• Effective April 1, 2009, the list of medications included in the Copay Waiver Program will change. The Copay Waiver Program gives members taking select brand-name medications the opportunity to try a generic at no charge.  When a member switches from a select brand-name medication to a generic alternative, the first covered prescription will be free. Please see the Q&A document and Copay Waiver Drug List for more information.
  
  
• In 2008, the State of Florida created legislation giving eligible over-aged dependents the option to maintain dependent medical coverage from the end of the calendar year in which the dependent becomes 25 through the end of the calendar year in which the dependent becomes 30. The law applies to medical coverage only and does not apply to dental, vision, life/Accidental Death and Dismemberment (AD&D), cancer, and any other non-medical insurance. See memo below for more details on dependent eligibility and documentation required.
  • Medical Coverage for Over-aged Dependents (ages 26-30)
    
    
  Employees electing this additional coverage are financially responsible for this coverage. The monthly cost, per over-aged dependent, is $402.92 for the HMO and $519.39 for the PPO. Premiums for this coverage will be withheld through payroll deduction and will be $201.46 for HMO and $259.70 for PPO per pay period, based on 24 of the 26 pay periods each year.

  Employees can enroll dependents during annual open enrollment or if a qualifying event has occurred.

  Should you have any questions regarding this coverage or would like to add this medical coverage for your over-aged dependent, please contact the Office of Employee Services at (352) 343-9596.

• Responsible Rx Expansion Notice
  
  
• BlueCross BlueShield of Florida “Care Profile” – Frequently Asked Questions
  
  
• Information Regarding Dependent Benefits Coverage and HIPAA Privacy Rights (10/23/2006)
  
  
• Memo regarding Prescription Drug Coverage and Medicare Part D
  
  
• Notice about Prescription Drug Coverage and Medicare (7/20/2006)
  
  
• 2008 Medicare D Notice
  
  

The County has two plans; an HMO and a PPO plan. The BlueCare (HMO - Open Access) and BlueChoice (PPO) plans provided through BlueCross and BlueShield of Florida (BCBS). The HMO and PPO networks include both Lake County hospitals as well as providers state-wide.

Through BCBS, members may have access to coverage outside of the state of Florida. The BlueCare (HMO - Through BCBS, members may have access to coverage outside of the state of Florida. The BlueCare (HMO - Open Access) plan offers guesting privileges in other BCBS networks around the country, and the BlueChoice (PPO) plan offers the BlueCard program which allows access to doctors and hospitals around the world.

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

• BlueCare (HMO)
  
  • Summary of BlueCare HMO Benefits
    
    
• BlueChoice (PPO)
  
  • Summary of BlueChoice PPO Physician Copayment Benefits
  • BlueChoice PPO Schedule of Benefits
  
  
• Useful BlueCross BlueShield Links
  • Access providers within Florida
  • Access providers outside of Florida
  • Health & Wellness Information
  • Blue Card Program
  • Blue Complements
  • Request a Replacement ID Card or Benefit Booklet
  
  
• Mental Health & Substance Abuse Benefit
  Effective 10/01/08, employees/members on the County’s medical plan are eligible for Mental Health and Substance Abuse services through BCBS. The plan in which the employee/member is on will determine the manner in which they contact a provider, as well as what their payment structure. Please review the documents for payment structure and how to coordinate services through MHNet if you have the HMO medical plan.
  • Mental Health/Substance Abuse Benefit Information
  • MHNet Information
  
  
• Prescription Drug Formulary - For the most up-to-date information please visit www.bcbsfl.com
  
  
• If you are on Medicare or soon will be, below is a link to more information regarding Medicare.
  http://www.medicare.gov/publications/pubs/pdf/10050.pdf
  

A BlueCross and BlueShield of Florida representative is available on-site to meet with employees regarding their medical coverage, at the Office of Employee Services & Quality Improvement typically from 9 a.m. to 4 p.m., every other Thursday. .

Employees can make an appointment by contacting Erin Showe at (352) 343-9406 or by e-mail. Employees are also welcomed on a walk-in basis.

If an employee has an urgent matter that cannot wait until one of these visits, they are advised to contact BlueCross and BlueShield's customer services lines directly.  

BlueCare (HMO) - (877) 352-2583
BlueChoice (PPO) - (800) 322-2808
Flexible Spending Program (FSA) - (800) 753-4681

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.

New Amendment to the Section 125 Plan

The following two updates were included in an amendment to the County’s Section 125 Flexible Spending Account Plan (Cafeteria Plan):

• Incorporation of the Heroes Earning Assistance and Relief Tax Act (HEART Act) - June of 2008, the HEART Act was enacted, which provides military personnel tax benefits and incentives. One of the benefits included are special distribution rules for accessing unused health FSA funds. Effective February 17, 2009, military personnel employed by Lake County BCC who have contributed funds to a FSA account, and are called to active duty for at least 180 days or for an indefinite period, will be able to withdraw those unused funds from their Flexible Spending Account through a Qualified Reservist Distribution (QRD). (See Article 3 of the Amendment.)
• Clarification on which benefits premiums are pre or post-tax and the manner in which enrollments/changes will be administered. (See “Other Revisions,” Article 4 of the Amendment.)

• Plan Summary
• Plan Amendment
• Dependent Care Reimbursement Form
• Health Care Reimbursement Form
• Frequently Asked Questions
• Examples of Qualified Medical Expenses
• Annual Expense Worksheet
• HEART Qualified Reservist Distribution (QRD) Claim Form

There are three types of dental plans offered through CompBenefits:

• Dental Health Maintenance Organization (DHMO) includes predetermined fees paid directly to dentist for services, does not have a deductible or a claim form to file, but does have a limited network of dentists.
  • CompBenefits DHMO Policy Document

• Advantage Plan is an open access plan, which provides a wide variety of benefits through participating providers (a network similar to that of the PPO). At the time of service, the member pays the dentist for any applicable co-payments according to the schedule of benefits.
  • CompBenefits Advantage Policy Document
  • Additional information on Advantage Plan and frequently asked questions

• Preferred Provider Organization (PPO) allows employee to use any dentist; in or out of network. The employee pays a percentage of the Reasonable & Customary Charge, and there is an annual cap on benefits paid by the plan.
  • CompBenefits PPO Policy Document

Search for dental providers at CompBenefits.com

Under the VSP Vision Plan, offered through Ameritas, members have the option of obtaining services from a network of providers who accept the fees as full payment for services under prearranged guidelines. Additionally, members have access to vision-related discounts.

• VSP Vision Plan Website
• Vision Plan Summary
• Vision Plan Document
• VSP Directory for Lake County
• VSP Directory for all of Florida
• Vision Privacy Notice
• Search the online directory (most current) by logging on to the VSP Web site and clicking:
  1. Members and Consumers
  2. Find a VSP Network Doctor
  3. "Are you a member" - select "No"
  4. Continue without signing on

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

Please review the brochure for more information. If you currently participate in this benefit, call 1-800-845-7519 for additional information.

Cancer Plan Brochure

The Employee Assistance Program (EAP) provides employees and their family members up to 6 free visits a year along with a variety of counseling and informational services.  The EAP is available for problems not normally covered under the mental health provisions in your Group Health Plan, such as stress, weight loss, financial issues, family problems, etc. It can also be used for information and referral if you need help determining how to tackle a personal or workplace problem. A supervisor may also refer an employee to the EAP if it appears personal issues are interfering with work performance. Basically, the EAP is a tool for you to use to regain equilibrium during a stressful period.

MHNet EAP Web site:  This site allows you to access the Legal and Financial Resource Center, Quarterly newsletters, Online Care Library, and Satisfaction Survey, as well as contact a MHNet coach.  To access, please follow the instruction below:

• Go to www.unipsych.com
• On the top right-hand corner you will see on-line services login.   
  Type in:  Username: Lakecounty Password: LakeCounty
  [type these in exactly as they are written]

Lifehub Web site:  This is also known as the “Employee Assistance Services On-line” area of MHNet.  Lifehub requires registration to access, which ensures confidentiality.  LifeHub is an internet service that can provide information on life management issues and challenges including stress, leadership, performance, career skills, health and fitness, childcare, eldercare, parenting, personal finance or relationships. You can use LifeHub to:

• Design your own wellness program - including smoking cessation, starting an exercise program or learning to eat better
• Participate in Leadership or Stress Management training
• Look up resources for behavioral health, eldercare or childcare
• Read an article on topics ranging from finding a healthier hot dog to getting out of credit card debt
• You can request information on specific questions such as emotional health issues, Attention Deficit Disorder, Stress Management, Exercise, Nutrition and more

To access, please follow the instruction below:

1. Go to www.lifehub.com
2. On the right side of the page is a box asking for a key code – type in lakecounty
3. When you enter the key code a "Terms of Use" box will pop up on the right hand side of the page. It is important to read this information carefully and then click "I agree" at the bottom of the page.
4. When you click "I agree" within that same space a "New Users" box will appear. This box contains some required fields for you to complete.
5. Fill in only the required fields (do not enter your social security number) and hit the "enter" key on your keyboard.
6. The New Users box will contain your user name and the temporary password (your temporary password will be your user name).
7. Click the "Close" button and you will return to the original Login page.
8. Go to the Login Box on the left side of your screen and enter your User Name and temporary password (your temporary password will be your user name).
9. You will now see a screen that will allow you to pick your own password. Your User Name already appears on the page.
10. Enter your temporary password as the "Old Password" and then enter your new password and then enter it again to confirm the password (use any word or words you will remember).
11. When you are finished, click the "OK" in the upper right corner of the screen.
12. You are now within the Life Hub site. You can view information within any of the articles and special learning programs that interest you.

Once you are registered, you will only need to access the page beginning with the Login Screen.  Type in your User Name and password, hit the enter key on your keyboard and you are there! 

For more information about the EAP or to schedule a consultation or appointment, call (800) 272-3626. Corporate office hours are 8:30 a.m. to 5 p.m., Monday through Friday. The office is also available after hours and weekends for emergency calls.

Please remember that the EAP is not a substitute for medical diagnosis and treatment. Always consult physician regarding your health concerns.

Overview of the legal and financial services that are covered by the Employee Assistance Program and benefits summary.

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.

• Notice of Privacy Practices
• Privacy Notice for Summary Plan Document (SPD)
• Individual Request to Not Use or Disclose Health Information
• Individual Authorization for Use/Disclosure of Protected Health Information (PHI)
• Request to Correct or Amend a Record
• Employee Confidentiality Agreement of Lake County Board of County Commissioners