Florida Market Overview

Small businesses in Florida can choose from many health insurance options – multiple carriers, tiered doctor networks, government exchange vs private market plans, etc. The large number of plans in the Florida market can make finding the right health insurance plan intimidating. SimplyInsured’s guide to the Florida market can help narrow the downs with guidance on the strength and value of the different insurance carriers. We’ve summarized the various options into a high level set of recommendations below.

Florida Health Insurance Carriers at a GlanceFlorida Market at a Glance.png

Looking for specific coverage & rate information? See every carrier & plan online at SimplyInsured.com.


Insurance Carrier Overview: aetna-logo

Aetna is a national carrier offering medical, dental, and vision coverage. Aetna offers four tiers of networks in Florida, ranging from broad PPOs to smaller HMOs. Aetna’s HMO plans are among the least expensive plans in the market, however Aetna’s PPO options tend to be more expensive than similar plans from other carriers. Companies can mix and match up to 5 different plans to offer employees. (View Aetna plans & rates)

Network Overviewaetna-florida-network-overview

  • Open Choice PPO: Aetna’s largest network in Florida, with access to expansive network of doctors and hospitals. Offers nationwide coverage through Aetna’s national network
  • Open Access Managed Choice POS: Similar in size to the Open Choice PPO. Plans on the Managed Choice network places in-network doctors into preferred and non-preferred tiers, with greater savings when you utilize a preferred tier doctor.
  • Health Network Options (HNOptions): Slightly smaller POS network with fewer participating doctors and hospitals compared to the full network. Plans are ~20% less expensive than the Open Choice PPO, so the plan does offer quite a bit of premium savings.
  • Health Network Only (HNOnly): HMO network with fairly large network of doctors and hospitals, and is 25% less expensive compared to Open Choice PPO network.

Insurance Carrier Overview: avmed-logo

AvMed is regional health insurance carrier that primarily operates in South Florida and Central Florida. AvMed plans have very good coverage within its geographic footprint, but doesn’t have as strong of a statewide or nationwide network. AvMed plans tends to be among the lowest cost plans in the market.

AvMed offers 3 different networks, including a PPO, POS,  and HMO option. (View AvMed plans & rates)

Network Overviewavmed-florida-network-overview

  • Agility PPO: The Agility PPO network is the largest network available through AvMed, and provides national coverage through a partner network, the Private Healthcare Network. The Agility plan is a fairly good value in terms of cost, though will have more limitations on available doctors.
  • Empower POS: The Empower POS network has nearly the same size doctor network as the Agility plans, but does not have the same national network coverage.
  • Engage HMO: The Engage HMO network is the smallest network offered, and has substantially fewer in-network doctors and hospitals. The plan requires a Primary Care Physician to make referrals for specialist visits. The plan slightly less expensive than the Empower plans, so generally isn’t a very good value.

Insurance Carrier Overview: florida-blue-logo

Florida Blue is the largest carrier in Florida, and offers medical and dental coverage. Florida Blue offers 3 tiers of networks, two PPO networks and a HMO. PPO plans provide national coverage through the Blue Cross Blue Shield BlueCard network.

Florida Blue rates are among the more expensive plans available in most areas of Florida, but do provide access to a very strong network. (View Florida Blue plans & rates)

Network Overviewflorida-blue-network-overview

  • BlueOptions PPO: Full PPO network with access to the largest network in Florida, and nationwide coverage through the BlueCard network. Plans on the BlueOptions network tend to be among the more expensive options compared to similar full PPOs on other carriers.
  • BlueCare HMO: The BlueCare HMO network is a fairly broad HMO network, and about ~10% smaller than the full BlueOptions network. The plans are typically 18% less expensive than BlueOptions as well, and are most cost competitive with other carriers.
  • BlueSelect PPO: BlueSelect is a narrow network PPO, and includes ~50% of the doctors amd hospitals as the BlueOptions PPO network. The plans are much less expensive, but typically still more costly than the PPO options with other carriers.

Insurance Carrier Overview: humana-logo

Humana offers a variety of medical, dental, and vision coverage. Humana offers four networks in Florida: two PPO nteworks and two HMO networks. Humana’s full PPO plans have an expansive network of doctors and hospitals, both statewide and nationwide coverage.

Humana is also very small business friendly, and covers many classes of small businesses that other insurance carriers do not, such owner-only companies and husband/wife-only companies. (View Humana plans & rates)

Network Overviewhumana-florida-network-overview

  • ChoiceCare PPO: Full PPO network with access to a very large Florida doctor network and nationwide coverage on Humana’s national network.
  • NPOS – Open Access: Similar to the ChoiceCare PPO network in breadth, however the NPOS plan separates physicians into preferred vs non-preferred tiers. Going to physicians in the preferred tier will result in lower bills than a physician on the non-preferred tier. Plans on this network are ~5% less expensive than the full network.
  • HMO Premier: Humana’s full HMO network and includes a fairly broad network of participating doctors and hospitals. Plans are ~11% less expensive than the ChoiceCare PPO, and is among the lowest cost plans in the market.
  • HMO Select: Humana’s narrow HMO network and includes ~85% of the full HMO network. Plans on the Select tier are substantially less expensive, and are typically the lowest cost plans in the market.

Insurance Carrier Overview: united-healthcare-logo

United Healthcare is the largest carrier in the country, and offers medical, dental, and vision coverage in Florida. United Healthcare PPO plans provide access to the nationwide United Healthcare network. United Healthcare offers a combination of PPO and HMO plans, and allows companies to offer a mix of plans.

United Healthcare PPO plans are fairly competitive, especially for higher tier Gold and Platinum plans. (View United Healthcare plans & rates)

Network Overviewunited-healthcare-florida-network-overview

  • Choice Plus PPO: Full PPO network with access to one of the largest network of doctors and hospitals in Florida and nationwide coverage through United Healthcare’s national network.
  • Choice EPO: Access to the same network of doctors and hospitals as Choice Plus, but plans do not include out of network coverage. Choice EPO plans are ~2% less expensive than the full PPO version.
  • Choice HMO: Same network as the Choice PPO, however plans on the HMO network require the use of a Primary Care Physician and specialist referrals. Plans are ~7% less expensive compared to the full Choice Plus network.
  • Neighborhood Health Plan (NHP): NHP is a narrow network with both HMO and POS plans. The network is much smaller than the Choice networks, and includes ~66% of the doctors and hospitals. NHP plans are substantially less expensive.

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