Open Enrollment 2016. Welcome - Online Enrollment - FBMC information FCSRMC - Life Insurance - Long Term Disability Medical Benefits Florida Blue – Edith

Open Enrollment 2016

Welcome - Online Enrollment - FBMC information

FCSRMC - Life Insurance - Long Term Disability

Medical Benefits

Florida Blue – Edith HodgesFlorida 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 login at bmc.myfbmc.com

FBMC Online Enrollment

Medical Plan Changes

• Reviewed plan designs / offeringsIntroduced 4 choices

Varying benefits and costs

Committed to compliance and stabilization

• College contribution commitment

• Rising costs and premiums

Last Year --- Where Were We?

Dental and Vision Changes

• Change from self-insured to FCSRMC

Offered multiple choices in coverage

Rates and benefits set for 2 years

Last Year --- Where Were We?

Medical Plan Coverage• Plans stabilized as promised

FHC Plan’s have no changes to benefits

FL Blue has minimal changes to benefits

• Premium Increases (based on employee only coverage)

FHCP: TS1 = 4.6% T51= 5.3%

FL Blue: 03769 = 3.7% 03559*= 8.2%*03559 was offered at the lower price in 2015

• College continues to pays $520/ month• Employee pays balance

This Year --- Where Are We?

Dental and Vision Plans• As stated in October 2014, there are no

changes to premiums or benefits for the January 2016 plan year

Life Insurance• No changes to rates or benefits

This Year --- Where Are We?

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

Flexible Spending Accounts

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

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.

2016 Life Insurance

http://www.unum.com/

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

http://www.unum.com/

Edith Hodges

Introducing Florida Blue

• Access to over 44,000+ providers in Florida; 817,000+ nationally

• Access to 200+ countries Worldwide

• Local hospitals in-network Option 1

• Bert Fish Medical Center in-network Option 2

• Emergency 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 BlueOptions

Hospitals 7

PCPs 308

Specialists 473

VOLUSIA BlueOptions

Hospitals 6

PCPs 284

Specialists 264

FLAGLER BlueOptions

Hospitals 1

PCPs 39

Specialists 49

Wuesthoff Hospital - RockledgeWuesthoff Medical – MelbourneCape 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

Florida Hospital - Flagler

Florida Hospital – OceansideHalifax Medical CenterHalifax Hospital Port OrangeBert Fish Medical Center (Option 2)Florida Hospital – DeLandFlorida Hospital – Fish Memorial

Mayo ClinicShands all locations (Option 2)All Florida Hospital System locationsCleveland Clinic

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

Independent Diag Test Centr Outpatient Hospital

$30/$50$0 (Quest only)$50 (Adv Imaging- Ded+20%)

DED + 20% Opt 1/Opt 2

$30/$50$0 (Quest only)DED + 20%$150 Opt 1 / $250 Opt 2

ER (Facility)ER (Physician)

DED + 20%$100

$100 + 20%DED + 20%

Urgent Care $65 $50

Inpatient Hospital Stay

$1,000 Option 1$2,000 Option 2

$750 Option 1$1,500 Option 2


Prescription Drug Coverage

BlueOptions 03769

BlueOptions 03559

Generic $15 copay $15 copay

Brand $45 copay $60 copay

Non-preferred Brand $65 copay $100 copay

Specialty Pharmacy25%

(member out of pocket max up to $250 per

month per Rx)

$100 copay

Mail Order (Up to 90 days supply)

2 x Retail Copay 2 x Retail Copay


Florida Blue Medical Premiums

For Plan Year Effective January 1, 2016 through December 31, 2016

Deductions begin December 15, 2015

Florida Blue Plans (PPO)Blue Option 03559 Blue Option 03769

24-Pay per Year Per pay Per Month Per pay Per Month

College $260.00 $520.00 $260.00 $520.00

Employee $51.50 $103.00 $45.00 $90.00

Employee & Spouse $182.00 $364.00 $172.50 $345.00

Employee & Child(ren) $149.50 $299.00 $141.00 $282.00

Employee & Family $271.50 $543.00 $261.00 $522.00

Florida Blue Plans (PPO)Blue Option 03559 Blue Option 03769


College $346.67 $693.34 $346.67 $693.34Employee $68.67 $137.34 $60.00 $120.00

Employee & Spouse $242.67 $485.34 $230.00 $460.00


Employee & Family $362.00 $724.00 $348.00 $696.00

The per pay totals were formula generated and may reflect slight rounding differences

David Miller

Introducing FHCP

• Access to over 1500 providers

• All local hospitals in-network

• Emergency & Urgent Care covered worldwide

• WFW Extended Hour Centers reduced $10 copay

• FREE Access to over 60 local Gyms

• FHCP.com and myFHCP – find providers, view claims, benefit info, member handbook, order new ID Cards

• Nurse Advice Hotline (24/365) – 866-548-0727

• Dedicated Case & Disease Management

• Flu Shots available at no cost at FHCP facilities

FHCP HMO PlansFeatures & Benefits

FLAGLER

SEMINOLE

VOLUSIA

BREVARD

Orange City

FHCP - Access to CareFlagler, Volusia, Seminole and Brevard Counties

WFW Locations:Daytona BeachDeLandEdgewaterOrmond BeachOrange CityPalm CoastPort Orange-Advanced Urgent Care

Growing Network in:Altamonte RockledgeCocoa SanfordLake Mary TitusvilleMelbourne And more

.

Contracts with Hospitals

• All Volusia/Flagler Counties Hospitals

• Central Florida Regional Hospital

• Putnam Community Medical Center

• Mayo Clinic Hospital

• Arnold Palmer Children’s Hospital (by referral)

• Shands Lake Shore Regional Medical Center

• Shands Live Oak Regional Medical Center

• Shands Starke Regional Medical Center

• Parrish Medical Center

• Wuesthoff Medical Center-Melbourne

• Wuesthoff Medical Center-Rockledge

FHCP HMO Plans

Benefit HMO TS1 HMO T51


Person / Family $1,000 / $2,000

Out-of-Pocket Limit Person / Family$3,500 / $10,500

Person / Family$5,000 / $10,000




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


Emergency Room

Urgent Care

Hospital Stay

NOTE: Actual cost share amounts are based on location of service

FHCP HMO Plans

Florida Health Care

Primary care visit $10 copay

Urgent care visit $10 copay

Sports Physical, Well Woman, Child Health and Vaccinations

$0 copay

Routine Injections that are administered during a PCP visit

Included in the visit copay; no extra participant out of pocket

Wellness Coaching face-to-face $10 copay

Work Force WellnessExtended Hour Centers

Central Scheduling 386-676-7198 · Toll Free 855-210-2648Available 7:00 – 7:00 Monday-Friday

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


Non-preferred Brand$55 copay$60 copay


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



Florida Health Care Plans (HMO)

FHCP-TS1 FHCP-T51


College $260.00 $520.00 $260.00 $520.00

Employee $30.35 $60.70 $12.72 $25.44

Employee & Spouse $152.59 $305.18 $127.53 $255.06


Employee & Family $234.76 $469.52 $204.71 $409.42

Florida Health Care Plans (HMO)

FHCP-TS1 FHCP-T51


College $346.67 $693.34 $346.67 $693.34

Employee $40.47 $80.94 $16.96 $33.92

Employee & Spouse $203.45 $406.90 $170.04 $340.08


Employee & Family $313.01 $626.02 $272.95 $545.90


Florida Blue Florida Health Care


Person / Family $500 / $1,500

Out-of-Pocket Limit Person / Family $6,000 / $12,000

Person / Family$3,500 / $10,500




In-Network Benefits

In-Network Benefits


Diagnostic TestsRadiology (Office/IDTC)

$30/$50 (BOptions 03769)

DED +20% (BOptions 03559)

$0 -10% Coinsurance no deductible

Outpatient SurgeryDED +20% (BOptions 03769)$150 Opt 1 / $250 Opt 2 (BOptions 03559)


Emergency RoomDED + 20% (BOptions 03769)

$100 copay + 20% (BOptions 03559)

Urgent Care $65 copay (BOptions 03769)$50 copay (BOptions 03559)

Hospital Stay$1000 Opt 1 / $2000 Opt 2 (BOptions 03769)$750 Opt 1 / $1500 Opt 2 (BOptions 03559)


Preferred Generic$15 copay (BOptions 03769)

$15 copay (BOptions 03559) $3 copay FHCP Pharmacy

Non-Preferred Generic

$15 copay (BOptions 03769)

$15 copay (BOptions 03559) $10 copay$15 copay


Preferred Brand$45 copay (BOptions 03769)

$65 copay (BOptions 03559) $30 copay$35 copay


Non-Preferred Brand$65 copay (BOptions 03769)

$100 copay (BOptions 03559)

$55 copay$60 copay


Specialty Drugs Formulary

25% (BOptions 03769)

$100 (BOptions 03559) $125 copay

Only available at FHCP Pharmacies

Mail Order – up to 90 days supply

2x Retail Cost$1 discount per 31 day

supplyFHCP Pharmacy

Prescription Drug CoveragePer 31 day supply – In-network

2016 Medical Premiums




Florida Blue Plans (PPO) Blue Option 03559 Blue Option 03769

24-Pay per Year Per pay Per Month Full Premium Per pay Per Month Full Premium

College $260.00 $520.00 $260.00 $520.00

Employee $51.50 $103.00 $623.00 $45.00 $90.00 $610.00

Employee & Spouse $182.00 $364.00 $884.00 $172.50 $345.00 $865.00

Employee & Child(ren) $149.50 $299.00 $819.00 $141.00 $282.00 $802.00

Employee & Family $271.50 $543.00 $1,063.00 $261.00 $522.00 $1,042.00

Florida Blue Plans (PPO)

Blue Option 03559 Blue Option 03769


College $346.67 $693.34 $346.67 $693.34

Employee $68.67 $137.34 $830.68 $60.00 $120.00 $813.34

Employee & Spouse $242.67 $485.34 $1,178.68 $230.00 $460.00 $1,153.34

Employee & Child(ren) $199.33 $398.66 $1,092.00 $188.00 $376.00 $1,069.34

Employee & Family $362.00 $724.00 $1,417.34 $348.00 $696.00 $1,389.34

2016 Medical Premiums




Florida Health Care Plans (HMO)FHCP-TS1 FHCP-T51


College $260.00 $520.00 $260.00 $520.00

Employee $30.35 $60.70 $580.70 $12.72 $25.44 $545.44

Employee & Spouse $152.59 $305.18 $825.18 $127.53 $255.06 $775.06


Employee & Family $234.76 $469.52 $989.52 $204.71 $409.42 $929.42

Florida Health Care Plans (HMO)FHCP-TS1 FHCP-T51


College $346.67 $693.34 $346.67 $693.34

Employee $40.47 $80.94 $774.28 $16.96 $33.92 $727.26

Employee & Spouse $203.45 $406.90 $1,100.24 $170.04 $340.08 $1,033.42

Employee & Child(ren) $162.80 $325.60 $1,018.94 $131.87 $263.74 $957.08

Employee & Family $313.01 $626.02 $1,319.36 $272.95 $545.90 $1,239.24

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 866-548-0727

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

Rates and coverage have not changed for the 2016 plan year

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

2016 Delta DentalFor Plan Year Effective: January 1, 2016 through December 31, 2016


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 & 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 & 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

2016 VSPFor Plan Year Effective: January 1, 2016 through December 31, 2016


The per pay totals were formula generated and may reflect slight round differences


Reminders: FRS Beneficiaries

www.myfrs.com

MyFRS Financial Guidance Line toll-free at 1-866-446-9377

http://www.myfrs.com/

Reminder: Dependent Verification

Dependent Verification Documentation Verify Eligible Dependents under your Medical, Dental, and/or Vision Plans if adding for plan year 2016

All required documentation must be submitted to the Employee Benefits Department by Wednesday, October 28, 2015

Coverage will not be effective and new premium amount(s) will not begin until all required documentation has been received

and approved by the Employee Benefits Department.

Questions & concerns please contact Sandra Walker 386-506-3082 or Krystal Hoy-Gentile 386-506-3394

REQUIRED DOCUMENTATIONSubmit all required documentation to you by the Employee Benefits Department

Representative.

SpouseTo add spouse coverage: A copy of the legal marriage certificate. REMINDER: A spouse is the legally recognized marital partner (as defined by Florida Law) of a Covered Employee.

Child(ren)A copy of the birth certificate, adoption papers, or other legal paperwork for the child(ren). Documents MUST show the child(ren)'s name, date of birth, date of placement for adoption, or date of adoption.

Reminder: Employee Benefits Health Fair

Conclusion

1. Everyone must enroll (or waive coverage) online between October 12 – October 28, 2015

2. Log into your enrollment account at bmc.myfbmc.com

3. Have beneficiary information on hand during the enrollment process

4. Questions