Paul Sanchez
Florida offers its state employees a comprehensive package of health insurance benefits, including the Shared Savings Program, which aims to reduce healthcare costs and reward employees for making cost-effective decisions. The State Group Insurance website offers personalised information, health management programs, discounts, and services. Employees can also use SurgeryPlus to save money and earn rewards on planned medical procedures. Additionally, the Healthcare Bluebook allows employees to compare and select doctors and hospitals based on quality and cost ratings, helping them save on out-of-pocket medical expenses.
| Characteristics | Values |
|---|---|
| Name of Insurance | Florida Blue |
| Who is eligible? | Executive Service (AEX), University Support Personnel System (USPS), Faculty (CTP), Administrative and Professional (A&P), and eligible OPS employees |
| New Hire OPS employee eligibility | Appointed to work 30 hours or more, .75 FTE or greater |
| Transfer OPS employee eligibility | OPS employees transferring from a benefits-eligible position remain eligible until the end of their stability period |
| Additional OPS employee eligibility | If an OPS employee is appointed to an additional position and that additional appointment puts them over .75 FTE, the employee may then be eligible for benefits |
| New Hire Measurement Period | Begins the 1st day of the month following initial hire with the state and calculates hours worked over that 12-month period |
| New Hire Measurement Period end date (between January and October 2nd) | Stability period for eligibility is through December of that same calendar year |
| New Hire Measurement Period end date (between October 3rd and December) | Stability period is through December of the following calendar year |
| Stability period for OPS employees with prior position or qualifying event | Through December of the current year |
| Open Enrollment Measurement Period | Determines eligibility for the following year |
| OPS employees not meeting hours requirement during Open Enrollment Measurement Period | Coverage ends on December 31st of the current year; not eligible for benefits the following year without a qualifying event |
| PPO health insurance option | Employees can receive care from any doctor or healthcare provider; lower cost when using in-network providers; most services not covered until the annual deductible is met |
| SurgeryPlus | Allows employees to save money and earn rewards on planned medical procedures; separate from the health plan but with its own network of providers; surgeries covered are also covered under the State Group Health Insurance Program |
| Healthcare Bluebook | Allows employees to compare the quality and cost ratings of doctors and hospitals to make informed decisions and save on out-of-pocket medical expenses |
| Shared Savings Program | Rewards program to reduce healthcare costs and reward employees for making informed and cost-effective decisions about healthcare services |
| Telehealth benefits | Available through the Division of State Group Insurance website |
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What You'll Learn
Florida Blue PPO plans
Florida Blue offers affordable health insurance plans to individuals, families, and businesses. Florida Blue's PPO plans are called BlueOptions and BlueSelect. These plans offer out-of-network coverage and allow members to manage their care, including choosing their doctors and specialists, without requiring a primary care doctor.
Additionally, Florida Blue provides online tools and resources to support members in managing their health and healthcare costs. Members can access their online accounts to view claim status, request a replacement ID card, print forms, and update information. They can also estimate the cost of medical services, compare medical costs, and access health management programs, discounts, and services.
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$5.99 $17.99
SurgeryPlus
Florida offers a comprehensive package of health insurance benefits to its state employees, including the SurgeryPlus program.
The program achieves this by bundling commonly used services into a single, value rate. For instance, for a knee replacement surgery, instead of receiving separate bills from the surgeon, the surgery center or hospital, the anesthesiologist, and the radiologist, the State of Florida will receive one bill with a "bundled" rate for doctors and medical procedures by cost and quality. This means that the employee will pay less for their procedure and earn rewards.
Overall, SurgeryPlus is a valuable program for Florida state employees, offering cost savings and rewards on planned medical procedures through a separate network of providers.
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Shared Savings Program
The State of Florida offers a Shared Savings Program to reward its employees for making informed and cost-effective healthcare decisions. The program allows employees to shop for healthcare services and earn rewards.
Florida's state employees can access a comprehensive package of health insurance benefits through the Division of State Group Insurance (DSGI) website. The DSGI website offers benefits for active and retired state employees and their eligible spouses and/or children.
One way that the Shared Savings Program rewards employees is through SurgeryPlus. Effective as of January 1, 2019, State Employees can use SurgeryPlus to save money and earn rewards on planned medical procedures. SurgeryPlus is separate from the employee's health plan and has its own network of providers. Surgeries covered under SurgeryPlus are also covered under the State Group Health Insurance Program but are packaged differently to deliver more value. SurgeryPlus bundles commonly used services into a single, value rate, saving employees money. For example, for a knee replacement surgery, instead of receiving separate bills from the surgeon, the surgery center or hospital, the anesthesiologist, and the radiologist, the State of Florida gets one bill with a “bundled” rate for doctors and medical procedures by cost and quality.
Another way that the Shared Savings Program helps employees save money is through Healthcare Bluebook. Also effective as of January 1, 2019, State Employees can use Healthcare Bluebook to search the quality and cost ratings for doctors and hospitals. This information can help employees make informed decisions about their healthcare and save on their out-of-pocket medical expenses.
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Healthcare Bluebook
Florida offers its state employees a comprehensive package of health insurance benefits, which can be accessed via the Division of State Group Insurance website. This includes the Healthcare Bluebook, an online transparency site that allows users to compare and shop for healthcare services, facilities, and providers based on quality and cost ratings.
The Healthcare Bluebook platform offers a simple and user-friendly interface for comparing doctors and hospitals. It provides detailed information on the quality and cost ratings of various healthcare providers, allowing users to make like-for-like comparisons. This transparency helps employees identify high-quality, cost-effective healthcare services, facilities, and providers.
Additionally, Healthcare Bluebook is complemented by the SurgeryPlus program, which allows state employees to save money and earn rewards on planned medical procedures. SurgeryPlus simplifies the billing process by bundling commonly used services into a single, value-based rate. This means that instead of receiving multiple bills from different providers involved in a procedure, the State of Florida receives one bill with a "bundled" rate that covers all doctors and medical procedures by cost and quality.
Overall, the Healthcare Bluebook is an essential component of Florida's employee health insurance benefits, promoting informed decision-making, cost savings, and improved access to quality healthcare services for state employees and their eligible dependents.
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OPS employee eligibility
The State of Florida offers a range of health insurance benefits to its employees, including temporary staff (OPS). OPS employees who work an average of 30 hours per week or more (.75 FTE) are eligible for medical insurance. This includes access to Standard and High Deductible PPO plans provided by Florida Blue, with SurgeryPlus benefits, and Standard and High Deductible HMO plans with providers varying by region.
OPS employees are also eligible for dental insurance plans, including Prepaid (DHMO), Standard PPO, and Indemnity PPO options, if they meet the same 30-hour workweek requirement. It is important to note that dental coverage and costs can vary between plans, and some treatments may have waiting periods.
Additionally, OPS employees in Florida can take advantage of Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA). FSAs allow employees to contribute pre-tax money for eligible expenses, with options for healthcare and dependent care. HSAs are available to those enrolled in a high-deductible health plan, with the state contributing pre-tax funds to the employee's account with each paycheck.
Retirement savings plans are also an option for OPS employees. The State of Florida offers Voluntary 457(b) Florida Deferred Compensation Plans and Fidelity Voluntary 403(b) Plans, which can supplement an employee's retirement income or function as stand-alone plans. These plans have tax-deferred and post-tax Roth options, annual IRS contribution limits, and no employer contributions.
To access personalized information and manage their health benefits, OPS employees in Florida can utilize the Division of State Group Insurance website (DSGI) and their online platform, Floridablue.com.
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Frequently asked questions
Florida state employees have access to a comprehensive package of health insurance benefits, including the PPO health insurance option. This allows them to receive care from any doctor or healthcare provider, although costs are lower when using in-network providers.
SurgeryPlus is a program that Florida state employees can use to save money and earn rewards on planned medical procedures. It covers surgeries also included in the State Group Health Insurance Program but packages them in a way that offers more value.
Florida state employees can access personalized information, health management programs, discounts, and services online. They can also view how claims were processed, including out-of-pocket costs, and estimate the cost of medical services.
