Open Enrollment

 July is Open Enrollment for Alachua County employees; this is the time to review your benefits, make changes to your insurance elections for the upcoming plan year and enroll or re-enroll in the flexible spending accounts.    
 
The benefit elections you make continue through the plan year (October 1 - September 30), and cannot be changed unless you experience a qualified life or family status change.     
 
Open enrollment meetings will be held over Zoom.  You do not need to register to attend a meeting.

 

Key Changes a​nd Highlights for 2022

       Health Insurance 
      The current BlueOptions 05770 and Blueoptions 05781 plans will not change although there will be a premium               increase.
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​​Biweekly Premium PPO Plan (05570)​ per pay period increase​ HDHP (05781)​ ​per pay period increase
​Employee $44.67​ $3.31​ $16.45​ $1.22​
​Employee + 1 ​$213.50 $15.81​ $146.04​ $10.82​
​Family ​$301.00 ​$22.30 $205.89​ ​$15.25
 
 
    Flexible Spending Accounts Enrollment

Employees who wish to participate or continue to participate in either the medical or dependent care FSA plan must enroll annually during Open Enrollment.  Please go online to P​rime Pay​ to register (if enrolling for the first time) and make a plan election.  Board employees who are currently participating need to log into their account and make a new election.​   Library, Sheriff, Property Appraiser and Clerk employees need to register as a new user.   Please follow the Prime Pay instructions​​ to make your plan election.

Dependent Verification documents are required to enroll or add dependents to your health insurance coverage
Employees who are newly enrolling dependents in the health insurance will have to provide copies of the required dependent verification documents and complete the dependent verification form​.  A list of eligible dependents and accepted documents can be found here​.  If required documents are not provided, you will not be able to enroll your dependents.  A 30 day grace period will be allowed to provide the dependent verification documents. 
  
Summary of Benefits and Coverage
The summary of benefits and coverage is a health plan informational document required under the Affordable Care Act and will help you understand your benefits and coverage.
 
The summary of benefits and coverage can be viewed online after July or you can request a paper copy by contacting Risk Management at 374-5297 or 337-6180.   

  Open Enrollment Document and Plan Summaries

Open Enrollment Document​​ - important open enrollment information - Please read and share this information with your spouse and/or dependents  

  
  
  
 Florida Blue Health Plan Summaries
 
 
Summary of Benefits and Coverage (SBC) will be posted when available.
Plan 05770
Plan 05781
  
Florida Combined Life Dental Plan Summaries
 
   

BlueDental Care PS220 

 

BlueDental Choice - High Option​

 

Humana Vision Summary 

 

Enrollment and Change Forms 

All Forms are due back to Risk Management by July 31, 2022

Florida Blue Health Insurance

   

Florida Blue Change form - add or drop dependents, cancel coverage  

Florida Blue Enrollment form ​- enroll in the health insurance plan   

Dependent Verification requirements​​​ - ​this form must be completed along with the required documents to enroll dependents in the health insurance plan   


 Florida Combined Life Dental Insurance   

 

Dental Enrollment Form - enroll in the dental plan

Bluedental Choice PPO high or low option change form​ - change form for PPO dental plan, use this form to add or drop dependents, cancel your dental plan, change from high to low, or low to high option.     

Bluedental Care (PS220) change form  - change form for managed care dental plan, use this form to add or drop dependents, or cancel your dental plan. 

Humana/CompBenefits Vision Insurance  
 
Vision Enrollment form​​​​​ - enroll in vision plan 
  

Vision change form - change form to drop coverage or add/delete dependents   


UsableLIfe Insurance - Life Insurance and AD&D 


Beneficiary Change Form


Life Change Form​ - use this form to decrease or cancel life insurance coverage, or to increase AD&D coverage.

Evidence of Insurability form​ - use this form to apply for additional life insurance coverage. 


 ​Prime Pay Flexible Spending Accounts Enrollment
   

Employees must enroll in the flexible spending accounts with a new dollar amount each year.  You must go online to the Prime Pay por​tal​ to enroll.  ​Please follow the step by step instructions, there are instructions for new participants and also for current participants.

Prime Pay enrollment instructions​​

Prime Pay guide​​​​


Florida Blue  
 

Voluntary Supplemental Benefits (Board employees only)

Voluntary Benefits Summary booklet​

Critical Illness, Accident (Standard)
Legal and ID Theft Protection (Legalshield)

Standard enrollment form 


 

Medicare D Creditable Coverage Notice   

 

This creditable coverage notice is for retirees, employees or covered spouses who are eligible for Medicare.   

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