Medical
High HMO Health PlanIMPORTANT NOTE
This is an open access plan that requires you to choose a primary care physician. For details on how to find out if your medical provider – primary care provider, or specialist is considered In-Network for the Low and High HMO plans without logging into your account, click here.
Highlights
- You must choose a primary care physician.
- The District offsets a portion of your dependents’ coverage.
- DOES NOT cover out-of-network expenses except for ER visits and Ambulance Services.
- View the video below for more details:
What is an HMO Plan
How It Works
This is an HMO plan and requires you to choose a primary care physician. You may choose the physician of your choice. However, to receive your maximum benefit, you must select an in-network doctor from participating BlueCareHMO network providers found at www.floridablue.com.
Plan Details Include:
- Your School District continues to offset a portion of the dependent coverage cost
- Employees must choose an in-network provider at the time of service
- Deductible and coinsurance applies to all services that do not have set copays; for example:
- Inpatient hospitalization
- All out-of-network services.
- Deductible, coinsurance and copays (including Rx), count toward 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
HMO High Health Plan Bi-Weekly Contribution Rates
| PER PAY EMPLOYEE DEDUCTIONS | 20 PAY | 24 PAY |
|---|---|---|
| Employee Only | $42.00 | $35.00 |
| Employee & Spouse | $330.71 | $275.59 |
| Employee & Child(ren) | $250.26 | $208.55 |
| Employee & Family | $605.80 | $504.83 |
| Receiving Spouse | $187.71 | $156.42 |
Sanitas
Florida Blue and Sanitas Medical Centers deliver integrated, accessible primary care in one place—offering services like urgent care, mental health, diagnostics, wellness, and insurance support. With both in-person and 24/7 virtual access, these Value Choice Providers aim to simplify and lower the cost of high-quality healthcare for Florida Blue members.
Learn More
Get the App
Access your insurance and the tools to help you use it anytime, anywhere with the mobile app.
Medical Plan Benefit Comparison Chart
For Summary Plan Descriptions and Medical Plan Documents, please click Here.
-
You must re-enroll and select your Medical FSA and Dependent Care accounts each year. These will not automatically roll over.
- 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