Employees and retirees have a choice of three medical plan options provided by Florida Blue.

• Blue Options PPO Standard Plan #05772

• Blue Options PPO Premier Plan #05770

• Blue Options High Deductible Health Plan #05192/05193 compatible with a Health Savings Account (IRS guidelines regulate eligibility requirements for Health Savings Accounts)

A plan summary is provided below for each plan offered .

In addition to the three plan choices above, Medicare eligible retirees and Medicare eligible dependents of retirees have the option of enrolling in the Blue Medicare PPO health plan (some restrictions may apply). Plan summaries for the Blue Medicare health and RX plan are provided below.

Health Plan Information:

• High Deductible Health Plan 05192 (Single Tier) Summary

• High Deductible Health Plan 05193 (Family Tiers) Summary

• PPO Premier Plan 05770 Summary

• PPO Standard Plan 05772 Summary

Pharmacy Information

• Prime Therapeutics 1-855-457-0007

• Amazon Rx (Home Delivery for 90 Day Supply) 855-965-7539

• Accredo (Specialty Medications) 888-425-5970

• Medication Guide

Medicare Information:

• Medicare Fact Sheet - Introduction to Medicare

• Medicare Fact Sheet - Medicare Decisions for Someone Nearing Age 65

• Medicare Fact Sheet - Deciding Whether to Enroll in Medicare Part A and B When You Reach 65

• 2025 Medicare Program Overview for Retirees

• 2025 Medicare Summary PPO Elite Rx Elite

• 2025 Medicare Summary PPO Elite Rx Platinum

Forms:

• FL Blue Health Plan Grievance and Appeal Form

• FL Blue Claim Form

Helpful Links:

• Blue 365 Discounts - Including Gym Memberships, Lasik Eye Surgery and Hearing Aids

• Prior Authorizations

• Drugs That are Not Covered

• Florida Blue

• FL Blue Nurse Line 1-877-789-2583

• FL Blue Retail Center Information: 1680 Airport Rd., Pensacola, Florida 850-202-4150

• Florida Blue User Registration

• General Wellness Guidelines Adult - Children

• Florida Blue Healthy Addition Prenatal Program