Medical

Highlight Reel

Everyone gets sick from time to time. And it’s not just Olympians who strain their hamstrings. Medical insurance protects you from paying full freight for your health care needs. FanDuel offers a variety of medical plans, paying the monthly cost for two of them and heavily subsiding the others, to keep you game-ready.

Inclusive Care Through Anthem

Traditionally, LGBTQ folks have faced barriers to getting the health care they need. We’re addressing those obstacles head on. If you or a covered dependent identifies as LGBTQ, take a look at how Anthem can tailor the health care experience.

For additional details, see Anthem’s Inclusive Care program overview.

Understanding Insurance Lingo

Don’t be intimidated by insurance terms. Some of them may be unfamiliar to you, but we’re here to explain them.

Deductible

The amount of money you pay for covered health care expenses each year before your medical plan starts paying.

Copay

A flat amount that you pay for a health care service. Copays don’t count toward your deductible, but they do count toward your out-of-pocket maximum.

Coinsurance

The percentage amount that you pay for the cost of your health care services after hitting your deductible for the year. You’ll pay coinsurance until you reach your out-of-pocket maximum.

Annual out-of-pocket maximum

The maximum amount of money you’ll pay each year for covered health care expenses. After you hit the out-of-pocket maximum, your medical plan will pay 100% of the cost of covered health care expenses.

Premium

The monthly cost of your medical plan. FanDuel covers the full premium for two plans. For the other three plans, you’ll make contributions via paycheck deduction to cover part of the premium (but FanDuel still covers 95% of it!).

In-network

A provider that has agreed to charge you and your insurance company discounted rates for care. Because it’s more cost-effective, medical plans cover in-network care at higher levels. For some plans, only in-network care is covered when it’s not an emergency.

Out-of-network

A provider that hasn’t negotiated with your insurance company to charge lower rates. You pay more when you receive out-of-network care. For some plans, you may be responsible for 100% of the cost.

Preventive care

Routine checkups, exams, vaccinations, and screenings. These services are 100% covered at no cost to you, even before you meet your deductible.

Primary care physician (PCP)

Your doctor. The one who knows you best. The one you go to for your annual physical.

Provider

A doctor or health care facility.

Still struggling with the vocab?

Remember that the experts at Health Advocate are available to answer your questions, help you pick the right medical plan, and more.

Medical Plan Overview

FanDuel offers four medical plans to all full-time employees, plus a fifth to California and Georgia residents. Each plan works a bit differently, but they all cover preventive care and prescription drugs.

Before we get into details, give us a moment to brag: for two of the plans, FanDuel pays 100% of the premiums. Single coverage? Check. Adding your spouse? Yep. The whole family? FanDuel still pays it. And we’re proud to.

Not a full-time employee?

FanDuel still takes care of you with a valuable medical plan. Part-time and daily on-call employees are only eligible to enroll in the Consumer Advantage with HSA plan, but you don’t pay a dime in premiums. And we’ll still add money to your HSA if you enroll and set up an account. Pretty sweet deal, right?

Medical Plan Scouting Reports

FanDuel’s medical plans are like athletes. Each plan excels in a different way, and the right fit depends on your health needs.

The good news? You can’t really go wrong. All five plans deliver valuable, affordable medical coverage for you and any family members you cover.

Consumer Advantage with HSA

The Consumer Advantage with HSA, administered by Anthem, is a high-deductible health plan, which sounds scarier than it is. Sure, the deductible is higher than other plans. But it’s also the only FanDuel plan that comes with a health savings account (HSA).

If you’re enrolled in this plan, FanDuel adds money to your HSA ($700 if you only cover yourself and $1,200 if you’re also covering a family member). Any contributions you make, up to the IRS limit, are tax-advantaged. Plus, FanDuel pays 100% of this plan’s premium for you and your eligible dependents. The high deductible doesn’t sound so scary anymore, huh?

Once you meet your deductible, the plan starts sharing costs with you. At that point, you’ll pay coinsurance—a percentage of the cost of your care—until you meet the annual out-of-pocket maximum.

Highlights

  • Administered by Anthem, and it’s the only FanDuel plan with an HSA
  • Free money from FanDuel for your HSA—$700 for single coverage or $1,200 if you also cover a dependent (prorated if you enroll midyear)
  • Premiums for you and your dependents 100% covered by FanDuel
  • Cost sharing with the plan through coinsurance, a percentage of the total cost, when you receive care
  • The only plan available to part-time and daily on-call employees

$500 PPO

The $500 PPO is a preferred provider organization (PPO) plan administered by Anthem. You can receive care from any doctor or facility you’d like, but that’s where the “preferred provider” part comes in. You’ll pay more if you go to a provider outside of Anthem’s network, since those providers haven’t agreed to the lower, PPO-contracted rates.

The “$500” part refers to the plan’s deductible. You’ll need to reach $500 in out-of-pocket expenses before the plan starts sharing costs with you. However, you don’t need to meet your deductible for services that have a copay, like primary care, specialist, and urgent care visits.

Highlights

  • A preferred provider organization (PPO) plan administered by Anthem
  • $500 deductible
  • Know how much you’ll pay before you receive care, with flat copays for office or urgent care visits
  • FanDuel subsidizes 95% of this plan’s premium

$1,500 PPO

The $1,500 PPO is a preferred provider organization (PPO) plan administered by Anthem. You can receive care from any doctor or facility you’d like, but that’s where the “preferred provider” part comes in. The $1,500 PPO covers providers in the Anthem network—preferred ones—at higher rates.

The “$1,500” part refers to the plan’s deductible. You’ll need to reach $1,500 in out-of-pocket expenses before the plan starts sharing costs with you. However, you don’t need to meet your deductible for services that have a copay, like primary care, specialist, and urgent care visits.

FanDuel pays for 100% of this plan’s premium for you and your eligible dependents.

Highlights

  • A preferred provider organization (PPO) plan administered by Anthem
  • $1,500 deductible
  • Know how much you’ll pay before you receive care, with flat copays for office or urgent care visits
  • Premiums for you and your dependents 100% covered by FanDuel

EPO

The EPO plan is an exclusive provider organization (EPO) plan administered by Anthem. As the name suggests, your care is only covered when you visit exclusive providers in the Anthem network (except for emergencies). However, EPO uses the same expansive network of providers as the $500 PPO and $1,5000 PPO plans.

You don’t have a deductible under the EPO plan, which means your insurance starts sharing costs with you immediately. When you receive care, you’ll pay a flat copay.

Highlights

  • An exclusive provider organization (EPO) plan administered by Anthem
  • $0 deductible
  • Cost sharing with the plan, with a flat copay when you receive care
  • Only allows you to receive care from Anthem network doctors (except for emergencies)

Kaiser HMO

If a one-stop shop for medical care appeals to you, the Kaiser HMO is a good bet. With Kaiser, you and each of your covered dependents pick a primary care physician (PCP) in the Kaiser network. Your PCP is your first contact when you need care. Then, when you need to see a specialist, your PCP coordinates it and refers you.

Highlights

  • A health maintenance organization (HMO) plan administered by Kaiser
  • $0 deductible
  • Cost sharing with the plan through a flat copay when you receive care
  • Only allows you to receive care from Kaiser doctors (except for emergencies)
  • Requires you to designate a primary care physician and receive referrals for specialist care
  • Only available to California or Georgia residents

In-Network Care: It Just Makes Cents

Health care is cheaper for you when you stay in your plan’s network. And, if you’re enrolled in the EPO or the Kaiser HMO, only in-network care is covered (except for emergencies).

Find a Network Provider
Florida
All other states
Kaiser HMO members

Plan Comparison

Consumer Advantage with HSA

Deductible

Individual
Family (per person)
Family (total)
In-Network
$2,000
$4,000
$4,000
Out-of-Network
$4,000
$4,000
$8,000

Annual Out-of-Pocket Maximum

Individual
Family (per person)
Family (total)
In-Network
$4,000
$8,000
$8,000
Out-of-Network
$8,000
$8,000
$16,000

Cost Sharing1

Preventive care
PCP visit
Specialist visit
Urgent care visit
ER visit
Hospital admission
In-Network
$0
20% coinsurance
20% coinsurance
20% coinsurance
20% coinsurance
20% coinsurance
Out-of-Network
40% coinsurance
40% coinsurance
40% coinsurance
40% coinsurance
20% coinsurance
40% coinsurance
1 Copays do not count toward your deductible (but do count toward your annual out-of-pocket maximum). Coinsurance only takes effect once you’ve met your deductible.

$1,500 PPO

Deductible

Individual
Family (per person)
Family (total)
In-Network
$1,500
$1,500
$3,000
Out-of-Network
$3,000
$1,500
$6,000

Annual Out-of-Pocket Maximum

Individual
Family (per person)
Family (total)
In-Network
$5,000
$5,000
$10,000
Out-of-Network
$10,000
$5,000
$20,000

Cost Sharing1

Preventive care
PCP visit
Specialist visit
Urgent care visit
ER visit
Hospital admission
In-Network
$0
$25 copay
$45 copay
$25 copay
$150 copay2
20% coinsurance
Out-of-Network
40% coinsurance
40% coinsurance
40% coinsurance
40% coinsurance
$150 copay2
40% coinsurance

1 Copays do not count toward your deductible (but do count toward your annual out-of-pocket maximum). Coinsurance only takes effect once you’ve met your deductible.

2 The ER copay is waived if you’re admitted to the hospital.

$500 PPO

Deductible

Individual
Family (per person)
Family (total)
In-Network
$500
$500
$1,000
Out-of-Network
$1,000
$500
$2,000

Annual Out-of-Pocket Maximum

Individual
Family (per person)
Family (total)
In-Network
$3,000
$3,000
$6,000
Out-of-Network
$6,000
$3,000
$12,000

Cost Sharing1

Preventive care
PCP visit
Specialist visit
Urgent care visit
ER visit
Hospital admission
In-Network
$0 copay
$20 copay
$30 copay
$20 copay
$150 copay2
10% coinsurance
Out-of-Network
30% coinsurance
30% coinsurance
30% coinsurance
30% coinsurance
$150 copay2
30% coinsurance

1 Copays do not count toward your deductible (but do count toward your annual out-of-pocket maximum). Coinsurance only takes effect once you’ve met your deductible.

2 The ER copay is waived if you’re admitted to the hospital.

EPO

Deductible

Individual
Family (per person)
Family (total)
In-Network
$0
N/A
$0

Annual Out-of-Pocket Maximum

Individual
Family (per person)
Family (total)
In-Network
$2,000
$2,000
$4,000

Cost Sharing1

Preventive care
PCP visit
Specialist visit
Urgent care visit
ER visit
Hospital admission
In-Network
$0
$20 copay
$35 copay
$20 copay
$150 copay2
$250 copay

1 Copays do not count toward your deductible (but do count toward your annual out-of-pocket maximum). Coinsurance only takes effect once you’ve met your deductible.

2 The ER copay is waived if you’re admitted to the hospital.

Kaiser CA and GA HMO

Deductible

Individual
Family (per person)
Family (total)
In-Network
$0
N/A
$0

Annual Out-of-Pocket Maximum

Individual
Family (per person)
Family (total)
In-Network
$1,500
N/A
$3,000

Cost Sharing1

Preventive care
PCP visit
Specialist visit
Urgent care visit
ER visit
Hospital admission
In-Network
$0
$20 copay
$35 copay
$20 copay
$100 copay2
$250 copay

1 Copays do not count toward your deductible (but do count toward your annual out-of-pocket maximum). Coinsurance only takes effect once you’ve met your deductible.

2 The ER copay is waived if you’re admitted to the hospital.

Online care: A winning option

FanDuel employees have two valuable choices to see a doctor from the comfort of home. The best news of all? One of them is free if you’re enrolled in the $500 PPO, $1,500 PPO, or EPO plans.

Overtime!

To dig deeper on what’s available to you, be sure to visit the Film Room and Resources. The Film Room lists upcoming events and instant replays of webinars and videos. Resources links you to flyers, links to download apps, comparison charts, and much more.

Related Benefits

Contacts

Kaiser

800-464-4000
Website
App Store
Google Play

Health Advocate

866-799-2731
Website
Email
App Store
Google Play