2021 | Medical
Contributory Plan

Highlights

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How It Works 

This is an open access plan that does not require you to choose a primary care physician. You may choose the physician of your choice. However, to receive your maximum benefit, you should select an in-network doctor from participating Florida Blue, Blue Options (Network Blue) providers found at www.floridablue.com.

Plan Details Include: 

  • There is a cost for Employee-Only coverage
  • Employees have the freedom to choose an in-network or out-of-network service provider at the time of service
  • Does not have an in-network deductible
  • Coinsurance applies to all services that do not have set copays; for example:
    • Inpatient and outpatient hospitalization
    • Ambulatory surgical center facility
    • All out-of-network services
  • Coinsurance and copays (including Rx) count towards the maximum out-of-pocket limit
  • Medical Flexible Spending Account available (Employee Contributions Only)
  • PayFlex Card accounts will not roll over the amount elected in the prior plan year

Note: If you wish to contribute to the Medical FSA, you must make that election at your enrollment session. Prior year contributions are not going to automatically roll over. 

Contributory Plan Bi-Weekly Contribution Rates

PER PAY EMPLOYEE DEDUCTIONS 20 PAY 24 PAY
Employee Only $112.97 $94.14
Employee & Spouse $430.14 $358.45
Employee & Child(ren) $346.42 $288.68
Employee & Family $715.73 $596.44
Health Savings Account N/A
Medical FSA/PayFlex Card Employee Contributions Only

Contact

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Medical Plan Benefit Comparison Chart

For Summary Plan Descriptions and Medical Plan Documents, please click here.

  • If you do not wish to make any changes to your current benefit elections and you do not make employee contributions to an MFSA, DFSA, or HSA, your current benefit elections will automatically carry forward to this plan year
  • ID Cards – You can print a temporary Florida Blue ID card or request a new member ID card by visiting www.floridablue.com
  • Blue365 offers member discounts on Gym memberships and Lasik at LasikPlus Centers. Call 1-855-511-2583. To access Blue365, logon to: www.floridablue.com