2015 Benefits Enrollment Presentation

Report
Open Enrollment
for 2015
October 13 – October 27, 2014
Agenda
Welcome - Online Enrollment - FBMC information
FCSRMC - Life Insurance - Long Term Disability
Medical Benefits
Florida Blue – Pam Smith
Florida Health Care Plans – David Miller
Dental Benefits - Delta Dental
Vision Benefits - VSP
Important Enrollment Websites
Daytona State College Employee Benefits
daytonastate.edu/employee_benefits
Florida Benefits Management Center (FBMC)
bmc.myfbmc.com
FBMC Online Enrollment
The first step of the enrollment process is to create
your login at bmc.myfbmc.com
NOTE: BenefitSolver is not being used for 2015 enrollment.
Flexible Spending Accounts
Types of Accounts
– Healthcare Spending Account – medical, dental, vision & Rx
Maximum contribution - $2,500/year
– Child/Dependent Care Account – Day Care
Maximum contribution - $5,000/year
Two Reimbursement Options
– Debit Card
– Submit claims to Health Equity for direct deposit
NOTE: Paper checks will be available; however, a fee of $2.00/check will
automatically be withheld from the reimbursed amount
2015 Life Insurance
The College pays for two times your annual base
salary up to a maximum benefit of $500,000
For example: If your annual base salary is $40,000, then
the value of your Basic Life insurance policy is $80,000.
You may purchase an additional policy up to three times your
base salary, not to exceed a maximum benefit of $500,000
If you purchase an additional policy, may also purchase a spouse life and or
a dependent life policy.
During the online enrollment with FBMC, you will have to enter
your beneficiary information. You will need your beneficiary’s
SSN, Date of Birth and Address to complete this process.
Long Term Disability
The College provides Long Term
Disability coverage and pays
100% of the cost for this benefit.
Long Term Disability coverage is
pay check insurance. This benefit
begins if you become totally and
permanently disabled and are no
longer able to work, ensuring that
your income continues.
Introducing Florida Blue
Pam Smith
Florida Blue PPO Plans
Features & Benefits
• Access to over 44,813 providers in Florida; 817,762
nationally
•
•
•
•
•
Access to 200+ countries worldwide
Local hospitals in-network Option 1
Bert Fish Medical Center in-network Option 2
Emergency & Urgent Care covered worldwide
FloridaBlue.com – find providers, view claims, benefit
info, member handbook, order new ID Cards
• Nurse Advice Hotline (24/365) – 877-789-2583
• Dedicated Case & Disease Management
• Flu Shots available at no cost at participating pharmacies
Florida Blue - Access to Care
Brevard, Flagler and Volusia Counties
FLAGLER
BREVARD
BlueCare
BlueOptions
Hospitals
1
1
Hospitals
PCPs
34
38
Specialists
49
48
Florida Hospital - Flagler
VOLUSIA
BlueCare
BlueOptions
6
6
PCPs
264
279
Specialists
350
352
Hospitals
Florida Hospital – Oceanside
Halifax Medical Center**
Halifax Hospital Port Orange
Bert Fish Medical Center (Option 2)**
Florida Hospital – DeLand
Florida Hospital – Fish Memorial
** Providers in BlueSelect Network
BlueCare
BlueOptions
7
7
PCPs
285
289
Specialists
492
506
Wuesthoff Hospital - Rockledge**
Wuesthoff Medical – Melbourne**
Cape Canaveral Hospital
Holmes Regional Medical Center
Palm Bay Hospital
Parrish Medical Center
Viera Hospital
Space Coast Area
KEY PROVIDER GROUPS:
• Brevard Medical Group
• Coastal Cardiovascular and Thoracic
• Healthcare Partners of Memorial
• Medical Associates of Brevard
• Melbourne Internal Medicine Associates
• Memorial Physicians
• Omni Healthcare
• Osler Medical **
• Quality Medical Care
• Royal Oaks Medical Center
Florida Blue PPO Plans
Benefit
BlueOptions 03769
BlueOptions 03559
Deductible
Person / Family
$600 / $1,800
Person / Family
$600 / $1,800
Out-of-Pocket Limit
Person / Family
$6,000 / $12,000
Person / Family
$6,000 / $12,000
Primary Care Visit
$30 copay
$30 copay
Specialist Visit
$50 copay
$50 copay
Preventative Care
No Charge
No Charge
Florida Blue PPO Plans
Benefit
BlueOptions 03769
BlueOptions 03559
$30/$50
$0
$50
DED + 20% Opt 1/Opt 2
$30/$50
$0
DED + 20%
$150 Opt 1 / $250 Opt 2
Emergency Room
DED + 20%
$100 + 20%
Urgent Care
$65
$50
Hospital Stay
DED + 20% Opt 1 & 2
$150 Opt 1/$250 Opt 2
Diagnostic Tests
Physician Office
Independent Clinical Lab
IDTC
Hospital
NOTE: Actual cost share amounts are based on location of service
Florida Blue PPO Plans
Prescription Drug
Coverage
BlueOptions
03769
BlueOptions
03559
Generic
$15 copay
$15 copay
Brand
$45 copay
$60 copay
Non-preferred Brand
and Specialty Drugs
$65 copay
$100 copay
2 x Retail Copay
2 x Retail Copay
Mail Order
(Up to 90 days supply)
Florida Blue Medical Premiums
For Plan Year Effective January 1, 2015 through December 31, 2015
Deductions begin December 15, 2014
Blue Option 03559 or 03769
Blue Option 03559 or 03769
24-Pay per Year
Per pay
Per month
18-Pay per Year
Per pay
Per month
College
$260.00
$520.00
College
$346.67
$693.34
Employee
$28.00
$56.00
Employee
$37.33
$74.66
Employee & Spouse
$148.50
$297.00
Employee & Spouse
$198.00
$396.00
Employee & Child(ren)
$119.00
$238.00
Employee & Child(ren)
$158.67
$317.34
Employee & Family
$232.00
$464.00
Employee & Family
$309.33
$618.66
The per pay totals were formula generated and may reflect slight round differences
The Florida College System Risk Management Consortium (FCSRMC) sincerely regrets that an error was made in the development of
Daytona State College’s 2015 health plan rates. The two Florida Blue PPO plan rates were inadvertently switched.
FCSRMC will honor the 2015 rates that have been quoted and supplied to Daytona State College and their employees. We sincerely regret
any inconveniences. Through this error Daytona State College employees will be able to enroll in the higher level of Florida Blue PPO
benefits at the lower plan price for 2015. Effective January 1, 2016 the correct rate plus any needed increase will be introduced.
Introducing FHCP
David Miller
FHCP HMO Plans
Features & Benefits
•
•
•
•
•
•
Access to over 1100 providers
All local hospitals in-network
Emergency & Urgent Care covered worldwide
WFW Extended Hour Centers reduced $10 copay
FREE Access to over 50 local Gyms
FHCP.com and myFHCP – find providers, view claims,
benefit info, member handbook, order new ID Cards
• Nurse Advice Hotline (24/365) – 800-548-0727
• Dedicated Case & Disease Management
• Flu Shots available at no cost at FHCP facilities
FHCP - Access to Care
Flagler, Seminole and Volusia Counties
Daytona Beach
DeLand
Edgewater
Ormond Beach
Orange City
Palm Coast
Port Orange-Advanced
Urgent Care
FLAGLER
Deland
VOLUSIA
Orange City
SEMINOLE
FHCP HMO Plans
Contracts with Hospitals
•
•
•
•
•
•
•
•
•
.
All Volusia/Flagler Counties Hospitals
Central Florida Regional Hospital
Putnam Community Medical Center
Mayo Clinic Hospital
Moffit Cancer Clinic
Arnold Palmer Children’s Hospital
Shands Lake Shore Regional Medical Center
Shands Live Oak Regional Medical Center
Shands Starke Regional Medical Center
FHCP HMO Plans
Benefit
HMO TS1
HMO T51
Deductible
Person / Family
$500 / $1,500
Person / Family
$1,000 / $2,000
Out-of-Pocket Limit
Person / Family
$3,500 / $10,500
Person / Family
$5,000 / $10,000
Primary Care Visit
$20 copay
$30 copay
Specialist Visit
$35 copay
$50 copay
Preventative Care
No Charge
No Charge
FHCP HMO Plans
Benefit
HMO TS1
HMO T51
Diagnostic Tests
including Radiology
$0 -10% No deductible
or 20% after deductible
$0 - 20% Coinsurance
after deductible
20% Coinsurance after
deductible
20% Coinsurance after
deductible
Outpatient Surgery
Emergency Room
Urgent Care
Hospital Stay
NOTE: Actual cost share amounts are based on location of service
FHCP HMO Plans
Prescription Drug
Coverage
Network Pharmacies
Preferred Generic
$3 copay
FHCP Pharmacy
Non-Preferred Generic
$10 copay
$15 copay
FHCP Pharmacy
Select Walgreen’s Pharmacy
Preferred Brand
$30 copay
$35 copay
FHCP Pharmacy
Select Walgreen’s Pharmacy
Non-preferred Brand
$55 copay
$60 copay
FHCP Pharmacy
Select Walgreen’s Pharmacy
Specialty Drugs
Formulary
$125 copay
Only available at FHCP pharmacies
Mail Order – up to 90 days
supply
$1 discount
per 31 day
supply
FHCP Pharmacy
FHCP Medical Premiums
For Plan Year Effective January 1, 2015 through December 31, 2015
Deductions begin December 15, 2014
FHCP-TS1
FHCP-T51
24-Pay per Year
Per pay
Per month
Per pay
Per month
College
$260.00
$520.00
$258.91
$517.82
Employee
$17.64
$35.28
$0.00
$0.00
Employee & Spouse
$134.52
$269.04
$108.99
$217.98
Employee & Child(ren)
$105.37
$210.74
$81.81
$163.62
Employee & Family
$213.09
$426.18
$182.26
$364.52
FHCP-TS1
FHCP-T51
18-Pay per Year
Per pay
Per month
Per pay
Per month
College
$346.67
$693.34
$345.21
$690.42
Employee
$23.51
$47.02
$0.00
$0.00
Employee & Spouse
$179.36
$358.72
$145.32
$290.64
Employee & Child(ren)
$140.49
$280.98
$109.08
$218.16
Employee & Family
$284.12
$568.24
$243.02
$486.04
The per pay totals were formula generated and may reflect slight round differences
2015 Medical Premiums
For Plan Year Effective January 1, 2015 through December 31, 2015
Deductions begin December 15, 2014
Blue Option 03559 or 03769
FHCP-TS1
FHCP-T51
24-Pay per Year
Per pay
Per month
Per pay
Per month
Per pay
Per month
College
$260.00
$520.00
$260.00
$520.00
$258.91
$517.82
Employee
$28.00
$56.00
$17.64
$35.28
$0.00
$0.00
Employee & Spouse
$148.50
$297.00
$134.52
$269.04
$108.99
$217.98
Employee & Child(ren)
$119.00
$238.00
$105.37
$210.74
$81.81
$163.62
Employee & Family
$232.00
$464.00
$213.09
$426.18
$182.26
$364.52
Blue Option 03559 or 03769
FHCP-TS1
FHCP-T51
18-Pay per Year
Per pay
Per month
Per pay
Per month
Per pay
Per month
College
$346.67
$693.34
$346.67
$693.34
$345.21
$690.42
Employee
$37.33
$74.66
$23.51
$47.02
$0.00
$0.00
Employee & Spouse
$198.00
$396.00
$179.36
$358.72
$145.32
$290.64
Employee & Child(ren)
$158.67
$317.34
$140.49
$280.98
$109.08
$218.16
Employee & Family
$309.33
$618.66
$284.12
$568.24
$243.02
$486.04
The per pay totals were formula generated and may reflect slight round differences
Health Dialog
Nurse Advice Hot Line
Florida Blue 877-789-2583

Speak to a
Health Coach or
Registered
Nurse

24 hours a day,
7 days a week,
365 days a year

Confidential
·
FHCP 800-548-0727
Delta Dental Plans
Delta Dental - Option 1
Network
Payment Basis
In-Net
PPO
Plan Year Maximum
$1000 per covered
member
Deductible (per
member/per family) per
calendar year
Out-Net
PPO
Delta Dental - Option 2
In-Net PPO
Premier
Out-Net
80th
$1000 per covered
member
DeltaCare – Option 3
In-Network Only
48N
No plan year
maximum
$50/$150
$50/$150
$50/$150
$50/$150
Office Visit $5 copay
100%
100%
100%
100%
D&P $0 - $45 copay
Basic Services
80%
60%
80%
80%
$0 - $115 copay
Major Services
50%
40%
50%
50%
$0 - $485 copay
Diagnostic/Preventive
Service (D&P)
Major Services Waiting
Period
None
None
None
Delta Dental Plans
Delta Dental
Option 1
Delta Dental
Option 2
Network
Payment Basis
In-Net
PPO
Out-Net
PPO
In-Net PPO
Premier
Out-Net
80th
Exams, cleanings, bite-wing Xrays
100%
100%
100%
100%
Oral Surgery
80%
60%
80%
80%
Non-Surgical Periodontics
80%
60%
80%
80%
Surgical Periodontics
80%
60%
80%
80%
Space Maintainers
100%
100%
100%
100%
General Anesthesia
80%
60%
80%
80%
Endodontics (root canal)
80%
60%
80%
80%
Perio Maintenance (4910)
80%
60%
80%
80%
Crowns, bridges, inlays, onlays
50%
40%
50%
50%
Implants
Covered
Covered
DeltaCare
Option 3
In-Network Only
48N
DeltaCare
Schedule 48N
Not Covered
Delta Dental Premiums
2015 Delta Dental Two Year Rate Guarantee
For Plan Year Effective: January 1, 2015 through December 31, 2015
Deductions begin December 15, 2014
Delta Dental PPO - Option 1
Delta Dental PPO - Option 2
Delta Dental DMO - Option 3
24 Pay per Year
Per pay
Per month
Per pay
Per month
Per pay
Per month
Employee
$12.31
$24.62
$14.73
$29.46
$5.98
$11.96
Employee & Spouse
$25.86
$51.72
$30.93
$61.86
$10.46
$20.92
Employee & Child(ren)
$26.11
$52.22
$31.23
$62.46
$12.56
$25.12
Employee & Family
$43.30
$86.60
$51.79
$103.58
$17.64
$35.28
Delta Dental PPO - Option 1
Delta Dental PPO - Option 2
Delta Dental - DMO Option 3
18 Pay per Year
Per pay
Per month
Per pay
Per month
Per pay
Per month
Employee
$16.41
$32.82
$19.64
$39.28
$7.97
$15.94
Employee & Spouse
$34.48
$68.96
$41.24
$82.48
$13.95
$27.90
Employee & Child(ren)
$34.81
$69.62
$41.64
$83.28
$16.75
$33.50
Employee & Family
$57.73
$115.46
$69.05
$138.10
$23.52
$47.04
The per pay totals were formula generated and may reflect slight round differences
VSP - Vision Plan
Choice Network
Copay
$10 Exam; $10 Materials
Exam
Every 12 months
Lenses
Every 12 months
Frames
Every 24 months
Examination
Covered after copay
Contact Lens Exam
(fitting & evaluation)
Standard Fit – covered in full after copay; member receives 15% off
contact lens exam services and copay will never exceed $60
Premium Fit – covered in full after copay; member receives 15% off contact
lens exam services and copay will never exceed $60
Lenses
Covered after copay for the following:
• Single Vision
• Lined Bifocal
• Lined Trifocal
• Lenticular
VSP - Vision Plan
Single Vision
Multifocal
$41
$41
No copay
No copay
Polycarbonate
$31
$35
Progressive
N/A
$55
Photochromic
$70
$82
Scratch Resistant Coating
$17
$17
Anti-reflective Coating
Polycarbonate for Children
Frames
$150
Elective Contact Lenses*
$120
Necessary Contact Lenses*
Covered after copay
*Contact lenses are in lieu of spectacle lenses and frames once every 12 months.
VSP - Vision Premiums
2015 VSP Two Year Rate Guarantee
For Plan Year Effective: January 1, 2015 through December 31, 2015
Deductions begin December 15, 2014
Vision Option
Vision Option
24 Pay per Year
Per pay
Per month
18 Pay per Year
Per pay
Per month
Employee
$2.93
$5.86
Employee
$3.91
$7.82
Employee & Spouse
$5.87
$11.74
Employee & Spouse
$7.83
$15.66
Employee & Child(ren)
$6.04
$12.08
Employee & Child(ren)
$8.05
$16.10
Employee & Family
$8.36
$16.72
Employee & Family
$11.14
$22.28
The per pay totals were formula generated and may reflect slight round differences
Conclusion
1. Everyone must enroll (or waive coverage)
online between October 13 – October 27, 2014
2. Create your enrollment account at
bmc.myfbmc.com
3. Have beneficiary information on hand during
the enrollment process
4. Questions

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