Employees are eligible beginning the 1st calendar day of the month following one month of employment for most benefits.
- Medical plans with three options to choose from, including two at $0 premium for the employee-only coverage.
- Dental plans with two options to choose from, one of which is $0 premium for the employee-only coverage.
- Health Savings Account (with participation in qualified medical plan), with employer contribution.
- Employee Life Insurance
- Workers’ Compensation
- Short Term and Long Term Disability
As of July 1, 2022, insurers and group health plans must provide public access to two types of rate files and update these files on a monthly basis. An update on this implementation is provided below.
The Transparency in Coverage final rules require non-grandfathered group health plans and health insurance issuers offering non-grandfathered coverage in the group and individual markets to disclose on a public website information regarding:
- In-network negotiated rates for covered items and services
- Out-of-network allowed amounts and billed charges for covered items and services
As of July 1, 2022, these machine-readable files (MRFs) must be made “publicly available and accessible to any person free of charge and without conditions, such as establishment of a user account, password, or other credentials, or submission of personally identifiable information (PII) to access the file” and must be updated on a monthly basis. The website where these MRFs will be housed is:
The site will also include a Table of Contents file with specific details on how to identify the file that applies to a specific health plan.
Groups may copy and paste the above link to their public website in order to comply with these rules.
Important notes about these files:
- These files are extremely large (minimum file size is 20 GB) and are designed to allow researchers, regulators, and application developers with data related to payment rates for health care services.
- Due to the size of these files, an individual’s ability to view or download these files will be dependent on their hardware, browser, and internet speed.
- The data on these files does not reflect the application of benefits or cost-sharing (deductibles, copayments, coinsurance) for a specific health plan.
- Each MRF uses a standard data format and schema (JSON) defined by federal agencies.
- For fully insured groups, there will be one MRF per plan network (BlueOptions, BlueCare, etc.).
- For self-insured groups, there will be one MRF per plan network (BlueOptions, BlueCare, etc.) per group employee identification number (EIN). Users should contact their employer directly to obtain their EIN.
- All MRFs will only include rates for benefits that Florida Blue or Truli for Health administers – rates for benefits that are “carved out” to other vendors (i.e., pharmacy) will have to be obtained from that vendor.