The following information applies to all of your NortonLifeLock health care plans as indicated below and in the attached links to the required notices. If you have questions about any of these notices, please submit a ticket through People and Payroll Service Now
Under the Affordable Care Act, we are required to provide Summaries of Benefits & Coverage (SBC) that have simple and consistent information about health plan benefits and coverage. The SBCs will help employees better understand the coverage they have and allow them to easily compare different coverage options. It will summarize the key features of the plan or coverage, such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions.
2021 Medical Plans
- Anthem HSA (pdf)
- Anthem PPO (pdf)
- Anthem PPO 500 - AZ Only (pdf)
- Kaiser - Northern California (pdf)
- Kaiser - Southern California (pdf)
2022 Medical Plans
- Cigna HSA (pdf)
- Cigna OAP (pdf)
- Cigna OAP 500 – AZ Only (pdf)
- Cigna HSA - UT Only (pdf)
- Cigna PPO - UT Only (pdf)
- Kaiser – Northern California (pdf)
- Kaiser – Southern California (pdf)
This section provides an overview of the major benefits programs that are offered to all employees regularly scheduled to work 20 or more hours per week.
Every effort has been made to describe the following benefit plans accurately and in simple language. The complete text of each plan is contained in the actual summary plan document (SPD). If there is any conflict between the on-line benefits information and the provisions of the PDF document, the plan document and contract between the carrier and NortonLifeLock will always take precedence. The following on-line documents replace all descriptions of benefit plans included in prior printed material.
Although NortonLifeLock expects to continue these benefits, the company does reserve the right to change or terminate any benefit for any reason without notice at any time.
|2021 Plan Documents|
|NortonLifeLock Health and Welfare Group Plan (pdf)|
|Medical||Anthem||Anthem Health Savings Plan (HSA) (pdf)
Anthem PPO Plan (pdf)
Anthem PPO 500 - AZ Only (pdf)
|Kaiser||Northern California SPD (pdf)
Southern California SPD (pdf)
|Dental||Delta Dental 1.0 (pdf)
Delta Dental 2.0 (pdf)
|Vision||VSP 1.0 (pdf)
VSP 2.0 (pdf)
Life, Accidental Death and Dismemberment and Dependent Life (pdf)
|Savings||Flexible Spending Account (pdf)
Premium Only Plan (pdf)
Commuter Spending Account (pdf)
NortonLifeLock 401(k) Plan (pdf)
NortonLifeLock 401(k) Acquisition Plan (pdf)
|Other||Anthem Employee Assistance Program (EAP) (pdf)
Best Doctors (pdf)
ARAG UltimateAdvisor (pdf)
ARAG UltimateAdvisor Plus (pdf)
NortonLifeLock Severance Plan (pdf) and First Amendment (pdf)
Summary Annual Reports provide financial information on the benefits we have reported to the Federal Government which NortonLifeLock is required to do on an annual basis.
NortonLifeLock Corporation Section 401(k) Plan (pdf)
EIN 77-0181864, Plan No. 001, for period January 1, 2020 through December 31, 2020. The annual report has been filed with the Employee Benefits Security Administration, U.S. Department of Labor, as required under the Employee Retirement Income Security Act of 1974 (ERISA).
NortonLifeLock Corporation Group Welfare Benefit Plan (pdf)
EIN 77-0181864, Plan No. 501, for period January 1, 2020 through December 31, 2020. The annual report has been filed with the Employee Benefits Security Administration, U.S. Department of Labor, as required under the Employee Retirement Income Security Act of 1974 (ERISA).
COBRA—the Consolidated Omnibus Budget Reconciliation Act—requires group health plans to offer continuation coverage to covered employees, former employees, spouses, former spouses, and dependent children when group health coverage would otherwise be lost due to specific events called "qualifying events". In accordance with COBRA regulations, you and your eligible dependents have a right to continue your health care coverage if a qualifying event occurs and you or your dependents to lose coverage through NortonLifeLock Benefits.
The following are qualifying events for a covered employee if they cause the covered employee to lose coverage:
- Termination of the covered employee’s employment for any reason other than “gross misconduct”; or
- Reduction in the covered employee’s hours of employment.
The following are qualifying events for a spouse and dependent child of a covered employee if they cause the spouse or dependent child to lose coverage:
- Termination of the covered employee’s employment for any reason other than “gross misconduct”;
- Reduction in hours worked by the covered employee
- Covered employee becomes entitled to Medicare;
- Divorce or legal separation of the spouse from the covered employee; or
- Death of the covered employee.
In addition to the above, the following is a qualifying event for a dependent child of a covered employee if it causes the child to lose coverage:
- Loss of “dependent child” status under the plan rules. Under the Affordable Care Act, plans that offer coverage to children on their parents’ plan must make coverage available until the adult child reaches the age of 26.
In the event a COBRA "qualifying event" occurs with regard to you and/or your dependents' coverage, you will receive additional information, including enrollment details.
COBRA coverage is generally available for 18 months and an additional 18 months is available in certain circumstances. To receive COBRA coverage, you must pay certain premium payments. The required premium is equal to both the amount formerly paid by NortonLifeLock and your prior contribution amount, plus up to a 2 percent administration fee.
Note that while federal COBRA coverage provisions do not consider domestic partners or their children to be eligible dependents, NortonLifeLock extends the same continuation opportunities to these individuals.
For a more thorough explanation of COBRA rights under group health plans, please see the notice below.
COBRA Continuation (pdf)
The Patient Protection and Affordable Care Act (PPACA), commonly called Obamacare or the Affordable Care Act (ACA), is a United States federal statute that aims to increase the quality and affordability of health insurance, lower the uninsured rate by expanding public and private insurance coverage, and reduce the costs of health care for individuals and the government. It provides a number of mechanisms - including mandates, subsidies, and insurance exchanges to increase coverage and affordability.
Below, you will find a link to a detailed explanation of your coverage options through the Health Insurance Marketplace, where you can purchase health insurance not sponsored or made available by NortonLifeLock.
Health Care Reform notice (pdf)
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) gives individuals a fundamental right to be informed of the privacy practices of their health plans and of most of their health care providers. HIPAA includes provisions that protect the privacy of health plan participants and their Protected Health Information (PHI). These provisions govern how entities such as health insurance companies, plan administrators, medical professionals, and plan sponsors (e.g., NortonLifeLock) must handle PHI.
HIPPA requires that an individual has a right to adequate notice of how a covered entity may use and disclose protected health information about the individual, as well the individual’s rights and the covered entity’s obligations with respect to that information. NortonLifeLock Corporation is required by law to periodically provide you with information about the privacy regulations under HIPAA.
NortonLifeLock maintains a Notice of Privacy Practices applicable to its self-funded health plans. The Notice provides information to individuals whose PHI will be used or maintained by ERISA. Please see the link below for a copy of NortonLifeLock HIPAA Notice of Privacy Practices.
HIPAA Notice of Privacy Practices (pdf)
For employees living and working in San Francisco, NortonLifeLock is required to spend a minimum amount on health benefits that is paid to the San Francisco City Option for covered employees. We are providing a notice about the San Francisco Health Care Security Ordinance. You do not need to take any action other than reviewing the notice. If applicable, additional information will be provided to you.
SFHCSO Notice (pdf)
Your health plan is committed to helping you achieve your best health. Rewards for participating in a wellness program are available to all employees. If you think you might be unable to meet a standard for a reward under this wellness program, you might qualify for an opportunity to earn the same reward by different means. Contact us at People & Payroll ServiceNow and we will work with you (and, if you wish, with your doctor) to find a wellness program with the same reward that is right for you in light of your health status.
NMHPA was signed into law on September 26, 1998 and includes important protections for mothers and their newborn children with regard to the length of the hospital stay following childbirth. Group health plans and health insurance issuers generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother's or newborn's attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under federal law, require that a provider obtain authorization from the plan or the insurance issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours). If you would like more information on maternity benefits, call your plan administrator.
If you decline enrollment in a NortonLifeLock medical or health plan for you or your dependents - including your spouse - because of other health insurance or group health plan coverage, you or your dependents may be able to enroll in a NortonLifeLock health plan without waiting for the next open enrollment period if you:
- Lose other coverage. You must request enrollment within 31 days after the loss of other coverage.
- Gain a new dependent as a result of marriage, birth, adoption, or placement for adoption. You must request enrollment within 31 days after the marriage, birth, adoption, or placement for adoption.
- Lose Medicaid or Children's Health Insurance Program (CHIP) coverage because you are no longer eligible. You must request enrollment within 60 days after the loss of such coverage.
If you request a change due to a special enrollment event within the 31 day timeframe, coverage will be effective the date of birth, adoption or placement for adoption. For all other events, coverage will be effective the first of the month following your request for enrollment. In addition, you may enroll in NortonLifeLock's medical plan if you become eligible for a state premium assistance program under Medicaid or CHIP. You must request enrollment within 60 days after you gain eligibility for medical plan coverage. If you request this change, coverage will be effective the first of the month following your request for enrollment. Specific restrictions may apply, depending on federal and state law.
Note: If your dependent becomes eligible for a special enrollment rights, you may add the dependent to your current coverage or change to another health plan.
If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov.
If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available.
If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan.
If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272).
If you live in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The following list of states is current as of July 31, 2020. Contact your State for more information on eligibility –
|ALABAMA – Medicaid||COLORADO – Health First Colorado (Colorado’s Medicaid Program) & Child Health Plan Plus (CHP+)|
Health First Colorado Website:
Health First Colorado Member Contact Center:
1-800-221-3943/ State Relay 711
CHP+ Customer Service: 1-800-359-1991/ State Relay 711
Health Insurance Buy-In Program (HIBI): https://www.colorado.gov/pacific/hcpf/health-insurance-buy-program
|ALASKA – Medicaid||FLORIDA – Medicaid|
|The AK Health Insurance Premium Payment Program
|ARKANSAS – Medicaid||GEORGIA – Medicaid|
Phone: 1-855-MyARHIPP (855-692-7447)
Phone: 678-564-1162 ext 2131
|CALIFORNIA – Medicaid||INDIANA – Medicaid|
Healthy Indiana Plan for low-income adults 19-64
All other Medicaid
IOWA – Medicaid and CHIP (Hawki)
|MONTANA – Medicaid|
Hawki Phone: 1-800-257-8563
|KANSAS – Medicaid||NEBRASKA – Medicaid|
|KENTUCKY – Medicaid||NEVADA – Medicaid|
Kentucky Integrated Health Insurance Premium Payment Program (KI-HIPP) Website:
KCHIP Website: https://kidshealth.ky.gov/Pages/index.aspx
Kentucky Medicaid Website: https://chfs.ky.gov
Medicaid Website: http://dhcfp.nv.gov
Medicaid Phone: 1-800-992-0900
|LOUISIANA – Medicaid||NEW HAMPSHIRE – Medicaid|
Phone: 1-888-342-6207 (Medicaid hotline) or 1-855-618-5488 (LaHIPP)
Toll free number for the HIPP program: 1-800-852-3345, ext 5218
|MAINE – Medicaid||NEW JERSEY – Medicaid and CHIP|
TTY: Maine relay 711
Private Health Insurance Premium Webpage:
TTY: Maine relay 711
Medicaid Phone: 609-631-2392
CHIP Website: http://www.njfamilycare.org/index.html
CHIP Phone: 1-800-701-0710
|MASSACHUSETTS – Medicaid and CHIP||NEW YORK – Medicaid|
|MINNESOTA – Medicaid||NORTH CAROLINA – Medicaid|
|MISSOURI – Medicaid||NORTH DAKOTA – Medicaid|
|OKLAHOMA – Medicaid and CHIP||UTAH – Medicaid and CHIP|
Medicaid Website: https://medicaid.utah.gov/
CHIP Website: http://health.utah.gov/chip
|OREGON – Medicaid||VERMONT– Medicaid|
|PENNSYLVANIA – Medicaid||VIRGINIA – Medicaid and CHIP|
Medicaid Phone: 1-800-432-5924
CHIP Phone: 1-855-242-8282
|RHODE ISLAND – Medicaid and CHIP||WASHINGTON – Medicaid|
Phone: 1-855-697-4347, or 401-462-0311 (Direct RIte Share Line)
|SOUTH CAROLINA – Medicaid||WEST VIRGINIA – Medicaid|
Toll-free phone: 1-855-MyWVHIPP (1-855-699-8447)
|SOUTH DAKOTA - Medicaid||WISCONSIN – Medicaid and CHIP|
|TEXAS – Medicaid||WYOMING – Medicaid|
To see if any other states have added a premium assistance program since July 31, 2020, or for more information on special enrollment rights, contact either:
U.S. Department of Labor
|U.S. Department of Health and Human Services
Centers for Medicare & Medicaid Services
1-877-267-2323, Menu Option 4, Ext. 61565
Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with NortonLifeLock and about your options under Medicare's prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice.
There are two important things you need to know about your current coverage and Medicare's prescription drug coverage:
- Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.
- The prescription drug coverage sponsored by NortonLifeLock is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.
When can you join a Medicare drug plan?
You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15 to December 7.
However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan.
What happens to your current coverage if you decide to join a Medicare drug plan?
If you decide to join a Medicare drug plan, your current NortonLifeLock coverage will not be affected. If you decide to enroll in a Medicare prescription drug plan and you are an active employee or family member of an active employee, you may also continue your employer coverage. In this case, the NortonLifeLock plan will continue to pay primary or secondary as it had before you enrolled in a Medicare prescription drug plan. See pages 7- 9 of the CMS Disclosure of Creditable Coverage To Medicare Part D Eligible Individuals Guidance (available at http://www.cms.hhs.gov/CreditableCoverage/), which outlines the prescription drug plan provisions/options that Medicare eligible individuals may have available to them when they become eligible for Medicare Part D).
If you do decide to join a Medicare drug plan and drop your current NortonLifeLock coverage, be aware that you and your dependents may not be able to get this coverage back without experiencing a qualifying life event.
When will you pay a higher premium (penalty) to join a Medicare drug plan?
You should also know that if you drop or lose your current coverage with NortonLifeLock and don't join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later.
If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go 19 months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join.
For more information about this notice or your current prescription drug coverage:
Contact the benefits helpdesk listed below for further information. NOTE: You'll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through NortonLifeLock changes. You also may request a copy of this notice at any time.
For more information about your options under Medicare prescription drug coverage:
More detailed information about Medicare plans that offer prescription drug coverage is in the "Medicare & You" handbook. You'll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans.
For more information about Medicare prescription drug coverage:
Visit www.medicare.gov. Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the "Medicare & You" handbook for their telephone number) for personalized help. Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at www.socialsecurity.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778).
Remember: Keep this Creditable Coverage notice (pdf). If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and, therefore, whether or not you are required to pay a higher premium (a penalty).
For more information about this notice or your prescription drug coverage, contact:
Benefits Helpdesk - NortonLifeLock Corporation
60 E. Rio Salado Pkwy, Suite 1000, Tempe, AZ 85281
A Participant who is absent from employment with his Employer on account of being in "uniformed service" as defined by the Uniformed Services Employment and Reemployment Rights Act of 1994 ("USERRA") may elect to continue participation in the Plan. The coverage period shall extend for the lesser of 24 months or until the Participant fails to apply for reinstatement or to return to employment with the Employer. The Participant shall be responsible for making the required contributions during the period in which he or she is in "uniformed service." The manner in which such payments are made shall be determined by the Plan Administrator, in a manner similar to that of FMLA Leave.
As required by the Women's Health and Cancer Rights Act of 1998 our plan provides benefits for mastectomy-related services including all stages of reconstruction and surgery to achieve symmetry between the breasts, prostheses, and complications resulting from a mastectomy, including lymphedema.
If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women's Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient, for:
- All stages of reconstruction of the breast on which the mastectomy was performed;
- Surgery and reconstruction of the other breast to produce a symmetrical appearance;
- Prostheses; and
- Treatment of physical complications of the mastectomy, including lymphedema
These benefits will be provided subject to the same deductibles and coinsurance applicable to other medical and surgical benefits provided under this plan. If you would like more information on WHCRA, call your plan administrator.
Provider-Choice Rights Notice
Kaiser Permanente’s Traditional HMO Plan generally requires the designation of a primary care provider. You have the right to designate any primary care provider who participates in our network and who is available to accept you or your family members.
For children, you may designate a pediatrician as the primary care provider.
You do not need prior authorization from Kaiser Permanente or from any other person (including a primary care provider) in order to obtain access to obstetrical or gynecological care from a health care professional in our network who specializes in obstetrics or gynecology. The health care professional, however, may be required to comply with certain procedures, including obtaining prior authorization for certain services, following a pre-approved treatment plan, or procedures for making referrals.
For a list of participating health care professionals, contact Kaiser Permanente at 800-464-4000, open 7 days a week 24 hours a day. You can also visit Kaiser online at www.kp.org.