The plan year begins on October 1 of each year. All contracts and funding levels are based on an October 1 through September 30 plan year, although multi-year guarantees are obtained from the carriers whenever possible.

The PRM Group Health Trust offers its membership a selection of Medical Plans, Dental Plans, Vision Plans, Life Insurance, and an Employee Assistance Program (EAP). Medical coverage is required for participation in the Group Health Trust.

The Patient Protection and Affordable Care Act, otherwise known as Healthcare Reform, created numerous requirements for all group medical plans. Healthcare Reform distinguishes between Grandfathered Plans and Non-Grandfathered Plans in the context of required plan designs. Non-Grandfathered Plans are identical to Grandfathered Plans, except they comply with additional requirements imposed by Healthcare Reform.

Select the following links to learn more about the various plan options:

Medical Plans
Employee Assistance Program (EAP)
Dental Plans
Vision Plan
COBRA Administration
Medical Conversion
Life Insurance

 

Medical Plans
The following PRM Group Health Trust medical plans are administered by Blue Cross Blue Shield of Florida.

Blue Choice PPO - There are two (2) Preferred Provider Plan (PPO) options:

• Grandfathered Plan 702 or Non-Grandfathered Plan 0702 offers excellent comprehensive benefits with minimal out of pocket costs.


• Grandfathered Plan 719 or Non-Grandfathered Plan 0727 offers comprehensive benefits but higher out of pocket limits.

These plans are ideal for employees looking to maintain freedom in choosing their healthcare provider while keeping costs at a reasonable level. A retail and mail order pharmacy benefit is included.

Blue Care HMO:

• Grandfathered Plan 5 or Non-Grandfathered Plan 05 offers comprehensive benefits with low co-pays for office visits.


• Grandfathered Plan 15 or Non-Grandfathered Plan 042 offers comprehensive benefits but with a higher co-pay.

A retail and mail order pharmacy benefit is included.

Blue Options BO: Blue Options plans offer a slightly smaller provider network with physicians and facilities selected by Blue Cross Blue Shield of Florida.

• Grandfathered Plan 1748 or Non-Grandfathered Plan 03748 – This program is the closest to an open access HMO that PRM offers. The Plan has co-pays for in-network providers. A retail and mail order pharmacy benefit is included.


• Grandfathered Plan 1553 or Non-Grandfathered Plan 03559 includes office visit co-pays along with a retail and mail order pharmacy benefit.


• Grandfathered Plan 3359 or Non-Grandfathered Plan 03359 is a high deductible, lower cost option plan. A retail and mail order pharmacy is included.


• Grandfathered Plan 3360 or Non-Grandfathered Plan 05360 is a high deductible, lower cost plan. A retail and mail order pharmacy benefit is included.


• Grandfathered Plans 1166/1167 or Non-Grandfathered Plans 05168/05169 are high deductible, Health Savings Account (HSA) plans. Plans 1166 or 05168 provide “Employee Only” coverage. Plans 1167 or 05169 provide “Employee & Dependent” coverage. A discount retail and mail order pharmacy program is included.

As an Administrative Services Only (ASO) group, PRM is able to streamline its plans to be more advantageous to its membership. Members have the choice of offering any or all of the plans available. This allows employees to choose how their healthcare will be delivered.

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Employee Assistance Program (EAP)
The PRM Group Health Trust includes an Employee Assistance Plan (EAP) provided by MHNet of Florida, Inc. The EAP program provides a variety of counseling, referral and information services. Counseling for many areas, such as stress, alcohol & drug abuse, depression & anxiety, family problems, legal & financial issues, are available. The EAP is included with the medical program.

Participating in the EAP is automatic once members enroll in the PRM Group Health Trust.

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Dental Plans
The PRM Group Health Trust offers two (2) Dental PPO plans through Florida Combined Life:

Plan 1 provides benefits at the same co-insurance levels in-network and out-of-network.
Plan 2 provides benefits at a higher co-insurance level in-network and a lower co-insurance level out-of-network.

Participation in the Dental Plan is not required for participation in the PRM Group Health Trust.

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Vision Plan
The Group Health Trust offers vision coverage through National Vision Administrators (NVA) on an employer and employee paid basis.

Participation in the Vision Plan is not required for participation in the PRM Group Health Trust.

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COBRA Administration
The administration of COBRA benefits is provided by Businessolver. All COBRA materials are kept up to date to meet current compliance guidelines and requirements of the COBRA statute and related regulations.

This benefit is provided to its members by the PRM Group Health Trust.

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Medical Conversion
The PRM Group Health Trust offers a Medical Conversion Policy through Celtic Life Insurance Company. Coverage is available after COBRA benefits have been exhausted.

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Life Insurance
The Life Insurance Plan provided through PRM is written by Lincoln Financial.

Life Insurance benefits are elected by individual entities and may be based on salary or flat amount. Standard PRM life plan benefits include basic life, basic accidental death and dismemberment. Additional life plan benefits for supplemental employee life and dependent life are available.

Participation in the Life Insurance Plan is not required for participation in the PRM Group Health Trust.

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