Health Plan - CDHP 2016
Health Insurance - Consumer Driven Health Plans (CDHP)

HEALTH PLAN OPTIONS FOR 2016

In response to significant increases in our pharmacy plan costs, claim costs for two plans exceeding premiums, and the potential impact of Health Care Reform’s “Cadillac Tax” (a 40% excise tax based on the actuarial value of the plans) in 2018, we are implementing several changes for 2016.
 
The major change is the replacement of the Consumer Driven Health Plan (CDH OON) with Out of Network coverage with a new High Deductible Health Plan with Out of Network coverage (HDHP OON).  Members enrolled in the current CDH OON plan will see a significant reduction in their monthly premium for the new HDHP OON plan. 

Summary of Benefits
 

Highlights of CDH Plans

The County offers two Consumer Driven type Health Plans (CDHP). CDHP designs are intended to encourage and empower individuals to be more informed about their health and health care options and become actively involved in making their own healthcare decisions. The County’s CDH plans also help employees save money for future health expenses through a County-funded Health Reimbursement Account (HRA). See Health Accounts for more details.
  • No changes to CDH Plan design, deductibles, coinsurance, copays, and out-of-pocket maximums for CDH High and CDH Low Plans.  Both plans have higher premiums due to significant increase in pharmacy costs.
  • Preventive services covered 100% in-network
  • Some services received for a copay (varies by CDH plan)
  • Some services subject to the annual deductible/co-insurance (varies by CDH plan)
  • Student passport program for dependents attending college outside of the service area
  • Behavioral health out-patient services  first 20 visits covered at no cost (CDH High only)
  • Diagnostic tests at a participating freestanding facility capped at $100 per test
  • Annual eye exam at no cost at a participating optometrist
  • Discount dental plan included at participating dental providers
Networks
CDH High and CDH Low-Humana’s Florida Premier HMO network-Open Access*

* Open Access means a referral to see most network specialists is not required.  However, certain services require Prior Authorization. 
FULLTIME​ ​ ​ Consumer Driven Health (CDH) Plan
CDH LOW​ ​ ​ ​
​ ​ ​ ​ ​Consumer Driven Health (CDH) Plan
CDH HIGH
​Bi-Weekly
Premium
​Bi-Weekly
Subsidy
Bi-Weekly
​Payroll
Deduction
​Annual
HSA/HRA
Bi-Weekly
​Premium
​Bi-Weekly​
Subsidy
Bi-Weekly
​Payroll
Deduction
​Annual
HSA/HRA
​Employee ​$265.25 ​$222.96 ​$42.29 ​$300.00 ​$300.26 ​$240.46 ​$59.80 $300.00
​Emp+Spouse
​$567.91 ​$474.83 ​$93.08 ​$675.00 $643.19 ​$512.48 ​$130.71 ​$675.00
​Emp+Child $485.96 ​$407.78 ​$78.18 ​$675.00 $550.34 ​$439.97 ​$110.37 ​$675.00
​Emp+Family $829.14 ​$674.04 ​$155.10 ​$800.00 ​$939.19 ​$729.07 ​$210.12 ​$800.00
  
PARTTIME​
PT20 ​ ​
Consumer Driven Health (CDH) Plan
CDH LOW​ ​ ​ ​
​ ​ ​ ​ ​ ​Consumer Driven Health (CDH) Plan
CDH HIGH
​Bi-Weekly
Premium
​Bi-Weekly
Subsidy
Bi-Weekly
​Payroll
Deduction
​Annual
HSA/HRA
Bi-Weekly
​Premium
Bi-Weekly
​Subsidy
​Bi-Weekly
Payroll
Deduction
​Annual
HSA/HRA
​Employee ​$265.25 ​$163.34 ​$101.91 ​$300.00 ​$300.26 ​$180.84 ​$119.42 $300.00
​Emp+Spouse
​$567.91 ​$415.21 ​$152.70 ​$675.00 $643.19 ​$452.86 ​$190.33 ​$675.00
​Emp+Child $485.96 ​$348.16 ​$137.80 ​$675.00 $550.34 ​$380.35 ​$169.99 ​$675.00
​Emp+Family $829.14 ​$614.42 ​$214.72 ​$800.00 ​$939.19 ​$669.45 ​$269.74 ​$800.00
 
OPEN ACCESS
All of the County’s health plans are Open Access which means members do not select a Primary Care Physician (PCP) and NO referral is needed in order to see most network specialists. Members are encouraged (but not required) to see a primary care or family medicine physician for routine care. Physicians listed under the Primary Care and Family Medicine category in Humana’s directory have a lower copay/cost that physicians listed as a Specialist. Because it is not required that you obtain a referral to see a specialist, it is recommended you keep your primary/family physician up to date on any specialty care received so that all your personal health care information resides in one location.
EXCLUSIONS AND LIMITATIONS
All health plans have specific Exclusions and Limitations. Please contact the on-site Humana Reps for more information. (see below)

STUDENT PASSPORT PROGRAM
The Student Passport Program allows full-time students going to school outside of the Florida HMO Premier network to access Humana’s National POS Network based on the location of their educational institution, college, university, vocational or secondary school. Students aged 19-30 can enroll in the Student Passport Program by completing a Student Passport Program Application and submitting it along with formal proof of January 2016 enrollment (schedule, registration, letter from Registrar, etc.).
SURVIVOR BENEFITS

 

All of the health insurance plans offer a 12-month Survivor Benefit for employees enrolled in a County health plan. Under this benefit, dependents continue to be covered, at no charge, under the same insurance plan they were enrolled in at the time of the employee’s death for a period up to 12 months. During this 12-month period, a dependent must continue to meet eligibility requirements per the conditions set forth for this benefit. This 12-month Survivor Benefit is counted toward the period of COBRA or Domestic Partner Continuation Coverage for which the Survivor and/or dependents would be eligible.

If a plan is no longer offered, or if the survivor changes plans during open enrollment or due to a qualifying event, the survivor benefit will end and coverage may be continued under another plan at the full COBRA rate in effect at that time
. 

 

Contact Information
Member Services: 855-202-2517
On-site Humana Rep. Susan Kaus  954-357-7191
On-site Humana Rep. Marc Dormeus  954-357-7192

Website, myHumana
Humana Logo 
​ ​
​​