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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.

*