The County has two plans; an HMO and a PPO plan. The BlueCare (HMO - Open Access) and BlueChoice (PPO) plans provided through Florida Blue. The HMO and PPO networks include both Lake County hospitals as well as providers state-wide. Through Florida Blue, members may have access to coverage outside of the state of Florida. The BlueCare - HMO - have access to emergency only coverage outside of the state of Florida and the BlueChoice (PPO) plan offers the BlueCard program which allows access to a limited network of doctors and hospitals around the world.
The medical coverage includes a 24-hour live nurse line, health management and wellness programs, and Blue 365. Blue 365 provides members with a wide range of discounted services for vision care, alternative medicine, hearing care, weight management and fitness memberships. Please review the Florida Blue documents and website for more information. There are two types of medical plans to choose from.
Verifying Provider Participation-Members are responsible for verifying the participation status of a Physician, Hospital, or other provider prior to receiving Health Care Services.
“Independent Clinical Labs” - Quest Diagnostics
The Florida Blue (formerly Blue Cross and Blue Shield of Florida) in-network provider for laboratory services (i.e., screenings) is Quest Diagnostics
. Members enrolled in the BlueCare HMO plan are responsible for ensuring that they and their physician are using the in-network provider, Quest Diagnostics, for their lab work. Lab work performed by any provider other than Quest Diagnostics is not covered under the HMO plan.
Members enrolled in the BlueChoice PPO plan may use an out-of-network provider for laboratory services, but will be required to pay 40% of the cost (member responsibility for in-network lab work is 20%). Members can schedule their lab appointments online with Quest Diagnostics
and search locations by visiting Quest Diagnostic’s website
for locations and to schedule appointments. The online appointment scheduler also has a feature that will remind members of their appointment.
Lake County welcomes you to take advantage of its new Primary Care Connection - Employee Health and Wellness Center, to open in close proximity to the County Administration building this October. Powered by Healthstat, the center will be free to visit for anyone under the Lake County health plan, including dependents, and will offer convenient, flexible hours. The PCC can be used as your primary care service, or in conjunction with your current primary care doctor.
At the PCC, you and your dependents will receive free, easily accessible primary care services, commonly dispensed medications at no cost and pre-scheduled appointments, which eliminate long wait times.
The PCC will be staffed with Healthstat medical professionals including a Board Certified doctor and a medical office assistant. These on-site medical professionals can diagnose ailments, test vitals, conduct blood draws, treat illnesses and prescribe and dispense many medications for free.
By taking a free and confidential health risk assessment screening, either at a Healthstat location in October, or at the PCC through Dec. 15, 2016, employees will receive a 7% waiver on their healthcare premiums.
Using the center as a primary care service will result in both savings for the county and its employees under the self-funded medical plan.
- BlueCare HMO
- BlueChoice PPO
Florida Blue Summary of Benefits and Coverage (SBC)
As an employee, the health benefits available to you represent a significant component of your compensation package. They also provide important protection for you and your family in the case of illness or injury.
To help you make an informed decision, Florida Blue provided a Summary of Benefits and Coverage (SBC). The SBC summarizes important information about your health options in a standard format.
Lake County Board of County Commissioners intends that the SBC is in good faith compliance with the requirements under the recent Health Care Reform Law. If you have any questions please contact Human Resources at 343-9596.
HMO Plan - Balance Billing Prohibited
A contracted or non-contracted Florida licensed medical provider or facility cannot bill a subscriber if the HMO fails to pay a claim for a covered service. Florida Law prohibits providers from billing members for covered services except for applicable co-payments, co-insurance or deductibles.
Several times throughout the year, a Florida Blue representative will be available for one-on-one on-site
meetings with employees regarding their medical coverage. Employees who are not able to attend a meeting, but would still like to speak with the rep that day, can reserve a time on the online training calendar and call into Human Resources, 352-343-9596, at the reserved time to speak with the Florida Blue representative directly.
Employees are also welcomed on a call-in/walk-in basis.
The days, times and locations of the one-on-one Florida Blue representative visits will be announced via email. You can also access the calendar by clicking on the link below:
Training Calendar and Registration
If an employee has an urgent matter that cannot wait until one of these visits, they are advised to contact one of the following Florida Blue's customer service lines directly.
Florida Blue Customer Service - 1-800-352-2583