海角社区

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Insurance Plans

海角社区offers budgeted and eligible non-budgeted employees the opportunity to participate in a selection of voluntary insurance benefit programs.

Marketplace Notice: Please visit for more information, about the Health Insurance Marketplace for employment-based health coverage offered by the state of Florida, should you choose not to enroll through the State Group Insurance Program

Health Insurance

海角社区offers the following health insurance coverage:
Preferred Provider Organization | Health Maintenance Organization | Health Investor Health Plan


Health insurance coverage is available to all budgeted faculty, administrative, support, and eligible non-budgeted employees at the 海角社区. Employees have 60 calendar days from their hire date to enroll in a State Group Insurance Program health insurance plan. Plan changes are only made during the annual open enrollment period or due to an approved . To enroll in a new plan or make changes to your current health plan, if eligible, please contact the Office of Human Resources at (904) 620-2903 and ask to speak with a member of the Benefits and Retirement team.

You can also sign-up for a State Group Insurance Program health insurance plan online through  or by contacting the People First Service Center at 866-663-4735.

Note: 

  • If you enrolled online or through the People First Service Center, please contact the Office of Human Resources at (904) 620-2903 and ask to speak with a member of the Benefits and Retirement team so that the premium deductions are set up on a per pay period basis to avoid any premium payment delinquencies that may cause your plan to become inactive.
  • 海角社区employees whose spouse also works for the State of Florida may qualify for health insurance coverage at a reduced cost. Please refer to the Spouse Program page on the  webpage for more information. 
  • All nine-month faculty (who have not elected deferred pay) enrolled in a State Group Insurance Program health insurance plan will have their deductions doubled starting with the first paycheck in February through the first paycheck in May. Refer to the Nine-Month Faculty Benefits page for more information. 
  •  - must be satisfied for all dependents upon enrollment into a state plan within the grace period, or dependents could lose coverage. Please be sure to read all People First correspondence as it may relate to keeping active benefits coverage for your dependents.

 will manage your prescription benefits like your health insurance company manages your medical benefits. That means helping you get the medication you need and helping you find ways to save. For more information, please call 800-547-9767.

Preferred Provider Organization (PPO)

Standard PPO coverage provides flexibility in choosing both network and non-network providers. The deductibles and coinsurance out-of-pocket costs will be less when visiting an in-network provider. A summary of the Standard PPO plan is below. For complete plan details and a plan comparison chart, please visit the  website.


*Premium deductions take place on a biweekly basis. To calculate the amount deducted from your paycheck, divide the employee contribution amount by two. The employee contribution amounts shown above are based on an active, full-time employee. Part-time employee contribution amounts may be higher. Contact the Office of Human Resources at (904) 620-2903 to calculate the employee contribution for a part-time employee.


Network Coverage:

In-Network:

(You will pay the least)

Out-of-Network:

(You will pay the most)

Annual Deductible:

Employee: $250

Family: $500

Employee: $750

Family: $1,500

Coverage:

United States

Worldwide

Co-Payments:

Primary Care: $15/visit

Specialist: $25/visit

Hospital: 20%  + $250 Per Admission Deductible

Primary Care and Specialist:  40% Coinsurance + amount above allowance

Hospital: 40% Coinsurance + $500 Per Admission Deductible + amount above allowance

Prescriptions:

Generic: $7

Preferred brand: $30

Non-preferred brand: $50

(Mail order, 90-day-supply prescriptions also available)

You pay in full, file a claim, and will not get reimbursed the entire amount.

 


Health Maintenance Organization (HMO)

Standard HMO coverage offers benefits through network providers without deductible or coinsurance out-of-pocket costs. Non-network providers do not provide covered services. A summary of the Standard HMO plan is below. For complete plan details and a plan comparison chart, please visit the  website.

Plan Summary


*Premium deductions take place on a biweekly basis. To calculate the amount deducted from your paycheck, divide the employee contribution amount by two. The employee contribution amounts shown above are based on an active, full-time employee. Part-time employee contribution amounts may be higher. Contact the Office of Human Resources at (904) 620-2903 to calculate the employee contribution for a part-time employee.


 


Health Investor Health Plan (HIHP) 

HIHP high deductible coverage gives you either PPO or HMO coverage at a reduced premium for the trade-off of an increased out-of-pocket cost. A summary of the HIHP high deductible PPO and HMO plan is below. For complete plan details and a plan comparison chart, please visit the  website.

  •  Health Investor PPO
  •  Health Investor HMO

Health Investor Health Plan (HIHP) Plan Summary

HIHP PPO

*Premium deductions take place on a biweekly basis. To calculate the amount deducted from your paycheck, divide the employee contribution amount by two. 
The employee contribution amounts shown above are based on an active, full-time employee. Part-time employee contribution amounts may be higher. Contact the Office of Human Resources at (904) 620-2903 to calculate the employee contribution for a part-time employee. 

Network Type: Network: Out of Network:
Annual Out-of-Pocket Maximum:

Employee Only Coverage: $3,000

Family Coverage: $6,000

Employee Only Coverage: $7,500

Family Coverage: $15,000

Annual Deductibles:

Employee Only Coverage: $1,500

Family Coverage: $3,000

Employee Only Coverage: $2,500

Family Coverage: $5,000

Medical Care: 20% of the network-allowed amount after the annual deductible is met. 40% of the non-network-allowed amount after the annual deductible is met.
Hospital Stay: 20% of the network-allowed amount after the annual deductible is met. 20% of the non-network-allowed amount and $1,000 admission deductible after the annual deductible is met.

Prescriptions:

Generic: 30%

Preferred Brand: 30%

Non-Preferred Brand: 50%

Member pays in full and files a claim.

HIHP HMO


*Premium deductions take place on a biweekly basis. To calculate the amount deducted from your paycheck, divide the employee contribution amount by two. The employee contribution amounts shown above are based on an active, full-time employee. Part-time employee contribution amounts may be higher. Contact the Office of Human Resources at (904) 620-2903 to calculate the employee contribution for a part-time employee.

Life Insurance

海角社区offers the following life insurance coverage:

Life insurance coverage is available to all budgeted faculty, administrative, support, and eligible non-budgeted employees at the 海角社区. Employees have 60 calendar days from their hire date to enroll in a State Group Insurance Program life insurance plan. Plan changes are only made during the annual open enrollment period or due to an approved . To enroll in a new life insurance plan or make changes to your current life insurance plan, if eligible, please contact the Office of Human Resources at (904) 620-2903 and ask to speak with a member of the Benefits and Retirement team.

You can also sign-up for a State Group Insurance Program life insurance plan online through  or by contacting the People First Service Center at 866-663-4735.
  

Note:  

  • If you enrolled online or through the People First Service Center, please contact the Office of Human Resources at (904) 620-2903 and ask to speak with a member of the Benefits and Retirement team so that the premium deductions are set up on a per pay period basis to avoid any premium payment delinquencies that may cause your plan to become inactive.  
  • All nine-month faculty (who have not elected deferred pay) enrolled in a State Group Insurance Program life insurance plan will have their 海角社区offers the following life insurance coverage will have their deductions doubled starting with the first paycheck in February through the first paycheck in May. Refer to the Nine-Month Faculty Benefits webpage for more information.

 

Basic Life Insurance 

A free, basic group term life insurance benefit of $25,000 is available to all full-time budgeted employees. Part-time budgeted employees pay pro-rated premiums based on their FTE. Eligible non-budgeted employees pay the full premium. 

Plan Summary


*Premium deductions take place on a biweekly basis. To calculate the amount deducted from your paycheck, divide the monthly premium amount by two. The employee premium amounts shown above base on an active, full-time employee. Part-time employee premium amounts may be higher. To enroll in a new plan or make changes to your current Basic Life insurance plan, if eligible, or for information regarding part-time premium deductions, please contact the Office of Human Resources at (904) 620-2903 and ask to speak with a member of the Benefits and Retirement team.

 

Optional Life Insurance 

Salaried employees enrolled in basic life insurance coverage can also elect additional term life insurance. Medical Underwriting may be required. 

Plan Summary


*Premium deductions take place on a biweekly basis. To calculate the amount deducted from your paycheck, divide the monthly premium amount by two. The employee premium amounts shown above base on an active, full-time employee. To enroll in a new plan or make changes to your current Optional Life insurance plan, if eligible, please contact the Office of Human Resources at (904) 620-2903 and ask to speak with a member of the Benefits and Retirement team.

 


Spousal Life

All employees enrolled in basic term life insurance may elect and pay for dependent spouse coverage. 

Plan Summary 


*Premium deductions take place on a biweekly basis. To calculate the amount deducted from your paycheck, divide the monthly premium amount by two. The employee premium amounts shown above base on an active, full-time employee. To enroll in a new plan or make changes to your current Spousal Life insurance plan, if eligible, please contact the Office of Human Resources at (904) 620-2903 and ask to speak with a member of the Benefits and Retirement team.


Dependent Life 

Plan Summary 


*Premium deductions take place on a biweekly basis. To calculate the amount deducted from your paycheck, divide the monthly premium amount by two. The employee premium amounts shown above base on an active, full-time employee. To enroll in a new plan or make changes to your current Dependent Life insurance plan, if eligible, please contact the Office of Human Resources at (904) 620-2903 and ask to speak with a member of the Benefits and Retirement team.

Dental Insurance

海角社区offers the following dental insurance plan types:

Indemnity | PPO | Prepaid 


Dental insurance coverage is available to all budgeted faculty, administrative, support, and eligible non-budgeted employees at the 海角社区. Employees have 60 calendar days from their date of hire to enroll in a State Group Insurance Program dental insurance plan. Plan changes are only made during the annual open enrollment period or due to an approved qualifying status change. To enroll in a new plan or make changes to your current dental plan, if eligible, please contact the Office of Human Resources at (904) 620-2903 and ask to speak with a member of the Benefits and Retirement team. 

You can also sign-up for a State Group Insurance Program dental insurance plan online through or by contacting the People First Service Center at 866-663-4735.


Note: 

  • If you enrolled online or through the People First Service Center, please contact the Office of Human Resources at (904) 620-2903 and ask to speak with a member of the Benefits and Retirement team so that the premium deductions are set up on a per pay period basis to avoid any premium payment delinquencies that may cause your plan to become inactive. 
  • All nine-month faculty (who have not elected deferred pay) enrolled in a State Group Insurance Program dental insurance plan will have their deductions doubled starting with the first paycheck in February through the first paycheck in May. Refer to the Nine-Month Faculty Benefits page for more information.  

海角社区offers the following dental insurance plan types:

Indemnity Dental Plan

With the indemnity dental options, you may receive care from any dentist. You have a deductible to meet and then pay a part of the cost for the services you receive. A summary of the Indemnity dental plan is below. For complete plan details and a plan comparison chart, please visit the  website.

 

*Premium deductions take place on a biweekly basis. To calculate the amount deducted from your paycheck, divide the employee contribution amount by two. The employee contribution amounts shown above are based on an active, full-time employee. Part-time employee contribution amounts may be higher. Contact the Office of Human Resources at (904) 620-2903 to calculate the employee contribution for a part-time employee.

Indemnity with PPO Dental Plan 

With the indemnity dental options, you may receive care from any dentist. You have a deductible to meet and then pay a percentage of the cost for the services you receive. A summary of the plan can be found below. Complete plan details and a plan comparison chart can be found on the  website. 

 

 


*Premium deductions take place on a biweekly basis. To calculate the amount deducted from your paycheck, divide the employee contribution amount by two. The employee contribution amounts shown above are based on an active, full-time employee. Part-time employee contribution amounts may be higher. Contact the Office of Human Resources at (904) 620-2903 to calculate the employee contribution for a part-time employee.

PPO Dental Plans 

With the PPO Dental plan, you may choose to receive care from any dentist although your cost is lower when you use network dentists. You have a deductible to meet and then pay part of the cost for the services you receive. A summary of the plan can be found below. Complete plan details and a plan comparison chart can be found on the  website. 

 

 

 


*Premium deductions take place on a biweekly basis. To calculate the amount deducted from your paycheck, divide the employee contribution amount by two. The employee contribution amounts shown above are based on an active, full-time employee. Part-time employee contribution amounts may be higher. Contact the Office of Human Resources at (904) 620-2903 to calculate the employee contribution for a part-time employee.

Prepaid  (HMO) Dental Plans

With prepaid dental plans you must use in-network providers. These plans do not have a deductible and cover most preventive care at no charge. You pay a specific dollar amount for other care you receive. A summary of the plan can be found below. For complete plan details and a plan comparison chart can be found on the  website. 

 


 


*Premium deductions take place on a biweekly basis. To calculate the amount deducted from your paycheck, divide the employee contribution amount by two. The employee contribution amounts shown above are based on an active, full-time employee. Part-time employee contribution amounts may be higher. Contact the Office of Human Resources at (904) 620-2903 to calculate the employee contribution for a part-time employee.

 

Vision Insurance

Vision insurance coverage is available to all budgeted faculty, administrative, support, and eligible non-budgeted employees at the 海角社区. Employees have 60 calendar days from their date of hire to enroll in a State Group Insurance Program vision insurance plan. Plan changes are only made during the annual open enrollment period or due to an approved  qualifying status changeTo enroll in a new plan or make changes to your current vision plan, if eligible, please contact the Office of Human Resources at (904) 620-2903 and ask to speak with a member of the Benefits and Retirement team. 

You can also sign-up for a State Group Insurance Program vision insurance plan online through or by contacting the People First Service Center at 866-663-4735.

Note:  

  • If you enrolled online or through the People First Service Center, please contact the Office of Human Resources at (904) 620-2903 and ask to speak with a member of the Benefits and Retirement team so that the premium deductions are set up on a per pay period basis to avoid any premium payment delinquencies that may cause your plan to become inactive.  
  • All nine-month faculty (who have not elected deferred pay) enrolled in a State Group Insurance Program vision insurance plan will have their deductions doubled starting with the first paycheck in February through the first paycheck in May. Refer to the Nine-Month Faculty Benefits page for more information.

海角社区offers the following vision insurance plan types: 


Vision/Exam + Materials 

Caring for your eyes is a very important part of your overall health and wellness. That's why the State offers you competitive vision coverage at affordable rates. You have access to one of the largest vision networks in the United States, with more than 108,000 access points with independent optometrists and ophthalmologists and national retail locations—and every one accepts new patients. A summary of the vision plan is below. For complete plan details and a plan comparison chart, please visit  website.. 

Vision Insurance Plan Summary


*Premium deductions take place on a biweekly basis. To calculate the amount deducted from your paycheck, divide the employee contribution amount by two. The employee contribution amounts shown above are based on an active, full-time employee. Part-time employee contribution amounts may be higher. Contact the Office of Human Resources at (904) 620-2903 to calculate the employee contribution for a part-time employee.

 

Flexible Spending

The state offers three reimbursement accounts (FSAs) that can provide tax breaks on predictable out-of-pocket costs. For more information, visit  website and check out the Savings and Spending Accounts and review the  Guide at the bottom of the . The  is also available to help you decide if the reimbursement accounts are beneficial for you.

If you have a high deductible HMO or PPO plan (HDHP), learn more about opening a  (HSA).

Chard Snyder is the administrator for all savings and spending accounts.

Carryover

For the healthcare FSA and limited purpose FSA, December 31 is the last day to incur claims for the current plan year, and you must submit all claims by April 15 of the following plan year. If you have funds remaining at the end of the current plan year, a maximum of $570 will carry over to the next plan year while any funds in excess of $570 will forfeit.

Note: 

The carryover does not apply to the dependent care FSA. For the dependent care FSA, the grace period to use funds ends March 15 of the next plan year and you must submit all claims by April 15 of the next plan year. Otherwise, you will lose any remaining money. 

Flexible Spending Account Plan Summaries
Type Healthcare FSA: Dependent Care FSA: Limited Purpose FSA:
Employee Contribution Limits

$60 to $2,850 in pretax dollars

$60 to $5,000 in pretax dollars ($2,500 if you're married filing separate tax returns)

$60 to $2,850 in pretax dollars

Use For:

Out-of-pocket medical, prescription, dental, vision and over-the-counter medication expenses not paid by insurance or reimbursed from any other source.

Care for children under the age of 13 or a dependent age 13 and older who live with you at least 8 hours a day and who need supervised care, such as an elderly parent or spouse with a disability.

Out-of-pocket dental, vision and over-the-counter medication expenses not paid by insurance or reimbursed from any other source. Not available for medical expenses.

When is Money Available?

The total amount of your annual election is available January 1 (for open enrollment) or on your enrollment date (for new hires or if you have an appropriate Qualifying Status Change (QSC) event).

Money is added to your account after each payroll deduction. You may use only the amount you have in your account at the time.

The total amount of your annual election is available January 1 (for open enrollment) or on your enrollment date (for new hires or if you have an appropriate Qualifying Status Change (QSC) event).

Submitting Claims December 30 of each year is the last day to incur claims for the current plan year, and you must submit all claims by April 15 of the following year.  Otherwise, if you have funds remaining at the end of the current year, a maximum of $570 will carry over to the next plan year, while any funds in excess of $570 will forfeit. March 15 of each year is the last day to incur claims for the previous plan year, and you must submit all claims by April 15. Otherwise, you lose any remaining money. December 30 of each year is the last day to incur claims for the current plan year, and you must submit all claims by April 15 of the following year.  Otherwise, if you have funds remaining at the end of the current year, a maximum of $570 will carry over to the next plan year, while any funds in excess of $570 will forfeit.

 

Important considerations to consider before making your FSA choices.

Post-Tax Insurance

Post-tax insurance plans are available to all faculty, administrative and support staff employees at the 海角社区. Employees have 60 calendar days from their date of hire to enroll in post-tax insurance plans. Some insurance plans allow plan changes throughout the year while others only allow changes during an open enrollment period. To enroll in a new post-tax insurance plan or make changes to your current post-tax insurance plan, if eligible, please contact the Office of Human Resources at (904) 620-2903 and ask to speak with a member of the Benefits and Retirement team.

Enrollment forms may be mailed in or faxed to (904) 620-2742 if an appointment is not needed.

Note: 

If you mailed or faxed your enrollment forms, please contact the Office of Human Resources at (904) 620-2903 and ask to speak with a member of the Benefits and Retirement team so that the premium deductions are set up on a per pay period basis to avoid any premium payment delinquencies that may cause your plan to become inactive.

Post Tax Insurance Plan Summary
Name: Plan Summary Insurance Providers:
Long Term Disability:

Long-term disability replaces 60% of your income tax-free to a maximum of $15,000 per month. For complete plan details, please visit the  website or contact one of the representatives on the participating investment companies web page.

NOTE: This plan will not cover any disability that results from a pre-existing condition in the first 12 months after the effective date of coverage.

 

Phone: (800) 330-6115

Long Term Care:

Long-term care insurance provides coverage to individuals who are unable to perform at least two activities of daily living or to someone who has severe cognitive impairment. This coverage may be used to cover expenses relating to care in a skilled nursing facility or home-based care.

Phone: (800) 330-6115

Level Term Life Insurance:

Level Term Life Insurance is the least expensive form of life insurance available. Underwritten by Symetra Life Insurance Company. This plan features easy payroll deduction, competitive pricing, predictable premiums, customized and portable coverage.

 

Phone: (800) 330-6115

Whole Life Insurance:

Whole Life Insurance with Mass Mutual offers three important guarantees: Guaranteed Death Benefit, Guaranteed Level Premium and Guaranteed Increase in cash value. This plan features easy payroll deduction, predictable premiums and portable coverage. Employees may apply for up to $250,000 in coverage. Spouses and children can also be insured.

Phone: (800) 330-6115

Legal Insurance: Legal insurance provides assistance with adoptions, wills and trusts, real estate, administrative hearings, attorney office work and matrimonial matters, among other things.

Phone: (800) 356-5297

Supplemental Insurance

Supplemental insurance coverage is available to all faculty, administrative, and support staff employees at the 海角社区. Employees have 60 calendar days from their date of hire to enroll in supplemental insurance plans. Plan changes can be made only during the annual open enrollment period or as a result of an approved qualifying status changeTo enroll in a new plan or make changes to your current health plan, if eligible, please contact the Office of Human Resources at (904) 620-2903 and ask to speak with a member of the Benefits and Retirement team.

Enrollment forms may be mailed in or faxed to (904) 620-2742 if an appointment is not needed.

Notes:

  • If you mailed or faxed your enrollment forms, please contact the Office of Human Resources at (904) 620-2903 and ask to speak with a member of the Benefits and Retirement team so that the premium deductions are set up on a per pay period basis to avoid any premium payment delinquencies that may cause your plan to become inactive.    

 Capital Insurance has developed updated portals for New and Existing/Retiring employees:

  •  - New employee pre-tax benefit packet that includes all of the Aflac, Cigna, MetLife, and Humana benefits forms.
  • - Retirement Benefits Packet that guides and enables exiting and retiring employees to continue any insurance plans they may currently have with Capital Insurance Agency.
Supplemental Insurance Plan Summary
Benefit Summary: Insurance Providers: Contact
Accident Insurance: Help you pay the following types of expenses when injured during a covered accident:
  • Expensive medical treatment for broken bones and dislocations, or physical therapy
  • Crutches, wheelchairs or other medical aids you may need as a result of your accident
  • Copayments and deductibles
 

Phone: (888) 899-4135

Cancer Insurance: Depending on the plan you choose, supplemental benefits for:
  • Cancer diagnosis and treatment, including certain screening tests
  • Procedures and treatments you may require to care for your cancer
 
 (through Capital Insurance Agency)

Phone: (800) 780-3100

 

Phone: (888) 899-4135

Disability Insurance: Helps supplement your income during short-term disability.

Phone: (888) 899-4135

Hospitalization Insurance:

  • Deductible
  • Room and board
  • Special hospital facility charges
  • Home health care
  • Daily benefit for hospital confinement
 
 (through Capital Insurance Agency)

Phone: (800) 780-3100

 (through State Securities)

Phone: (800) 277-2300

Intensive Care Insurance: Daily benefit for confinement in a hospital intensive care or a sub-acute intensive care unit.  (through Capital Insurance Agency)

Phone: (800) 780-3100

Phone: (888) 899-4135

 

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