Medical Plans - Active Employees
You have four types of medical plans to choose from:
- Health Investor PPO - with medical benefits administered by Blue Cross Blue Shield of Florida and prescription drug benefits administered by Caremark.
- Health Investor HMO - depending on where you live or work in the State.
- Standard PPO Plan - with medical benefits administered by Blue Cross Blue Shield of Florida and prescription drug benefits administered by Caremark.
- Standard HMOs - depending on where you live or work in the State.
Each option provides services and shares costs with you in a different way, so taking time to learn about the options can help you decide which plan is the best fit for you. Here's a general look at some key features:
| Health Investor PPO | Health Investor HMO | Standard PPO | Traditional HMOs | |
| Your contributions for coverage (payroll deduction) | Lower for Career Service employees and University Faculty, Staff and Administrative, and Professional employees* | Higher for Career Service employees and University Faculty, Staff and Administrative, and Professional employees* | ||
| Choice of providers | In and Out of Network** | Network only | In and Out of Network** | Network only |
| Lifetime maximum | $2 million/person+ | Unlimited | $2 million/person+ | Unlimited |
| Open a Health Savings Account? | Yes | Yes | No | No |
| Your HSA balance earns interest, carries forward year-to-year and is portable if you leave | ||||
| Have a Reimbursement Account? | Yes, a Limited Purpose Medical Reimbursement Account | Yes, a regular Medical Reimbursement Account | ||
| Annual deductible (network) | Higher | Higher | Lower | None |
| How you pay for most care | Percentage of cost after deductible | Percentage of cost after deductible |
Network: set copayments or % of network allowed amount Non-network: percentage of non-network allowance after deductible | Set copayments |
|
With single coverage, you must meet the individual deductible before anything but preventive care is covered With family coverage, you must meet the family deductible before anything but preventive care is covered | ||||
| Preventive care | Some physical exams and screenings covered at 100% with no deductible; see preventive care details | |||
| Annual out-of-pocket maximum (network) | Higher | Higher | Lower | Lowest |
* Individuals in the Spouse Program or in employment classifications eligible for State-paid or university-paid coverage will still make no contribution for their medical coverage.
** You will pay significantly higher out-of-pocket costs when using out-of-network providers.
+ Combined benefit under State Employees' Health Investor and Standard PPO while covered as employee, retiree or dependent.
If you enroll in a Health Investor plan, you may also open a Health Savings Account with contributions from the state, as long as you have no other medical coverage for 2009.
*