Skip navigation links
Government
Residents
Business
Visitors
Employees
Resources
Careers
Skip navigation links
Learning and Organizational Development Training
Section I - Employee Agreement
Section II - Eligibility and Documentation Requirements
Section III - Pre-Tax Health, Dental, Vision and FSA Plans
Health Insurance - Humana
Pharmacy Rx Plan
Dental Insurance
Vision Insurance
Flexible Spending Accounts (only for CDH Plans)
Health Saving Account (HSA)
Section IV - After-Tax Supplemental Plans
Section V - Well-Being Programs
Section VI - Deferred Compensation and Retirement Plans
Section VII- Notices
Health Insurance - Humana

Broward County offers a High Deductible Health Plan (HDHP) and three Consumer Driven Type Health plans (CDH):

  • CDH Low Plan
  • CDH High Plan
  • CDH with Out-of-Network Plan
  • High Deductible Health Plan (HDHP)

OPEN ACCESS

Although the County’s plans are Open Access, which means you do not need a referral to see a specialist, it is recommended that you have a Primary Care or Family Medicine Physician to coordinate and be the central repository where all your health records reside.

WHY IS IT IMPORTANT TO HAVE A PRIMARY/FAMILY CARE PHYSICIAN?

Often coordination of medical treatment and/or pharmacy prescribing is greatly hindered when important and essential medical records are not maintained in one centralized location. A good example of this would be during an emergency your Primary/Family Care provider and/or family members would not be able to give complete medical history information to the treating emergency room physician.

Another example would be if your specialist wanted to confer with your Primary/Family Care provider about prior medical treatments or history, your Primary/Family Care provider would be able to provide complete information. When self-referring to specialists, it is recommended that you request your medical reports be sent to your Primary/Family Care provider for the reasons described above.

Physicians/specialists join and leave health plans throughout the year based on their contract period and other factors; there is no guarantee that a physician, specialist, facility or hospital in the network will continue in the plan through the end of the calendar year. It is recommended that you contact the physician or specialist prior to enrollment and at the time of making an appointment to verify that they are participating in the plan.

SERVICE AREA (start here)

Based on the employee’s address on file in the payroll system, the employee can enroll in the CDH as follows:

EMPLOYEE DOMICILED IN PLAN ALLOWED TO ENROLL IN NETWORK

Employee address on file with the County is in a Florida County covered by HUMANA’s Florida HMO Premier Network: Alachua, Baker, Bradford, Broward, Charlotte, Citrus, Clay, Collier, Columbia, Dixie, Duval, Flagler, Gilchrist, Hernando, Hillsborough, Indian River, Lake, Lee, Levy, Manatee, Marion, Martin, Miami-Dade, Nassau, Orange, Osceola, Palm Beach, Pasco, Pinellas, Polk, Putnam, Sarasota, Seminole, St. Johns, St. Lucie, Union and Volusia

CDH High Plan
CDH Low Plan
HDHP 

HUMANA’s Florida HMO Premier Network with Open Access
No Out-of-Network coverage except for a true medical emergency

CDH with Out-of-Network 

HUMANA’s National POS-Open Access Network:
Services received in the network are covered at the In-network benefit level. Services received outside of the network are subject to Out-of-Network annual deductible and coinsurance.

STUDENTS GOING TO COLLEGE OUTSIDE OF THE NETWORK

  • Employees enrolled in the HDHP, CDH High or CDH Low Plans: Students going to college outside of Humana’s Florida HMO Premier Network can apply for the Student Passport Program which will allow the student to have access to Humana’s National Point of Service (POS)-Open Access Network. Benefits will be paid subject to the CDH with Out-of-Network Plan benefit. Students’ benefits will not be accumulated or applied to the HDHP deductible or out-of-pocket maximums.
  • Employees enrolled in CDH with Out-of-Network Plan: Students going to college outside of Humana’s National Point of Service (POS)-Open Access Network will be subject to the CDH with Out-of-Network Plan – Out of Network benefit level..

COMMON QUESTIONS ASKED ABOUT HEALTH INSURANCE

Is my medical card accepted at pharmacies?
No, you must use your Catamaran pharmacy ID card. See the section on Pharmacy for details.

Am I covered in an emergency when away on vacation, or have children/dependents that live out of the area?
Yes; however, follow-up or routine care is not covered unless you are on the CDH with Out-of-Network plan.

  • HDHP, CDH High and Low plans - Members will be covered on a participating level in an emergency. Routine and follow-up care from an emergency must be received by a participating provider within Humana’s Florida HMO Premier service area to be covered. Services received outside the service area, or from nonparticipating providers, with the exception of an emergency, ARE NOT COVERED by the insurance company. Any charges incurred, other than under the emergency provision, including follow-up emergency care, will be your responsibility to pay. Service areas are shown above.
  • CDH Out-of-Network plan – Members will be able to access Humana’s National POS - Open Access Network for in-network services. Services received outside of the network are subject to the annual deductible and coinsurance. Out-of-Network services (with the exception of wellness exams) are subject to a $2,100 annual deductible per person after which claims will be paid at 70 percent of the Usual and Customary rate.

CONSUMER DRIVEN HEALTH PLANS and HIGH DEDUCTIBLE HEALTH PLAN

CDH and HDHP Plan Definitions:

Copayment (applies only to CDH Plans): A specific dollar amount, except as otherwise provided for by statute, whichthe member must pay upon receipt of Covered Services. Healthcare Professionals have the obligation to collect these copayments.

Coinsurance: The sharing of expenses for Covered Services between Insurance Plan and the Member. Coinsurance is expressed in a percentage rather than a dollar amount.

Deductible: The amount a member must pay before Insurance Plan will make any payment toward Covered Services subject to the annual deductible.

Health Reimbursement Account (applies to CDH Plans and HDHP if not eligible for an HSA): A Health Reimbursement Account (HRA) is a County funded pool of money available at the beginning of the year, or prorated upon benefit eligibility, to pay eligible health care expenses for you and any enrolled dependent* which has not been previously reimbursed by your health plan, such as copayments, coinsurance and deductible.

Health Savings Account (applies only to HDHP): Health Savings Accounts (HSAs) are like personal savings accounts, but the money in them is used to pay for qualified health care expenses. You – not your employer or insurance company – own and control the money in your health savings account. The money you deposit into the account is not taxed, and it is not taxed when used to pay for qualified health care expenses (as defined by the IRS). To be eligible to open an HSA, you must be enrolled in a high deductible health plan.

* See Over Age Dependents age 26 to 30 and Domestic Partner exclusions.

Maximum Out of Pocket: A maximum out-of-pocket expense is the “maximum” amount of money you will be responsible to pay for services that are subject to a deductible and coinsurance before the plan pays 100 percent. (100 percent level based on contracted rate In-Network and usual and customary for Out-of-Network.)

HOW TO USE YOUR CDH PLAN

When Do I Pay A Copayment?
Copays only apply to certain services and vary by plan design. Review the full Benefit Summary provided by Humana for a detailed list of services and cost.

When do I pay Coinsurance and/or a Deductible?
You are subject to the annual deductible and coinsurance under the County’s CDH plans for all services not subject to a copay or covered under Preventive Services. As the plan designs vary, please review the Benefit Summary provided by Humana for a detailed list of services and costs.

How many family members must satisfy a deductible?
Under the CDH plans, the family deductible is equal to twice the individual deductible. Once any combination of family members has met the family deductible, all insureds will be deemed to have met their deductible. No one individual can be charged more than his/her individual annual deductible.

How many family members must satisfy coinsurance?
Under the CDH plans, the family coinsurance maximum is equal to twice the individual coinsurance maximum. Once any combination of family members has met the family coinsurance maximum, all insureds will be deemed to have met their coinsurance maximum. No one individual can be charged more than his/her individual coinsurance maximum.

HOW TO USE YOUR HDHP

When Do I Pay A Copayment?
There are no copayments associated with HDHP, only deductible and coinsurance.

When do I pay Coinsurance and/or a Deductible?
You must satisfy the annual deductible for all health and pharmacy services not covered under Preventive Care. Once the annual deductible is satisfied, you pay 30 percent and the insurance plan pays 70 percent coinsurance of contracted in-network healthcare costs. Under the County’s HDHP once the Out-of-Pocket maximum has been satisfied, the health plan pays 100 percent of contracted in-network healthcare costs. Please review the HDHP Benefit Summary provided by Humana for a detailed list of services and costs.

How many family members must satisfy a deductible?
The deductible under the HDHP is an integrated deductible: medical and prescription costs apply to the same deductible. There are only two levels of deductible: Employee Only coverage and Employee plus Dependent(s) coverage (Spouse/Domestic partner, children, or family). For Employee plus Dependent(s) coverage, the family deductible must be met before the health plan will pay any benefits.

How many family members must satisfy coinsurance?
The coinsurance maximum under the HDHP also applies to medical and prescription costs. There are only two levels of coinsurance: Employee Only coverage and Employee plus Dependent(s) coverage (Spouse/Domestic partner, children, or family). For Employee plus Dependent(s) coverage, the family coinsurance amount must be met before the health plan will pay 100 percent of contracted in-network healthcare costs. Please review the HDHP Benefit Summary provided by Humana for a detailed list of services and costs.

What is the difference between a CDH plan and the HDHP?
Both plan designs provide preventive coverage at no cost to the member. However, there are several differences between the two types of plans for non-preventive services:

 Item CDH Plans   HDHP Plan*
Deductible for Employee Only tier $1,300 CDH-High
$2,100 CDH-Low
$2,100
Deductible for dependent tiers of coverage  $1,300 Individual,
$2,600 Family Max - CDH High
$2,100 Individual,
$4,200 Family Max - CDH Low
$4,200 Combined Family
Coinsurance maximum for Employee Only tier $1,500 - CDH High & CDH Low $1,500
Coinsurance maximum for dependent tiers of coverage  $3,000 - CDH High & CDH Low $3,000 Combined Family
Copays  Some services available for a set copay (see Schedule of Benefits) No copays 
Services provided during an office visit (non-Preventive) All services covered under copay (see Schedule of Benefits) All in-network services (x-rays, blood work, EKG, etc.) subject to annual deductible, then coinsurance up to annual out-of-pocket maximum.
Prescriptions Covered for a set copay (see Schedule of Benefits) Excluding prescriptions on the Preventive List, all in-network prescription drugs subject to annual health deductible and coinsurance maximum.
*All in-network services provided at acarrier contracted rate.   

HEALTH PLAN COMPARISON CHART

For your convenience we have taken the most commonly used plan benefits and prepared a comparison chart of the three CDH plans (CDH High, CDH Low, and CDH with Out-of-Network) offered. In addition, we have prepared a special separate HDHP benefits chart to help you compare differences in plan designs and payments between the CDH Plans and the HDHP. This information represents only some of the plans’ benefits. You are encouraged to read the information provided by Humana as plan selection is irrevocable and cannot be changed after election is made unless due to a Change in Status/Qualifying Event under IRS Section 125 rules. In the event of a discrepancy between the chart and the Certificate of Coverage, the Certificate of Coverage will govern.

Failure to read, understand and ask questions regarding this important informational document prior to enrollment deadlines will not constitute a valid reason for an exception.

THIS INFORMATION REPRESENTS ONLY HIGHLIGHTS OF SOME OF THE PLAN BENEFITS, SEE HUMANA’S
BROCHURE FOR DETAILED INFORMATION.

We urge all individuals who have special health care needs to thoroughly research the health plan benefits, exclusions and limitations as well as discuss these concerns with the provider in order to make a choice by the enrollment deadline.

2014 BENEFIT PLAN RATES – BIWEEKLY HEALTH INSURANCE – FULL-TIME EMPLOYEES (Employees waiving medical coverage receive $119.23 Waiver Credit biweekly.) Waiver of Health coverage requires proof of other insurance coverage  

CDH HIGH
Florida HMO Premier Network – Open Access

CDH LOW
Florida HMO Premier Network – Open Access

CDH OUT OF NETWORK
National POS Network-Open Access

BI-WEEKLY DEDUCTIONS

Employee Only

$20.49

$9.49

$28.44

Employee + Spouse/DP

$49.52

$23.65

$129.59

Employee + Child(ren)

$46.41

$24.29

$114.88

Employee + Family

$159.11

$121.29

$276.16

Over Age Dependent (age 26-30) additional $20 biweekly

DEDUCTIBLE/CO-INSURANCE/COPAY MAXIMUMS

IN-NETWORK

IN-NETWORK

IN-NETWORK

OUT OF NETWORK

Annual Deductible

Individual $1,300
Family $2,600

Individual $2,100
Family $4,200

Individual $1,300
Family $2,600

Individual $2,100
Family $4,200

Co-insurance/Co-pay Maximum

Individual $1,500
Family $3,000

Individual $1,500
Family $3,000

Individual $1,500
Family $3,000

Individual $1,500
Family $3,000

Maximum Out of Pocket Limit
(Deductible/Co-insurance/Copays)

Individual $2,800
Family $5,600

Individual $3,600
Family $7,200

Individual $2,800
Family $5,600

Individual $3,600
Family $7,200

PREVENTIVE CARE

Preventive office visits (up to age 18)

Preventive office visits and tests are covered at 100 percent. Visit/tests/services must be billed by the physician as a "preventive visit."

30%, no deductible

Preventive immunization (up to age 18)

30%, no deductible

Preventive office visit (over age 18)

30%, no deductible

Preventive mammography

30%, no deductible

Preventive pap smears

30%, no deductible

Preventive outpatient lab tests

30%, no deductible

Preventive prostrate screenings

30%, no deductible

Preventive flu/ pneumonia immunization

30%, no deductible

PHYSICIAN SERVICES

Office visit – primary care physician

$25 copay

$30 copay

$25 copay

30% after annual deductible

Office visit – specialist

$50 copay

30% after annual deductible

$50 copay

30% after annual deductible

Diagnostic tests, lab and x-rays in physician’s office

Included in applicable office visit copay

30% after annual deductible

Included in applicable office visit copay

30% after annual deductible

Chiropractor – Exam only

$50 copay

30% after annual deductible

$50 copay

30% after annual deductible

Chiropractor – Treatment/Manipulation

20% after annual deductible

30% after annual deductible

20% after annual deductible

30% after annual deductible

Allergy Injections (when no other health service is received)

$25 copay

30% after annual deductible

$25 copay

30% after annual deductible

Infertility Services

Not Covered

Not Covered

Not Covered

Not Covered

FACILITY SERVICES

Retail Clinics (located inside stores or pharmacies)

$25 copay

$30 copay

$25 copay

30% after annual deductible

Concentra Urgent Care Facility (owned by Humana)

$30 copay

$30 copay

$30 copay

30% after annual deductible

Urgent Care Facility $50 copay $50 copay $50 copay 30% after annual deductible

Emergency Room

$250 copay (waived if admitted)

30% after annual deductible

$250 copay (waived if admitted)

$250 copay (waived if admitted)

Inpatient Care

20% after annual deductible

30% after annual deductible

20% after annual deductible

$500 copay per admission, plus 30% after annual deductible

Outpatient Surgery at Freestanding Facility Outpatient Surgey at Hospital

20% after annual deductible

30% after annual deductible

20% after annual deductible

30% after annual deductible

40% after annual deductible

Outpatient nonsurgical care

20% after annual deductible

30% after annual deductible

20% after annual deductible

40% after annual deductible

Organ Transplants

20% after annual deductible

30% after annual deductible

20% after annual deductible

50% after annual deductible

Skilled Nursing Facility (up to 60 days per calendar year)

20% after annual deductible

30% after annual deductible

20% after annual deductible

30% after annual deductible

Ambulance

20% after annual deductible

30% after annual deductible

20% after annual deductible

30% after annual deductible

Diagnostic Tests at a Freestanding Facility (including Advanced Imaging-MRI, CRA, CAT, PET scans, etc.)

20% up to a maximum of $100

30% up to a maximum of $100

20% up to a maximum of $100

30% after annual deductible

Diagnostic Tests at an outpatient Hospital-based Facility (including Advanced Imaging-MRI, CRA, CAT, PET scans, etc.)

20% after annual deductible

30% after annual deductible

20% after annual deductible

40% after annual deductible

Physical, occupational, cognitive, and speech therapy (limited to 60 visits per year)

20% after annual deductible

30% after annual deductible

20% after annual deductible

30% after annual deductible

Durable Medical Equipment

20% after annual deductible

30% after annual deductible

20% after annual deductible

50% after annual deductible

BEHAVIORAL HEALTH

Mental Health – Outpatient Services

$0 copay for first 20 visits; $25 copay per visit thereafter

30% after annual deductible

$0 copay for first 20 visits; $25 copay per visit thereafter

30% after annual deductible

Mental Health – Inpatient Services

20% after annual deductible

30% after annual deductible

20% after annual deductible

$500 copay, then 30% after annual deductible

Alcohol and Chemical Dependency – Outpatient Services

$0 copay for first 20 visits; $25 copay per visit thereafter

30% after annual deductible

$0 copay for first 20 visits; $25 copay per visit thereafter

30% after annual deductible

Alcohol and Chemical Dependency – Inpatient Services

20% after annual deductible

30% after annual deductible

20% after annual deductible

$500 copay, then 30% after annual deductible

ADDITIONAL SERVICES

Vision Care – basic eye exam at a participating optometrist

No copay

No copay

No copay

Not Covered

Dental Discount Plan

Refer to Dental Schedule of Benefits

Refer to Dental Schedule of Benefits

Refer to Dental Schedule of Benefits

Not Covered

Hearing Exam $0 copay for two ears per year to annual maximum of $1,500 per member $0 copay for two ears per year to annual maximum of $1,500 per member $0 copay for two ears per year to annual maximum of $1,500 per member Not Covered

Open Access: Member does not need a referral to see a specialist. Physicians not listed under the Primary Care and Family Medicine category are considered specialists.

Prior Authorization: Some services/tests require Prior Authorization by the carrier. Your physician is responsible for submitting the Prior Authorization request along with the documentation of medical necessity.

Exclusions and Limitations: All plans have exclusions and limitations. Please review your Certificate of Coverage for details.

This summary is provided for information only; it does not contain complete details of the Plan which are available in the Certificate of Coverage, and it does not constitute an agreement. In the event of a discrepancy, the Certificate of Coverage will govern.

HIGH DEDUCTIBLE HEALTH PLAN (HDHP) Florida HMO Premier Network - Open Access  
BI-WEEKLY DEDUCTIONS  
Employee Only $0.00
Employee + Spouse/DP  $3.00
Employee + Child(ren) $6.00
Employee + Family $50.00
Over Age Dependent (age 26-30) additional $20 biweekly  
Spousal/DP Surcharge: additional $20 biweekly (if spouse has coverage available through his/her employer)  
DEDUCTIBLE/COINSURANCE MAXIMUMS
Annual Deductible Individual $2,100, Family $4,200 
Coinsurance Maximum Individual $1,500, Family $3,000
Maximum Out of Pocket Limit (Deductible/Co-insurance) Individual $3,600, Family $7,200
Preventive office visits (up to age 18)
Preventive immunizations
Preventive office visits (18 years and above)
Preventive mammography
Preventive Pap Smears
Preventive outpatient laboratory tests
Preventive colonoscopy
Preventive prostate screenings
Preventive flu/pneumonia immunization

Preventive office visits and tests are covered at 100%.

Visit/tests/services must be billed by the physician as a "preventive visit."

PHYSICIAL SERVICES
Office Visit - Primary Care Physician
Office Visit - Specialist
Allergy testing (covered as part of office visit)
Physician visit to emergency room
Diagnostic tests, lab and X-rays (when performed in an office or facility
Allergy Serum
Inpartient/outpatient services
Physician surgery visit (inpatient/outpatient)
Allergy injections

Annual deductible must be met first, then subject to 30 percent coinsurance.

Covered at 100 percent after annual out-of-pocket-maximum.

FACILITY SERVICES
Inpatient care (semiprivate room & board, nursing care, ICU)
Outpatient surgery
Outpatient nonsurgical care
Emergency room visit (copayment is waived if admitted)
Skilled nursing facility (up to 60 days per calendar year)
Home health care (up to 60 days per calendar year)
Durable medical equipment
Advanced imaging in outpatient hospital facility or emergency room (PET,MRI,MRA,CAT,SPECT)
Ambulance
Physical, occupationsl, cognitive, and speech therapy
Spinal manipulations, adjustments and modalities (up to 60 visits per calendar year)
Diagnostic radiology; at freestanding facility (PET,MRI,MRA,CAT,SPECT)
Urgent Care
Retail clinics

Annual deductible must be met first, then subject to 30 percent coinsurance

Covered at 100 percent after annual out-of-pocket-maximum

Basic annual eye exam No cost 
Dental care  Refer to Dental Schedule of Benefits 
Hearing exam No Cost - for two ears per year to annual maximum of $1,500 per member 
MENTAL HEALTH
Inpatient Services
Outpatient Services

Annual deductible must be met first, then subject to 30 percent coinsurance

Covered at 100 percent after annual out-of-pocket-maximum

ALCOHOL & CHEMICAL DEPENDENCY  
Inpatient services

Annual deductible must be met first, then subject to 30 percent coinsurance.

Covered at 100 percent after annual out-of-pocket-maximum 

Outpatient services

Annual deductible must be met first, then subject to 30 percent coinsurance

Covered at 100 percent after annual out-of-pocket-maximum 

Open Access: Member does not need a referral to see a specialist. Physicians not listed under the Primary Care and Family Medicine
category are considered specialists. Prior Authorization: Some services/tests require Prior Authorization by the carrier. Your physician is
responsible for submitting the Prior Authorization request along with the documentation of medical necessity. Exclusions and Limitations:
All plans have exclusions and limitations. Please review your Certificate of Coverage for details. This summary is provided for information
only; it does not contain complete details of the Plan which are available in the Certificate of Coverage, and it does not constitute
an agreement. In the event of a discrepancy, the Certificate of Coverage will govern.

 

HEALTH REIMBURSEMENT ACCOUNT (HRA)

As a component of the CDH health plans, the County funds a Health Reimbursement Account (HRA) based on tier of coverage. This account may be used to reimburse eligible health care and prescription expenses for you and any enrolled, eligible dependent(s)* which have not been reimbursed by your health plan such as copayments, coinsurance and deductible. These expenses can be reimbursed up to the HRA account balance. Vision and dental expenses are not reimbursable under the HRA. *See Over Age Dependents age 26-30 and Domestic Partner exclusions on page 45. You may also choose to “bank” your HRA funds for rollover accrual. The accrual maximum is $20,000. See Health Reimbursement Account & Flexible Spending Account booklet for detailed plan rules on
usage, documentation and payback rules.

--- VISION AND DENTAL EXPENSES ARE NOT REIMBURSABLE UNDER THE HRA ---

OTHER HRA HIGHLIGHTS:

Unused balances rollover into the next plan year when continuously enrolled in a County CDH plan.

Health copays, coinsurance and deductible can be paid at time of service/sale by using your WageWorks Health Care Card up to the available balance. Pharmacy* copays are included, but must be coordinated if also enrolled in an FSA Medical Expense Account. Some expenses will require supporting documentation.

Unused balances are eligible for vesting; upon separation of employment vested monies are placed in a tax advantaged account with ICMA and can be drawn upon tax-free beginning at age 55. See vesting schedule on page 19.

COUNTY FUNDED 2014 CALENDAR YEAR HRA

 Employee Only  $  600 
 Employee + Child/Children  $1,350
 Employee + Spouse   $1,350
 Employee + Family $1,600  $1,600

How can I use my HRA account to pay for eligible services?

There are two ways to access your HRA funds:

  1. By using your WageWorks Health Care Card at the time of service/sale for immediate payment to the provider. (Note: expenses other than set copays will require further documentation, see your HRA & FSA booklet); or
  2. By mailing or faxing a manual reimbursement request using an HRA/FSA “Pay Me” claim form and attaching a copy of your Explanation of Benefits (EOB) from the health insurance provider or an itemized bill/receipt showing date of service, type of service, name of patient, name of provider, cost of service. Under IRS rules, a credit card or “paid” receipt is not detailed enough to substantiate an expense.

For pharmacy copay reimbursements, attach a copy of your itemized pharmacy receipt showing your name, date, and prescription information and mail or fax it to WageWorks. You may also elect direct deposit so that you can receive your reimbursement more quickly than by mail..

Payment order, if enrolled in the FSA Medical Expense Account:

    1.  First: Prescription drug copays must be reimbursed from your FSA.
    2. Second: After the FSA is exhausted pharmacy copays may be submitted to your HRA for reimbursement.

If enrolled only in the HRA: Prescription drug copays will automatically be deducted from your HRA.

ACCOUNT

Primary account for claim payment if enrolled in an HRA and FSA

Claim Type

HRA

FSA

Health Claims: Copays, Coinsurance & Deductible

First

Second (if HRA is exhausted)

Pharmacy Claims: Copays

Second (if HRA is exhausted)

First

Dental Expenses

Not eligible

First

Vision Expenses

Not eligible

First

Can I receive reimbursement from both my HRA account and FSA Medical Expense Account for the same expense?
No, the IRS does not allow duplicate reimbursement.

What if I don’t use all my HRA money before the end of the year?
HRA accounts will automatically rollover in early January and be added to your 2014 allotment. You may use the account balance to pay for 2013 or 2014 claims. Upon separation all vested (see vesting schedule) monies are invested in a Retirement Health Savings Account in your name per plan guidelines.

What if I use all my HRA money before the end of the year?
Being able to use your HRA monies to offset out of pocket expense is a great plan benefit to you. However, once your monies are exhausted you would then have the same responsibility to pay any health plan expenses for the remainder of the year. Medical claims submitted via WageWorks Health Care Card or paper submission will automatically adjudicate from the HRA plan first.

Reminder: The HRA will not reimburse dental or vision claims.

HEALTH REIMBURSEMENT ACCOUNT (HRA) GUIDELINES

HEALTH REIMBURSEMENT ACCOUNT (HRA) ROLLOVER

Accumulate/rollover cap of $20,000 for all employees regardless of tier of coverage.

VESTING SCHEDULE

Upon Retirement
Vesting Schedule
Less than 1 calendar year = 0% 
2 full calendar years = 20%
3 full calendar years = 40%
4 full calendar years = 60%
5 full calendar years = 80%
6 full calendar years = 100%
20% - for every consecutive year of HRA enrollment beginning with the second plan year.
100% - Upon completion of six consecutive years of participation in the HRA

Upon Termination
Less than six consecutive years of calendar years = 0%
Six full calendars years = 100%

 

TERMINATION OR NON RE-ENROLLMENT OF COVERAGE PRIOR TO VESTING

Termination of employment or non re-enrollment in a CDH plan prior to vesting will cause any unused HRA funds to forfeit and revert back to the County. Upon subsequent re-enrollment in any given year, HRA allowance begins at entry level amount.

TERMINATION OF PROGRAM BY COUNTY

All unused HRA funds will automatically vest and roll into a Retirement Health Savings Account through ICMA.

ROLLOVER OF HRA MONIES UPON RETIREMENT FROM COUNTY

HRA monies rollover after the group account has been reconciled at the end of the plan year. The account remains open under the group plan for 90 days after the end of the calendar year in order to allow for run out of claims from the prior year. Once the account has been reconciled, the money will be transferred to a Retirement Health Savings Account through ICMA.

ADDING NEW DEPENDENTS

HRA is prorated for the remainder of the year – Employees enrolled in the HRA plan who add a new dependent midyear will receive an increase, if the tier of coverage increases, to their HRA amount equivalent to one-twelfth of the annual HRA allocation, for each full month remaining in the plan year after effective date of change. Accumulated HRA balances from prior years would not be affected.

DROPPING DEPENDENTS

The HRA account of an employee enrolled in the HRA plan, who drops a dependent mid-year, thus changing their tier of coverage, would not be affected.

ENROLLING IN HDHP If eligible to participate in the Health Savings Account, County will automatically vest HRA.


Switch to Full Site   | Terms of use
Official Mobile Website of Broward County, Florida
The version of this site is best viewed on a mobile device.