Health Insurance

 
Through the State of Florida, the University offers a choice of health care programs: The State Employee’s Group Health Self-Insurance Plan (PPO) and several HMO’s. To participate, employees must enroll within 60 days of the starting date of employment.

* The State Self-Insured Group Plan provides world-wide coverage and the freedom to choose individual health care providers. The maximum lifetime benefits is $2,000,000.00.

* The selection of an HMO plan is dependent upon an employee’s county of residence or county of employment, and requires selection of a primary care physician; referrals to specialists are requested through the primary care physician.
 

All of the aforementioned insurance plans provide for the individual (employee only) or the family (employee and eligible dependents). Because benefits vary from one plan to another, it is important to review the plan brochures before making a selection. Changes in enrollment (addition/deletion of dependents or switching plans) can only occur during the annual Open Enrollment period unless a Qualifying Status Change (QSC) event occurs.
 

If an employee terminates and/or dependents become ineligible for health insurance coverage, continuation of the coverage is available through the Consolidated Omnibus Budget Reconciliation Act (COBRA). COBRA is a federal act which requires that employers offer terminated employees the option of continuing the group health insurance.
 

Regardless of the health insurance plan chosen, an employee’s portion of the premium and the State’s contribution toward the premium are the same. When an employee and the spouse both work for State agencies and select the same health care plan, both are eligible for the Spouse Program. If both the spouses are full time, the employer pays the full cost: however, if one or both.
 

State Employee’s Group Health Self-Insurance Plan

The Plan offers a combination of Preferred and Non-Preferred Patient Care options: Preferred Patient Care options are physicians, labs, and/or facilities that contract with the carrier to provide services at reduced rates while Non-Preferred Patient Care options are other physicians, labs, and/or facilities that will provide services at regular rates which are usually higher. Employees are not required to choose between Preferred and Non-Preferred; rather, employees may choose to seek services from a Preferred Provider for one ailment, while a Non-Preferred Provider may be chosen for something totally different. Pre-existing conditions are not usually covered for the first twelve months; however, there is a mechanism by which pre-existing conditions may be covered. Contact Employee Benefits for more information.

A prescription program is also included. The State PPO plan provides employees with an option to order a 90 day supply through the mail.

Health Savings Account (HSA)

The Health Savings Account (HSA) is a new healthcare choice for 2006. The HSA is a special savings/spending account owned by the employee. Contributions made to the account by the employer and employees are used to satisfy the high deductible associated with the Health Investor Health Plans which are also new healthcare choices for 2006. The HSA is to be used in conjunction with the Health Investor Health Plan. The HSA will be funded by employer contributions; and employees have an opportunity to contribute on a pre-tax basis. Total contributions (employer and employee) to the HSA are limited annually to the high deductible health plan deductible of $1,250 for an employee enrolled in individual health coverage and $2,500 for an employee enrolled in family health coverage. The HSA is portable (remains with account holder even after leaving employment).

2006
Annual Health Savings Account (HSA) Contributions

Health Insurance Coverage Level	Employer's Annual Contributions	Employee's Annual Contribution*	Maximum Annual Contribution
Individual	$500	$750	$1,250
Family	$1,000	$1,500	$2,500

Note: Employer's Monthly HSA Contributions:
Individual Health Coverage: $41.66
Family Health Coverage: $83.33

*Note
1. Employee Contributions to HSA are optional
2. Individuals enrolled in an HSA cannot also be enrolled in the Standard Medical Reimbursement Account (FSA).
3. HSA participants may enroll in a Limited Purpose Medical Reimbursement Account with allowable expenses of dental, vision and preventative care services.

Health Investor High Deductible Health Plans (HIHP)

The Health Investor High Deductible Health Plans are high deductible health plans that do not cover medical expenses, except for preventative care, until the high deductible is met. The HIHP offers a reduced premium and all covered benefits must apply to the Plan Deductible, including prescriptions. In addition to the higher deductibles, employees will play co-insurance vs. set dollar co-payments and will have higher out of pocket maximums.

The HSA is to be used in conjunction with the Health Investor Health Plans, and employees have an opportunity to participate in the HSA if they have no other health insurance coverage.

Employees may elect to particpate in the (1) Health Investor PPO Health Plan or the (2) Health Investor HMO Health Plans. The HIHP Providers are:

PPO Health Investor Health Plan:
Blue Cross/Blue Shield

HMC Health Investor Health Plans:
AvMed Health Plan (Tampa Bay area)
United Healthcare (Tampa Bay area)

Capital Health Plan

Florida Health Care

United Health Care

Vista—North Florida (HPSE)