Health Plan Overview
 

Medical Health Plan

The Manatee YourChoice Health Plan is the self-funded medical, dental and health management plan for the employees and their eligible dependents of Manatee County Government, including all of the Constitutional Agencies. What does Self-Funded or Self-Insured mean? It means Manatee County Government, through their own Health Plan “Manatee YourChoice”, uses their own plan design and pays for all health care directly instead of paying an insurance company to handle it. Although the Plan was created and designed by the Employee Benefits Division and is managed by the Employee Health Benefits Manager, the plan hires a “Third Party Administrator” (Aetna) to process claims, provide customer service support to members, and to run the Provider Network. The YourChoice Health Plan has a very unique model that provides on-site, individualized and personalized clinical resources for the employees. The clinical staff that support the Health Plan include Registered Nurse Case Managers, Clinical Pharmacist, Wellness/Fitness Coaches, Registered Dietician and Behavioral Health Staff, all working as an integrated multi-disciplinary Team under the direction of the County.

Summary Benefit of Coverage (SBC) 

GLOSSARY of Health Coverage and Medical Terms


Additional Benefits and Coverage Information

2014 Benefit Rates

2013/2014 Additional Life & LTD Premiums

2014 Levels of Reimbursement

Benefits Summary: Provider Network/Contacts/Online Services

Benefits Online Services "MyHealth Benefits": Order New ID Card, View Claim Status, Benefits, Online Wellness Programs, and more.

Plan Document 

Child Dental Preventive Care Benefits

Qualifying Event Guidelines and Incentive Program

Deferred Compensation

Cobra

Are Your Dependents Eligible?

Participants have the choice to enroll in one of four Health Plans based upon completing specific Qualifying Events.

 

The “YourChoice” Health Plan Levels:

  • ULTIMATE - Highest Level of Reimbursement (co-pay, no deductible, no co-insurance)
  • BEST - Middle to Highest Level of Reimbursement (co-pay, deductible & co-insurance)
      
  • BETTER - Middle Level of Reimbursement (deductible & co-insurance applies)
       
  • BASIC - Lowest Level of Reimbursement (deductible & co-insurance applies)
     
The only difference among the four plans is the Level of Reimbursement (Refer to the Reimbursement Levels).

*The level is determined by the co-pay, deductible or co-insurance, and the maximum out of pocket expense not including the deductible.

All four plans have:
  • Identical Prescription Benefits with identical cost sharing
  • Identical Medical Benefits with different cost sharing
  • Identical Lifestyle Assessment & Modification Program (LAMP) Benefits with identical cost sharing
  • Choice to utilize the Manatee Health Network or  Non-Manatee Health Network Providers with different cost sharing
  • Choice to utilize or not to utilize “YourChoice” Medical Management Programs and Guidelines
  • Choice to utilize the Member Advocacy Program

 

Click Here for Qualifying Event details

 

 

 

 
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