#024463 Continuation Form For GLTC Policy

Duval County Public Schools Request for Conversion Materials

The Plan generally allows the designation of a primary care provider. You have the right to designate any primary care provider who participates in the network and who is available to accept you or your family members. For...

Model-Disclosure-Notice-Regarding-Patient-Protections-Against-Surprise-Billing-2Download

FBMC Benefits Management Inc., benefits manager for Duval County Public Schools (DCPS) has contracted with PayFlex Systems USA, Inc. to administer COBRA services as required by law. The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances, such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. This right extends to your plan’s Medical and Health FSA.

– DCPS Contributory Plan
– DCPS Non-Contributory Plan

This notice has information about your current prescription drug coverage with DCPS and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan.

– DCPS High Deductible Health Plan

This notice has information about your current Prime Therapeutic prescription drug coverage with DCPS and about your options under Medicare’s prescription drug coverage

If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace.

This notice describes how medical information about you may be used and disclosed and how you can get access to this information.

Chapter 2007-251 Laws of Florida, requires agencies to notify individuals of the purpose(s) that require the collection of Social Security numbers.

Your plan, as required by the Women’s Health and Cancer Rights Act of 1998, provides benefits for mastectomy-related services including all stages of reconstruction and surgery to achieve symmetry between the breasts, prostheses, and complications resulting from a mastectomy, including lymphedemas.

This notice is provided to ensure you understand your right to apply for the DCPS District Group Healthcare Plan in the event of a change in your status, including marriage, birth or adoption. Please read the notice even if you plan to waive coverage at this time.

This notice provides you information about the Health Insurance Marketplace as well as the employment-based healthcare coverage offered by your employer. It can assist you as you evaluate options for you and your family.

Certain benefits may be taxed if you become disabled, depending on how the premiums were paid during the year of the disabling event. Payments, such as disability, from coverages purchased with pretax premiums and/or nontaxable employer credits, will be subject to...

Social Security consists of two tax components: the FICA or OASDI component (the tax for old-age, survivors’ and disability insurance) and the Medicare component. A separate maximum wage to which the tax is assessed applies to both tax components. There is no maximum...

According to IRS regulations, you can pay premiums on a pretax basis for the first $50,000 of life insurance coverage under a group term life insurance, a group term life insurance plan, covering your life. However, you must pay tax on such coverage exceeding $50,000.

Health Insurance benefits will be provided not by your employer’s flexible benefits plan, but by the health insurance plan(s). The types and amounts of health insurance benefits available under the health insurance plan(s), the requirements for participating in the...

FBMC Benefits Management, Inc. (FBMC) has been authorized by your employer to provide certain administrative services for some the insurance plans offered within your employer’s benefit program. Importantly, FBMC is not the policyholder or an insurance company. The...

The Newborn and Mothers Health Protection Act has set rules for group health plans and insurance issuers regarding restrictions to coverage for hospital stays in connection with childbirth. The length of stay may not be limited to less than: 48 hours following a...

The Plan complies with the privacy requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). These requirements are described in a Notice of Privacy that is included on this website. A copy of this notice is available upon request.