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Health

State PPO

HMO

Life Insurance

Dental

Vision

Supplemental

   

Important Considerations: Choosing a Health Plan

Link to: Compare the four main types of options

 

Compare the four main types of options - the Standard PPO, Standard HMOs and Health Investor PPO or HMO.

1a - State Employees Standard PPO Plan and Health Investor PPO Plan comparison chart
1b - State Employees Standard HMO Plan and Health Investor HMO Plan comparison chart
1c - State Employees Wellness Benefits comparison chart

Link to: Which plans are available in your area

Check to see which doctors, hospitals and specialists are available in each plan.

Link to: Think about your likely medical care needs for the coming year

Think about your likely health care needs for the coming year, then compare your cost for that care and your cost for coverage under each of the different options.

Link to: Compare the coverage costs

Factor the Health Savings Account and the Medical Reimbursement Accounts into your decision.

Link to: Health Savings Account and the Reimbursement Accounts

Decide which option is best for you.


Compare the four main types of options - the Standard PPO, Standard HMOs and Health Investor PPO or HMO.

All four types cover the same kinds of services, but the way they pay benefits is different.

Key Decision Points:

 

Access to care How you pay for care Insurance premiums (payroll deductions)**

Standard HMO

Use network providers to receive benefits

Set dollar copays for more predictable costs

Higher

Health Investor HMO

Use network providers to receive benefits

Annual deductible* and percentage of cost

Lower

Standard PPO

See network or non-network providers … your share of cost is lower when you use the network

Set dollar copays for more predictable costs for some network care. A percentage of cost - or annual deductible and percentage of cost for other care

Higher

Health Investor PPO

See network or non-network providers … your share of cost is lower when you use the network

Annual deductible* and percentage of cost

Lower

*Individuals must meet the deductible before anything but preventive care is covered.
**For those employees' who pay premiums for coverage - including state Career Service employees' and University Faculty, Staff and Administrative and Professional Employees'.

Use the highlights for the Standard PPO, the Standard HMOs, the Health Investor PPO and the Health Investor HMO to help you understand key differences in how the four types of plans work.

For more information, view the State Employees PPO Plan Booklet and Benefits Document or the individual HMO's certificates of coverage (available from the HMOs).
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Check to see which doctors, hospitals and specialists are available in each plan.

Many doctors, specialists and other healthcare providers participate in several different networks.

  • Go to HMO Offerings in Your Area to see which health plans are available in your geographic area. Then go to the Web sites for those plan administrators to find out what doctors and hospitals are in the network. The chart below includes web links and easy step-by-step instructions to help make your search easier.
  • Keep in mind that health providers are subject to change at any time without notice. You cannot change plans because a provider leaves the network.
Health Plan Instructions

Florida Blue - BlueCross BlueShield (Standard and Health Investor PPO)

1. Click "Members"
2. Click "Find a Doctor and More"

AvMed

Click "Find Doctor"

Capital Health Plan

1. Click "Physicians/Providers"
2. Click "Network Directory"

Florida Health Care Plans

1. Click "Members"
2. Click "Find a Provider/Facility"

UnitedHealthcare

Click "Find a Doctor/Hospital"

Coventry Health Care of Florida

1. Click "Find a Doctor"
2. Click "Enter Provider Search"

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Compare your cost for anticipated care under the different health plan options, then compare your cost for that care and your cost for coverage under each of the different options.

Be sure to use the online Medical Plan Cost Estimator to compare your overall cost for medical care.

Coverage costs are also listed on the Benefit Statement in the enrollment package you receive.

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Factor the Health Savings Account and the Medical Reimbursement Accounts into your health plan decision.

The Health Savings Account, Medical Reimbursement Account and Limited Purpose Medical Reimbursement Account all offer a tax advantage by allowing you to set aside pretax dollars for eligible healthcare expenses. And the Health Savings Account (available when you enroll in one of the Health Investor Health Plans) offers more – including state contributions to your account and a carry forward of any unused HSA account balance from year-to-year. If you have deductibles, copayments or coinsurance to pay, consider funding them through these accounts – tax free!

  If you enroll in a Health Investor HMO or PPO and have no other health coverage
If you enroll in the Standard PPO or a Standard HMO

You may enroll in

  • Medical Reimbursement Account is available to set aside pretax money to pay health, dental and vision deductibles, copayments, coinsurance and such

Points to note

  • HSA balance earns interest and you may have the opportunity to decide how it is invested
  • Unused HSA balance carries forward year-to-year; portable if you leave
  • Unused Limited Purpose Medical Reimbursement Account balances are forfeited if you do not use them by March 15 for the previous plan year.
  • Unused Medical Reimbursement Account balances are forfeited if you do not use them by March 15 for the previous plan year.
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Decide which option is best for you

  • Think about your options from steps 1-4. When you're ready to enroll go to People First
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