Documents Library

search

Filter by Type

Sort by Date

Worksheet

2022 Retiree Rate Worksheet

Certificate

JPOFFHIT Plan Document and Summary Plan Description

Rx Formulary

UF Health / Envolve Rx Formulary

Benefit Summary

2022 UF Health Benefit Summary

Instructions

Unum Be Well Benefit Information

Instructions

How to File a Unum Claim

Benefit Summary

2022 UF Health Direct Summary of Benefits and Coverage

Benefit Summary

2022 BlueOptions 5782 Summary of Benefits and Coverage (SBC)

Benefit Summary

2022 BlueCare 65 Summary of Benefits and Coverage (SBC)

Benefit Summary

2022 BlueCare 48 Summary of Benefits and Coverage (SBC)

Notice

CHIPRA Premium Assistance Under Medicaid

Worksheet

Overage Dependent Affidavit

Worksheet

2022 JPOFFHIT Member Rates

Benefit Summary

Unum Critical Illness Benefit Summary

Benefit Summary

Unum Accident Benefit Summary

Benefit Summary

Unum Hospital Benefit Summary

Worksheet

2022 Retiree Rate Worksheet

Benefit Summary

Basic Vision Summary

Benefit Summary

Premier Vision Summary

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

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