Medical and Dental
Triple S Salud is our medical coverage provider. You have the opportunity to enroll in our health insurance benefits through Triple S.
Triple S Salud is our medical coverage provider. You have the opportunity to enroll in our health insurance benefits through Triple S.
We are pleased to share that ZARA has decided to maintain employee contributions for the 2025-2026 plan year! We hope that this reflects our ongoing commitment to the well-being of our employees.
Please review the following pages carefully as you make your elections for the 2025-2026 plan year.
Medical / Dental Plan and Contributions
| Plan Highlights | Participating Providers | Non-Participating Providers | |||
| Deductible Amount | $0 | N/A | |||
| Out-of-Pocket Maximum | $6,350 / $12,700 | N/A | |||
| Preventive Care/Screening/ Vaccines | No charge for preventive services according to the Federal Law $0 copay for other immunizations 20% coinsurance for the immunization for respiratory syncytial virus. 25% coinsurance for diagnostic tests | Covered in emergency cases, and is going to be paid to the provider based on whichever is less between what you pay for and the plan fee to the provider in network, discounting the copay. | |||
| Primary Care Physician (PCP) / Specialist Copay | $5 copay / $10 copay | Covered in emergency cases, and is going to be paid to the provider based on whichever is less between what you pay for and the plan fee to the provider in network, discounting the copay. | |||
| If you are admitted to the hospital | $25 copay preferred / $50 copay non-preferred facility / admission | Covered in emergency cases, and is going to be paid to the provider based on whichever is less between what you pay for and the plan fee to the provider in network, discounting the copay. | |||
| Facility fee (e.g., outpatient surgery center) | $25 copay / visit | Covered in emergency cases, and is going to be paid to the provider based on whichever is less between what you pay for and the plan fee to the provider in network, discounting the copay. | |||
| Emergency | $50 copay / visit | $50 copay / visit | |||
| Urgent Services | $25 copay / visit | $25 copay / visit | |||
| Dental check up | $0 | Reimburses the difference between 100% of the expense incurred and 100% of the fee that would have been paid to a participating surgeon-dentist for the same service according to the fees established by Triple-S, after deducting the deductibles or applicable coinsurance. | |||
| Prescription drugs (30-day supply) Generics/Preferred brand/Brand/Non-preferred generic & brand/Specialty | $5 / $10 / $15 / lesser of $100 or 20% coins / lesser of $100 or 20% coins | Covers pharmacies only in the United States. Triple-S will reimburse the insured 75% of the rate established for a pharmacy in the network after deducting applicable copayment and/or coinsurance. | |||
| Prescription drugs ordered by mail (90-day supply) Generics/Preferred brand/Brand/Non-preferred generic & brand/Specialty | $10 / $20 / $30/ lesser of $100 or 20% coins / N/A | Not Covered | |||
| Dependent Age Limit | Up to 26 years old | ||||
| NOTE: This chart does not describe all covered services. See the plan summaries for full coverage information. | |||||
Employee Medical Contributions (24 times per plan year)
Please review contributions carefully. Contribution changes will take effect on October 1, 2025.
| Individual | $16.88 | $115.95 |
| Partner | $92.29 | $173.36 |
| Family | $115.36 | $216.74 |
Save Money on Health Care Expenses
No one wants to spend any more than necessary on health care. Here are some ways to be a smart health care consumer and save money.
Stay in your network. Seeing a doctor in your network will almost always cost you less. Use in-network convenience care clinics. For minor illnesses and injuries, convenience care clinics located in pharmacies, grocery stores, and other retail stores provide quick, affordable care.
Use the emergency room only for true emergencies. For non-life-threatening emergencies, visit an urgent care center instead of the emergency room. You’ll get treated more quickly and pay less.
Ask for generic drugs. You can save up to 80% compared to brand-name drugs.
Limit hospital visits. Many procedures like MRIs and colonoscopies cost less when done at independent outpatient centers instead of a hospital. Outpatient surgery is also less expensive than hospitalization.
Get regular preventive care. Getting checkups, immunizations and other health screenings can help detect health problems early when they are less expensive to treat.
Talking with Your Doctor About Health Care Costs
If you need help navigating your benefits, contact one of the below resources:
- Triple S Member Services: Call the number on the back of your ID card – 800-981-3241
- Health Advocate: 866-799-2731
- Benefits Help Desk: 1-877-373-6535 or benefitshelpdesk@epicbrokers.com
- ZARA Benefits Team: benefits@us.inditex.com
Remember: Certain services may require precertification or prior approval from the health plan provider to qualify services for payment.Typically, in-network providers will obtain the required precertification and approval. For out-of-network services, it is the member’s responsibility to handle the precertification process.
You may contact member services first to determine if precertification is necessary and if the provider is out-of-network.
Don’t be afraid to ask about the costs and benefits of different treatment options and make choices that are right for you.
When your doctor recommends tests – To make sure you don’t spend time and money on unnecessary tests, ask your doctor why the test is needed and where you can have it done at the lowest cost.
Estimate your costs – Utilize the resources on the Cigna member website or MyCigna App to get cost estimates before you get care.
If your doctor recommends surgery or hospitalization – Ask if there are other treatment options that don’t require surgery or if the procedure can be done on an outpatient basis. If you do need surgery, make sure the hospital, the surgeon and any other specialists your doctor refers you to are in the network.
When your doctor writes you a prescription – Ask if there are less expensive generic drugs or even over-the-counter medications that might work for you. Ask if you can improve your condition without drugs by changing your eating habits or getting more exercise.
Savings & Finance 
Voluntary Benefits