Open Enrollment for 2015

October 13 – October 27, 2014

Welcome - Online Enrollment - FBMC information

FCSRMC - Life Insurance - Long Term Disability

Medical Benefits

Florida Blue – Pam SmithFlorida Health Care Plans – David Miller

Dental Benefits - Delta Dental

Vision Benefits - VSP

Agenda

Daytona State College Employee Benefitsdaytonastate.edu/employee_benefits

Florida Benefits Management Center (FBMC)bmc.myfbmc.com

Important Enrollment Websites

The first step of the enrollment process is to create your login at bmc.myfbmc.com

NOTE: BenefitSolver is not being used for 2015 enrollment.

FBMC Online Enrollment

Types of Accounts– Healthcare Spending Account – medical, dental, vision & Rx

Maximum contribution - $2,500/year

– Child/Dependent Care Account – Day CareMaximum contribution - $5,000/year

Two Reimbursement Options– Debit Card

– Submit claims to Health Equity for direct deposit

NOTE: Paper checks will be available; however, a fee of $2.00/check will automatically be withheld from the reimbursed amount

Flexible Spending Accounts

The College pays for two times your annual base salary up to a maximum benefit of $500,000 For example: If your annual base salary is $40,000, then the value of your Basic Life insurance policy is $80,000.

You may purchase an additional policy up to three times your base salary, not to exceed a maximum benefit of $500,000 If you purchase an additional policy, may also purchase a spouse life and or a dependent life policy.

During the online enrollment with FBMC, you will have to enter your beneficiary information. You will need your beneficiary’s

SSN, Date of Birth and Address to complete this process.

2015 Life Insurance

The College provides Long Term Disability coverage and pays 100% of the cost for this benefit.

Long Term Disability coverage is pay check insurance. This benefit begins if you become totally and permanently disabled and are no longer able to work, ensuring that your income continues.

Long Term Disability

Pam Smith

Introducing Florida Blue

• Access to over 44,813 providers in Florida; 817,762 nationally

• Access to 200+ countries worldwide

• Local hospitals in-network Option 1

• Bert Fish Medical Center in-network Option 2

• Emergency & Urgent Care covered worldwide

• FloridaBlue.com – find providers, view claims, benefit info, member handbook, order new ID Cards

• Nurse Advice Hotline (24/365) – 877-789-2583

• Dedicated Case & Disease Management

• Flu Shots available at no cost at participating pharmacies

Florida Blue PPO PlansFeatures & Benefits

Florida Blue - Access to CareBrevard, Flagler and Volusia Counties

BREVARD BlueCare BlueOptions

Hospitals 7 7

PCPs 285 289

Specialists 492 506

VOLUSIA BlueCare BlueOptions

Hospitals 6 6

PCPs 264 279

Specialists 350 352

FLAGLER BlueCare BlueOptions

Hospitals 1 1

PCPs 34 38

Specialists 49 48

Wuesthoff Hospital - Rockledge**Wuesthoff Medical – Melbourne**Cape Canaveral HospitalHolmes Regional Medical CenterPalm Bay HospitalParrish Medical CenterViera Hospital

Space Coast AreaKEY PROVIDER GROUPS:• Brevard Medical Group • Coastal Cardiovascular and Thoracic• Healthcare Partners of Memorial• Medical Associates of Brevard• Melbourne Internal Medicine Associates • Memorial Physicians• Omni Healthcare• Osler Medical **• Quality Medical Care• Royal Oaks Medical Center** Providers in BlueSelect Network

Florida Hospital - Flagler

Florida Hospital – OceansideHalifax Medical Center**Halifax Hospital Port OrangeBert Fish Medical Center (Option 2)**Florida Hospital – DeLandFlorida Hospital – Fish Memorial

Florida Blue PPO Plans

Benefit BlueOptions 03769 BlueOptions 03559

DeductiblePerson / Family $600 / $1,800

Person / Family $600 / $1,800

Out-of-Pocket Limit Person / Family$6,000 / $12,000

Person / Family$6,000 / $12,000

Primary Care Visit $30 copay $30 copay

Specialist Visit $50 copay $50 copay

Preventative Care No Charge No Charge

NOTE: Actual cost share amounts are based on location of service

Benefit BlueOptions 03769 BlueOptions 03559

Diagnostic Tests Physician Office Independent Clinical Lab IDTC Hospital

$30/$50$0$50DED + 20% Opt 1/Opt 2

$30/$50$0DED + 20%$150 Opt 1 / $250 Opt 2

Emergency Room DED + 20% $100 + 20%

Urgent Care $65 $50

Hospital Stay DED + 20% Opt 1 & 2 $150 Opt 1/$250 Opt 2

Florida Blue PPO Plans

Prescription Drug Coverage

BlueOptions 03769

BlueOptions 03559

Generic $15 copay $15 copay

Brand $45 copay $60 copay

Non-preferred Brand and Specialty Drugs $65 copay $100 copay

Mail Order (Up to 90 days supply)

2 x Retail Copay 2 x Retail Copay

Florida Blue PPO Plans

Florida Blue Medical Premiums

Blue Option 03559 or 03769 Blue Option 03559 or 03769

24-Pay per Year Per pay Per month 18-Pay per Year Per pay Per month

College $260.00 $520.00 College $346.67 $693.34

Employee $28.00 $56.00 Employee $37.33 $74.66

Employee & Spouse $148.50 $297.00 Employee & Spouse $198.00 $396.00

Employee & Child(ren) $119.00 $238.00 Employee & Child(ren) $158.67 $317.34

Employee & Family $232.00 $464.00 Employee & Family $309.33 $618.66

The per pay totals were formula generated and may reflect slight round differences

For Plan Year Effective January 1, 2015 through December 31, 2015

Deductions begin December 15, 2014

The Florida College System Risk Management Consortium (FCSRMC) sincerely regrets that an error was made in the development of Daytona State College’s 2015 health plan rates. The two Florida Blue PPO plan rates were inadvertently switched.

FCSRMC will honor the 2015 rates that have been quoted and supplied to Daytona State College and their employees. We sincerely regret any inconveniences. Through this error Daytona State College employees will be able to enroll in the higher level of Florida Blue PPO benefits at the lower plan price for 2015. Effective January 1, 2016 the correct rate plus any needed increase will be introduced.

David Miller

Introducing FHCP

• Access to over 1100 providers

• All local hospitals in-network

• Emergency & Urgent Care covered worldwide

• WFW Extended Hour Centers reduced $10 copay

• FREE Access to over 50 local Gyms

• FHCP.com and myFHCP – find providers, view claims, benefit info, member handbook, order new ID Cards

• Nurse Advice Hotline (24/365) – 800-548-0727

• Dedicated Case & Disease Management

• Flu Shots available at no cost at FHCP facilities

FHCP HMO PlansFeatures & Benefits

Deland

Orange City

FLAGLER

VOLUSIA

SEMINOLE

FHCP - Access to CareFlagler, Seminole and Volusia Counties

Daytona BeachDeLandEdgewaterOrmond BeachOrange CityPalm CoastPort Orange-Advanced Urgent Care

.

Contracts with Hospitals• All Volusia/Flagler Counties Hospitals

• Central Florida Regional Hospital

• Putnam Community Medical Center

• Mayo Clinic Hospital

• Moffit Cancer Clinic

• Arnold Palmer Children’s Hospital

• Shands Lake Shore Regional Medical Center

• Shands Live Oak Regional Medical Center

• Shands Starke Regional Medical Center

FHCP HMO Plans

Benefit HMO TS1 HMO T51

DeductiblePerson / Family $500 / $1,500

Person / Family $1,000 / $2,000

Out-of-Pocket Limit Person / Family$3,500 / $10,500

Person / Family$5,000 / $10,000

Primary Care Visit $20 copay $30 copay

Specialist Visit $35 copay $50 copay

Preventative Care No Charge No Charge

FHCP HMO Plans

Benefit HMO TS1 HMO T51

Diagnostic Tests including Radiology

$0 -10% No deductible or 20% after deductible

$0 - 20% Coinsuranceafter deductible

Outpatient Surgery

20% Coinsurance after deductible

20% Coinsurance after deductible

Emergency Room

Urgent Care

Hospital Stay

NOTE: Actual cost share amounts are based on location of service

FHCP HMO Plans

FHCP HMO Plans

Prescription Drug Coverage Network Pharmacies

Preferred Generic $3 copay FHCP Pharmacy

Non-Preferred Generic $10 copay$15 copay

FHCP PharmacySelect Walgreen’s Pharmacy

Preferred Brand$30 copay$35 copay

FHCP PharmacySelect Walgreen’s Pharmacy

Non-preferred Brand$55 copay$60 copay

FHCP PharmacySelect Walgreen’s Pharmacy

Specialty Drugs Formulary

$125 copay Only available at FHCP pharmacies

Mail Order – up to 90 days supply

$1 discount per 31 day

supplyFHCP Pharmacy

FHCP Medical Premiums

FHCP-TS1 FHCP-T51

24-Pay per Year Per pay Per month Per pay Per month

College $260.00 $520.00 $258.91 $517.82

Employee $17.64 $35.28 $0.00 $0.00

Employee & Spouse $134.52 $269.04 $108.99 $217.98

Employee & Child(ren) $105.37 $210.74 $81.81 $163.62

Employee & Family $213.09 $426.18 $182.26 $364.52

FHCP-TS1 FHCP-T51

18-Pay per Year Per pay Per month Per pay Per month

College $346.67 $693.34 $345.21 $690.42

Employee $23.51 $47.02 $0.00 $0.00

Employee & Spouse $179.36 $358.72 $145.32 $290.64

Employee & Child(ren) $140.49 $280.98 $109.08 $218.16

Employee & Family $284.12 $568.24 $243.02 $486.04

The per pay totals were formula generated and may reflect slight round differences

For Plan Year Effective January 1, 2015 through December 31, 2015

Deductions begin December 15, 2014

2015 Medical Premiums

Blue Option 03559 or 03769 FHCP-TS1 FHCP-T51

24-Pay per Year Per pay Per month Per pay Per month Per pay Per month

College $260.00 $520.00 $260.00 $520.00 $258.91 $517.82

Employee $28.00 $56.00 $17.64 $35.28 $0.00 $0.00

Employee & Spouse $148.50 $297.00 $134.52 $269.04 $108.99 $217.98

Employee & Child(ren) $119.00 $238.00 $105.37 $210.74 $81.81 $163.62

Employee & Family $232.00 $464.00 $213.09 $426.18 $182.26 $364.52

Blue Option 03559 or 03769 FHCP-TS1 FHCP-T51

18-Pay per Year Per pay Per month Per pay Per month Per pay Per month

College $346.67 $693.34 $346.67 $693.34 $345.21 $690.42

Employee $37.33 $74.66 $23.51 $47.02 $0.00 $0.00

Employee & Spouse $198.00 $396.00 $179.36 $358.72 $145.32 $290.64

Employee & Child(ren) $158.67 $317.34 $140.49 $280.98 $109.08 $218.16

Employee & Family $309.33 $618.66 $284.12 $568.24 $243.02 $486.04

The per pay totals were formula generated and may reflect slight round differences

For Plan Year Effective January 1, 2015 through December 31, 2015

Deductions begin December 15, 2014

Speak to a Health Coach or Registered Nurse

24 hours a day, 7 days a week, 365 days a year

Confidential

Health DialogNurse Advice Hot Line

Florida Blue 877-789-2583 · FHCP 800-548-0727

Delta Dental Plans

Delta Dental - Option 1 Delta Dental - Option 2 DeltaCare – Option 3

NetworkPayment Basis

In-NetPPO

Out-NetPPO

In-Net PPO Premier

Out-Net80th

In-Network Only48N

Plan Year Maximum $1000 per covered member

$1000 per covered member

No plan year maximum

Deductible (per member/per family) per calendar year

$50/$150 $50/$150 $50/$150 $50/$150 Office Visit $5 copay

Diagnostic/Preventive Service (D&P)

100% 100% 100% 100% D&P $0 - $45 copay

Basic Services 80% 60% 80% 80% $0 - $115 copay

Major Services 50% 40% 50% 50% $0 - $485 copay

Major Services Waiting Period

None None None

Delta Dental Plans

Delta DentalOption 1

Delta DentalOption 2

DeltaCare Option 3

NetworkPayment Basis

In-NetPPO

Out-NetPPO

In-Net PPO Premier

Out-Net80th

In-Network Only48N

Exams, cleanings, bite-wing X-rays

100% 100% 100% 100%

Oral Surgery 80% 60% 80% 80%

Non-Surgical Periodontics 80% 60% 80% 80%

Surgical Periodontics 80% 60% 80% 80%

Space Maintainers 100% 100% 100% 100%

General Anesthesia 80% 60% 80% 80%

Endodontics (root canal) 80% 60% 80% 80% DeltaCare Schedule 48N

Perio Maintenance (4910) 80% 60% 80% 80%

Crowns, bridges, inlays, onlays 50% 40% 50% 50%

Implants Covered Covered Not Covered

Delta Dental Premiums

2015 Delta Dental Two Year Rate GuaranteeFor Plan Year Effective: January 1, 2015 through December 31, 2015

Deductions begin December 15, 2014

Delta Dental PPO - Option 1 Delta Dental PPO - Option 2 Delta Dental DMO - Option 3

24 Pay per Year Per pay Per month Per pay Per month Per pay Per month

Employee $12.31 $24.62 $14.73 $29.46 $5.98 $11.96

Employee & Spouse $25.86 $51.72 $30.93 $61.86 $10.46 $20.92

Employee & Child(ren) $26.11 $52.22 $31.23 $62.46 $12.56 $25.12

Employee & Family $43.30 $86.60 $51.79 $103.58 $17.64 $35.28

Delta Dental PPO - Option 1 Delta Dental PPO - Option 2 Delta Dental - DMO Option 3

18 Pay per Year Per pay Per month Per pay Per month Per pay Per month

Employee $16.41 $32.82 $19.64 $39.28 $7.97 $15.94

Employee & Spouse $34.48 $68.96 $41.24 $82.48 $13.95 $27.90

Employee & Child(ren) $34.81 $69.62 $41.64 $83.28 $16.75 $33.50

Employee & Family $57.73 $115.46 $69.05 $138.10 $23.52 $47.04

The per pay totals were formula generated and may reflect slight round differences

VSP - Vision Plan

Choice Network

Copay $10 Exam; $10 Materials

Exam Every 12 months

Lenses Every 12 months

Frames Every 24 months

Examination Covered after copay

Contact Lens Exam (fitting & evaluation)

Standard Fit – covered in full after copay; member receives 15% off contact lens exam services and copay will never exceed $60

Premium Fit – covered in full after copay; member receives 15% off contact lens exam services and copay will never exceed $60

Lenses Covered after copay for the following:• Single Vision• Lined Bifocal• Lined Trifocal• Lenticular

VSP - Vision Plan

Single Vision Multifocal

Anti-reflective Coating $41 $41

Polycarbonate for Children No copay No copay

Polycarbonate $31 $35

Progressive N/A $55

Photochromic $70 $82

Scratch Resistant Coating $17 $17

Frames $150

Elective Contact Lenses* $120

Necessary Contact Lenses* Covered after copay

*Contact lenses are in lieu of spectacle lenses and frames once every 12 months.

VSP - Vision Premiums

Vision Option

24 Pay per Year Per pay Per month

Employee $2.93 $5.86

Employee & Spouse $5.87 $11.74

Employee & Child(ren) $6.04 $12.08

Employee & Family $8.36 $16.72

Vision Option

18 Pay per Year Per pay Per month

Employee $3.91 $7.82

Employee & Spouse $7.83 $15.66

Employee & Child(ren) $8.05 $16.10

Employee & Family $11.14 $22.28

2015 VSP Two Year Rate GuaranteeFor Plan Year Effective: January 1, 2015 through December 31, 2015

Deductions begin December 15, 2014

The per pay totals were formula generated and may reflect slight round differences

Conclusion

1. Everyone must enroll (or waive coverage) online between October 13 – October 27, 2014

2. Create your enrollment account at bmc.myfbmc.com

3. Have beneficiary information on hand during the enrollment process

4. Questions