Medical Coverage

Bloomin' Benefits 5 Benefits 5 Medical Coverage

Medical Insurance

Benefits-eligible Team Members have a choice of four medical insurance plans administered by Blue Cross and Blue Shield of Florida (BCBSFL).

Get Started

  • First, use the information below to compare the coverage offered and what you would pay for each plan.
  • Then, learn how to choose and use your plan and your health savings or reimbursement account (HSA or HRA).
  • Once you’re a member, activate your account in My Health Toolkit to take advantage of services, programs, and resources from BCBSFL.

Helpful Terms & Definitions

Deductible

This is the amount you must pay for your eligible medical and prescription drug claims before your health plan starts to share in the cost. If you receive non-covered services (such as cosmetic surgery), or are balance billed by an out-of-network provider, these expenses will not count toward your deductible.

Coinsurance

It is a percentage amount that you are responsible for paying after you have met your deductible but before you have met your out-of-pocket maximum. This is when the plan starts to share in the cost of eligible claims.

Out-of-Pocket Maximum

The out-of-pocket maximum is the maximum amount you are responsible to pay for eligible, covered expenses during a calendar year. If you receive non-covered services (such as cosmetic surgery), or are balance billed by an out-of-network provider, these expenses will not count toward your out-of-pocket maximum.

Blue Cross & Blue Shield of Florida (BCBSFL)

Blue Cross & Blue Shield of Florida (BCBSFL)

Medical

Contact Information

Medical: 1-833-578-1132
Quit for Life: 1-866-784-8454

Quick Links
Heads up! This information reflects the current 2024 plan year, which ends Dec. 31.

Plan Information

There are four BCBSFL medical plan options for you to choose from: Choice HSA, Value HSA, Choice HRA, and Value HRA.

  • Under the BCBSFL medical plans, you can see any doctor (including specialists) or use any hospital in the network: no referrals are required and you don’t need to choose a primary care physician (PCP).
  • When you receive care outside of the network, you are covered by insurance, but your costs will be higher.
  • Preventive care is covered 100% with in-network providers.

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Medical Plan Coverage Comparison

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BenefitChoice HSAValue HSAChoice HRAValue HRA
Health Rewards you can earnUp to $400/individual coverage;
Up to $800/family coverage;
Up to $150 additional for spouse
Up to $400/individual coverage;
Up to $800/family coverage;
Up to $150 additional for spouse
Up to $400/individual coverage;
Up to $800/family coverage;
Up to $150 additional for spouse
Up to $400/individual coverage;
Up to $800/family coverage;
Up to $150 additional for spouse
Wellness/preventive careCovered in full (eligible office visits, labs, screenings, and contraceptives)Covered in full (eligible office visits, labs, screenings, and contraceptives)Covered in full (eligible office visits, labs, screenings, and contraceptives)Covered in full (eligible office visits, labs, screenings, and contraceptives)
Calendar year deductible (medical and prescription drugs)$2,500/individual; $5,000/family$4,300/individual; $8,600/family$5,000/individual; $10,000/family$6,550/individual; $13,100/family
Office and urgent care visits20% after deductible20% after deductible30% after deductible0% after deductible
Teladoc visits$55 (general visits)
$85 (dermatology)
Varies for mental health services
$55 (general visits)
$85 (dermatology)
Varies for mental health services
$55 (general visits)
$85 (dermatology)
Varies for mental health services
$55 (general visits)
$85 (dermatology)
Varies for mental health services
Emergency room$300 copay after deductible$300 copay after deductible$300 copay after deductible0% after deductible
Hospital care20% after deductible20% after deductible30% after deductible0% after deductible
Generic prescription drugs20% after medical deductible20% after medical deductible20% after medical deductible0% after medical deductible
Preferred brand prescription drugs20% after medical deductible20% after medical deductible20% after medical deductible0% after medical deductible
Non-preferred brand prescription drugs40% after medical deductible40% after medical deductible40% after medical deductible0% after medical deductible
Calendar year out-of-pocket maximum$5,000/individual; $8,200/family$6,500/individual; $9,000/family$7,000/individual; $14,000/family$6,550/individual; $13,100/family

Plan Costs Per Paycheck

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Salary for 2023-2024Plan TypeTeam Member onlyTeam Member and spouseTeam Member and child(ren)Team Member and spouse and child(ren)
Annual salary less than $45,000Choice HSA$62.17$150.03$123.73$205.25
Value HSA$51.80$127.22$104.03$174.15
Choice HRA$43.71$109.41$88.65$149.87
Value HRA$43.13$108.14$87.55$148.14
Annual salary greater than $45,000 but less than $150,000Choice HSA$86.54$208.30$170.90$285.88
Value HSA$76.17$185.49$151.20$254.78
Choice HRA$68.08$167.69$135.82$230.50
Value HRA$67.50$166.42$134.72$228.76
Annual salary of $150,000 or moreChoice HSA$90.66$218.23$179.05$299.52
Value HSA$80.29$195.42$159.35$268.42
Choice HRA$72.20$177.62$143.97$244.14
Value HRA$71.62$176.35$142.87$242.40

Transparency in Coverage

The link below leads to the machine-readable files (MRFs) from our health plan provider that Bloomin’ Brands is making available in response to the federal Transparency in Coverage Rule.

  • Health Plan Provider: Blue Cross and Blue Shield of Florida (BCBSFL)
  • Bloomin’ Brands Plans Covered: BCBSFL Choice HSA, BCBSFL Value HSA, BCBSFL Choice HRA, BCBSFL Value HRA
  • Machine-Readable Files (MRFs): Access the MRFs (Available July 1, 2022)

The MRFs include negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators and application developers to more easily access and analyze data. If you are an employee looking for cost information about your plan, it’s recommended that you visit the Find Care section of your My Health Toolkit account.

Heads up! This information reflects the new 2025 plan year, which begins Jan. 1.

Plan Information

For the 2025 plan year, there are two new BCBSFL medical plan options for you to choose from – the Value PPO and the Choice PPO – in addition to the existing Choice HSA medical plan.

The existing Value HRA, Choice HRA, and Value HSA medical plans will be frozen to new participants and no longer offered after 2025. If you are currently enrolled in one of these three plans you can keep your current plan for one more year, or you may change your election to the new Value or Choice PPO or the Choice HSA plan.

  • Under all BCBSFL medical plans, you can see any doctor (including specialists) or use any hospital in the network: no referrals are required and you don’t need to choose a primary care physician (PCP).
  • When you receive care outside of the network, you are covered by insurance, but your costs will be higher.
  • Preventive care is covered 100% with in-network providers.

Some plan highlights are outlined below. Make sure to review the updated plan comparison and biweekly rates in the next section for detailed cost and coverage information.

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Value PPO & Choice PPO

We are adding two new medical plan options that have set copays for office visits and some prescription drugs: the Value PPO plan and the Choice PPO plan.

Who can enroll? All benefits-eligible employees will be able to enroll.

Deductibles:

  • The Value PPO plan has a $6,550 deductible for individual coverage or a $13,100 deductible for family coverage.

  • The Choice PPO plan has a $2,500 deductible per person with a $5,000 family maximum.

FSAs and HSAs: If you choose the Value PPO plan or the Choice PPO plan, you will be able to set aside pretax dollars in the Health Care Flexible Spending Account (FSA) to help pay for eligible expenses.

What you’ll pay: Your per-paycheck deduction will depend on your salary and the medical plan you choose.

Choice HSA

In addition to the new Value PPO and Choice PPO plans, you’ll have the option to enroll the existing Choice HSA plan.

Who can enroll? All benefits-eligible employees will be able to enroll.

Deductible: The Choice HSA plan has a $2,500 deductible for individual coverage or a $5,000 deductible for family coverage.

FSAs and HSAs: The Choice HSA plan still has a Health Savings Account (HSA) available.

What you’ll pay: Your per-paycheck deduction will depend on your salary and the medical plan you choose.

Value HRA, Choice HRA & Value HSA

The existing Value HRA, Choice HRA, and Value HSA plans will be frozen to new participants and no longer offered after 2025.

Who can enroll: If you are currently enrolled in one of these plans, you can choose to stay in your current plan for one more year. If you want to change your plan, you can choose the Value PPO, Choice PPO, or Choice HSA.

What you’ll pay: Your per-paycheck deduction will depend on your salary and the medical plan you choose.

Using your existing HRA funds:

  • If you are currently enrolled in the Value HRA or the Choice HRA, you’ll have until the end of 2025 to spend any funds that remain in your HRA.
  • Your HRA funds will no longer be available after Dec. 31, 2025.
  • No new contributions will be made to your HRA in 2025.
  • You can check your HRA balance by logging in to your account with Accrue Health.

Medical Plan Coverage Comparison

New
Value PPO
New
Choice PPO
Choice HSAValue HRA2Choice HRA2Value HSA2
Calendar Year Deductibles1
Individual Coverage$6,550 individual$2,500 per person$2,500 individual$6,550 per person$4,300 per person$4,300 individual
Family Coverage$13,100 family$5,000 family max$5,000 family$13,100 family max$8,600 family max$8,600 family
Calendar Year Out-of-Pocket Maximums1
Individual Coverage$7,500 individual$5,000 per person$5,000 individual$6,550 per person$6,300 per person$6,500 individual
Family Coverage$15,000 family$10,000 family max$8,200 family$13,100 family max$9,000 family max$9,000 family
What You Pay for In-Network Care
Wellness, Preventive Care & LabsEligible office visits, screenings, contraceptives, labs, and preventive medications are covered in full by all plans.
Primary Care Office Visit$30 copay$25 copay20% after deductible0% after deductible30% after deductible20% after deductible
Specialist Office Visit$70 copay$50 copay20% after deductible0% after deductible30% after deductible20% after deductible
Teladoc General Visit$30 copay
$25 copay$55 or less $55 or less$55 or less$55 or less
Teladoc Dermatology Visit$70 copay$25 copay$85 or less$85 or less$85 or less$85 or less
Teladoc Therapist/ Psychologist Visit$70 copay$50 copay$90 or less$90 or less$90 or less$90 or less
Teladoc Psychiatrist Visit$70 copay$50 copay$220 or less initial visit; $100 or less ongoing visit$220 or less initial visit; $100 or less ongoing visit$220 or less initial visit; $100 or less ongoing visit$220 or less initial visit; $100 or less ongoing visit
Urgent Care20% after
deductible
$60 copay20% after
deductible
0% after deductible30% after deductible20% after deductible
Emergency Room20% after
deductible
$350 copay$300 copay after deductible0% after deductible$300 copay
after deductible
$300 copay
after deductible
Most Other Services20% after deductible20% after deductible20% after deductible0% after deductible30% after deductible20% after deductible
What You Pay for Pharmacy Services
Generic Prescription Drugs: 30-Day Supply$10 copay$10 copay20% after
deductible
0% after deductible20% after deductible20% after deductible
Preferred Brand Prescription Drugs: 30-Day Supply20% after
deductible
$30 copay20% after
deductible
0% after deductible20% after deductible20% after deductible
Non-Preferred Brand Prescription Drugs: 30-Day Supply40% after
deductible
$50 copay40% after
deductible
0% after deductible40% after deductible40% after deductible
Generic Maintenance Medications: 90-Day Supply$10 copay$25 copay20% after
deductible
0% after deductible20% after deductible20% after deductible
Preferred Brand Maintenance Medications: 90-Day Supply20% after
deductible
$75 copay20% after
deductible
0% after deductible20% after deductible20% after deductible
Non-Preferred Brand Maintenance Medications: 90-Day Supply40% after
deductible
$125 copay40% after
deductible
0% after deductible40% after deductible40% after deductible
1 The deductible and out-of-pocket limits are "embedded" for the Value HRA, Choice HRA, and Choice PPO plans, and "aggregate" for the Value HSA, Choice HSA, and Value PPO Plans.
2The Value HRA, Choice HRA, and Value HSA plans will be discontinued after 2025. Any remaining HRA account balances will be forfeited. No new enrollments will be accepted into the Value HRA, Choice HRA and Value HSA plans for the 2025 plan year."

Medical Plan Costs Per Paycheck

New
Value PPO
New
Choice PPO
Choice HSA​Value HRAChoice HRAValue HSA
Annual salary less than $45,000
You$45.29$71.81$65.28$45.29$45.90$54.39
You + Spouse$113.56$173.29$157.54$113.56$114.89$133.58
You + Child(ren)$91.94$142.92$129.93$91.94$93.09$109.23
Family$155.55$237.07$215.52$155.55$157.37$182.86
Annual salary $45,000 to $150,000
You$70.88$99.96$90.88$70.88$71.49$79.99
You + Spouse$174.74$240.59$218.72$174.74$176.08$194.77
You + Child(ren)$141.46$197.39$179.45$141.46$142.61$158.76
Family$240.20$330.20$300.18$240.20$242.03$267.52
Annual salary more than $150,000
You$75.21$104.72$95.20$75.21$75.81$84.31
You + Spouse$185.17$252.07$229.15$185.17$186.50$205.20
You + Child(ren)$150.02$206.81$188.01$150.02$151.17$167.32
Family$254.53$345.95$314.50$254.53$256.35$281.84

My Health Toolkit

After you’ve enrolled in a BCBSFL medical plan, your My Health Toolkit account so that you have easy access to your member ID card, plan coverage details, in-network care locator, and claims.

Find an In-Network Doctor

You can use the Find Care section of your My Health Toolkit account to find a provider that is covered by your plan.