BlueCare HMO-58*

Who Pays?

100% Employee Premium: PHSC pays

100% Dependent Coverage Premium Portion: Employee pays through payroll deductions ($1,360 per month)

When You Are Eligible

The first day of the following month after date of employment.

What You Receive

BlueCare Health Maintenance Organization (HMO) benefits include preventive health care. Care must be provided by a participating BlueCare in-network provider. This HMO BlueCare group plan does not request a primary health provider referral for specialist care. This plan has an unlimited lifetime maximum. No deductibles. 100% of claim paid after copay. $40 physician co-pay. $60 Specialist co-pay. $350 ($1,750 max) per day hospital admission co-pay. 20% emergency room co-pay.

*Employee may be enrolled in only one plan.

BlueOptions PPO-03769*

Who Pays?

100% Employee Premium:  PHSC pays

100% Dependent Coverage Premium Portion: Employee through payroll deductions ($760 per month)

When You Are Eligible

The first day of the following month after date of employment.

What You Receive

FloridaBlue (BCBS) group medical and hospitalization protection. BlueOptions Physician Provider Organization (PPO) allows the choice of a health care provider with an increased benefit level for BlueOptions PPO in-network providers. Lifetime maximum is unlimited. Coverage is subject to an $800 year deductible per insured, with a family aggregate deductible of $2,400. After deductible, benefits are paid at 80%, if a BlueOptions in-network provider is used, or at 60% of scheduled allowance, if a non in-network provider is used. BlueOptions in-network provider office visit co-pay is $40, or $60 for a specialist. The maximum out-of-pocket expense for allowable charges per calendar year is $7,000 for one person or $14,000 for family aggregate. Co-pays and deductible are considered part of the out-of-pocket maximum.

*Employee may be enrolled in only one plan. 

DV: Dental, Vision Employee Only Option

Who Pays?

PHSC

When You Are Eligible

The first day of the following month after date of employment.

What You Receive

This option is designed as an alternative for employees with other adequate health insurance. The program includes employee-only coverage for Dental and Vision.

Delta Dental - deductible $50 per calendar year deductible applies to Type II and III services. Maximum benefits $1,000 calendar year. Preventive Services, no deductible (Type I). Preventive services provided at 100% of the schedule of allowances. These services include oral examinations, cleaning and fluoride treatments (services provided once during a 6 month period.) Basic Services (Type II) include x-rays and diagnostic services, periodontics (gum treatment), endodontics (root canals), oral surgery and restorative services (fillings), are covered at 80% of the schedule of allowances. Major Services (Type III) include crowns, bridges, full dentures, partial dentures and periodontal surgery and are covered at 50% of the schedule of allowances. Request a pretreatment estimate to get an estimate of your out-of-pocket cost.

What is a Health Savings Account (HSA)?

PHSC's HSA is managed by you and HealthEquity, and allows for most prior HSA accounts to transfer in. PHSC currently contributes annually to each HSA enrolled employee account. Employee has the option to make their own payroll contributions. The account funds roll over into the New Year. There are some strict IRS limitations to all HSA's.

PHSC's Health Care Prescription Plan

What You Receive

$15 Prescription Drug co-pay for generic, $45 Prescription Drug co-pay for preferred name-brand and $65 Prescription Drug co-pay for non-preferred name brand. If a Brand Name Prescription drug is purchased when a Generic is available and the Physician has not indicated that a Brand Name is Medically Necessary, you will be required to pay the difference between the cost of the Brand name and the Generic. Mail-order prescription drug service for a 90-day supply: $30 co-pay for generic, $90 co-pay preferred name-brand, $130 copay for non-preferred name brand.