Medical

To support your health and financial wellness, LPL Financial provides valuable benefits that help you and your family stay healthy and pay for care in the event of illness or injury.

Medical Plans

LPL Financial offers you a choice of medical plans with a range of coverage levels and costs, so you have the flexibility to select the option that’s best for you. These plans are administered by Aetna or Kaiser Permanente, depending on your location.

¹Your responsibility after deductible, except for preventive prescription drugs on the Health Fund (HSA) or Traditional (PPO) plans.
²Combined max of 40 visits/calendar year includes in-network chiropractic and acupuncture services.
³Combined max of 20 visits/calendar year includes in-network plus out-of-network chiropractic services.
⁴Depending on the type of services, a copayment, coinsurance or deductible may apply.
⁵Specialty drugs under RxBenefits/Express Scripts must be obtained through Accredo for all Aetna plans.
⁶Up to a 100-day supply.

A High Deductible Health Plan (HDHP) requires a larger deductible than our other health plans. In exchange, LPL Financial will contribute funds monthly to a tax-free Health Savings Account (HSA) that helps you save for future medical expenses. HSA plans encourage members to consider their health care decisions and costs.

How the Aetna Health Fund (HSA) Plan works

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

HSA

You can set aside tax-free money from your paycheck (and receive company contributions) to help cover your costs — now, or in the future.

Deductible

You pay 100% of your medical and prescription costs until you meet the annual deductible.

Coinsurance

After meeting the deductible, you and the plan share the cost of covered medical care and prescriptions, with the plan paying the majority.

Out-of-pocket maximum

You’re protected by an annual limit on costs — the plan pays 100% of any further covered expenses for the rest of the year.

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

With a Preferred Provider Organization (PPO) plan you have greater flexibility and choice to use any medical providers. When you receive services from Aetna’s “in-network” doctors, specialists or facilities, your out-of-pocket expenses will be lower than if you visit an “out-of-network” provider.

How the Aetna Traditional (PPO) Plan works

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

Copay

You pay a small fee at the time of service for doctor visits and prescriptions.

Deductible

For care that doesn’t charge a copay, such as hospital services, you pay 100% of the costsuntil you meet the annual deductible.

Coinsurance

After meeting the deductible, you and the plan share the cost of certain services, with the plan paying the majority.

Out-of-Pocket Maximum

You’re protected by an annual limit on costs — the plan pays 100% of any further covered expenses for the rest of the year.

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

An EPO (Exclusive Provider Organization) requires you and enrolled dependents to select a Primary Care Physician (PCP) who will direct the majority of your health care needs. With the Aetna Select (EPO), all services must be provided by in-network providers. You and enrolled dependents select a Primary Care Physician (PCP) who will direct the majority of your health care needs.

How the Aetna Select (EPO) Plan works

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

Copay

You pay a small fee at the time of service for doctor visits and prescriptions.

Deductible

For care that doesn’t charge a copay, such as hospital services, you pay 100% of the costs until you meet the annual deductible.

Out-of-Pocket Maximum

You’re protected by an annual limit on costs — the plan pays 100% of any further covered expenses for the rest of the year.

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

This accountable care organization (ACO) plan option is offered in partnership with Atrium Health to deliver high-quality care at a lower cost for those in the Charlotte metro area of NC/SC*. It features: low payroll deductions, low copays, no deductibles, and no PCP referral from Aetna required to see an Atrium Health specialist. If you have dependents who live outside the Charlotte metro area, or if you need urgent care when you are traveling, the Aetna PPO network is considered in-network.

If you're already using Atrium Health hospitals and providers, then the Aetna Atrium (ACO) plan option may be a great choice for you.

*Eligible NC and SC employees can select this option if they live in: Anson, Cabarrus, Cleveland, Gaston, Lancaster, Lincoln, Mecklenburg, Stanly, Union or York county.

How the Aetna Atrium (ACO) Plan works

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

Copay

You pay a small fee at the time of service for in-network medical care and prescriptions.

Deductible

This plan has no annual deductible for in-network care. The plan pays 100% of the costs after you pay your copay.

Out-of-Pocket Maximum

You're protected by an annual limit on costs — the plan pays 100% of any further covered expenses for the rest of the year.

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

The HMO Plan provides coverage only when you receive care from providers within the Kaiser Permanente network. Your Primary Care Provider (PCP) will coordinate your care to help manage costs.

How the Kaiser Permanente HMO Plan works

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

Copay

You pay a small fee at the time of service for in-network medical care and prescriptions.

Deductible

This plan has no annual deductible for in-network care. The plan pays 100% of the costs after you pay your copay.

Out-of-Pocket Maximum

You’re protected by an annual limit on costs — the plan pays 100% of any further covered expenses for the rest of the year.

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

If you are enrolled in the Kaiser Permanente HMO, your pharmacy benefits will be accessed through Kaiser Permanente. If you are enrolled in the Aetna Select (EPO) Plan, the Aetna Traditional (PPO) Plan or the Aetna Health Fund (HSA) Plan, your pharmacy benefits will be accessed through Rx Benefits/Express Scripts.

Many FDA-approved prescription medications are covered through the benefits program. Regardless of the plan you have, you will save money by filling prescription requests at participating pharmacies.

Drug tiers

Each plan has a drug formulary, or list of prescription drugs including both generic and brand-name medications that are preferred. Each plan has four drug tiers. The cost of your prescription drugs under each medical plan depends on the tier of the medication:

Tier 1 covers generic formulary medications.

Generic drugs are required by the FDA to contain the same active ingredients as their brand-name counterparts.

Tier 2 covers brand-name formulary.

Brand-name medications are protected by a patent and can only be produced by one specified manufacturer.

Tier 3 covers non-formulary medications which are not included on the plan’s drug formulary.

These drugs will often have a Tier 1 or Tier 2 equivalent drug available at a lower cost.

Tier 4 covers specialty medications.

Specialty medications most often treat chronic or complex conditions and may require special storage or close monitoring.

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 Rx Benefits/Express Scripts or Kaiser Permanente mail order program.

Retail 90-day Fill

If you are enrolled in Aetna medical coverage, you have another cost-saving option available to you for filling maintenance medications via the CVS Exclusive Smart90 prescription program through RxBenefits/Express Scripts.

You have access to medical advice from board-certified physicians 24/7, 365 days a year through your plan’s telemedicine service. Teladoc from Aetna and Virtual Care with Kaiser offer you fast, convenient diagnosis and treatment for many common conditions through video consult on your smartphone or computer. Visit the Teladoc from Aetna or Virtual Care with Kaiser website to enroll or learn more.

The cost of a Telemedicine visit is based on the medical plan you select.

New! Diabetes Reversal Program

The Virta Health program helps reverse type 2 diabetes with treatment through a virtual clinic. Virta Health offers a personalized care plan with a health coach and medical provider to help participants lose weight, lower blood sugar, and reduce or eliminate medications. From a 10-week clinical study, 87% of participants stopped or reduced insulin.

Participants will receive a nutrition plan with recipes and food lists, daily health coaching, health tracking tools (e.g, scale, meter, test trips), access to Virta's care app, and more!

This program is available to LPL employees and eligible dependents enrolled in an Aetna medical plan who are type 2 diabetes patients at no extra cost. To learn more about eligibility and enrollment, visit the Virta Health website.

For additional support, email Virta Health and view the FAQs.

Health benefits can be confusing, medical costs are rising, and finding the right care for you and your family can be frustrating and time consuming. We are here to simplify your healthcare experience and help you take control of healthcare costs. Your personal Health Pro consultant will take care of you, so you can spend more time on what matters most. This service is available at no cost to all employees and dependents enrolled in any LPL medical plan option. Visit the Alight Health Pro website or call 800.513.1667 ext 4402 to learn more.

Watch the video below to learn more about Alight and how a Health Pro can provide you access to simpler, smarter healthcare.

TeleHealth – You have access to medical advice from board-certified physicians 24/7, 365 days a year through your plan’s telemedicine service. Teladoc from Aetna and Virtual Care with Kaiser offer you fast, convenient diagnosis and treatment for many common conditions through video consult on your smartphone or computer. Visit the Teladoc from Aetna or Virtual Care with Kaiser website to enroll or learn more.

Medical plan website – Find a doctor, compare costs, manage claims, and more. Visit:

• Aetna
• Kaiser Permanente

Prescription website – Order or refill prescriptions, sign up for mail order, and more. Visit:

• Rx Benefits/Express Scripts
• Kaiser Permanente

HSA/FSA tools – Manage your Health Savings Account or Flexible Spending Account online.

• PayFlex
• TRI-AD

Using in-network providers will save you money due to the negotiated discount they accept for their services. Here’s how to find doctors in your medical plan network.

Aetna

• Go to https://www.aetnadocfind.com/lpl/ and enter your zip code within the appropriate plan tile to search by plan.
• Call Aetna at 877-204-9186 to get help finding a doctor or facility.

Kaiser Permanente

• Go to kp.org/searchdoctors to browse our doctor profiles and select a doctor who matches your needs.
• Call Kaiser Permanente at 1.510.675.2663, M-F 8:30 a.m. to 5:00 p.m. to get help finding a doctor.

5 tips to save money

Get the most value from your medical plan and help reduce your health care spending by following these consumer-smart tips:

1. Use in-network providers. They’ve agreed to charge only up to negotiated rates and bill your insurance company directly, which saves you money and time. Also, check with your insurance company to ensure that a service is covered before you receive care. Note: If you’re enrolling in an HMO or EPO plan (if available in your area), the plan only pays benefits for care received in network.
   
   
2. Keep up with preventive care. It’s covered in full by all of our medical plans and can help detect and prevent potentially costly health issues early. You pay nothing for annual physicals, recommended immunizations, routine cancer screenings, and more when you see in-network providers.
   
   
3. Use tax-free money to pay for eligible health expenses. Contributing to a Health Savings Account (HSA) and/or a Flexible Spending Account (FSA) is easy and saves you money. You can set aside before-tax dollars from your paycheck to use for your out-of-pocket costs. Keep in mind that with an HSA, you can only spend contributions that have actually been deposited into your account. And with a Healthcare or Limited Purpose FSA, you can only carry over up to $550 of unused money to the next year; you will forfeit amounts above $550. Unused Dependent Care FSA funds do not carry over to the next plan year; you must “use it or lose it.”
   
   
4. Shop smart for prescriptions. Using generic alternatives will almost always save you money — and they’re just as effective as brand name prescriptions. Also, login to your member portal (Kaiser Permanente or Rx Benefits/Express Scripts) and use the prescription pricing tools, use GoodRx or other pharmacy comparison app, or try calling a few local pharmacies to compare prices before deciding where to fill a prescription. For your ongoing prescriptions, use the mail-order or retail fill service to save money and time.
   
   
5. Take advantage of the LPL Financial wellness program. It offers valuable resources to help you improve your health, which could prevent the need for costly care. Plus, you can earn rewards when you participate in wellness activities and challenges!
   
   
6. Use your plan’s website. Register and log in to the Aetna or Kaiser Permanente website to see how much of your deductible you’ve met, review claims, find in-network providers, use helpful cost-estimating tools, and more.
   
   
7. Download the mobile app. Convenient on the go access to plan information, ID cards, member services, cost saving tools and more.
   
   
8. Choose the right place to get care. Facilities charge different amounts for the same services, so think about your options when you or a family member needs medical attention. Use the guide below to help you save money and choose the most appropriate care for your situation:

*Average costs are from healthcarebluebook.com. Contact your health insurance carrier for your specific costs.