2026 Medical Insurance

This is the 2026 health insurance policy for team members in the United States.

The carrier for medical insurance may change year to year. Renewals are finalized in mid-Q4 of each year, with open enrollment to begin shortly after. Open enrollment usually falls in November.

Eligibility

All team members working 30 or more hours per week are eligible to enroll in a health plan immediately upon starting with thoughtbot. Your effective date is your start date.

2026 Medical Benefits

thoughtbot pays at least 90% of the medical insurance premiums for individuals and at least 75% for their families for all medical plans. Family plans cover spouses, domestic partners, and/or children. thoughtbot offers co-pay based plan and a HSA-powered plan to all full-time US team members, allowing you to pick the best plan for you and your family. Our plan years run on a calendar year cycle: January 1st to December 31st.

Blue Cross Blue Shield (BCBS) + Benemax

We are continuing to offer plans for you to select from: co-pay based plan and a HSA-powered plan. This year's plans integrate two components: a fully insured BCBS PPO plan and a secondary payer, Benemax, which allows thoughtbot to pay for a portion of the services that you use. The end result is a co-pay based plan and a HSA-powered plan similar to what we've had in previous years.

The co-pay based plan and a HSA-powered plan have the same network of BCBS doctors and cover all the same services, but the cost for those services vary. This section reviews some of the benefits of both plans.

With a PPO plan, you do not need to get a referral from a primary care doctor before seeing a specialist. But you should make sure all providers you see are in-network. In-network providers will get approval from BCBS before a procedure. It is your responsibility to get approval from BCBS before a procedure if you see an out-of-network provider.

Both in-network and out-of-network expenses count towards a single deductible. There are not separate deductibles for in-network and out-of-network services.

💳 Using your Insurance

The Benemax Summary has a quick overview on how Benemax works.

You should present both your BCBS and Benemax member cards at the doctor's office, pharmacy, hospital, etc. On your first visit in 2026 to any doctor, pharmacy, hospital, etc., you should also present this Benemax letter for providers to explain how Benemax coverage and payment work.

🥇 Co-pay Based PPO (Gold) Plan $1000/$2000 with Benemax Wrap

The following highlights apply to in-network coverage. Out-of-network services have co-insurance. - Preventative care continues to be fully covered. - This is a co-pay based plan. Copays of $30 apply to specialist office visits, sick visits, urgent care, etc. - The deductible is $1000 for individuals, and $2000 for plans with dependents. - Prescription drugs are fully covered on this plan. - You will receive a Benemax debit card at the start of the plan year. The Benemax debit card will cover a part of the expenses. - You are not eligible to enroll in the HSA if you select this plan.

🥈 High Deductible PPO plan + HSA (Silver) Plan $2000/$4000 with Benemax Wrap

The following highlights apply to in-network coverage. Out-of-network services have co-insurance. - Preventative care is fully covered, before deductible. - All other services are fully covered after deductible, including emergency room visits, hospitalization, surgery, and prescription drugs. - The deductible is $2000 for individuals, and $4000 for plans with dependents. - If you enroll in this plan, a [Health Savings Account (HSA)] will be opened for you. - thoughtbot is contributing $750 on individual plans and $1000 on plans with dependents towards participating team members’ HSA accounts on this plan. This effectively reduces the deductible to $1250 and $3000, respectively. - A Benemax debit card will be sent to you once your deductible is reached to pay for all further expenses. - You are not eligible to enroll in the FSA if you select this plan.

Monthly Premiums for Employees

Medical Plans	🥇 Co-pay Based PPO (Gold) Plan $1000/$2000 with Benemax Wrap	🥈 High Deductible PPO plan + HSA (Silver) Plan $2000/$4000 with Benemax Wrap
Employee only	$82.83	$50.00
Employee + spouse/domestic partner	$300.00	$165.00
Employee + child(ren)	$250.00	$135.00
Employee + family	$500.00	$225.00

Changing Your Benefits

You have 30 days to make changes after life events (marriage, childbirth, death, divorce, loss of spousal coverage, etc.). Otherwise changes must be made during the open enrollment period. You may add or drop dependents with a qualifying life event to plans that you are currently enrolled in due to a life event. You may only switch plans during open enrollment.

To change your enrollment following a life event, visit Employee Navigator. We may follow up with you to collect additional information necessary to make the requested change.

Termination

Unless otherwise stated, upon termination, your medical benefits will remain in effect until the last day of the month in which you are terminated.

Upon termination you may be entitled to continuation or conversion of the group medical insurance plan in accordance with the terms of the policy and/or applicable state and federal law. For more information, contact benefits@thoughtbot.com.