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 BlueOptions 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.
LOOKING FOR MORE SPECIFICS?
Check Out the 2023 Summary of Health Plan Benefits!
Here we have answers to questions like: How much do I pay per visit? What's my deductible? How much is covered at the pharmacy?
New in 2023
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.
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.
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.
2023 Additional Resources (Summary of Benefits and Coverage)
2023 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
2023 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.
2023 Summary of Benefits and Coverage (MEDICAL)
The SBC shows how you and the plan would share the cost for covered health care services.
2023 Schedule of Benefits and Coverage (PHARMACY)
The SBC shows how you and the plan would share the costs for covered pharmacy services.
Contact your dedicated Florida Blue representative
- Gainesville—(352) 594-3354
- Jacksonville & Central Florida—(904) 244-9130
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.