open enrollment for 2015
DESCRIPTION
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 - PowerPoint PPT PresentationTRANSCRIPT
Open Enrollment for 2015
October 13 – October 27, 2014
Welcome - Online Enrollment - FBMC information
FCSRMC - Life Insurance - Long Term Disability
Medical Benefits
Florida Blue – Pam SmithFlorida Health Care Plans – David Miller
Dental Benefits - Delta Dental
Vision Benefits - VSP
Agenda
Daytona State College Employee Benefitsdaytonastate.edu/employee_benefits
Florida Benefits Management Center (FBMC)bmc.myfbmc.com
Important Enrollment Websites
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.
FBMC Online Enrollment
Types of Accounts– Healthcare Spending Account – medical, dental, vision & Rx
Maximum contribution - $2,500/year
– Child/Dependent Care Account – Day CareMaximum 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
Flexible Spending Accounts
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.
2015 Life Insurance
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.
Long Term Disability
Pam Smith
Introducing Florida Blue
• 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 PPO PlansFeatures & Benefits
Florida Blue - Access to CareBrevard, Flagler and Volusia Counties
BREVARD BlueCare BlueOptions
Hospitals 7 7
PCPs 285 289
Specialists 492 506
VOLUSIA BlueCare BlueOptions
Hospitals 6 6
PCPs 264 279
Specialists 350 352
FLAGLER BlueCare BlueOptions
Hospitals 1 1
PCPs 34 38
Specialists 49 48
Wuesthoff Hospital - Rockledge**Wuesthoff Medical – Melbourne**Cape Canaveral HospitalHolmes Regional Medical CenterPalm Bay HospitalParrish Medical CenterViera Hospital
Space Coast AreaKEY 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** Providers in BlueSelect Network
Florida Hospital - Flagler
Florida Hospital – OceansideHalifax Medical Center**Halifax Hospital Port OrangeBert Fish Medical Center (Option 2)**Florida Hospital – DeLandFlorida Hospital – Fish Memorial
Florida Blue PPO Plans
Benefit BlueOptions 03769 BlueOptions 03559
DeductiblePerson / 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
NOTE: Actual cost share amounts are based on location of service
Benefit BlueOptions 03769 BlueOptions 03559
Diagnostic Tests Physician Office Independent Clinical Lab IDTC Hospital
$30/$50$0$50DED + 20% Opt 1/Opt 2
$30/$50$0DED + 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
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
Mail Order (Up to 90 days supply)
2 x Retail Copay 2 x Retail Copay
Florida Blue PPO Plans
Florida Blue Medical Premiums
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
For Plan Year Effective January 1, 2015 through December 31, 2015
Deductions begin December 15, 2014
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.
David Miller
Introducing FHCP
• 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 HMO PlansFeatures & Benefits
Deland
Orange City
FLAGLER
VOLUSIA
SEMINOLE
FHCP - Access to CareFlagler, Seminole and Volusia Counties
Daytona BeachDeLandEdgewaterOrmond BeachOrange CityPalm CoastPort Orange-Advanced Urgent Care
.
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
DeductiblePerson / 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% Coinsuranceafter deductible
Outpatient Surgery
20% Coinsurance after deductible
20% Coinsurance after deductible
Emergency Room
Urgent Care
Hospital Stay
NOTE: Actual cost share amounts are based on location of service
FHCP HMO Plans
FHCP HMO Plans
Prescription Drug Coverage Network Pharmacies
Preferred Generic $3 copay FHCP Pharmacy
Non-Preferred Generic $10 copay$15 copay
FHCP PharmacySelect Walgreen’s Pharmacy
Preferred Brand$30 copay$35 copay
FHCP PharmacySelect Walgreen’s Pharmacy
Non-preferred Brand$55 copay$60 copay
FHCP PharmacySelect 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
supplyFHCP Pharmacy
FHCP Medical Premiums
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
For Plan Year Effective January 1, 2015 through December 31, 2015
Deductions begin December 15, 2014
2015 Medical Premiums
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
For Plan Year Effective January 1, 2015 through December 31, 2015
Deductions begin December 15, 2014
Speak to a Health Coach or Registered Nurse
24 hours a day, 7 days a week, 365 days a year
Confidential
Health DialogNurse Advice Hot Line
Florida Blue 877-789-2583 · FHCP 800-548-0727
Delta Dental Plans
Delta Dental - Option 1 Delta Dental - Option 2 DeltaCare – Option 3
NetworkPayment Basis
In-NetPPO
Out-NetPPO
In-Net PPO Premier
Out-Net80th
In-Network Only48N
Plan Year Maximum $1000 per covered member
$1000 per covered member
No plan year maximum
Deductible (per member/per family) per calendar year
$50/$150 $50/$150 $50/$150 $50/$150 Office Visit $5 copay
Diagnostic/Preventive Service (D&P)
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
Major Services Waiting Period
None None None
Delta Dental Plans
Delta DentalOption 1
Delta DentalOption 2
DeltaCare Option 3
NetworkPayment Basis
In-NetPPO
Out-NetPPO
In-Net PPO Premier
Out-Net80th
In-Network Only48N
Exams, cleanings, bite-wing X-rays
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% DeltaCare Schedule 48N
Perio Maintenance (4910) 80% 60% 80% 80%
Crowns, bridges, inlays, onlays 50% 40% 50% 50%
Implants Covered Covered Not Covered
Delta Dental Premiums
2015 Delta Dental Two Year Rate GuaranteeFor 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
Anti-reflective Coating $41 $41
Polycarbonate for Children No copay No copay
Polycarbonate $31 $35
Progressive N/A $55
Photochromic $70 $82
Scratch Resistant Coating $17 $17
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
Vision Option
24 Pay per Year Per pay Per month
Employee $2.93 $5.86
Employee & Spouse $5.87 $11.74
Employee & Child(ren) $6.04 $12.08
Employee & Family $8.36 $16.72
Vision Option
18 Pay per Year Per pay Per month
Employee $3.91 $7.82
Employee & Spouse $7.83 $15.66
Employee & Child(ren) $8.05 $16.10
Employee & Family $11.14 $22.28
2015 VSP Two Year Rate GuaranteeFor Plan Year Effective: January 1, 2015 through December 31, 2015
Deductions begin December 15, 2014
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