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Rate Sheet

2022 JPOFFHIT Member Rates

Provider Search

UF Health – Find a Provider

Rate Sheet

2023 JPOFFHIT Member Rates

Certificate

2022 Prescription Drug Summary Plan Description

Benefit Summary

2023 UF Direct Health SBC

Benefit Summary

2023 BlueCare 65 SBC

Benefit Summary

2023 BlueCare 48 SBC

Benefit Summary

2023 Blue Options 5782 SBC

Benefit Summary

2023 Aflac Critical Illness Benefit Summary

Worksheet

2023 Retiree Rate Worksheet

Benefit Summary

2023 Aflac Accident Benefit Summary

Benefit Summary

2023 Aflac Hospital Indemnity Benefit Summary

Benefit Summary

2023 Base Vision Summary

Benefit Summary

2023 Premier Vision Summary

Benefit Summary

2023 Base DHMO Dental Benefit Summary

Benefit Summary

2023 Silver Dental Benefit Summary

Benefit Summary

2023 Gold Dental Benefit Summary

Benefit Summary

2023 Platinum Dental Benefit Summary

Benefit Summary

2023 UF Health Benefit Summary

Benefit Summary

2023 Blue Options 5782 Benefit Summary

Benefit Summary

2023 BlueCare 65 Benefit Summary

Benefit Summary

2023 BlueCare 48 Benefit Summary

Worksheet

2022 Retiree Rate Worksheet

Certificate

JPOFFHIT Plan Document and Summary Plan Description

Instructions

Unum Be Well Benefit Information

Instructions

How to File a Unum Claim

Notice

CHIPRA Premium Assistance Under Medicaid

Worksheet

Overage Dependent Affidavit

Benefit Summary

Unum Critical Illness Benefit Summary

Benefit Summary

Unum Accident Benefit Summary

Benefit Summary

Unum Hospital Benefit Summary

Worksheet

2022 Retiree Rate Worksheet

Benefits Guide

2022 Active Member Benefits Guide

Worksheet

JPOFFHIT Public Comment Card

Notice

Medicare Part D – Annual Notice of Creditable Coverage

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