Orlando Health Benefits 2023

2023
Focus
on
Benefits

Benefits

Eligibility and Enrollment................................................................. 5
Medical Plans and Deductions.................................................... 6
Prescription Drug Plan..................................................................... 9
Orlando Health Pharmacies......................................................... 11
Health Savings Account................................................................. 12
Flexible Spending Accounts.......................................................... 13
Dental Plans......................................................................................... 14
Vision Plan............................................................................................. 15
Life Insurance...................................................................................... 16
Paid Time Off....................................................................................... 17
Leave of Absence and Extended Leave Plan....................... 18
Disability................................................................................................ 19
Family Care Benefits........................................................................ 20
Retirement Savings Plan................................................................. 21

Career  

Education Assistance Programs.................................................. 22

Well-Being

Well-Being Program......................................................................... 23

Additional Benefits and Discounts ............................................ 24

Quick Reference

Pre-Enrollment Worksheet............................................................. 25
Benefits Contact Information....................................................... 26
Disclosure Notice............................................................................... 27

Want more information on Benefits?

Visit SWIFT>Menu>Human Resources>Benefits

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O R L A N D O H E A LT H T E A M M E M B E R B E N E F I T S

We recognize that healthcare is a
rewarding, and sometimes, challenging
profession. People in your care need you to
be your best. That’s why we care so much
about everyone who has chosen to work at
Orlando Health.

Here, we believe that “Orlando Health is Your Best Place to Work,”
because we are committed to providing you the benefits, programs
and services for the continued assistance and growth of our team
members.
We begin your benefits on day one, and we offer flexibility wherever
possible so that you can be present for your passions. In addition, we
have invested in well-being programs designed to provide dedicated
support for you and your loved ones.
“Orlando Health is Your Best Place to Work” is not just something we
say, it’s our promise to you.

3

Common Benefits Terms

403(b) Retirement Savings Plan Allows you and Orlando Health to make contributions towards your retirement.
Beneficiary Person who is listed as the recipient of the proceeds from your benefit plans.
Coinsurance The percentage of covered expenses you pay (the plan pays the remaining percentage).
Copayment A flat fee you pay at the time of service, regardless of the cost of the service, such as the office visit copay.
Deductible The amount you pay for healthcare expenses before your plan begins to pay for benefits.
Dependent Your spouse and children who are eligible for benefits.
Explanation of Benefits (EOB) A record that outlines the healthcare services you used, how much you owe and how much
your plan covered. You will receive an EOB for medical and dental services.
Flexible Spending Account (FSA) An account that allows you to save pre-tax dollars from every paycheck to be used for
eligible expenses, based on which account you select: healthcare and/or dependent care. You must use the funds or risk
losing them.
Health Savings Account (HSA) If you’re enrolled in the high-deductible health plan, an HSA allows you to save tax-free
money from each paycheck. Orlando Health also contributes to your account. Balances roll over from year to year and
never expire. If you change jobs or medical plans you may also keep this account.
High Deductible Health Plan (HDHP) A plan with a higher deductible than a traditional medical plan. The payroll
contributions are lower – but you pay more health care costs yourself through your deductible – before the plan starts
to pay its share. A high deductible plan (HDHP) can be combined with a health savings account (HSA), allowing you to
pay for certain medical expenses with money free from federal taxes. The IRS has specific deductible and out-of-pocket
maximum requirements for an HDHP.
Out-of-Pocket Maximum The most you’ll pay for covered services in a plan year. If you meet your out-of-pocket
maximum, all eligible services will be covered at 100 percent.
Pre-Tax Deductions Money that’s taken from your gross pay before taxes are calculated, which reduces your taxable
wages (this is found through your medical, dental, vision, 403(b), FSA and HSA accounts).
Roth 403(b) Post-tax contributions from a team member’s paycheck toward their 403(b) plan.

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O R L A N D O H E A LT H T E A M M E M B E R B E N E F I T S

Eligibility and Enrollment

Are You Eligible?
If you’re a regular full-time, variable full-time or part-
time team member, you’re eligible to participate in the
Orlando Health benefit plans. This group, and our pool
team members, are eligible for our retirement plan, along
with auto and pet insurance.

Refer to the Summary Plan Description (SPD) for more information. This can be found in Team
Member Connect>Benefit Resources>Benefits Compliance Documents.

Work Status Work Hours a Week Let’s Get (En)Rolling

Full-Time (FT) 40 Hours Not sure what to choose?
Meet ALEX: Your Online
Variable Full-Time (VFT) 30 - 39 Hours Benefits Counselor

Part-Time (PT) 24 - 29 Hours ALEX is an interactive, personalized
online tool to help you select your
Dependent Eligibility Verification benefit plans. He may be virtual, but
he’s really quite helpful. To
Upon enrollment in any Orlando Health medical, dental and/or vision plan, access ALEX, go to MyAlex.com/
all team members must provide required documentation verifying their OrlandoHealth/2023/OH
dependent’s eligibility with Mercer Dependent Verification Center.
Already Decided?
Newbie? Here’s When You Can Enroll
Visit Team Member Connect for step-
New team members are immediately eligible for benefits. You can enroll by-step instructions, along with the link
anytime within 10 calendar days of your hire date, or the date you are in to enroll in your benefits.
a benefits-eligible position. If you do not elect your benefits within 10 days, Team Member Connect is available
you’ll have to wait until the next Open Enrollment to elect coverage (unless at TeamMemberConnect.
you have a qualified life event highlighted below). OrlandoHealth.com

Changing Your Benefit Choices

Generally, your benefit choices will remain in effect for a full calendar year,
so make good choices when you enroll. But if you think you want to make
changes to your benefits, you’ll have the ability to do so during open
enrollment, which is held annually in the fall.

If you have a qualified life event — such as a loss/gain of coverage, marriage,
divorce, or birth/adoption of a child — you may be able to make changes
to your selections within 31 days of the life event. Changing is easy. Start the
process by submitting your request on Team Member Connect within 31 days
of your life event and include any necessary documents.

5

Benefits – Eligibility & Enrollment

Medical Plans Review the chart below for the features and flexibility
of each plan. Use ALEX, our personalized benefits
counselor for assistance in choosing the best plan at
MyAlex.com/OrlandoHealth/2023/OH.

Exclusive Care Key Features HSA Care
Care Plus

Network No out-of-network benefits in In-network and out- In-network and out-of-network benefits are available offering
this plan, except in emergency of-network benefits are you more flexibility
situations or traveling outside of available offering you
the network area more flexibility

Office Visits Minimal office visit copayments Minimal office visit Deductible, then 20% coinsurance
copayments
For healthcare services (other than preventive care
which is covered at 100%) and prescription drugs,
you pay 100% of the cost until you meet the deductible

Deductible A low deductible for high-cost A moderate deductible Has a higher deductible, which must be met before the plan
services for high-cost services begins to pay benefits. Healthcare and prescription drugs
costs are combined to meet the deductible

When covering more than one person, the family deductible
must be met before the plan begins to pay benefits, even when
one family member has reached the individual deductible

Pre-Tax Eligible to elect a Healthcare Eligible to elect a Eligible to elect a Health Savings Account (HSA)
Accounts Flexible Spending Account (FSA) Healthcare Flexible and a Limited Purpose Flexible Spending Account (FSA) to save
Spending Account (FSA) money tax-free

Virtual Visits Orlando Health Provider Network

Sometimes, circumstances or your schedule make it difficult to go What’s the best thing about working with the best healthcare team
see the doctor. That’s why we offer virtual visits, the easy way to get in Florida? The fact that you can be cared for by us as well. Utilizing
on-demand, quality healthcare, when and where you need it. To take providers in the Orlando Health Network will provide the highest
advantage of this easy way to get care, register for Virtual Visits at level of coverage for any of the medical plans. You’ll be asked
VirtualVisit.OrlandoHealth.com. to designate a Primary Care Physician (PCP) for all medical plan
options. Your PCP will help you navigate your care. To locate an in-
Orlando Health-MyChart network provider, visit UMR.com/OrlandoHealth or contact UMR for
assistance at (844) 614-8435.
With MyChart, you can manage your Orlando Health appointments,
access test results, request prescription refills and pay bills all in In the Care Plus Plan, team members may use the United Health Care
a few clicks on your phone, tablet or computer. MyChart is your (UHC) Choice Plus Network, as shown on page 7.
healthcare connection, whenever you need it and wherever you are.
Register today by scanning this QR Code. Ongoing Condition and Emerging Care
Management
6
UMR will provide specialized assistance to team members and
covered dependents undergoing care for chronic medical
conditions. They also provide support to members at moderate risk
of developing a chronic medical condition. We encourage all team
members and covered dependents to participate in these programs
to ensure you are getting the care you need most.

O R L A N D O H E A LT H T E A M M E M B E R B E N E F I T S

2023 Orlando Health Medical Benefits Overview

Exclusive Care Care Plus HSA Care

Medical Coverage In-Network Out-of- In-Network UHC Network Out-of-Network In-Network Out-of-
Annual Deductible Network Network
$1,250/
Single/Family $500/ N/A $2,500 $4,000/ $6,000/ $3,000/ $7,000/
Individual per $1,000 $8,000 $12,000 $6,000 $14,000
Family pays
Out of Pocket Max, $500 N/A $1,250 $4,000 $6,000 $6,000 $14,000
Single/Family
General Coinsurance $4,000/ N/A $4,000/ $6,750/ $9,000/ $5,000/ $7,000/
$8,000 N/A $8,000 $13,500 $18,000 $10,000 $14,000
Preventive Care
0% 0% 50% 50% 20% 0%
Virtual Visit
Primary Care Office Visits Deductible and
Coinsurance
Physician $0 Not $0 $0 $0 Deductible
Specialist $0 Covered Deductible and
Maternity Care $30 $0 $50 PCP Coinsurance Deductible Deductible
(Physician Services) $50 Not $70 Specialist
$300 Covered Deductible and
Urgent Care Services $40 $50 Coinsurance Deductible and Deductible
Not Coinsurance Deductible
Emergency Dept Visit Covered $60 $70 Deductible and Deductible
Coinsurance Deductible and
Ambulance Services Not $300 $400 Coinsurance
Covered Deductible and
Minor Diagnostics Coinsurance Deductible and
(Labs) Not Coinsurance
Covered Deductible and
Minor Diagnostics Coinsurance
(X-rays) Emergency Services
**
Major Diagnostics $30 CareSpot, $100 $40 CareSpot, $80 Deductible and Deductible
$80 Others $250* $80 Others ** Coinsurance **
Outpatient Surgery **
Durable Medical $250* Deductible, Deductible, Deductible and Deductible and
Equipment (DME) then $250* then $250* Coinsurance Coinsurance

$250 ** $250 $250 Deductible and Deductible and
Coinsurance Coinsurance

Outpatient Services Deductible and
Coinsurance
$20 OH/ Not $25 OH/ $45 Deductible and Deductible
$30 Others Covered $40 Others Deductible and Coinsurance Deductible
Coinsurance Deductible
$20 OH/ Not $25 OH/ $60 Deductible and Deductible
$30 Others Covered $40 Others Deductible and Coinsurance Deductible
Coinsurance
Deductible, Not Deductible, Deductible and Deductible and
then $250 Covered then $350 Coinsurance Coinsurance

Deductible, Not Deductible, Deductible and Deductible and
then $250 Covered then $350 Coinsurance Coinsurance

Purchase: $75 Not Purchase: $75 Deductible and Deductible and
Rental: $50 Covered Coinsurance
Rental: $50 Coinsurance

Inpatient Services

Inpatient Services Deductible, Not Deductible, Deductible and Deductible and Deductible and Deductible
then $500 Covered then $500 Coinsurance Coinsurance Coinsurance
daily, 3 day daily, 3 day

max max

*Waived if admitted. **Same as in-network, if true emergency. 7

2023 Medical Plan Deductions*

Tier Exclusive Care Care Plus HSA Care

TM Only Biweekly Monthly Biweekly Monthly Biweekly Monthly
TM and Spouse
TM and Child(ren) Salary under $30,000

Full Family $41.22 $89.30 $28.92 $62.66 $5.77 $12.51
$57.72 $125.07
TM Only $128.62 $278.67 $104.02 $225.38 $50.51 $109.44
TM and Spouse $89.47 $193.86
TM and Child(ren) $112.54 $243.83 $91.02 $197.21

Full Family $199.36 $431.94 $161.23 $349.34
$43.52
TM Only Salary between $30,000 - $60,000
TM and Spouse
TM and Child(ren) $94.30 $31.23 $67.66 $8.08 $17.50
$69.85 $151.34
Full Family $136.58 $295.93 $111.43 $241.43 $61.12 $132.42
$108.26 $234.57
TM Only $119.51 $258.94 $97.50 $211.25
TM and Spouse
TM and Child(ren) $211.70 $458.68 $172.72 $374.22
$55.23
Full Family Salary between $60,000 - $90,000

$119.66 $34.45 $74.65 $11.31 $24.50
$113.15 $245.15
$184.04 $398.75 $159.44 $345.45 $99.00 $214.50
$175.37 $379.96
$169.03 $366.23 $139.51 $302.27

$285.25 $618.04 $247.13 $535.44
$68.98 $82.01
Salary above $90,000

$149.45 $37.85 $14.70 $31.85
$147.09 $318.69
$221.75 $480.45 $193.38 $419.00 $128.70 $278.85
$227.98 $493.95
$196.38 $425.48 $169.21 $366.62

$323.73 $701.42 $285.61 $618.82

*Part-time Team Member premiums will fall into the salary tier equivalent to annual salary on full-time basis.

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O R L A N D O H E A LT H T E A M M E M B E R B E N E F I T S

Prescription
Drug Plan

Retail Pharmacies Maintenance Medications

Retail pharmacies outside of the Orlando Health (OH) network can All maintenance medications (drugs you use on a regular basis for
be used for prescriptions that you need filled immediately or for a long-term health conditions) must be filled under a mandatory 90-
short time only. day supply through an Orlando Health Scripts onsite pharmacy after
the initial dispensing of up to a 30-day supply.
• Prescriptions may be filled at an OptumRx Network retail
Orlando Health offers two easy methods to refill these
pharmacy, like CVS or Walgreens, for up to a 30-day supply maintenance medications:

• Medical plan participants must have prescriptions filled at a Scripts Mail Order Service
Scripts mail order pharmacy services enable you to obtain up to a
pharmacy within the network 90-day supply of maintenance medications, sent directly to your
home. Visit Team Member Connect for more information.
• Refer to the Scripts Pharmacy website at OrlandoHealth.com/
Advantage 90
Services-And-Specialties/Scripts-Pharmacy for an in-network The Advantage 90 program allows team members walk-in service
pharmacy. Members may also call (844) 614-8435 or refer to the for their 90-day maintenance medications. This benefit is available
UMR.com/OrlandoHealth website to locate an in-network through an Orlando Health onsite pharmacy.
pharmacy.
Please visit the Scripts Pharmacy website at OrlandoHealth.com/
Mandatory Generic Services-and-Specialties/Scripts-Pharmacy for more information.

By law, brand and generic drugs must meet the same standards for
safety and effectiveness. Generic equivalents of prescription drugs
will be dispensed if available. If you or your physician request the
brand-name drug when a generic is available, you will be responsible
for the entire cost of your prescription. Ask your doctor to prescribe
generic drugs whenever possible.

9

Prescription The prescription drug plan is included as
Drug Plan part of your medical plan election.

Exclusive Care and Care Plus Plans HSA Care

Annual Deductible - Single/Family N/A $3,000/$6,000 $7,000/$14,000
In-Network
Prescription Drugs Retail In-Network Out-of-Network
(Up to 30-day Supply) Coinsurance Maximum
Deductible and File claim with
Tier 1 Generic 20% $20 Coinsurance OptumRX

Tier 2 Preferred brand 20% $60 Deductible and File claim with
Coinsurance OptumRX
Tier 3 Non-preferred brand 20% $120
20% $200 Deductible and File claim with
Tier 4 Specialty - Obtain at an onsite Coinsurance Maximum Coinsurance OptumRX
Orlando Health Pharmacy only 20% $50
Deductible and File claim with
Prescription Drugs – Mail-Order or Advantage Coinsurance OptumRX
90 (mandatory for maintenance drugs)
Deductible and File claim with
Tier 1 Generic Coinsurance OptumRX

Tier 2 Preferred brand 20% $150 Deductible and File claim with
Coinsurance OptumRX
Tier 3 Non-preferred brand 20% $300
Deductible and File claim with
Coinsurance OptumRX

Deductible and File claim with
Coinsurance OptumRX

Deductible and File claim with
Coinsurance OptumRX

Tier 4 Specialty Medications N/A N/A N/A N/A

Specialty Medications and Prior Authorizations

Certain medications, including specialty medications, require a prior authorization before they will be covered by your plan.
Specialty medications will be limited to a 30-day supply and must be obtained from a Scripts Specialty Pharmacy.
If you are currently taking any specialty medications and need to request prior authorization, please call our clinical call center at
(800) 711-4555.

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O R L A N D O H E A LT H T E A M M E M B E R B E N E F I T S

Orlando Health
Scripts Pharmacies

Scripts Pharmacy – Mail Order Scripts Pharmacy Orlando Health Heart and Vascular Institute
Mail Your Prescriptions To: 1222 South Orange Ave. | Orlando, FL 32806
P.O. Box 568624 | Orlando, FL 32856-8624 (321) 841-1649 | (321) 843-4694 fax
Visit OrlandoHealth.com/Scripts For More Details Monday through Friday | 9:00 am to 7:00 pm
(321) 841-8251 | (321) 843-6996 fax
Monday through Friday | 9:00 am to 5:30 pm Scripts Pharmacy Orlando Health Medical Pavilion – Lake Mary
392 Rinehart Rd., Ste. 1400 | Lake Mary, FL 32746
Scripts Specialty Pharmacy (321) 842-0640 | (321) 842-0641 fax
1111 Blackwood Ave. | Ocoee, FL 34761 Monday through Friday | 8:30 am to 5:00 pm
(321) 842-1622 | (321) 842-1629 fax
Monday through Friday | 9:00 am to 5:30 pm Scripts Pharmacy Orlando Health South Lake Hospital
1920 Don Wickham Dr., Ste. 135 | Clermont, FL 34711
Scripts Pharmacy Bayfront Health St. Petersburg (407) 407-0130 | (407) 407-0134 fax
701 6th St. South | St. Petersburg, FL 33701 Monday through Friday | 9:00 am to 5:30 pm
(727) 893-6334 | (727) 893-6337 fax
Monday through Friday | 9:00 am to 5:30 pm Scripts Pharmacy – Pick-Up Kiosk
Orlando Health St. Cloud Hospital
Scripts Pharmacy Orlando Health Arnold Palmer Hospital 2906 17th St. | St. Cloud, FL 34769
92 W. Miller St. | Orlando, FL 32806 Sign Up To Be A Script Center User
(321) 841-1648 | (321) 841-9102 fax (321) 841-8251
Monday through Friday | 9:00 am to 7:00 pm Prescription Pick-Up 24/7
Saturday and Sunday | 9:00 am to 5:00 pm
Scripts Pharmacy – Pick-Up Kiosk
Scripts Pharmacy Orlando Health Dr. P. Phillips Hospital Orlando Health South Seminole Hospital
9400 Turkey Lake Rd. | Orlando, FL 32819 555 W. Sr 434 | Longwood, FL 32750
(321) 842-7230 | (321) 842-7265 fax Sign Up To Be A Script Center User
Monday through Friday | 9:00 am to 7:00 pm (321) 842-0640
Saturday and Sunday | 9:00 am to 5:00 pm Prescription Pick-Up 24/7

Scripts Pharmacy Orlando Health – Health Central Hospital Scripts Pharmacy (Coming In March 2023)
10000 W. Colonial Dr. | Ocoee, FL 34761 Orlando Health Jewett Orthopedic Institute
(407) 296-1912 | (407) 296-2036 fax 60 Columbus St. | Orlando, FL 32806
Monday through Friday | 9:00 am to 7:00 pm
Saturday | 9:00 am to 5:00 pm 11
Sunday | Noon to 5:00 pm

Health Savings Account

A Health Savings Account (HSA) is a tax-advantaged savings account you can use in conjunction with the
HSA Care medical plan. The funds in the account are used to pay for eligible out-of-pocket healthcare
expenses such as services applied to the deductible, dental care, vision exams and more.

Concerned you might not use all the funds in your HSA account? Don’t worry. An HSA is not a “use-it-or-lose-it” account, and any leftover
funds roll over year-to-year. You must re-enroll in the HSA each year.

Orlando Health will make matching contributions dollar for dollar of a team member’s contribution up to $700 for team member-only
coverage and $1,400 for coverage levels that include dependents. Combined contributions cannot exceed the IRS maximum annual limit.

Catch-up contributions of $1,000 are available for team members who are age 55 or older and not enrolled in Medicare.

Eligibility

To take advantage of an HSA, you must:

• Enroll in the HSA Care Medical Plan
• Not be covered by other health insurance, such as another employer sponsored health plan through a spouse, any part of Medicare or

TRICARE

• Not be claimed as a tax dependent on someone else’s taxes
• Your address cannot be a PO Box

Contributions and IRS Limits

Contribution limits include both your contributions, as well as Orlando Health matching contributions.

• Individual $3,850/Family $7,750
• Annual election amount will be a pre-tax deduction per pay period in equal installments throughout the year
• A $1,000 minimum account balance is required to invest your assets
• Funds in the account belong to you and will be portable upon retirement or termination
• For contributions to be deposited into your account, you cannot have any unused funds in a Health Care FSA.

Coverage Level Maximum Team Member Contribution Maximum Employer Match Total
$3,850
Team Member $3,150 $700 $7,750

Team Member+Dependents $6,350 $1,400

Catch-up contributions of $1,000 are available for team members who are age 55 or older

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O R L A N D O H E A LT H T E A M M E M B E R B E N E F I T S

Flexible Spending Accounts

Flexible Spending Accounts (FSAs) allow you to set aside pre-tax dollars Child Care Tax Credit
to pay for eligible healthcare and dependent care expenses. vs. Dependent Care
Spending Account
Your annual election is divided evenly over the paychecks for the calendar year. FSAs are “use-
it-or-lose-it” benefits, meaning that you must use the money in your account by a certain date Dependent care expenses that are
or you forfeit the balance. You do not need to participate in an Orlando Health medical, dental, eligible for reimbursement are also
or vision plan to contribute to an FSA. You must re-enroll in the FSA each year. eligible for a federal income tax credit.
You can apply for only one of these two
Health Equity provides a variety of ways to access your account, including a debit card. You will favorable tax treatments — not both —
need to provide verification of your eligible expense for each transaction, including a copy of for the same expenses. For information
an itemized receipt with the incurred date of the expense, type of expense, and the provider’s about the federal income tax credit, see
name. IRS Publication 596, available at IRS.gov.

For a listing of eligible FSA expenses, please refer to IRS Publications 502 and 503 available at
IRS.gov or call (800) TAX-FORM (829-3676).

Benefits Healthcare FSA Limited Purpose FSA Dependent Care FSA

Who is Team members enrolled in Team members enrolled in HSA Care. All benefits eligible team members
eligible? Exclusive Care, Care Plus or The IRS does not allow team members to
not enrolled in medical be in the Healthcare FSA and a Health Daycare, in-home childcare fees (income must
Eligible Savings Account (HSA) at the same time be claimed by care provider), local day camp
Expenses fees for children up to the age of 13, or elderly
The Limited Purpose FSA allows you to parent living in your home who is physically or
How much participate in both the HSA and an FSA mentally unable to care for himself or herself
may I Biweekly Paid: $200 – $5,000 ($2,500 if
contribute? Medical copays, deductibles, Dental and orthodontic expenses, married filing separate income tax returns)
When is prescription, drug copays, vision expenses, hearing expenses Monthly Paid: $200 – $1,200
the money dental and orthodontic Funds are available after each payroll
available? expenses, vision expenses deposit. You may be reimbursed up to your
How long is contributions
the money $200 – $2,850 $200 – $2,850 Dates of service between
available? January 1, 2023 – December 31, 2023
Immediately upon enrollment Immediately upon enrollment

in the plan year in the plan year

Dates of service between January 1, 2023 – March 15, 2024

You have until March 31, 2024 to submit claims and request reimbursement You have until March 31, 2024 to submit claims
and request reimbursement

13

Dental At Orlando Health, there’s nothing we love more than seeing you smile.
Plans (And we know our patients love it, too.) That’s why we’re pleased to
offer three dental plan options through Cigna. Two plans leverage a
broad Dental Preferred Provider (PPO) Network, while the other uses a
narrower Dental Health Maintenance Organization (HMO) network.

Cigna Dental Preferred Provider Cigna Dental Health Maintenance
Organization (DPPO) Organization (DHMO)

The two DPPO plans offered are called Preventative and Premier. With the DHMO, team members select a network general dentist who
Both plans are based on Cigna’s DPPO Advantage Network, one of will handle all their dental care needs. After enrolling in the DHMO,
the largest networks in the country. The plans are different regarding a team member will receive a Patient Charge Schedule (PCS*) that
the coinsurance level, calendar year deductible, orthodontia lists the exact payments (copays) needed to be made for specific
coverage and plan maximum. Please refer to the comparison chart procedures. The PCS is beneficial because there are no hidden
below. charges — team members know up front what they will need to pay
for their dental care.
With the Cigna DPPO, you have the freedom to visit any licensed
dentist, but you can save money if you visit a DPPO Advantage Note: there is no out-of-network coverage under the DHMO.
Network dentist. Out-of-network dentists can bill you for the
difference between the payment they receive from your plan and For more information regarding the dental plans, visit Team Member
their full price. Connect.

Dental Plan Comparison

Preventative Premier DHMO
In-Network Out-of-Network In-Network Out-of-Network In-Network Only

Calendar Year Deductible $25/$75 $25/$75 $50/$150 $50/$150 $0/$0
Individual/Family
Calendar Year/Max Benefit $500 $500 $1,500 $1,000 None
Office Visit Copay $0 $0 $0 $0 $5
Preventive 50% 80%
Basic Restorative Care 100% 100% 100%
Major Restorative Care 50%+Ded 50%+Ded 80%+Ded 60%+Ded *
Not Covered Not Covered 50%+Ded 40%+Ded *
Orthodontics Coverage for 50%, up to 50%, up to
Children and Adults Not Covered Not Covered lifetime max lifetime max *

Tier $1,500 $1,500

TM Only Preventative Premier DHMO
TM + 1
TM + 2 or More Biweekly Monthly Biweekly Monthly Biweekly Monthly
$9.51 $20.60 $13.97 $30.26 $7.62 $16.51
$19.03 $41.23 $26.62 $57.68 $12.61 $27.32
$32.34 $70.07 $46.58 $100.93 $18.66 $40.44

14 *This can be found in Team Member Connect>Benefit Resources>Health Benefits>Dental.

O R L A N D O H E A LT H T E A M M E M B E R B E N E F I T S

Vision Benefit Member Cost Out-of-Network (OON)
Plan In-Network Reimbursement
Frequencies
EyeMed Vision Exam: once every calendar year
Eye Exam
Orlando Health is pleased to Retinal Imaging Lenses in lieu of contacts: once every calendar year
offer you vision insurance through Standard Contact Lens Fit and
EyeMed, one of America’s most Frames: once every calendar year
trusted vision benefit companies. Follow Up
Premium Contact Lens Fit and $15 copay Up to $35
Register at EyeMed’s member portal at
EyeMed.com to view and manage your Follow Up Up to $39 N/A
benefits, explore eligibility status, download Frame Allowance
ID cards, and find the right provider. Up to $40 N/A
If you have questions or need assistance, Single vision
EyeMed’s Customer Care Center is ready to Bifocal 10% off retail N/A
help. Please contact them at Trifocal
(866) 800-5457. $0 copay; 20% off balance Up to $60
Lenticular over $150 allowance
Savings Progressive standard Lenses Up to $25
for Members Progressive premium tiers 1–3 $10 copay Up to $40
Progressive premium tier 4 $10 copay Up to $60
40% off $10 copay Up to $60
Tint $10 copay Up to $60
Additional pairs of glasses and a UV $10 copay Up to $60
15% discount on conventional contact Scratch $10–$55 copay Up to $60
lenses once funded benefit is used — an Polycarbonate
industry exclusive. Standard anti-reflective $10 copay; 20% off retail N/A
Photochromic price less $120 allowance N/A
20% off Other add-ons Lens Options N/A
Premium AR (tiers 1 and 2) Up to $20
Any item not covered by the plan, $15 N/A
including non-prescription sunglasses. Conventional $15 Up to $38
$15 N/A
Lasik Disposable $0 N/A
Medically necessary $45
Lasik or PRK from US Laser Network $0 Up to $150
15% off retail price or 5% off promotional Network 20% off retail price
price $57–$68 Up to $150
Contact Lenses Up to $210
Hearing Care $0 copay; 15% off balance
over $150 allowance
Through Amplifon Hearing Health Care $0 copay; 100% of balance
Network, members receive up to 64% off over $150 allowance
hearing aids, an extended warranty, free $0 copay; paid-in-full
batteries and a low price guarantee.
INSIGHT

Vision Plan Deductions

Coverage Tier Team Member (TM) Vision Biweekly Vision Monthly
TM Only $5.28 $11.43
TM + 1 $10.19 $22.07
$14.14 $30.64
TM + 2 or More

15

Life Insurance

It’s important to protect those who depend on you,
should something unexpected happen.

That’s why we offer Life Insurance and Accidental Death and
Dismemberment (AD and D) coverage. You are eligible to participate
in the Orlando Health Basic and Supplemental Life plans if you are a
regular full-time, variable full-time, or part-time team member.

Basic Life and AD and D Costs

Orlando Health pays the full cost of this coverage. All regular The cost for Supplemental Life Insurance coverage is based on your
full-time, variable full-time and part-time team members are age, annual base pay, the amount of coverage and whether or not
automatically enrolled. Your life insurance benefit is based on the you are a tobacco user. (You qualify as a non-tobacco user if you
following: have not used tobacco for the last 12 consecutive months.) Your
payroll deduction will change mid-year with salary and annually with
• For regular full-time team members: your annual base pay based age-band changes.

on 40 hours per week in the system Evidence of Insurability (EOI)

• For variable full-time and part-time team members: your annual Under certain circumstances, an Evidence of Insurability (EOI) may be
required to obtain approval for Basic, Supplemental or Spouse Life
base pay based on your weekly standard hours in the system Insurance coverage. If needed, EOI forms will be sent to you directly
You must pay federal income tax on the value of any Orlando Health from the life insurance carrier for the following reasons:
Basic Life Insurance coverage over $50,000. This value is called
“imputed income” and is included on your paycheck and on your • If you are electing four or five times your annual base pay for
W-2 form at the end of the year. Basic Life coverage cannot exceed
$2,000,000, with Evidence of Insurability required for coverage over Supplemental Life Insurance, amounts over $1,000,000, Basic Life
$1,000,000. over $1,000,000, Spouse Life over $50,000 or increasing coverage
during open enrollment.
Supplemental Life Coverage
• In the event you must complete EOI, be sure to complete all tasks
You pay the full cost of this additional coverage. You can purchase
Supplemental Life Insurance coverage (rounded to the next higher in a timely manner to avoid delayed coverage
$1,000) in the amount of one to five times your annual base pay.
Amounts above three times your annual base pay or over $1,000,000 Dependent Life Insurance
require evidence of insurability. Supplemental Life coverage cannot
exceed $2,000,000. You may also enroll your spouse and dependent children for life
insurance coverage. You pay for the coverage with after-tax dollars
Don’t Forget from your pay. When you receive it, the life insurance benefit is not
taxable.
You must add your beneficiaries to the Basic Life Insurance in
Team Member Connect. Your designation will apply to the Basic You may enroll your spouse up to $100,000 and dependent children
and the Supplemental Life Insurance. You are automatically the up to $40,000 for Life Insurance coverage. Children between the
beneficiary for all Dependent Life Insurance you select. ages of birth to 14 days are eligible for $10,000 in coverage. All
eligible dependent children are eligible for one combined payroll
16 deduction.

If your spouse and/or child works for Orlando Health, they are not an
eligible dependent for the Dependent Life Insurance. If both parents
are employed at Orlando Health, only one parent may cover the
child(ren).

O R L A N D O H E A LT H T E A M M E M B E R B E N E F I T S

Paid Time Off (PTO)

It’s time to learn how our time off works.

We know the flexibility to take time off work is important to your well-being. That’s why Orlando Health
offers a comprehensive Paid Time Off (PTO) policy that gives you time off for vacation, holidays, personal
business or personal and family illness. Please refer to the PTO policy #5916-1001 for more information.
Executives and physicians please refer to your specific contract and offer letter regarding time off.

Payment Method Voluntary PTO Cash-In

PTO hours are paid at your base hourly rate of pay in effect at the time you use the hours. You PTO cash-in allows team members to
may use PTO hours at your current base hourly rate in minimum increments of five minutes. voluntarily cash-in PTO hours at 75% value
However, to maintain your employment status, the number of PTO hours used plus hours in February, May, August and November
worked must equal the standard number of hours required for your status. each year.

Eligibility

Full-time (FT), variable full-time (VFT) and part-time (PT) team members accrue PTO hours
based on the number of actual hours worked.

You may schedule time off based on your available PTO hours. You may not borrow against
PTO hours to be earned in the future or be paid in advance of the regular payday for PTO
hours.

PTO Donation Program

The PTO Donation Program gives you the ability to voluntarily transfer some of your accrued
PTO hours to a fellow team member. It’s a great way to help a fellow team member, should
the need arise. For details, please refer to the PTO Donation Program policy #5916-1032 for
details.

Paid Time Off Accruals Accrual per Hours Worked Maximum Accrual Biweekly Pay Period
0.0947 7.576 hours
Years of Service 0.0981 7.848 hours
0 to 2.99 0.1120 8.960 hours
3 to 4.99 0.1270 10.160 hours
5 to 9.99 0.1460 11.680 hours
10 to 14.99
15+

You accrue hours each pay period to a maximum amount based upon your Benefits Service Date.
This date will change if your status changes from or to a benefits-eligible status (Example: FT to Pool.)

17

Leave of Absence and
Extended Leave Plan

Even when you can’t be here with us, we’re here for you.

At Orlando Health, we know that team members are sometimes unable to work due to an ongoing illness or
other circumstances. We hope that never happens to you, but if it does, know that we have options to help.

Leave of Absence Extended Leave Plan (ELP)

If you need to take a Leave of Absence The Extended Leave Plan is a personal extended illness benefits program that is available
(LOA) contact our new leave administrator, after 24 consecutive work hours missed due to a personal illness. This benefit can also be
New York Life (NYL) beginning 01/01/23. They used to supplement voluntary short-term disability benefits. Team members accrue hours
will review your leave request to determine towards this plan based on hours worked per pay period up to the accrual limit. ELP does not
what type of leave you may be eligible for, carry a cash value. It cannot be paid out upon termination or cashed in at any time. For more
such as a Family Medical Leave. A leave of information, please refer to the Extended Leave Plan policy #5916-1019.
absence may also have income protection
benefits available, such as short-term and Extended Leave Accruals Per Pay Period Accrual Max Annual Accrual Max
long-term disability, if enrolled. Accrual per Hour Worked 1.232 32.03
0.0154

18

O R L A N D O H E A LT H T E A M M E M B E R B E N E F I T S

Disability

Short-Term Disability (STD) Long-Term Disability (LTD)

You pay the full cost of this insurance. Short-Term Disability insurance provides a biweekly Orlando Health pays the full cost of this
benefit that equals 60% of your pre-disability base earnings (up to a $1,000 weekly maximum) insurance. LTD insurance provides a monthly
if you are unable to work due to a non-work-related injury or illness during the first six months benefit that equals 60% of your pre-disability
of your disability. This benefit applies to full-time, variable full-time and part-time team base earnings up to a $10,000 monthly
members. If you have STD coverage, you must apply for disability benefits while on a medical maximum. Full-time, variable full-time
leave of absence with New York Life (NYL). Executives and physicians please refer to your and part-time team members are eligible
specific contract and offer letter regarding disability options. to receive this benefit after 180 days of
continuous total or partial disability.
Waiting Period
There are three different plan options to choose from, with various waiting periods. A waiting How to File a Claim
period is the amount of time before the plan begins paying benefits. For example, with the If you have an illness or injury that may
Short-Term Disability/15-day plan, you would receive Short-Term Disability payments on day qualify as a disability, call New York Life (NYL)
15 of an approved disability. at (888) 842-4462. A representative will
assist you with your disability claim.
Pre-Existing Conditions
A pre-existing condition is defined as any sickness, medical condition or injury for which
treatment was provided, recommended, or prescribed preceding the date your Short-Term
or Long-Term Disability went into effect. Please refer to the Summary Plan Description (SPD)
for more detailed information on pre-existing conditions and their application under the
policy. This can be found in Team Member Connect>Benefit Resources>Benefits Compliance
Documents.

Plan Name Waiting Period Rate Per $100 of Benefit Amount
STD/15 14 days $1.668

STD/30 29 days $1.265
STD/60 59 days $0.955

19

Family Care Benefits

Life happens. So we created benefits for that.

Orlando Health is committed to supporting our team members as they
care for their families. Whether something unexpected happens or
you’re going back to work after the birth or adoption of a child, we’re
here for you.

Team Members get up to 10 back-up childcare or eldercare days per year. Resources for Your
Family’s Ongoing Needs
Back-up Childcare
Through our membership with Sitter City,
When there’s a school closure, your child is sick or your nanny cancels, Bright Horizons can you’ll have access to providers who can help
assist you with skilled and trusted care in your home or at a designated back-up center meet your family where they are. Whether
designed for working parents just like you. you need tutoring, pet-sitting or house-
cleaning services, we’re here to help connect
Team members are responsible for a small copay to help cover the costs of back-up care, you to discounted and reliable resources.
but Orlando Health covers most — helping you focus on your family, not your wallet. Center-
based back-up care at a dedicated back-up center requires a $10 daily copay for one child Fertility Benefits
or $15 copay for the whole family. In-home care is only $4 per hour copay, up to 10 hours.
Through our medical and prescription drug
Register Now! Visit Clients.BrightHorizons.com/OrlandoHealth and use the Employer program, Orlando Health provides coverage
Username: Orlando and Password: Benefits4you. You can also download the Bright Horizons for fertility medication therapy, in-vitro
App. Search “back-up care” in the App Store or Google Play. Any questions? Call Bright fertilization, and other medical services,
Horizons at (877) BH-CARES (242-2737). For your Directory ID, use your network login ID, such up to the $5,000 lifetime maximum. Please
as Z12345Z. contact UMR at (844) 614-8435 for more
details about covered services. Optum
Elder Care Back-up Specialty Pharmacy offers discounted
rates for those who have reached the plan
When your loved one needs temporary support with the activities of daily living, it can be maximum. Call (877) 358-9016 for details.
hard to balance your responsibilities between home and work. With nationwide coverage
and partner agencies that are all vetted, on-boarded and trained through Bright Horizons, Adoption Assistance
you can count on skilled, compassionate, and affordable help. Back-up elder care can be
provided in-home for just $4 per hour copay, up to 10 hours. Now that you are a part of our family, we’d
love to help yours grow. Orlando Health will
Virtual Tutoring contribute up to $5,000 per year toward
eligible adoption expenses including
Orlando Health has partnered with Bright Horizons to provide your child (ages 5-18) help in adoption fees, court costs, attorney fees,
reading, math, science, social studies and more than 300 other subjects, as well as targeted travel expenses (meals and lodging) and
support with a math or reading expert who can identify areas of opportunity to help your other expenses related to legal adoption.
child excel. The program is also open to adult learners who are preparing for graduate school For more details, refer to the Adoption
or additional licenses/courses. Assistance Policy.

A back-up care day can be exchanged for four hours of virtual tutoring with a cost
of $10. Reserve by submitting a tutoring request through the back-up care site and then
schedule the days and times that work best for your family.

20

O R L A N D O H E A LT H T E A M M E M B E R B E N E F I T S

Retirement Savings Plan

Let’s Get Retirement Ready

No matter how much you love your career, you likely still dream about retirement. Experts
recommend saving 10-15 percent of your income in a retirement account annually. This is
made up of both your contributions and money from Orlando Health.

Auto Enrollment Matching Contributions: It’s Free Money.

All eligible team members are immediately Orlando Health will match dollar for dollar on the first 2% you contribute to your account
set up with a 2% auto enrollment into each pay period. After that, Orlando Health will match $0.50 for every $1, up to 8% of eligible
the Retirement Savings Plan, which earnings or up to 10% for team members with 10+ years of service. The Orlando Health match
automatically increases each year by 1%, will be made on both pre-tax and Roth contributions, up to applicable limits.
up to 8%. This increase occurs on the team
member’s date-of-hire anniversary. Team Here Is How the Match Works: Orlando Health Match % Total
members can opt out of auto enrollment Team Member % 2% 4%
at any time by contacting Fidelity at 2% 3% 7%
NetBenefits.com/OrlandoHealth or 4% 4% 10%
(800) 343-0860. 6% 5% 13%
8% 5% 15%
You may make pre-tax or Roth post-tax 6% 16%
contributions up to 50% of your pay. The IRS 10% with less than 10 years of service
annual limit is $20,500 for 2022 and may be 10% with more than 10 years of service
indexed annually.

Catch-Up Contributions Help Is Always Available

If you are 50 or older you may contribute an Financial planning may seem overwhelming. Fortunately, Orlando Health has financial service
additional $6,500 for a maximum of $27,000 representatives available to personally meet with you and provide assistance in the following
for 2022, which may be indexed annually. You areas:
may make changes to your contributions at
any time during the year. • Enrolling in the plan and selecting your investments
• Taking a loan or hardship withdrawal from the plan
Vesting • Rolling over an existing qualified plan into the Retirement Savings Plan

Vesting means ownership of the money in To schedule an appointment with a Financial Service Representative, please contact Fidelity
your retirement account. You are always at (800) 642-7131.
100% vested in your contributions, including
any earnings. You are 100% vested in Please refer to the Retirement Savings Plan Summary for plan details. This can be found in
Orlando Health’s contributions after three Team Member Connect>Benefit Resources>Benefits Compliance Documents.
years of service with 1,000 hours or more
each year. Retirement Gift

Upon retirement, you will receive a contribution to your retirement account of $5,000, if you
retire in good standing. To be eligible, your age and consecutive years of Orlando Health
service must equal at least 75, with the minimum age being 55, and you must also be 100%
vested in the Orlando Health Retirement Savings Plan.

21

Education
Assistance
Programs

Preferred Education Program Student Loan Repayment

The Preferred Education Program allows team members to attend We understand that student loan debt can take a financial and
a partner college for free. That’s because Orlando Health pays the mental toll on you, whether you’re just starting your career or taking
cost of tuition and books directly to the college for those who are steps to further it. That’s why we’re proud to be one of a small
considered residents of Florida for tuition purposes. number of employers that offers student loan repayment assistance
and tuition reimbursement benefits.
The Preferred Education Program offers an opportunity for team
members to pursue an associate degree, bachelor’s degree, or Team members with less than five years of service (in a non-
technical certificate in more than 120 programs. These include leadership position) are eligible for this benefit. The only requirements
nursing, diagnostic medical sonography, respiratory care, emergency are that you obtained your degree prior to your hire date, your
medical technology, business, accounting, health services position requires a bachelor’s degree or higher, or you are a
administration, food service management, and many more. registered nurse hired with an associate or bachelor’s degree.

Best of all, there’s no waiting on reimbursement for courses or a Career Online High School and
financial cap. Partners currently include Valencia College, Seminole My Time English
State College, St. Petersburg and Lake-Sumter State College.
Have you always wanted to complete your High School Diploma or
Tuition Reimbursement GED, but just can’t find the time or resources? Are you interested in
enhancing your English language skills due to English not being your
We also offer a Tuition Reimbursement Program, for team members first language? Orlando Health now offers both of these programs
pursuing degrees from additional colleges and universities. The at no cost to part-time and full-time team members! Career Online
program reimburses your tuition expense, up to $5,000 per year for High School is an 18-month program that is self-paced and online.
full-time and variable full-time and $2,500 for part-time. Plus, you will be assigned a coach to help you be successful. My Time
English is a 12-month program for team members with alternate
This benefit is available for any program, with no restrictions on first languages who want to improve their English speaking and
degree pursuit — even if the degree isn’t required for your job comprehension skills. Sign up today through EdAssist.
description. It’s our way of helping you grow — not only as an Orlando
Health team member, but as a person.

These degree programs can include any of the following:

• Professional certificates (like technical programs or vocational

training)

• Associate degrees
• Bachelor’s degrees
• Master’s and Doctorate degrees

Through our partner at EdAssist, Orlando Health has access to an
expansive list of accredited schools offering in-person and online
programs — many with tuition discounts and even deferred payment
options.

For additional information, please view the Education Assistance Policy, 5916-1009. You can visit OrlandoHealth.EDAssist.com and click
“Contact Us” from the left menu. You can also use the Live Chat feature on the EdAssist portal or call the Contact Center at (833) 890-3226.

22

O R L A N D O H E A LT H T E A M M E M B E R B E N E F I T S

Well-Being Program

Orlando Health is proud to offer a multi-faceted Well-Being Program to surround you with support: 
To learn more about the Well-Being Program, please Visit SWIFT>Menu>Human Resources>LifeWorks
and Well-Being Benefits.

LifeWorks Financial Well-Being

We know life and work can be challenging, and we’re here to help. Fidelity Retirement Service Representatives: Individuals meet
Orlando Health is pleased to offer well-being services and support personally to get you enrolled in the retirement plan, take a loan
for our team members through our selected partner, LifeWorks. or hardship withdrawal, or rollover a prior plan. To schedule an
The LifeWorks Well-Being Program offers team members and their appointment, call Fidelity at (800) 642-7131.
families free 24/7 access to work-life counseling, coaching and
wellness services. Orlando Health Pathways: A program offering one-on-one
coaching to help you achieve financial stability.
Earn up to $500 annually which includes assessment, habitudes,
snackable, challenges and more for team members enrolled in our Team Member Support Fund: Offers financial support during difficult
medical plan! situations.

Employee Assistance Program (EAP): Get confidential, 24/7 access Physical Well-Being
to counselors and coaches for personal, family or work issues.
Active and Fit: For only $25 per month, you have access to 11,000+
CareNow Programs: Discover self-directed digital programs to fitness centers and 2,500+ on-demand workout videos. Visit
help you develop positive coping strategies in dealing with life’s ActiveAndFitDirect.com/fitness/AF791517OR to get moving.
challenges, including stress, anxiety, depression and divorce.
Real Appeal Weight Loss Program: Medical plan participants have
Life Coaching: Offering powerful and dynamic professional access to a free online weight loss program, which includes coaching,
relationships, a life coach can help you achieve identified goals apps, and an at-home success kit. Start your transformation with
by acknowledging barriers, developing a strategic approach and Real Appeal at Enroll.RealAppeal.com.
providing accountability.

Additional LifeWorks Services:

• Childcare provider search and referral
• Mindfulness Program
• Work-Life solutions
• Legal resources, including will preparation
• Parenting resources
• Guidance on financial issues, like budgeting, home buying,

and tax planning

• Everyday guidance on home remodeling and repair,

car buying, and pet care

Visit Login.LifeWorks.com Use your

Orlando Health email address to log in.

Call (855) 395-1072

23

Additional Benefits
and Discounts

Discounts

The only thing more fun than spending money is saving it. That’s why Orlando Health partners with a variety of
different providers so you can enjoy discounts on attractions, cell phones, vacations and more.
Visit OrlandoHealth.com/For-Team-Members, Team Member Discounts, for more information.

Choice Auto Insurance

Orlando Health offers you access to a program designed to make shopping for auto insurance easier than ever. In
minutes, you can compare coverage, rates and discounts from some of America’s top-rated insurance companies.
To get a quote and/or enroll, call (855) 589-0565 or visit VoluntaryBenefits-OrlandoHealth.com.

Group Accident Insurance

Aflac Group Accident Insurance pays cash benefits to you that can be used toward medical expenses or everyday
bills — like rent or mortgage, utilities, and groceries — to help you stay up to speed while recovering from an accident
that is non-work-related. This benefit kicks in regardless of an existing employer-sponsored healthcare benefit, and
there are no limits on the number of claims a certificate holder can file. Group Accident Insurance includes a wide
range of benefit coverage with more than 50 covered events.

Critical Illness Benefits

Group Critical Illness is a valuable voluntary insurance available through Aflac, which helps to insure some of the risk
and pay for expenses you may incur if you are diagnosed with a critical illness. Benefits are paid directly to you as a
non-taxable lump-sum benefit. You choose level of coverage with benefit amounts of $10,000, $20,000, or $30,000.

Pet Insurance

Some members of your family may have fur or feathers, but that doesn’t mean they don’t need insurance. That’s why
we’re excited to offer a benefit for all your pets as well.
As an Orlando Health team member, you can elect employee group discounted pet health insurance for your dog(s),
cat(s), exotic or avian pet through payroll deduction with Nationwide Pet Insurance.
Nationwide’s pet health insurance plans give you the freedom to use any vet, anywhere, including specialists and
emergency providers. Discount pricing is available for up to five additional pets. Coverage, pricing, and other details
– as well as the ability to enroll – can be found on Team Member Connect. To obtain pricing for other pets, please
contact Nationwide directly at (800) 540-2016.

24

O R L A N D O H E A LT H T E A M M E M B E R B E N E F I T S

Pre-Enrollment Worksheet

Please review the benefit plans below and indicate which plan you’d like to enroll in. Once you are ready
to enroll online, use this reference as an easy and efficient way to complete your enrollment within Team
Member Connect. When your online enrollment is complete in Team Member Connect, please click on the
Save & Continue and Finalize Elections buttons to submit your enrollment elections.

Medical Team Member (TM) Only Health Savings Account (HSA)
TM + Spouse
Exclusive Care TM + Child(ren) Annual Election Amount: $________________________
Full Family Can be selected with the HSA Care Medical Plan
Care Plus

HSA Care
Primary Care Physician ID:
____________________________

Flexible Spending Account - Health Dental

Preventative Team Member (TM) Only

Annual Election Amount: $____________________ Premier TM + 1
Can be selected with the Exclusive or Care Plus Medical Plans

Dental DHMO TM + 2
Accident Insurance
Vision
Vision Plan Team Member (TM) Only Accident Insurance Team Member (TM) Only
TM + 1
TM + 2 TM + Spouse

TM + Child(ren)

Full Family

Critical Illness Insurance Basic Life Insurance

Team Member (TM) Only $10,000 Select your beneficiaries
$20,000
TM + Spouse $30,000 Allocate percentage to beneficiaries

TM + Child(ren) 3x salary

Full Family $20,000

Supplemental Life Insurance Spouse Life Insurance
Election Amount:________________________
1x salary 2x salary $10,000 increments, up to $100,000

4x salary 5x salary Short-Term Disability
15-day
Child Life Insurance $10,000 30-day
$5,000 $40,000 60-day
$30,000

Flexible Spending Account - Dependent Care
Annual Election Amount: $________________________

25

Benefits Contact Information

Page When You Have Questions About Contact Website Contact Number
Benefits (321) 841-8623
HR Solutions Center TeamMemberConnect.OrlandoHealth.com
Visit SWIFT>Human Resources>Benefits

5 Dependent Verification Mercer https://dependentverification.mercer.com/ (855) 978-2122
orlando/client/default.aspx

6-8 Medical Plan, Provider Network, UMR UMR.com/OrlandoHealth (844) 614-8435
Pre-Certification and Appeals

9-11 Prescriptions OptumRX UMR.com (877) 559-2955
(866) 960-8055
12 Health Savings Account (HSA) Health Equity My.HealthEquity.com (877) 924-3967
(800) 244-6224
13 Flexible Spending Account (FSA) Health Equity Participant.WageWorks.com (866) 268-4063
(888) 842-4462
14 Dental Plan Cigna MyCigna.com (888) 842-4462
(888) 842-4462
15 Vision Plan EyeMed EyeMed.com (877) BH-CARES
(242-2737)
16 Life Insurance New York Life (NYL) MyNYLgbs.com (800) 343-0860
(833) 890-3226
18 Request for Leave of Absence New York Life (NYL) MyNYLgbs.com

19 Short-/Long-Term Disability New York Life (NYL) MyNYLgbs.com

20 Back-up Childcare/Elder Care Bright Horizons Clients.BrightHorizons.com/OrlandoHealth

21 Retirement Savings Plan (RSP) Fidelity Investments NetBenefits.com/OrlandoHealth

22 Education Assistance Programs EdAssist OrlandoHealth.EdAssist.com

23 Employee Assistance Program LifeWorks Login.LifeWorks.com (855) 395-1072
and Well-Being Program

24 Accident and Critical Illness AFLAC AFLACGroupInsurance.com (407) 452-5049 or
(800) 433-3036
24 Pet Insurance Nationwide VoluntaryBenefits-OrlandoHealth.com
24 Auto Insurance Mercer VoluntaryBenefits-OrlandoHealth.com (800) 540-2016
WageWorks MyBenefits.WageWorks.com
COBRA – Health Equity (855) 589-0565

(877) 722-2667

26

O R L A N D O H E A LT H T E A M M E M B E R B E N E F I T S

Disclosures

Orlando Health complies with applicable state and federal civil rights laws and does not discriminate on the basis of race, color, religion,
national origin, sex, sexual orientation, gender identity, ancestry, place of birth, age, or physical or mental condition.

27

About This Guide

This guide describes the benefit plans and policies available to you as a team member of Orlando Health. The details of these
plans and policies are contained in the official plan and policy documents, including some insurance contracts. This guide is
meant only to cover the major points of each plan or policy. It does not contain all of the details that are included in your Summary
Plan Descriptions (as required by ERISA) found in your other team member benefit materials on Team Member Connect/Benefits
Resources. If there is ever a question about one of these plans and policies, or if there is a conflict between the information in this
guide and the formal language of the plan or policy documents, the formal wording in the plan or policy documents will govern.

1414 Kuhl Ave.
Orlando, FL 32806
(321) 841-8623

To learn more, visit
OrlandoHealth.com

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