraged to go to in-network providers, as this saves both you and JPMorgan Chase money. However, you have the option to use out-of-network providers if you choose. The Prescription Drug Plan is part of the Simplified Medical Plan and is administered by CVS Caremark — regardless of which option or health care company you choose.
If you are enrolled in the JPMC Simplified Medical Plan and move to a state other than Arizona or Ohio, you'll automatically be enrolled in the JPMC Core Medical Plan, effective when you submit your address change. Please note that your health care company (Aetna/Cigna), election (Option 1 or 2) and dependent coverage will remain the same and cannot be changed as a result of your move.
JPMorgan Chase has selected Aetna and Cigna to administer our Simplified 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 one of these health care companies administer your Medical Plan, regardless of whether you choose Option 1 or Option 2.
You can easily check which health care providers participate in the various JPMorgan Chase Medical Plan options by accessing your health care company's website at My Health.
Please Note: You should always check with your health care provider to ensure that he or she plans to continue participating in the network of the Medical Plan option you choose. If your health care provider decides to leave the network, it does not qualify as an event that allows you to change your health care company during the year.
When you enroll in Option 1 or 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 (out-of-network deductibles and copayments). You can earn Wellness Rewards for your MRA when you (and in some cases, your covered spouse/domestic partner) participate in certain wellness activities.
For questions or concerns regarding the Medical Plan, please contact your health care company (Aetna or Cigna) or the Prescription Drug Plan administrator, CVS Caremark:
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 JPMorgan Chase and any individual. JPMorgan Chase or you may terminate the employment relationship at any time.