Human Resource Services

Health Insurance and Health Investment Plans

The State of Florida offers the following health plan options:
PPO | HMO | Health Investment Plan

Special plans designed for spouses and domestic partners are also available:

State Employees' PPO Plan

Below is summary information about the plan. For complete plan details and for comparison purposes, please visit the the MyBenefits section of MyFlorida's web site.

This plan is offered through Blue Cross/Blue Shield of Florida.

Biweekly
premium*

Rates effective 1/1/2012

Employee: $25.00
UF contribution: $249.90

Family: $90
UF contribution: $531.67

 

Network

Non-Network

Deductible**

$250/individual/year
$500/family/year

$750/individual/year
$1,500/family/year

Coverages

Coverage area: United States

Coverage area: Worldwide

Co-Pay

Primary Care: $15/visit

Specialist: $25/visit

40% of allowance, plus difference

Hospital Stay

$250/admission then 20% of
network allowed amount for other covered services

$500/admission then 40% of
non-network allowed amount for other covered services

Prescriptions

Rates effective 1/1/2012:

Generic:
Retail: $7/$10
 Mail order: $14/20

Preferred brand:
Retail: $25/$30
Mail order $50/$60

Non-pref. brand:
Retail: $40/$50
Mail order $80/$100

Mail Order Requirement
You will be allowed to fill certain maintenance prescriptions up to 3 months at a retail pharmacy. After that, you’re required to send these prescriptions to the mail order pharmacy.

Pay in full and file a claim

Comment

This plan has a pre-existing condition provision which applies before covered services are paid relating to prior medical conditions. Effective 1/1/2011 the pre-existing will no long apply to dependents under 19 years old.  Please review the plan brochure or state of Florida’s website for more information or details on how to request a pre-existing condition provision waiver. For additional questions about the plan call Blue Cross, Blue Shield at 1-800-825-2583.

How to enroll

Choose one of the following ways to enroll:

  • Enroll online via the People First (PF) web site.
  • Call PF at 1-866-663-4735 to enroll or make a change by phone.
  • Mail your form or fax it to PF at 904-828-6092.
  • Attend the UF Benefits’ Group Enrollment Session for assistance with completing your online enrollment with People First.

Be sure to retain a record of your transactions. If an early effective date is requested (for new hires only) for coverage, please contact the benefits office at 392-2477 regarding payment of premiums.

* Employees whose full-time equivalency (FTE) is not 1.00 should contact University Benefits for exact premium amounts.
**Physician’s office visits are not subject to the calendar-year deductible.

Health Maintenance Organizations (HMOs)

Below is summary information about the plan. For complete plan details and for comparison purposes, please visit the MyBenefits section of MyFlorida's web site.

Blue Cross and Blue Shield PPO and Avmed  plans are the only providers in Alachua County. Please visit the HMO Service Area by County for the 2012 Plan Year to verify the plans offered in your area: http://www.myflorida.com/MyBenefits/pdf/HMOsbyCounty-2012.pdf

This plan is offered through the following providers:

Biweekly
Premium*

Rates effective 1/1/2012

Employee: $25.00
UF contribution: $249.90

Family: $90
UF contribution: $531.67

Deductible

None

Co-Pay

Rates effective 1/1/2012

PCP Office visit: $20

Rates effective 1/1/2012

Specialist: $40

Coverages

Regional coverage area. If outside of coverage area, must be life or limb threatening. However, HMOs serving employees in more than one service area will provide coverage to dependents residing in a different county if it is part of the HMO’s service area.

Hospital Stay

$250/admission

Prescriptions

Generic: $7 retail / $14 mail order

Preferred brand: $30 retail /$60 mail order

Non-preferred brand: $50 retail / $100 mail order

Comment

This plan does not have a pre-existing condition provision, which means that payment for covered services relating to prior medical conditions are covered from the effective date of the plan. Review the plan brochure or State of Florida’s web site for more information on covered services. For additional questions about a particular HMO vendor, please contact the company directly.
How to enroll

Choose one of the following ways to enroll:

  • Enroll online via the People First (PF) web site.
  • Call PF at 1-866-663-4735 to enroll or make a change by phone.
  • Mail your form or fax it to PF at 904-828-6092.
  • Attend the UF Benefits’ Group Enrollment Session for assistance with completing your online enrollment with People First.

Be sure to retain a record of your transactions. If an early effective date is requested (for new hires only) for coverage, please contact the benefits office at 392-2477 regarding payment of premiums.

* Employees whose full-time equivalency (FTE) is not 1.00 should contact University Benefits and Retirement for exact premium amounts.

Health Investor Plans (HMO or PPO)

Below is summary information about the plan. For complete plan details and for comparison purposes, please visit the appropriate section of the MyFlorida My Benefits web site:

This plan is offered through the following providers:

 

PPO

HMO

Biweekly
premium*

Rates effective 1/1/2012

Individual
Employee $7.50
UF contribution $249.90

Family
Employee $32.15
UF contribution $531.67

Rates effective 1/1/2012

Individual
Employee $7.50
UF contribution $249.90

Family
Employee $32.15
UF contribution $531.67

Deductible

In network

Non-network

In network only

$1,250 (individual)
$2,500 (family)

$2,500 (individual)
$5,000 (family)

$1,250
$2,500

Annual out-of-pocket maximum

$3,000 (individual)
$6,000 (family)

$7,500 (individual)
$15,000 (family)

$3,000 (individual)
$6,000 (family)


After the deductible is met, you pay:

Medical Care

20% of the network-allowed amount

40% of the non-network-allowed amount

20% of the contracted rate

Hospital Stay

No admission deductible, but subject to annual deductible + 20% for other covered services

$1,000 admission deductible + annual deductible + 20%

20% of the contracted rate

Prescription Drugs

Generic and brand: 30%

Non-preferred brand: 50%

Member pays in full and fills claim

Generic and brand: 30%

Non-preferred brand: 50%

 

The Health Savings Account and Limited Medical Reimbursement Account are plans available to employees electing to choose the Health Investor Plan.

Health Savings
Account (HSA)

An account owned by the employee where contributions to the account can be used to pay for additional medical expenses. The employee can make contributions to the account on a pre-tax basis, and the state will contribute $41.66 per month for individual coverage (or $83.33 for family coverage), for full-time employees.

The HSA earns interest and can be carried over from one year to the next. The HSA is also portable, meaning that the account is still owned by the employee after termination of employment.
Comments

The PPO Health Investor has a pre-existing condition provision. Effective 1/1/2011 the pre-existing will no long apply to dependents under 19 years old.  Coverage is available across the U.S. and world wide.

The HMO Health Investor does not have a pre-existing condition provision. Coverage is regional based on the plan’s network.

How to Enroll

Choose one of the following ways to enroll:

  • Enroll online via the People First (PF) web site.
  • Call PF at 1-866-663-4735 to enroll or make a change by phone.
  • Mail your form or fax it to PF at 904-828-6092.
  • Attend the UF Benefits’ Group Enrollment Session for assistance with completing your online enrollment with People First.

Be sure to retain a record of your transactions. If an early effective is requested for coverage, please contact the benefits office at 392-2477 regarding payment of premiums.

* Employees whose full-time equivalency (FTE) is not 1.00 should contact University Benefits and Retirement for exact premium amounts.

Spouse Program

Spouses who both work for the state of Florida are eligible to enroll in the state's spouse program. This program combines the state's matching portion of each member's insurance premium. This, in turn, provides family health coverage at a relatively minimal cost of $15/month per spouse—provided both employees are appointed full-time and are in benefits-eligible positions. Any changes related to work/life events—such as birth/adoption, divorce, termination, leave of absence, or change in FTE—must be reported to Human Resource Services within 31 days of the event. During this time, health coverage may be converted or dropped in order to prevent the underpayment of premiums and/or cancellation of coverage.

Biweekly premiums*

Based on 2 full-time spouses

Each employee: $7.50

Each agency’s contribution: $303.34

 

Based on a full-time (FT) & a part-time (PT) .50FTE spouse

FT employee: $7.50

FT agency contr.: $303.34

PT employee: $159.17

PT agency contr.: $151.67

In this example it is less expensive to enroll in family coverage for $180/mo instead of the spouse program. Consult with the Benefits office on cost if your FTE is below 1.0

Comments

Part-time employee premiums will vary based on the hours worked. Contact the Benefits office on specific cost.

Employees may select one of the state health options: PPO, HMO, Health Investor PPO or Health Investor HMO.

How to Enroll

Choose one of the following ways to enroll:

  • Complete a Spouse Program Enrollment, Health Enrollment and a Qualifying Status Change form (based on certain work/life events) and either mail or fax the forms to People First at 904-828-6092.
  • Attend the UF Benefits’ Group Enrollment Session for assistance with completing your enrollment forms which will be sent to People First.

Be sure to retain a record of your transactions. Contact the Benefits office at 392-2477 regarding your change so that the proper employer contribution or employee premium can be collected.

 

Domestic Partner Program

Below is summary information about the plan. For further details and forms, please click here.

Biweekly
premiums*

Rates effective 1/1/2012

Family: $90.00

UF contribution:
$613.14

Total: $703.14

Deductible

Network: AvMED Choice

Network: AvMED

Expanded & PHCS

Network: Out-of Network

$500 (per indivdual)
$1000 (maximum per family)

$1,000 (per indivdual)
$2,000
(maximum per family)

$2,000 (per indivdual)
$4,000
(maximum per family)

Co-Pay for Office Visit

AvMED Choice

AvMED Expanded & PHCS

Out-of Network

Network Primary Care: $15

Network Specialist:$30

Network Primary Care: $25

Network Specialist: $50

Primary and Specialist visits: 40% of UCR charge after the deductible

Coverages

Regional coverage area, choice network area, and out of network area through the United States

Comment

No pre-existing condition

Available to both same- and opposite-sex partners as well as children of the employee and partner. Under IRS regulations, premiums for the domestic partner are not eligible for a total pre-tax deduction. Therefore, the employee’s premium will be split deducting $50.00 pre-tax plus $130.00 post tax for a total of $180.00/month for family coverage.  The  IRS requires that the value of the “employer” portion paid on behalf of the domestic partner be considered taxable to the employee,  UF will adjust for taxes taken on this portion of the premium on the employee enrolled in the plan to compensate for the tax impact. 

Partner Program: Employees with domestic partners who work for the University of Florida and are in full-time benefits eligible positions are able to enroll in UF’s Partner Program. Coverage is provided at minimal cost.

Current employees seeking to change from the “state” health plan to the “UF” domestic partner plan and vice versa may only make this change during the annual open enrollment period.  NOTE:  Those currently enrolled in the domestic partner plan who is considering retirement should consult the benefits office at least a year ahead to coordinate this change during the next open enrollment period. The UF domestic partner plan cannot be converted into retiree coverage.   

Part-time employees pay rates based on the FTE worked.  If you terminate, go on a leave of absence or have a reduction in FTE, please contact the benefits office to discuss options for continuation or cancellation of coverage.

How to Enroll

Visit University Benefits and Retirement at 903 W. University Avenue, Gainesville, FL or call 352-392-2477.

* Employees whose full-time equivalency (FTE) is not 1.0 should contact University Benefits and Retirement for exact premium amounts.

NOTICE OF PUBLIC MEETING, HEARING OR WORKSHOP
The University of Florida announces the following public meetings.

Executive Sponsor Group for Health Insurance, Wednesday, May 16, 2012
Start Time: 8:00 a.m.
Executive Conference Room, 2nd Floor of the South Tower

Health Insurance steering committee, Thursday, April 26, 2012
Start time: 3:30 pm
Place:  1329 Building, Room 4150

Health Insurance steering committee, Thursday, March 29, 2012
Start time: 3:30 pm
Place:  1329 Building, Room 4150

Executive Sponsor Group for Health Insurance, Wednesday, March 21, 2012
Start Time: 8:00 a.m.
Executive Conference Room, 2nd Floor of the South Tower

Faculty and Staff Benefits Committee Wednesday, March 14, 2012
Start Time: 2:30 p.m.
Place: VP Conference Room, 2nd floor HRS Building, 903 W. University Avenue.

Health Insurance steering committee, Thursday, February 23, 2012
Start time: 3:30 pm
Place:  1329 Building, Room 4150

CANCELLED:Faculty and Staff Benefits Committee Wednesday, February 22, 2012
Start Time: 10:30 a.m.
Place: VP Conference Room, 2nd floor HRS Building, 903 W. University Avenue.

Health Insurance steering committee, Thursday, January 19, 2012
Start time: 3:30 pm
Place:  1329 Building, Room 4150

Executive Sponsor group for health insurance, Wednesday, January 18, 2012
Start time:  8:00 am
Place:  Executive Conference Room, 2nd floor of the South Tower

Health Insurance steering committee, Thursday, December 8, 2011
Start Time: 4:00 p.m.
Place: 1329 Building, Room 1123

Faculty and Staff Benefits Committee Tuesday, November 8, 2011
Start Time: 8:30 a.m.
Place: VP Conference Room, 2nd floor HRS Building, 903 W. University Avenue.