HealthPlanOptions

Medical Plan Options

Fortive offers two types of health plans each with two levels of cost and coverage options to support different individual needs. Below is a high-level overview and comparison.

PPO 500 & PPO 1000

• Both Preferred Provider Organization (PPO) plans have higher per-paycheck contribution than the Health Savings Account (HSA) plans, but with lower deductibles that can minimize unexpected out of-pocket costs.

• Both offer in and out-of-network benefits and the same network of providers as the HSA plans.

• Both provide the same comprehensive coverage as the HSA plans, including behavioral health care and pharmacy benefits. But make sure to compare carefully since some coverage levels differ.

HSA 1500 & HSA 3000

• The HSA plans are Consumer-Directed Health Plans (or High-Deductible Health Plans).

• They come with a Health Savings Account, a personal savings account that helps you pay for your health care expenses—through retirement.

• They offer lower per-paycheck deductions than the PPO Plans, but potentially higher out-of-pocket costs for services.

• Both offer in and out-of-network benefits and provide the same comprehensive coverage as the PPO plans. But make sure to compare carefully since some coverage levels differ.

Medical plan comparison

Medical Plan	PPO 500	PPO 1000	HSA 1500	HSA 3000
Deductible (Individual/Family)	$500/1,000*	$1,000/$2,000*	$1,500/$3,000**	$3,000/$6,000**
Employer HSA Contribution (Individual/Family)	N/A	N/A	$500/$1,000	N/A
Out-of-Pocket Maximum (Individual/Family)	$3,000/$6,000	$5,000/$10,000	$3,000/$6,000	$5,000/$10,000
Preventive Care	In-Network providers covered at 100%	In-Network providers covered at 100%	In-Network providers covered at 100%	In-Network providers covered at 100%
Coinsurance (The amount you play for covered services after the deductible is met)	15%	20%	20%	30%
Office Visit (Primary Care/ Specialist)	$20/$40 deductible waived	$30/$60 deductible waived	20%	30%
Telemedicine	$0 deductible waived	$0 deductible waived	0%	0%
Urgent Care	$50 deductible waived	$75 deductible waived	20%	30%
Emergency Room	$100	$150	20%	30%
Alternative Care (chiro/Acupuncture)	$25 deductible waived 30 visits per year	$30 deductible waived 30 visits per year	20% 30 visits per year	30% 30 visits per year

* With the PPO plans, once one family member meets the individual deductible, the plan starts to pay benefits for that individual.
** With the HSA plans, the entire family deductible needs to be met before the plan pays benefits.

Pharmacy

Pharmacy	PPO 500	PPO 1000	HSA 1500	HSA 3000
Retail Generic Rx	$10	$10	20% after deductible is met	30% after deductible is met
Retail Brand Preferred Rx	15% ($25 min, $50 max)	20% ($50 min, $100 max)	20% after deductible is met	30% after deductible is met
Retail Brand Non-Preferred RX	35% ($40 min, $100 max)	35% ($80 min, $200 max)	20% after deductible is met	30% after deductible is met
Specialty Rx	Same as other drugs	Same as other drugs	20% after deductible is met	30% after deductible is met

Health Savings Account

Fortive offers Health Savings Account, is a personal savings account that helps you pay for your health care expenses—through retirement. This account is offered when either the HSA 1500 or HSA 3000 plans is elected.

When you are enrolled in the HSA 1500 plan you are eligible to receive an annual employer contribution into your Health Savings Account up to $500 for employee only or $1000 for employee + dependent coverages.

Flexible Spending Accounts

Fortive offers its employees the option to enroll in flexible spending account to assist with health related or dependent care expenses.

Dependent Care Flexible Spending Account

Fortive offers a Dependent Care Flexible Spending Account to employees. A Dependent Care Flexible Spending Account, or “FSA” is a pre-tax benefit account used to pay for dependent care services while you are at work. The money you contribute to a Dependent Care FSA is not subject to payroll taxes, so you end up paying less in taxes and taking home more of your paycheck. Under this account a “dependent” is a child under 13 years of age and adult dependents who can’t take care of themselves. Remember, any money contributed will need to be used within the plan year.

Health Care Flexible Spending Account

A Health Care Flexible spending account is offered to employees to help cover out of pocket expenses such as physician co-pays, prescriptions, dental procedures, or vision care. If you enroll in one of the HSA eligible medical plans with Fortive you can still enroll in the Health Care Flexible Spending account, however you will only be eligible to use the money that is contributed in for dental and vision expenses. Remember, any money contributed will need to be used within the plan year. The money you contribute to a Health Care FSA is not subject to payroll taxes, so you end up paying less in taxes and taking home more of your paycheck.

Note: You will have a 2.5-month grace period to spend any remaining FSA funds, ending March 15 of the following year. Following that, you will have 90 days to submit receipts for expenses incurred.

*Funds contributed to the Health Savings Account (HSA) do rollover year over year.

Dental

Fortive dental is provided through Cigna Dental.

Dental plan comparison

Dental Plan	Premium	Basic
Deductible (Individual/Family)	$25/75	$50/150
Annual Maximum (excludes orthodontia)	$2,500 (4 cleanings per year)	$1,500 (2 cleanings per year)
Basic Services	90%	80%
Major Services	60%	50%
Orthodontia	50% (up to $2,500 max)	Not covered

Vision

Fortive vision is provided through VSP.

Vision plan comparison

Vision Plan	VSP Premium	VSP Basic
Exam	Covered at 100% (every 12 month)	$10 copay (every 12 months)
Frames	$15 copay; $200 allowance (lenses: every 12 months; frames: every 12 months)	$50 copay; $130 allowance (lenses: every 12 months; frames: every 24 months)
Contacts (instead of glasses)	$200 allowance (every 12 months)	$130 allowance (every 12 months)
Upgrade options available at point-of-service	Member can elect one of the following: Upgrade to $250 - frame or contact lenses Upgrade to covered in full - progressive lenses. photochromic lenses or antireflective lenses	N/A

Virtual Second Opinions with 2^nd.MD

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24/7 Telemedicine Support

Fortive also understands that there are never enough hours in the day—which is why, if you enroll in any of the medical plans, you’ll have access to a 24/7 medical service called Telemedicine. Telemedicine uses smartphone and computer video conferencing to connect you with doctors, whenever and wherever you are. This service also includes coverage for tele-behavioral health. Dial 911 if you have a medical emergency.

Disability Benefits

Short Term Disability

Short-term disability insurance is offered to all Fortive employees. Fortive pays 100% of an employee's salary for the first seven weeks of short-term disability and 75% thereafter. Short-term disability starts after a 7-day waiting period.

Long Term Disability

Fortive will provide all employees with a Company-Paid Long-Term Disability insurance. Employees are covered up to 50% of annual pay up to a maximum benefit of $4,166/month. Employees will be automatically enrolled in this plan. You will also have the option to purchase additional LTD coverage (60% to a monthly maximum of $25,000).

Plan provisions may vary by operating company. Please check with your local HR department for confirmation of benefits.

Health Plan Options