Designed with flexibility in mind, offering three tiers of benefit coverage
The Premium Plus plan offers you three network tier options. Tier 1 benefits are services you receive from the GatorCare Network. Tier 1 is primarily composed of UF Health facilities and physicians in Central Florida, Gainesville, and Jacksonville, however, select community providers are included to ensure adequate access to care. Tier 1 benefits offer the best value, with lower copays, deductibles and out of pocket costs. Tier 2 benefits apply when you receive services from Florida Blue’s Network Blue providers, which typically result in higher out-of-pocket costs. When using Tiers 1 and 2 for wellness and preventive care, annual physicals and labs are offered with no out-of-pocket expense to you. Tier 3 benefits apply when you receive services from an out-of-network provider; you still have coverage but may be billed for the difference between the provider’s charge and the allowed amount.
Overview and Benefits
OVERVIEW
Looking for an overview of the plan?
Here you can find general information about the plan and get a better idea of how our coverage works for you!
Looking for more specifics?
Check out our 2022 Health Plan Benefits Document!
Here we have answers to questions like: How much do I pay per visit? What’s my deductible? and How much is covered at the pharmacy?
Urgent Care Centers
New Tier 1 Urgent Care Centers in Florida 2023
Tier 1 UCC’s are being updated accurately reflect current locations and rates.
Faq’s
Learn more about Premium Plus
Read more about typical questions you may have before enrolling with a Premium Plus plan.
Coming Soon!
Look Forward to our 2023 Health Plan Benefits Document!
Changes made to the Health Plan Benefits Document here will become live on January 1st, 2023.
2023 Additional Resources (Summary of Benefits and Coverage)
Benefit Booklet
2023 Prime Plus Benefit Booklet [COMING SOON]
This booklet describes your coverage, benefits, limitations and exclusions for the self-funded Group Health Benefit Premium Plus Plan established and
maintained by GatorCare.
Schedule of Benefits
2023 Schedule of Benefits (CYD’s and OOP’s) [COMING SOON]
This Schedule of Benefits is part of your Benefit Booklet, where more detailed information about your
benefits can be found.
SBC Medical
2023 Summary of Benefits and Coverage (MEDICAL)
The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share the cost for covered health care services.
SBC PHarmacy
2023 Schedule of Benefits and Coverage (PHARMACY)
This document details the Premium Plus pharmacy coverage and benefits.
2022 Additional Resources
Benefit Booklet
2022 Premium Plus Benefit Booklet
This booklet describes your coverage, benefits, limitations and exclusions for the self-funded Group Health Benefit Premium Plus Plan established and
maintained by GatorCare.
Schedule of Benefits
2022 Schedule of Benefits (CYD’s and OOP’s)
This Schedule of Benefits is part of your Benefit Booklet, where more detailed information about your
benefits can be found.
SBC Medical
2022 Summary of Benefits and Coverage (MEDICAL)
The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share the cost for covered health care services.
SBC PHarmacy
2022 Schedule of Benefits and Coverage (PHARMACY)
This document details the Premium Plus pharmacy coverage and benefits.
Coming in 2023
Copay Assistance
Value Max Copay Assistance
The Value Max Copay Assistance Program is being expanded to cover diabetes medications. To view all affected medications, click the link below.
Free Diabetes Tests
Tier 0 Contour® and Contour® Next Test Strips
All members are eligible to receive free Contour® and Contour® Next Test strips at a tier 0 level of coverage.
Contact your dedicated Florida Blue representative
- Gainesville—(352) 594-3354
GatorCareCSR@bcbsfl.com - Jacksonville & Central Florida—(904) 244-9130
GatorCareCSR@bcbsfl.com
The following applies to the above plan:
As a result of the Affordable Care Act, GatorCare is required to provide employees with an easy-to-understand Summary of Benefits and Coverage (SBC) statement that describes the plan’s coverage. All insurance companies must use the same format allowing members to compare plan options. Please note that the examples on page 8 for medical and page 12 for pharmacy, do not reflect actual GatorCare co-pays and deductibles, rather they are general examples required by the federal government. To get your GatorCare medical specific cost of services, call (800) 664-5295; for Magellan Pharmacy Benefits, call (800) 651-8921.
For additional questions about enrollment or premiums, view the Enrollments section of the FAQ page or contact your Human Resources office.