Cleveland Clinic will offer EHP & EHP Plus to Florida caregivers in 2024
During open enrollment for 2024 benefits (Oct. 19 – Nov. 3, 2023) Cleveland Clinic Florida caregivers will be able to enroll in health benefits offered through the Cleveland Clinic Employee Health Plan. You will have two health plan options to choose from; EHP and EHP Plus.
The Employee Health Plan partners with a third-party administrator, Aetna, for claims processing, eligibility verification, explanation of benefits and more. Starting Jan. 1, 2024, these services will transition from UMR/United Healthcare to Aetna for Florida caregivers.
What does this mean for you?
You'll have health insurance coverage where you are.
As our organization grows, it is important to provide caregivers and their families options for comprehensive, nationwide health coverage. Two health plans will be offered during open enrollment this fall. Caregivers can choose to enroll in either EHP or EHP Plus.
EHP includes the Cleveland Clinic Quality Alliance (QA) network and the Florida Clinically Integrated Network (CIN). These networks include Cleveland Clinic facilities and employed physicians as well as contracted facilities and providers in Ohio and Florida.
The EHP network has been supplemented to include additional providers with locations in Florida for the following specialties: Pediatrics, OB-GYN/Obstetrics, Dermatology, Ophthalmology, Chiropractic, Otolaryngology (ENT), Oral Surgery, Behavioral Health, Neurology, Nutritionist, Pain Management, Podiatry. These providers are available in-network for all members who elect the EHP plan.
EHP Plus gives members access to the providers available in the EHP plan (above), PLUS Aetna’s Open Access Select network, which includes providers nationwide.
The change doesn't have to be complicated.
We are working closely with Aetna and UMR to ensure a smooth transition for our caregivers.
For the remainder of 2023, UMR will remain the third-party administrator for caregivers enrolled in the Florida Employee Health Plan. Please continue to use your current health insurance cards through Dec. 31, 2023.
This site is your hub to learn all about your health and pharmacy benefit options ahead of open enrollment, Oct. 19 – Nov. 3, 2023. From here you can:
- Search for doctors and providers with the “provider lookup” links below:
- View a video tutorial for navigating the provider lookup tool.
- Review new and updated frequently asked questions.
Simply Healthy Choice Program transition to Healthy Choice program
For Cleveland Clinic Indian River Hospital and Cleveland Clinic Martin Health caregivers only.
If you participated in the Simply Healthy Choice program in 2023, your discount earned will be available in Workday. Your Simply Healthy Choice discount will apply to your 2024 health plan election — EHP or EHP Plus.
Starting in January 2024, you can enroll and participate in Cleveland Clinic’s Healthy Choice program to earn a discount on your 2025 health plan premium. Look for more information about Healthy Choice as we approach the new year.
Want to learn more about 2024 benefits?
Employee Health Plan team members will visit each Florida Region hospital between Sept. 18 and Sept. 29. Stop by to learn more about EHP and EHP Plus, open enrollment, Healthy Choice and pharmacy options. You can also speak with health plan representatives who will be available to answer questions. Locations and dates are linked below.
|Weston Hospital||Martin South Hospital (including Martin FHC & St. Lucie FHC)|
|Martin North Hospital||Tradition Hospital|
|Indian River Hospital (including IR Health & Wellness Center & Vero Radiology)|
Florida Region FAQs
Note: The Tier 1 network has been expanded to include Aetna providers for the specialties of Behavioral health, Chiropractic, Dermatology, Neurology, Nutrition, OB/GYN, Ophthalmology, Oral Surgery, Otolaryngology (ENT), Pain Management, Pediatrics and Podiatry only. If you are currently using a UMR provider for any of these specialties, make sure you check to see if they are in the new expanded EHP network.
Aetna will be your Tier 2 Provider Network – your Tier 2 network of providers will change in 2024 to the Aetna Select Open Access network.
Yes, we recommend that you review your benefits for accuracy. If you do not actively enroll in Workday and are a current Florida health plan member, you will automatically be enrolled in the EHP plan for 2024.
During open enrollment, you will have the choice between two health plans in Workday:
2. EHP Plus (includes a national network of providers)
The EHP offering includes Cleveland Clinic providers, Quality Alliance providers and Florida Clinically Integrated providers. The EHP network has also been supplemented to include additional providers with locations in Florida for the following specialties. Network providers in these specialties will be covered at the full benefit:
- OB-GYN / Obstetrics
- Otolaryngology (ENT)
- Oral Surgery
- Behavioral Health
- Pain management
The EHP Plus offering gives members access to the providers available in the EHP plan (above), PLUS Aetna's Open Access Select network, which includes providers nationwide.
Both plans offer the same benefits and coverage, while premium and network size differ. The choice is up to you when you make your health plan elections during open enrollment.
Take action during open enrollment by logging into Workday and electing either EHP or EHP Plus. More details on these plans and the enrollment process will be made available as we get closer to open enrollment, Oct. 19 – Nov. 3.
A provider search is available for you to verify your provider's participation in the networks:
EHP provider search
EHP Plus provider search
EHP Main Campus and Weston Residents/Fellows search
It is your responsibility to verify your provider’s participation in the networks. Please reference the Aetna provider search tools to identify physicians and facilities covered in each plan.
Having trouble finding your provider? Contact the Aetna Concierge customer service unit at 833.414.2331.
Providers who are included in the EHP network or Aetna Select Open Access networks will be covered if you elect EHP Plus. If your specialist is participating in either of these networks, they are considered in-network and services will be covered. You can access the provider search tool for the EHP Plus plan to confirm that your specialist participates in the Aetna Select Open Access network.
A referral is not required to see a specialist in EHP or EHP Plus.
Both EHP and EHP Plus have large networks of participating Behavioral Health providers. Before open enrollment, you will be able to search providers for each plan. There is no out-of-network coverage in either plan except emergency or urgent care.
There will be no changes to the Healthy Choice Program. Any discount you earned during 2023 will apply to your health plan premium in 2024. Your Healthy Choice discount will be visible in Workday when you elect benefits during open enrollment.
Martin Health, Indian River or Vero Radiology caregivers:
The Simply Healthy Choice participation deadline is Sept. 30, 2023. Any discount you earned during the 2023 Simply Healthy Choice program year will apply to your health plan premium in 2024. Your Simply Healthy Choice discount will be visible in Workday when you elect benefits during open enrollment.
Beginning in 2024, caregivers and their spouses will be able to join the Healthy Choice premium discount program. For more information on the Healthy Choice program, click here. The Healthy Choice portal and other wellness programs will be available to you when you have your new health plan ID number.
Note: The Healthy Choice information on the EHP website is current for the 2023 program year and may not reflect the complete program requirements for 2024. Any updates to the program will be reflected on the website in January 2024.
No, the current prescription drug plan will continue to be managed by the EHP Pharmacy Management Department and insured by CVS/Caremark.
The health plan’s Prescription Drug Formulary can be found on the Employee Health Plan website, along with other information related to the Prescription Drug Benefit Program. Medications may be added to the formulary four times a year and removed from the formulary twice a year, once at the start of the benefit year in January and again at mid-year in July. Note: The pharmacy information on the Employee Health Plan website is subject to change in 2024.
Yes, the Prescription Drug Benefit Program is the same for both EHP and EHP Plus members.
Yes, your vision exams are covered under the EHP and EHP plus health plans. You also have the option to enroll in one of the EyeMed vision plans, which provide discounts on glasses and contacts. More information about vision plan coverage will be provided closer to the open enrollment period.
Yes, look for new health plan ID cards in the mail prior to January 2024. Please be sure your address is up to date in Workday prior to open enrollment. You should use your existing health plan ID card through December 2023 for services.
If you are planning to retire, please contact the HR Service Center to discuss your options at 216.448.2247 or 877.688.2247.
When an employee becomes eligible for COBRA they have the opportunity to continue the coverage that they had immediately prior to the COBRA qualifying event. This means that if they were enrolled in the EHP plan and become eligible for COBRA, their only option is to continue coverage in the EHP plan (not EHP Plus). However – an individual will have the opportunity to switch to EHP Plus during open enrollment (Payflex will mail COBRA open enrollment notifications to COBRA participants in the fall).
Eligible dependents who are away at school, like college students, are covered if they are enrolled in EHP or EHP Plus, if they use in-network providers for that plan.
Both EHP and EHP Plus plans allow college students to visit their student health center for non-routine, non-preventive services. These services will be covered as a specialty visit with a $35 copay. Services may include, flu shots, tetanus shots, allergy therapy, and PT/OT/Speech Therapy, if these are provided at the student health center. It is your responsibility to ensure the service you need can be performed at the college’s student health center for coverage.
There is no out-of-network coverage in either plan except for Emergency and Urgent Care visits. Urgent visits to the college student health centers for an acute illness are treated as such but may initially be denied as not all college student health centers are contracted with Aetna. If you receive a bill, contact Employee Health Plan Customer Service for resolution at 216-986.1050 or 888.246.6648.
Additional information will be coming soon. Please bookmark this site for the most current information.
- Workday or benefits questions: Contact the HR Service Center at 216.448.2247 or 877.688.2247.
- Employee Health Plan questions: Contact the Employee Health Plan at 216.986.1050 (option 1) or the Aetna Concierge Customer Service team at 833.414.2331.
- Simply Healthy Choice or Healthy Choice: Contact the Employee Health Plan Wellness team at 216.986.1050 (option 3) or 888.246.6648 (option 3).
- Employee Health Plan Pharmacy Management questions: Contact the Pharmacy Management Department at 216.986.1050 (option 4) or 888.246.6648 (option 4). You can also email the department at EHPRxMgmt@ccf.org.
Cleveland Clinic is invested in your health and well-being, and we look forward to continuing to offer you comprehensive healthcare benefits and a competitive My Pay + Benefits package.