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)
Medical
Contact Information
Medical: 1-833-578-1132
Quit for Life: 1-866-784-8454
Quick Links
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
Benefit | Choice HSA | Value HSA | Choice HRA | Value HRA |
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Health Rewards you can earn | 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 | Up to $400/individual coverage; Up to $800/family coverage; Up to $150 additional for spouse |
Wellness/preventive care | 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) | 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 visits | 20% after deductible | 20% after deductible | 30% after deductible | 0% 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 deductible | 0% after deductible |
Hospital care | 20% after deductible | 20% after deductible | 30% after deductible | 0% after deductible |
Generic prescription drugs | 20% after medical deductible | 20% after medical deductible | 20% after medical deductible | 0% after medical deductible |
Preferred brand prescription drugs | 20% after medical deductible | 20% after medical deductible | 20% after medical deductible | 0% after medical deductible |
Non-preferred brand prescription drugs | 40% after medical deductible | 40% after medical deductible | 40% after medical deductible | 0% 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
Salary for 2023-2024 | Plan Type | Team Member only | Team Member and spouse | Team Member and child(ren) | Team Member and spouse and child(ren) |
---|---|---|---|---|---|
Annual salary less than $45,000 | Choice 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 $150,000 | Choice 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 more | Choice 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.
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:
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The Value PPO plan has a $6,550 deductible for individual coverage or a $13,100 deductible for family coverage.
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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 HSA | Value HRA2 | Choice HRA2 | Value 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 & Labs | Eligible office visits, screenings, contraceptives, labs, and preventive medications are covered in full by all plans. | |||||
Primary Care Office Visit | $30 copay | $25 copay | 20% after deductible | 0% after deductible | 30% after deductible | 20% after deductible |
Specialist Office Visit | $70 copay | $50 copay | 20% after deductible | 0% after deductible | 30% after deductible | 20% 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 Care | 20% after deductible | $60 copay | 20% after deductible | 0% after deductible | 30% after deductible | 20% after deductible |
Emergency Room | 20% after deductible | $350 copay | $300 copay after deductible | 0% after deductible | $300 copay after deductible | $300 copay after deductible |
Most Other Services | 20% after deductible | 20% after deductible | 20% after deductible | 0% after deductible | 30% after deductible | 20% after deductible |
What You Pay for Pharmacy Services | ||||||
Generic Prescription Drugs: 30-Day Supply | $10 copay | $10 copay | 20% after deductible | 0% after deductible | 20% after deductible | 20% after deductible |
Preferred Brand Prescription Drugs: 30-Day Supply | 20% after deductible | $30 copay | 20% after deductible | 0% after deductible | 20% after deductible | 20% after deductible |
Non-Preferred Brand Prescription Drugs: 30-Day Supply | 40% after deductible | $50 copay | 40% after deductible | 0% after deductible | 40% after deductible | 40% after deductible |
Generic Maintenance Medications: 90-Day Supply | $10 copay | $25 copay | 20% after deductible | 0% after deductible | 20% after deductible | 20% after deductible |
Preferred Brand Maintenance Medications: 90-Day Supply | 20% after deductible | $75 copay | 20% after deductible | 0% after deductible | 20% after deductible | 20% after deductible |
Non-Preferred Brand Maintenance Medications: 90-Day Supply | 40% after deductible | $125 copay | 40% after deductible | 0% after deductible | 40% after deductible | 40% after deductible |
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 HRA | Choice HRA | Value 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.