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Worksheet

2022 Retiree Rate Worksheet

Certificate

Summary Plan Description

Benefit Summary

Basic Vision Summary

Benefit Summary

Premier Vision Summary

Benefits Guide

2022 Retiree Benefits Guide

Benefits Guide

2022 Active Member Benefits Guide

Worksheet

JPOFFHIT Public Comment Card

Benefit Summary

Delta Dental Base DHMO Summary

Benefit Summary

Dental Gold DPPO Summary

Benefit Summary

Delta Platinum DPPO Summary

Benefit Summary

Delta Silver DPPO Summary

Benefit Summary

2021 UF Health Benefit Summary

Benefit Summary

2021 UF Health SBC

Benefit Summary

2021 PPO 5782 SBC

Benefit Summary

Unum Be Well Benefit Information

Notice

Medicare Part D – Annual Notice of Creditable Coverage

Benefits Guide

2021 Benefits Guide for Retirees

Benefits Guide

2021 Benefits Guide for Active Members

Benefit Summary

FL Blue HMO 48 Lower Deductible Plan Summary

Benefit Summary

FL Blue HMO 65 Higher Deductible Plan Summary

Benefit Summary

FL Blue PPO 5782 Plan Summary

Certificate

Member Certificate for Florida Blue HMO 65 Plan

Certificate

Member Certificate for Florida Blue HMO 48 Plan

Certificate

Member Certificate for Florida Blue PPO Plan

Notice

Code Section 125 Status of Plan and Qualified Life Events

Notice

Mental Health Benefits HIPAA Exemption

Notice

Notice of Privacy Practices