The County offers a High Deductible Health Plan (HDHP). The HDHP has the lowest payroll deductions and the highest employer contribution. The plan's design is based on two components: a high deductible and a savings vehicle; a Health Savings Account (HSA). The deductible is $2,100 for employee only and $4,200 for employee + spouse/domestic partner, employee + child(ren), and employee + family.
How does the High Deductible Health Plan work?
- No co-payments are associated with this plan; only coinsurance. There are no co-payments for office visits and prescriptions
- All covered medical and prescription expenses will go toward the same integrated deductible
- Once the deductible is met, the Plan pays 70% and you pay 30% coinsurance of the eligible discounted costs
- When you reach the out-of-pocket maximum, the Plan pays 100% of eligible in-network expenses. You become fully protected from out-of-pocket medical expenses
- All preventive services are covered at 100%
When do I pay coinsurance and/or the deductible?
You must satisfy the annual deductible for all health and pharmacy services not covered under Preventative Care. Once the deductible is satisfied, you pay 30% and the insurance plan will pay 70% coinsurance of the contracted in-network healthcare costs. Under the County's HDHP, once the out-of-pocket maximum has been satisfied, the insurance plan will pay 100% of contracted in-network healthcare costs.
Does the HDHP include a Reimbursemet Account?
Yes, the HDHP plan is combined with a Health Savings Account (HSA) which can be funded by you and the County. The County will fund the account based on tier of health coverage.
Under the High Deductible Health plan, how do I pay for an office visit?
All services received during your office visit are billed individually. If the doctor performs any tests or blood work, each item is billed to you. Here are some examples below:
Example 1: Regular office visit with blood work
|| Amount Billed
|| Member Pays|
| Office Visit
| Blood Work
| Total Cost to member
Example 2: Urgent Care Visit with X-ray(s)
|| Amount Billed
|| Member Pays|
| Urgent Care Visit with x-rays (1 area)
| Urgent Care Visit with x-rays (2 areas)
Open Access - The County's health plans are open access which means you are not required to select a Primary Care Physician (PCP). Please see CDH Health Plans on Open Access. More...
Exclusions and Limitations - All benefit plans have exclusions and limitations. Please review your materials and ask questions to your insurance carriers before making decisions.
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 2013 enrollment (schedule, registration, letter from Registrar, etc.). Under the HDHP, the student's benefits will not be accumulated or applied towards to the HDHP's deductible or out-of-pocket maximums.
Member Services, 855-202-2517
Humana Rep Rima Merlano, 954-357-7191
Humana Rep Marc Dormeus, 954-357-7192