Privacy Notice The State Group Insurance Privacy Noce, available at mybenefits.myflorida.com, describes how medical informaon about you may be used and disclosed and how you can access this informaon. The Privacy Noce has been updated to reflect new benefit offerings under the State Group Insurance Program. Special Notice about the Medicare Part D Drug Program, Jan. 1, 2021 Please read this noce carefully. It explains the opons you have under Medicare prescripon drug coverage and can help you decide whether or not you want to enroll in Medicare Part D. Medicare prescripon drug coverage (Medicare Part D) became available in 2006 to everyone with Medicare through Medicare prescripon drug plans and Medicare Advantage Plans that offer prescripon drug coverage. All approved Medicare prescripon drug plans must offer a minimum standard level of coverage set by Medicare. Some plans may offer more coverage than required. As such, premiums for Medicare Part D plans vary, so you should research all plans carefully. The State of Florida Department of Management Services has determined that the prescripon drug coverage offered by the State Group Insurance Program is, on average, expected to pay out as much as or more than the standard Medicare prescripon drug coverage pays and is considered Creditable Coverage. You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15 to December 7. However, if you lose your current creditable prescripon drug coverage, through no fault of your own, you will also be eligible for a two-month Special Enrollment Period (SEP) to join a Medicare drug plan. If you do decide to enroll in a Medicare prescripon drug plan and drop your State Group Insurance health plan coverage, be aware that you and your dependents will be dropping your hospital, medical, and prescripon drug coverage. If you choose to drop your State Group Insurance health plan coverage, you will not be able to re-enroll in State Group Insurance health plan. If you enroll in a Medicare prescripon drug plan and do not drop your State Group Insurance health plan coverage, you and your eligible dependents will sll be eligible for health and prescripon drug benefits through the State Group Insurance Program. If you drop or lose your coverage with the State Group Insurance Program and do not enroll in Medicare prescripon drug coverage aſter your current coverage ends, you may pay more (a penalty) to enroll in Medicare prescripon drug coverage later. Addionally, if you go 63 days or longer without prescripon drug coverage that’s at least as good as Medicare’s prescripon drug coverage, your monthly premium will increase by no less than one (1) percent per month for every month that you did not have that coverage, and you may have to wait unl the following November to enroll. Addional informaon about Medicare prescripon drug plans is available at www.medicare.gov. Your State Insurance Assistance Program through the Florida SHINE (Serving Health Insurance Needs of Elders) program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number); and (800) MEDICARE or (800-633-4227). TTY users should call 1-877-486-2048. For people with limited income and resources, payment assistance for Medicare prescripon drug coverage is available. Informaon about this extra help is available from the Social Security Administraon (SSA). Contact your local SSA office, call 800-772-1213, or visit www.socialsecurity.gov for more informaon. TTY users call 800-325-0778. For more informaon about this noce or your current prescripon drug plan, call the People First Service Center at 866- 663-4735. Remember: Keep this Creditable Coverage noce. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this noce when you join to show whether you have maintained creditable coverage and, therefore, whether you are required to pay a higher premium amount (a penalty). Benefit Fair Webinar Series: Sept. 28, 2020 - Oct. 30, 2020 Open Enrollment Dates: Oct. 19, 2020 - Nov. 6, 2020 What’s New for 2021! Prescription Drugs (Rx) CVS Caremark was selected to connue as the Division of State Group Insurance’s Pharmacy Benefits Manager effecve for the 2021 Plan Year. For informaon regarding the prescripon drug plan, visit www.caremark.com/sofrxplan. Create your CVS Caremark account at www.caremark.com to monitor your prescripons and access other important account and health care informaon. Immunizations Effecve July 1, 2020, covered members may receive roune immunizaons, including flu shots, at no-cost from any parcipang retail pharmacy in the State Employees’ pharmacy benefit manager’s network. Before you go, call the pharmacy to confirm that the immunizaon you need is available and if an appointment is required. Go to www.Caremark.com/sofrxplan or log in at www.Caremark.com for more informaon. Telehealth Effecve Jan. 1, 2021, telehealth services are covered for members when receiving primary care benefits. Telehealth services are provided remotely through a two-way interacve electronic device that includes both audio and visual communicaon. Telehealth services may be provided through a telehealth vendor, or through a virtual visit with your network or non-network provider (PPO plan only). Contact your health plan to learn more about covered telehealth services. Employee Assistance Program Your State of Florida Employee Assistance Program (EAP) vendor is KEPRO effecve July 1, 2020. Employee Summary of Services is available in PeopleFirst at peoplefirst.myflorida.com/peoplefirst. Quesons? Call toll-free at (833) 746-8337. Optional Life Rate Increase Securian Oponal life insurance plan rates will increase for the 2021 Plan Year. Please check your annual benefits statement. Dental Rate Increase MetLife and Ameritas dental plan rates will increase for the 2021 Plan Year. Please check your annual Benefit Statement. HSA Contribution & Coverage Limits for 2021 Check inside for updated rates for the 2021 Plan Year. Healthcare and Limited Purpose FSA, Health Reimbursement Account, and Health Savings Account The CARES Act permanently reinstated coverage of eligible over- the-counter drugs and medicines, that normally would require a prescripon, as eligible for reimbursement from healthcare FSA, HRA and HSA without the need for a prescripon. Menstrual hygiene products may also now be purchased or reimbursed through these plans. You may use your Healthcare FSA, HRA and HSA funds for eligible over-the-counter medicaons and menstrual hygiene products as of Jan. 1, 2020. The carryover limit for healthcare and limited purpose FSA increased from $500 to $550. The increase starts with the 2020 plan year carryover. Weight Management Program This year marks the fourth year for the Weight Management Program. Members of Aetna, AvMed, Florida Blue and UnitedHealthcare are provided with lifestyle coaching, CDC- approved curriculum, and FDA-approved medicaons (as approved by your physician). See other eligibility requirements at hps://www.mybenefits.myflorida.com/health/weight_ management_pilot_program. Parcipants are responsible for all applicable medical and Rx co-payments, co-insurance, deducbles, and out-of-pocket expenses. Active State Employee Participants Check your Benefits: Before you decide whether or not you need to make any changes to your selected benefits, look over the “What’s New” secon of this insert. 2021 Open Enrollment Photo Credits to the Florida Department of Environmental Protecon (DEP). All Images listed here can be found at hps://www. floridastateparks.org/ Cover Banner Image - Savanna’s Preserve; Inside Leſt Page Leſt Image - De Leon Springs State Park; Inside Right Page Boom Image - Topsail Hill Preserve, Wekiwa Springs State Park
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Privacy NoticeThe State Group Insurance Privacy Notice, available at mybenefits.myflorida.com, describes how medical information about you may be used and disclosed and how you can access this information. The Privacy Notice has been updated to reflect new benefit offerings under the State Group Insurance Program.
Special Notice about the Medicare Part D Drug Program, Jan. 1, 2021 Please read this notice carefully. It explains the options you have under Medicare prescription drug coverage and can help you decide whether or not you want to enroll in Medicare Part D.
Medicare prescription drug coverage (Medicare Part D) became available in 2006 to everyone with Medicare through Medicare prescription drug plans and Medicare Advantage Plans that offer prescription drug coverage.
All approved Medicare prescription drug plans must offer a minimum standard level of coverage set by Medicare. Some plans may offer more coverage than required. As such, premiums for Medicare Part D plans vary, so you should research all plans carefully.
The State of Florida Department of Management Services has determined that the prescription drug coverage offered by the State Group Insurance Program is, on average, expected to pay out as much as or more than the standard Medicare prescription drug coverage pays and is considered Creditable Coverage.
You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15 to December 7. However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two-month Special Enrollment Period (SEP) to join a Medicare drug plan.
If you do decide to enroll in a Medicare prescription drug plan and drop your State Group Insurance health plan coverage, be aware that you and your dependents will be dropping your hospital, medical, and prescription drug coverage. If you choose to drop your State Group Insurance health plan coverage, you will not be able to re-enroll in State Group Insurance health plan. If you enroll in a Medicare prescription drug plan and do not drop your State Group Insurance health plan coverage, you and your eligible dependents will still be eligible for health and prescription drug benefits through the State Group Insurance Program.
If you drop or lose your coverage with the State Group Insurance Program and do not enroll in Medicare prescription drug coverage after your current coverage ends, you may pay more (a penalty) to enroll in Medicare prescription drug coverage later. Additionally, if you go 63 days or longer without prescription drug coverage that’s at least as good as Medicare’s prescription drug coverage, your monthly premium will increase by no less than one (1) percent per month for every month that you did not have that coverage, and you may have to wait until the following November to enroll.Additional information about Medicare prescription drug plans is available at www.medicare.gov.
Your State Insurance Assistance Program through the Florida SHINE (Serving Health Insurance Needs of Elders) program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number); and (800) MEDICARE or (800-633-4227). TTY users should call 1-877-486-2048.
For people with limited income and resources, payment assistance for Medicare prescription drug coverage is available. Information about this extra help is available from the Social Security Administration (SSA). Contact your local SSA office, call 800-772-1213, or visit www.socialsecurity.gov for more information. TTY users call 800-325-0778.
For more information about this notice or your current prescription drug plan, call the People First Service Center at 866-663-4735.
Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether you have maintained creditable coverage and, therefore, whether you are required to pay a higher premium amount (a penalty).
Benefit Fair Webinar Series:Sept. 28, 2020 - Oct. 30, 2020
Open Enrollment Dates:Oct. 19, 2020 - Nov. 6, 2020
What’s New for 2021! Prescription Drugs (Rx) CVS Caremark was selected to continue as the Division of State Group Insurance’s Pharmacy Benefits Manager effective for the 2021 Plan Year. For information regarding the prescription drug plan, visit www.caremark.com/sofrxplan. Create your CVS Caremark account at www.caremark.com to monitor your prescriptions and access other important account and health care information.
ImmunizationsEffective July 1, 2020, covered members may receive routine immunizations, including flu shots, at no-cost from any participating retail pharmacy in the State Employees’ pharmacy benefit manager’s network. Before you go, call the pharmacy to confirm that the immunization you need is available and if an appointment is required. Go to www.Caremark.com/sofrxplan or log in at www.Caremark.com for more information.
TelehealthEffective Jan. 1, 2021, telehealth services are covered for members when receiving primary care benefits. Telehealth services are provided remotely through a two-way interactive electronic device that includes both audio and visual communication. Telehealth services may be provided through a telehealth vendor, or through a virtual visit with your network or non-network provider (PPO plan only). Contact your health plan to learn more about covered telehealth services.
Employee Assistance ProgramYour State of Florida Employee Assistance Program (EAP) vendor is KEPRO effective July 1, 2020. Employee Summary of Services is available in PeopleFirst at peoplefirst.myflorida.com/peoplefirst. Questions? Call toll-free at (833) 746-8337.
Optional Life Rate IncreaseSecurian Optional life insurance plan rates will increase for the 2021 Plan Year. Please check your annual benefits statement.
Dental Rate Increase MetLife and Ameritas dental plan rates will increase for the 2021 Plan Year. Please check your annual Benefit Statement.
HSA Contribution & Coverage Limits for 2021 Check inside for updated rates for the 2021 Plan Year.
Healthcare and Limited Purpose FSA, Health Reimbursement Account, and Health Savings AccountThe CARES Act permanently reinstated coverage of eligible over-the-counter drugs and medicines, that normally would require a prescription, as eligible for reimbursement from healthcare FSA, HRA and HSA without the need for a prescription. Menstrual hygiene products may also now be purchased or reimbursed through these plans. You may use your Healthcare FSA, HRA and HSA funds for eligible over-the-counter medications and menstrual hygiene products as of Jan. 1, 2020.
The carryover limit for healthcare and limited purpose FSA increased from $500 to $550. The increase starts with the 2020 plan year carryover.
Weight Management ProgramThis year marks the fourth year for the Weight Management Program. Members of Aetna, AvMed, Florida Blue and UnitedHealthcare are provided with lifestyle coaching, CDC-approved curriculum, and FDA-approved medications (as approved by your physician). See other eligibility requirements at https://www.mybenefits.myflorida.com/health/weight_management_pilot_program. Participants are responsible for all applicable medical and Rx co-payments, co-insurance, deductibles, and out-of-pocket expenses.
Active State Employee Participants
Check your Benefits: Before you decide whether or not you need to make any changes to your selected benefits, look over the “What’s New” section of this insert.
2021 Open Enrollment
Photo Credits to the Florida Department of Environmental Protection (DEP). All Images listed here can be found at https://www.floridastateparks.org/ Cover Banner Image - Savanna’s Preserve; Inside Left Page Left Image - De Leon Springs State Park; Inside Right Page Bottom Image - Topsail Hill Preserve, Wekiwa Springs State Park
Get Your 1095-C Tax Form Electronically Get your 1095-C faster next year by setting up an electronic receipt. If you haven’t already consented to receiving your 1095-C electronically, log in to People First and follow this trail: Personal Information > Contact Information. Then select Notification Email. If you don’t have a notification email in People First, enter one. Check the appropriate box to receive your 1095-C electronically next year. Otherwise, we will mail the 1095-C to the mailing address listed in People First. Please keep all addresses current.
Need a Tax Break on Your Predictable Out-of-Pocket Costs?Do you know about how much you will pay for health care or dependent care expenses next year? Did you know you can get a tax break by enrolling in a healthcare or dependent care flexible spending account (FSA)? Find out how an FSA can help you save money by using Chard Snyder’s Tax-Savings Calculator. Visit www.mybenefits.myflorida.com/health/savings_and_spending_accounts. Click on the tax savings calculator link to access the calculator.
Special Notice About the Women’s Health and Cancer Rights Act As required by the Women’s Health and Cancer Rights Act of 1988, the State Group Insurance health plan benefits document for the State Employees’ PPO Plan or HMO Plan provides benefits for mastectomy-related services, including all stages of reconstruction, surgery to achieve symmetry between the breasts, prostheses, and complications resulting from a mastectomy, including lymphedema. Contact the Plan Administrator, the Division of State Group Insurance, at (800) 226-3734 for more information.
How to Make Changes in People First1. Turn off your pop-up blocker and log in to People First at
https://peoplefirst.myflorida.com. 2. Select the Complete Open Enrollment Now task in your
inbox.3. Follow the simple steps to verify your dependents and
complete your Open Enrollment elections.4. Review your covered dependents and elected plans.5. If you are enrolled in a health plan for 2021, make your
Shared Savings Program selections.6. Enter your password and select Complete Enrollment.
Remember that you can make changes to your elections during Open Enrollment as many times as you want. However, once Open Enrollment ends, a qualifying status change event is required to make a change.
Cafeteria PlanVisit https://www.mybenefits.myflorida.com/health or call People First to learn more about what a Cafeteria Plan is.
Active Employees Eligible for Medicare If you, as an active state employee, and/or your dependents become eligible for Medicare, your State Group Insurance health plan will continue to be your primary insurance coverage unless your dependent requires treatment for end-stage renal disease; see your plan document for details.
Medicare coverage pays secondary (after the health plan pays) only if you enroll in a State Group Insurance health plan. Medicare Part A (hospital insurance) is free, but Medicare Part B (medical insurance) requires you to pay a monthly premium.
As long as you are an active employee, you and/or your dependents can delay your Medicare Part B coverage without penalty. You should call your local Social Security Office to defer enrollment. However, as soon as you retire, you and/or your dependents should enroll in Part B. Once you and/or your dependents are eligible for either Medicare Part A or Part B as a retiree, your State Group Insurance health plan pays secondary. Even if you and/or your dependents don’t enroll in Medicare Part A or Part B. As a retiree, if you and/or your dependents do not elect your Medicare Part B coverage right away, you pay the first 80 percent of your health care expenses, making you responsible for expensive medical bills.
Health Savings Account (HSA)Employees must be enrolled in a High Deductible Health Plan to participate in an HSA. Refer to myBenefits.myflorida.com for more information.
The 2021 Maximum Contribution Amount includes the state contribution and employee payroll contribution.
HSA Annual Maximum Contribution Amount for 2021
Individual $3,600 (increase of $50)
Family $7,200 (increase of $100)
Catch-up (age 55+) $1,000 (no increase)
Medicare Advantage and Prescription Drug (MA-PD) Plans State of Florida retirees now have more health plan choices! At the direction of Governor DeSantis, State Group Insurance procured for and awarded three vendors contracts for MA-PD plans. A MA-PD is a Medicare Advantage (Part C) plan that includes prescription drug coverage. MA-PD plans contract with Medicare to provide Part A, Part B and Part D benefits. If you are a retiree enrolled in Medicare and currently enrolled in a State Group Insurance health plan, check out these new plans by visiting mybenefits.myflorida.com/health.
Dependent Audit Quality Assurance Beginning July 1, 2020, the People First Service Center will request documents as part of the Dependent Eligibility Verification process to confirm that an employee’s newly added dependents are eligible for insurance coverage. This process applies to new hires, marriages, births, and other life events during the year as allowed by a qualifying status change (QSC) event. All enrollees who add new dependents during these QSC events will receive the documentation request. Documentation requests will be generated through People First and sent via email from the [email protected] email to the enrollee’s notification email in People First. If the enrollee does not have a notification email, a letter will be mailed to the employee’s address on file.
Benefits StatementTo view your Benefits Statement, log in to PeopleFirst, select the Insurance Benefits tile and select the Insurance Benefits Statement icon. Benefits statements for new hires and new retirees will also be located on this screen.
$5.8 MILLION*
$1.4 IN NET SAVINGS
IN REWARDS
&
Shop. Select. Save.The Shared Savings Program, administered by the Division of State Group Insurance, allows State Group Insurance enrollees to earn rewards by shopping for and selecting high quality, lower cost healthcare services. This benefit, available to all State Group Insurance health plan enrollees and their eligible dependents at no additional cost, has generated approximately $5.8 millionin net savings for the state and approximately $1.4 million in rewards to state employee participants since January 2019.Learn more at myBenefits.MyFlorida.com.
MILLION*
*Totals for Jan. 2019 through June 30, 2020.
s ings.sharedFLORIDA DEPARTMENT OF MANAGEMENT SERVICES
Related Documents
