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 Health Benefits
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Important Notices
  • Women's Health and Cancer Rights Act (WHCRA) Annual Notice
    This notice provides information on the availability of mastectomy benefits and coverages
  • Medicare Part D Notice
    This notice has information about your current prescription drug coverage with Lake County Board of County Commissioners – Employee Health Benefit Plan and about your options under Medicare's prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan.
  • Marketplace Notice
    To assist you as you evaluate options for you and your family, this notice provides some basic information about the new Marketplace and employment-based health coverage offered by your employer.
  • HIPAA Special Enrollment Rights
    This notice is a description of an individual’s special enrollment rights.
  • HIPAA Privacy & Portability Rights Notice
    HIPAA’s privacy rules require covered entities to provide individuals with a “notice of information practices.” The notice describes (1) the uses and disclosures of Protected Health Information (PHI) that a covered entity may make; (2) an individuals’ rights; and (3) a covered entity’s responsibilities.
  • Medicaid and the Children's Health Insurance Program (CHIP)
    If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace.
Medical - Florida Blue

The County has two plans; an HMO and a PPO plan. The BlueCare (HMO - Open Access) and BlueChoice (PPO) plans provided through Florida Blue. The HMO and PPO networks include both Lake County hospitals as well as providers state-wide. Through Florida Blue, members may have access to coverage outside of the state of Florida. The BlueCare - HMO -  have access to emergency only coverage outside of the state of Florida and the BlueChoice (PPO) plan offers the BlueCard program which allows access to a limited network of doctors and hospitals around the world.

The medical coverage includes a 24-hour live nurse line, health management and wellness programs, and Blue 365.  Blue 365 provides members with a wide range of discounted services for vision care, alternative medicine, hearing care, weight management and fitness memberships. Please review the Florida Blue  documents and website for more information. There are two types of medical plans to choose from.

NOTE 1:
Verifying Provider Participation
-Members are responsible for verifying the participation status of a Physician, Hospital, or other provider prior to receiving Health Care Services.

NOTE 2:
“Independent Clinical Labs” - Quest Diagnostics

The Florida Blue in-network provider for laboratory services (i.e., screenings) is Quest Diagnostics. Members enrolled in the BlueCare HMO plan are responsible for ensuring that they and their physician are using the in-network provider, Quest Diagnostics, for their lab work. Lab work performed by any provider other than Quest Diagnostics is not covered under the HMO plan. Members enrolled in the BlueChoice PPO plan may use an out-of-network provider for laboratory services, but will be required to pay 40% of the cost (member responsibility for in-network lab work is 20%). Members can schedule their lab appointments online with Quest Diagnostics and search locations by visiting Quest Diagnostic’s website for locations and to schedule appointments. The online appointment scheduler also has a feature that will remind members of their appointment.

Primary Care Connection (PCC) - Employee Health and Wellness Center

Lake County welcomes you to take advantage of its new Primary Care Connection - Employee Health and Wellness Center, to open in close proximity to the County Administration building this October. Powered by Healthstat, the center will be free to visit for anyone under the Lake County health plan, including dependents, and will offer convenient, flexible hours. The PCC can be used as your primary care service, or in conjunction with your current primary care doctor.

At the PCC, you and your dependents will receive free, easily accessible primary care services, commonly dispensed medications at no cost and pre-scheduled appointments, which eliminate long wait times.

The PCC will be staffed with Healthstat medical professionals including a Board Certified doctor and a medical office assistant. These on-site medical professionals can diagnose ailments, test vitals, conduct blood draws, treat illnesses and prescribe and dispense many medications for free.

By taking a free and confidential health risk assessment screening, either at a Healthstat location in October, or at the PCC through Dec. 15, 2016, employees will receive a 7% waiver on their healthcare premiums.

Using the center as a primary care service will result in both savings for the county and its employees under the self-funded medical plan.

Forms

Plans

Florida Blue Summary of Benefits and Coverage (SBC)

As an employee, the health benefits available to you represent a significant component of your compensation package. They also provide important protection for you and your family in the case of illness or injury.

To help you make an informed decision, Florida Blue provided a Summary of Benefits and Coverage (SBC). The SBC summarizes important information about your health options in a standard format.

Lake County Board of County Commissioners intends that the SBC is in good faith compliance with the requirements under the recent Health Care Reform Law. If you have any questions please contact Human Resources at 343-9596.

HMO Plan - Balance Billing Prohibited

A contracted or non-contracted Florida licensed medical provider or facility cannot bill a subscriber if the HMO fails to pay a claim for a covered service. Florida Law prohibits providers from billing members for covered services except for applicable co-payments, co-insurance or deductibles.

Information

Programs, Tools & Tips

Pharmacy and Prescriptions

Florida Blue Visits

Several times throughout the year, a Florida Blue representative will be available for one-on-one on-site meetings with employees regarding their medical coverage. Employees who are not able to attend a meeting, but would still like to speak with the rep that day, can reserve a time on the online training calendar and call into the Office of Human Resources & Risk Management, 352-343-9596, at the reserved time to speak with the Florida Blue representative directly.

Employees are also welcomed on a call-in/walk-in basis.

The days, times and locations of the one-on-one Florida Blue representative visits will be announced via email. You can also access the calendar by clicking on the link below:

Training Calendar and Registration

If an employee has an urgent matter that cannot wait until one of these visits, they are advised to contact one of the following Florida Blue's customer service lines directly.

Florida Blue Customer Service - 1-800-352-2583

Flexible Spending Account (FSA) - TASC

For the 2017-2018 plan year, the maximum annual reimbursement amounts will be $5000 for dependent care and $2600 for medical/health care expenses.

To contact TASC, call customer service at 800-422-4661, or go online at www.tasconline.com. Please use the information and forms below when referencing your TASC Flexible Spending Account.

Employees may enroll in a Flexible Spending Account, within the provisions of the IRS Section 125 plan, which allows employees to have money deducted from their paycheck before it is taxed. This results in an employee reimbursing themselves for medical and dependent care expenses with tax-free dollars.

Dependent Care Reimbursement - Allows payroll deduction of qualified expenses for daycare or nursing home care for an eligible dependent while you or your spouse is at work.

Health Care Reimbursement - Allows payroll deduction for qualified health care costs not covered by insurance, e.g., physician office visit co-pays, deductible, co-insurance and prescription drug co-pays. Dental and vision expenses not covered by insurance are also eligible.

Notices and Updates

  • Over-the-counter (OTC) medicines and drugs are "ineligible" under FSA as of January 1, 2011, unless you retain a prescription or letter of medical necessity from your physician, or if it is insulin.

Forms

Tools

Information

Dental - Florida Combined Life

Forms

Plans

  • BlueDental Care (HMO)
    BlueDental Care gives you access to an extensive network of select general dentists and specialists throughout Florida, and every member of your family can choose his or her own dentist.
  • BlueDental Choice (PPO)
    BlueDental Choice is a flexible PPO plan designed to encourage regular cleanings and preventive services that lead to good oral health and better overall health.

Information

Cancer Plan - Bay Bridge Administrators

New enrollment in the Cancer Plan is currently closed.

If you currently participate in this benefit, call 1-800-845-7519 for additional information and policy number.

This is an optional benefit the employee pays for each month. Under the cancer plan members have additional coverage to help if cancer strikes. The plan also covers 32 other diseases such as, Malaria and Muscular Dystrophy. The following are some benefits of the cancer plan:

  • In and out of hospital benefits
  • Wellness and donor benefits
  • Portable (take it with you if you leave County employment)
  • Pays regardless of other coverage

Forms

Information

Employee Assistance Program (EAP)

Information

The Employee Assistance Program (EAP) provides the following benefits to employees and their dependents:

  • Confidential Counseling - Master’s and Doctoral level clinicians are available to employees for up to six (6) free counseling sessions per issue per year to help employees address stress, relationship and other personal issues they or their family may face along with a variety of counseling and informational services.
  • Financial Information and Resources – Employees can speak by phone with Certified Public Accountants and Certified Financial Planners on a wide range of financial issues such as: getting out of debt, retirement planning, credit card or loan problems, estate planning, tax questions, and saving for college.
  • Legal Support and Resources – Employees can talk to ComPsych attorneys by phone. If an employee requires representation, ComPsych will refer the employee to a qualified attorney in the area for a free 30-minute consultation with a 25% reduction in customary legal fees thereafter. Employees can call about divorce and family law, real estate transactions, debt and bankruptcy, civil and criminal actions, landlord/tenant issues, and contracts.
  • Work-Life Solutions – ComPsych’s Work-Life specialists will do the research for employees, providing qualified referrals and customized resources for matters such as child and elder care, college planning, moving and relocation, pet care, making major purchases, and home repair.
  • GuidanceResources® Online - GuidanceResources Online provides support, resources and information for personal and work-life issues. The website provides timely articles, HelpSheetsSM, tutorials, streaming videos and self-assessments, “Ask the Expert” personal responses to your questions, as well as child care, elder care, attorney and financial planner searches. To access the GuidanceResources® Online website, visit guidanceresources.com. To register as a “First Time User” , use the Organization Web ID: LCBCC.

To take advantage of the many benefits above, call ComPsych at 844.346.6682 TDD: 800.697.0353. Click here to learn what services the EAP offers.

HIPAA

A federal law, the Health Insurance Portability and Accountability Act of 1996 (HIPAA), requires that health plans protect the confidentiality of employee/member private health information. A complete description of employee/member rights under HIPAA can be found in the Plan's Privacy Notice. The documents provided below are distributed to employees upon enrollment in the plan.

Dependent Eligibility

If adding spouse or dependent(s) for the first time to any of the benefits plan(s), copies of marriage license and/or birth certificate(s) must be submitted with the Benefits Open Enrollment Election Form.

Medical, Dental and Vision

  1. Legally married spouse of an employee or retiree
  2. The natural child, stepchild, adopted child of an employee,
    1. Birth up to the end of the calendar year in which he or she turn twenty-six (26Medical Only Over-aged Dependent coverage - Between the ages of twenty-six (26) and the end of the calendar year in which he or she turns thirty (30) if the child:
      1. Is unmarried with no dependents of his or her own;
      2. Resides in the state of Florida OR is a full-or part-time student
      3. Does not have medical insurance available through his or her employer or is not eligible for Medicare, and is not covered under any other medical insurance plan including Medicare

Supplemental Life and AD&D

Dependent means Your spouse and Your Dependent Child. A Dependent must be a citizen or legal resident of the United State. Any person who is in full-time military service cannot be a Dependent.

  1. The Covered Employee's spouse under a legally valid existing marriage;
  2. Your unmarried children, stepchildren, legally adopted children; or
  3. Any other children related to You by blood or marriage who:
    1. Live with You in a regular parent-child relationship; or
    2. You claimed as a dependent on Your last filed federal income tax return; provided such children are primarily dependent upon You for financial support and maintenance and are:
      1. At least 14 days old but under age 26
      2. Age 26 or older and disabled. Such children must have become disabled before attaining age 26. You must submit proof, satisfactory to Us, of such children’s disability.
  4. A child of a covered dependent child (Covered Employee's grandchild), is eligible for coverage from birth to age 18 months.

Legal Services

  1. Legal spouse residing in same residence or domestic partner under the stipulation that they show proof that they have been in a committed relationship for no less than one year.
  2. Any unmarried child (adopted and step child) under 18 years of age and dependent upon the plan member for support and maintenance.
  3. Any unmarried child (including adopted and step child) 18- 25 years of age, whether or not living at the Plan Member’s residence, who is dependent upon plan member for support and maintenance and is a full time student in high school, college, university, etc. (written proof from institution may be required) and is residing on or near such school in pursuit of such studies.
 
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