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INFORMATION FOR RETIRED EMPLOYEESThe information provided herein is a summary of a portion of our benefits plans. Should there be a discrepancy between this information and the Medical Summary Plan Description (SPD) eff. 5/1/19 or specific contracts for benefits, the SPD or contracts prevail.
If you cannot find the answers to your questions after reviewing the items below, please contact the Office of Employee Benefits at (321) 633-1000, extension 11216.
To review your benefits at any time, click here: www.EasyBenefits.com. Be sure to have your employee ID number and password available.
Plan Information
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Medical [Cigna]
Pharmacy [Cigna]
Dental [Delta]
Vision [Humana]
Life Insurance [Securian/Minnesota Life]
Forms
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Authorization for Release of HealthInformation
Term LIfe Insurance Enrollment Form 2021
Term Life Insurance Enrollment Form 2020
Medical Plan Affidavit 2021 (covers Tobacco use AND Spousal Surcharge)
Affidavit for Spousal Surcharge 2020
Over-age Dependent Affidavit (Age 26 - 30 Non-disabled)
Plan Year 2021 & Miscellaneous Information
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BPS Presentation: Retiree Open Enrollment Meeting for Plan Year 2021 - 10/7/20
FSRBC Open Enrollment Letter for 2021
FSRBC Enrollment Guide for 2021
Retiree Benefits Guidebook (2021)
Retiree Benefits Guidebook (2020)
Retiree Benefit Rates (2021)
Retiree Benefit Rates (2020)
Creditable Coverage Disclosure Notice - Medicare
Flu Vaccination Participating Pharmacies
Preferred Health Centers Listing - $30 copay effective 1/1/20
Benefit Plan Partners - Contact Information
Save money in the BPS Health Plan with these two Wellness Activities:
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Biometric Screening & Health Assessment
- Letter sent to Retirees about the new PCP Biometric Screening Form
- Primary Care Physician (PCP) Biometric Screening Form
- Important Notice
- How to Complete the Health Assessment as a Retiree
- How to Complete the Health Assessment if you are a SPOUSE
Current Retirees: Deadline to complete a biometric screening AND a health assessment is 11/16/20 for a savings in the 2021 year.
Please read the following carefully and select theBiometric Screening document that applies to YOU:
A. If you are a retiree who's making a Family Status Change, use the following documents:
- Qualifying Event Enrollment Form
- Spousal Medical Plan Affidavit
- PCP Biometric Screening Form - Retirees & Spouses
B. If you currently have the BPS Health Plan and will be enrolling again in 2021, be sure to complete a biometric screening at a BPS Well-Care Center, using the following documents:
- Well-Care Center Locations
- PCP Biometric Screening Form - Retirees & Spouses
C. If you wish to visit your doctor to complete the biometric screening, it must be done during your annual physical, using the following BPS biometric Screening Form:
- PCP Biometric Screening Form - Retirees & Spouses
Florida School Retiree Benefits Consortium (FSRBC) for Medicare-eligible Retirees
If you are a retiree with Medicare, or have a dependent with Medicare, please contact AON/bswift at 1-833-686-0983, Monday-Friday, 8am - 8pm ET OR visit online at www.myfsrbc.bswift.comMAIL OUTS 2020
Retiree Open Enrollment Meeting postcard
Open Enrollment Password and Instruction Letter (which included the following documents)
- New Features for Plan Year 2021 flyer
- Gold & Silver plan chart with rates
- 2021 Retiree Non-Medicare Enrollment form
- Medical Plan affidavit
- Dependent Aged 26 - 30 (Non-disabled) affidavitMAIL OUTS 2019
Open Enrollment Password and Instruction Letter
Open Enrollment Password Letter attachment - Cigna Health Assessment
Affidavit - Dependent 26-30 (non-disabled)