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2. Agenda Benefit Plans
Wellness
Plan Experience
2012/2013 Benefits
Open Enrollment
Healthcare tips
Summary
Questions
3. ICUBA Members - 8,100 employees (13,400 members)- 8,100 employees (13,400 members)
4. Agenda Benefit Plans
Wellness
Plan Experience
2012/2013 Benefits
Open Enrollment
Healthcare tips
Summary
Questions
5. Benefit Plans at Rollins Benefits administered through ICUBA:
Health Insurance
FSA & HRA / Debit Cards
Employee Assistance Program (EAP)+
Dental Insurance
Voluntary Vision Insurance*+
Voluntary Life Insurance*+
Basic Life Insurance
Long Term Disability
Additional voluntary plan offered at Rollins:
Voluntary Long Term Care Insurance*+
*Voluntary Plans are made available to employees of Rollins College from various insurance companies. These benefit programs are not sponsored or maintained or endorsed by Rollins College, and participation in these programs is completely voluntary for employees.
+Part time benefits eligible employees (1000-1462 hrs/yr) are eligible for EAP, vision, voluntary life, and long term care. All other benefits listed above are for full time benefits eligible employees only
6. Agenda Benefit Plans
Wellness
Plan Experience
2012/2013 Benefits
Open Enrollment
Healthcare tips
Summary
Questions
7. Wellness
Health Fairs
Attendance dropped from 2008, but trending back up
Personal Health Assessment (PHA)
17% participation (Rollins)
43% of all plan members not aware of $25 HRA incentive
Total medical costs are 10.47% lower for those who complete PHA
Lower ER (3.5%)
Lower inpatient (11.68%)
Lower outpatient (22.90)
8. Personal Health Assessment Results WELCOA
Cholesterol and BP controlled by Rx
Focus on those who are borderline group not to get worse and high risk to be controlledWELCOA
Cholesterol and BP controlled by Rx
Focus on those who are borderline group not to get worse and high risk to be controlled
9. Agenda Benefit Plans
Wellness
Plan Experience
2012/2013 Benefits
Open Enrollment
Healthcare tips
Summary
Questions
10. Top 10 Causes of Death in US Diseases of heart
Malignant neoplasms (cancer)
Chronic lower respiratory diseases (such as chronic bronchitis, emphysema, and asthma)
Stroke
Accidents
Alzheimer’s disease
Diabetes mellitus
Kidney disease
Influenza and pneumonia
Intentional self-harm (suicide)
2010 National Center of Health Statistics
Homicide fell off the list2010 National Center of Health Statistics
Homicide fell off the list
11. Obesity Trend Medical expenses more than 41% higher than non-obese
Complications
High cholesterol and triglycerides
Type 2 diabetes
High blood pressure
Metabolic syndrome
Heart disease
Stroke
Cancer
Sleep apnea
Depression
Gallbladder disease
Nonalcoholic fatty liver disease
Osteoarthritis
Skin problems, such as poor wound healing
12. Medical Plan Experience
Medical Claims
National claims: 70% attributed to lifestyle choices
Top 5 diagnostic categories by claims expense (Rollins)
Neoplasms (cancer)
Musculoskeletal system (arthritis, back pain, inflammation)
Digestive System
Circulatory
Endocrine (diabetes)
WELCOA
Musculoskeletal - Rhumatoid arthritis/Inflamation, back
Endocrine - Diabetes
WELCOA
Musculoskeletal - Rhumatoid arthritis/Inflamation, back
Endocrine - Diabetes
13. Medical Plan Experience
Preventive Care
Underutilized
14. Pharmacy Plan Experience Plan trends
Top Drug Categories by Volume (Rollins)
Psychostimulants-antidepressants
Lipotropics (cholesterol)
Antihypertensives
Other Cardiovascular
Contraceptives
Narcotic Analgesics
Thyroid
Diabetic Therapy
Glucocorticoids (ant-inflammatory)
Bronchial Dilators
15. Pharmacy Plan Experience Plan costs
Plan costs trending at 12% increase from prior year
Top Drugs by Cost (Rollins)
Lipitor (cholesterol)
Gleevec (neoplasm)
Adviar Diskus (asthma)
Actos (diabetic therapy)
Nexium (GERD)
Singulair (asthma)
Crestor (cholesterol)
Lexapro (anxiety/depression)
Nexavar (neoplasm)
Tarceva (neoplasm)
16. Pharmacy Plan Experience Generic Utilization
Priced 80-85% less than brand
Average member savings of $660/year
Trending at 69.01% generic fill rate
For every 1% increase in generic fill rate, plan saves 2%
Drug Channels
90 day supply
Reduces cost for member and plan
Encourages adherence
17. Agenda Benefit Plans
Wellness
Plan Experience
2012/2013 Benefits
Open Enrollment
Healthcare tips
Summary
Questions
18. Medical Coverage What’s staying the same
BlueCross BlueShield of Florida (BCBSFL) plans
Risk/Reward Choice
Risk/Reward Options
PPO 70 Choice
PPO 70 Options
PPO 80 (no new enrollments)
HRA contributions with ICUBA Benefits MasterCard
Free wellness office visit, in-network labs, immunizations, diagnostics, and preventive benefits
BCBSFL “Know Before You Go” at 888-476-2227
Blue 365® from BCBSFL at www.bcbsfl.com
- No increase to deductible would mean premium increase of 9%
- Less than 10% of Rollins members met the deductible last year- No increase to deductible would mean premium increase of 9%
- Less than 10% of Rollins members met the deductible last year
19. BCBS Plan Components
Deductible: Amount that you must pay in the Plan Year before benefits will be paid by the Plan. (No Deductibles for Physician office visits, Therapy office visits, Urgent Care visits, Emergency Room visits and Prescription Drugs.)
Coinsurance: Defined percentage of a covered expense that you pay after the satisfaction of any applicable deductible.
Copays (Co-payments): Fixed dollar amount to pay each time a particular service is used. The copay does apply to out-of-pocket but does not reduce amounts applied to the Deductible or co-insurance. A copay may be $20 for an office visit.
Annual Out-of-Pocket Maximum: Maximum amount of deductible, co-insurance and co-payments paid during the Plan Year before the Plan begins to pay 100% of Covered Expenses for the balance of the Plan Year.
- No increase to deductible would mean premium increase of 9%
- Less than 10% of Rollins members met the deductible last year- No increase to deductible would mean premium increase of 9%
- Less than 10% of Rollins members met the deductible last year
20. Medical Coverage What’s changing
Deductible increase of $250 for all plans
96% of members did not meet the deductible in prior plan year
Deductibles apply to hospitalizations, surgeries outside a physician office, ambulance, diagnostic imaging, medical equipment, and other major services outside a physician office
No Deductibles for Physician office visits, Therapy office visits, Urgent Care visits, Emergency Room visits and Prescription Drugs
Premium increase of 6% to all plans
Market average around 11%
ICUBA risk pool reduces premium increase for Rollins
21. Medical Plan ComparisonRisk/Reward vs. PPO 70 Similarities
Catalyst Rx Prescription Drug Benefit
Free Wellness Benefit
All Free ICUBA CaresTM Benefits
Plan Rules
24/7 Health Info Hotline
ER & Urgent Care Differences
Premiums
Blue Options Provider Network vs. Blue Choice Network
Deductibles
Coinsurance
Copays
Annual Out-of-Pocket Maximums
HRA contributions
The three PPO plan designs are the same. The prescription drug benefit, wellness benefits and provider network are the same for all plans.
The three PPO plan designs are the same. The prescription drug benefit, wellness benefits and provider network are the same for all plans.
23. Risk/Reward Monthly Rates
24. Risk/Reward Monthly Rate Changes ``
25. PPO 70 Monthly Rates
26. PPO 70 Monthly Rate Changes
27. PPO 80 Monthly Rates*
28. PPO 80 Monthly Rate Changes*
29. Behavioral Health, Substance Abuse and EAP Benefits Free Employee Assistance Program (EAP) services
Up to 6 counseling sessions per issue per plan year are available to ALL employees and everyone in an employee’s household
Do not need to be enrolled in any ICUBA benefit plan in order for you or a household member to access EAP services
Behavioral Health Plan
Same as medical benefits (primary care, specialist, etc.)
Client Connect® Provider Matching Service
Assists members in locating an appropriate provider
MHNet website www.mhnet.com
Articles; interactive health and wellness instruments; health assessments and videos; family, personal, and mental health information; on-line seminars; discounts to vendors and community resources
Username: ICUBA Password: 8773985816
MHNet contact information is on the back of the Blue CrossBlue Shield of Florida ID card
30. Pharmacy Coverage What’s staying the same
CatalystRx, formerly Walgreens Health Initiatives
Benefits/Co-pays
Network
Coverage of aspirin and generic pre-natal vitamins
Walgreens product discount card
What’s changing
Expansion of free prescribed diabetic supplies to all brands
Includes meters, lancing devices, lancets, test strips, control solution, needles, and syringes
Explain Catalyst bought Walgreens HIExplain Catalyst bought Walgreens HI
31. Diabetic Supplies Covered at 100% Explain Catalyst bought Walgreens HIExplain Catalyst bought Walgreens HI
32. Pharmacy Benefit Tiered Copays Whenever possible, have your doctor consult your Preferred Medication List for the lowest cost generic or brand medications available for your therapy.
You may visit www.walgreenshealth.com or call Member Services at 1-800-207-2568.
33. Dental Coverage What’s staying the same
Humana plans
DHMO
PPO High
PPO Low
Rates
What’s changing
No changes
34. Dental Monthly Rates*
35. Dental Plan Comparison
35
36. Vision Coverage What’s staying the same
Advantica plan
Benefits
What’s changing
Reduced premiums with a 4 year rate guarantee
Employee Monthly Premium: $3.98
Family Monthly Premium: $10.18
37. Vision Plan Summary
38. Life Insurance– 4/1/2012 What’s staying the same
Benefits
Rates, with a 3-year rate guarantee
What’s changing
New carrier: CIGNA
Current benefit option will roll over into new plan year
One-time Evidence of Insurability (EOI) exception during open enrollment for 2012/2013
Option to elect insurance up to guaranteed issue (GI) amount ($150,000 employee/$50,000 spouse) with no EOI
Regardless if have any coverage
Ongoing EOI Requirements for future open enrollments/status changes
If you have coverage, you can elect up to the GI amounts of $150,000 employee and $50,000 spouse with no EOI;
If you do not have any coverage, ANY increase is subject to EOI
Explain Medical UnderwritingExplain Medical Underwriting
39. HRA and FSA Comparison
40. Health Care Flexible Spending Account (FSA) What’s staying the same
ICUBA
Funded by employee with pre-tax contributions
Used to pay for qualified healthcare (medical, Rx, dental, vision) expenses
Funds are available as of 4/1/2012
ICUBA Benefits MasterCard
Deadline to use funds 6/15/2013 or forfeit remaining balance (have until 6/30/2013 to submit all claims through 6/15/2013)
MUST elect every year, does not roll over
File your claims online at http://icubabenefits.org
What’s changing
Maximum annual contribution reduced to $2,500 per Health Care Reform
Remind about OTCRemind about OTC
41. Dependent Care Flexible Spending Account (FSA) What’s staying the same
ICUBA
Funded by employee with pre-tax contributions
Used to pay for qualified dependent day care expenses (not healthcare for dependents)
Maximum annual limit of $5,000 per family
Funds are available as they are deducted from payroll
Dependents: dependent under age 13, physically or mentally challenged adults who are unable to care for themselves
ICUBA Benefits MasterCard
Deadline to use funds 3/31/2013 or forfeit remaining balance (have until 6/30/2013 to submit all claims through 3/31/2013)
MUST elect every year, does not roll over
File your claims online at http://icubabenefits.org
What’s changing
No plan changes
42. Long Term Care Insurance Administered by CNA
Covers Facility and Home-Based Care
Employee, spouse, parents, grandparents
Premiums are after tax and do not increase with age
Three levels of Daily Facility Care benefit & Lifetime Max
Available with or without future benefit guarantee
Life insurance built in
Guaranteed benefit increase option
Guaranteed Issue
Portable
Contact HR for detail, rates, and enrollment forms
Can enroll at any time
43. Agenda Benefit Plans
Wellness
Plan Experience
2012/2013 Benefits
Open Enrollment
Healthcare tips
Summary
Questions
44. Open Enrollment 2012/2013 2/7/2012 - 2/17/2012
Current elections will carry over to 2012/2013, except FSAs
Must enroll if:
Want to make changes to any plans
Want to add or drop dependents
Want to have FSA for 2012-2013 (current election will default to $0)
Elections effective 4/1/2012-3/31/2013
No changes after 2/17/2012 unless you experience a qualified status change
Must notify HR within 31 days of a qualified status change
45. Open Enrollment 2012/2013 Web Enrollment
Enroll by logging onto http://icubabenefits.org
Company key for password reset is ICUBA
Select the Open Enrollment icon
Suggest log on and review coverage and beneficiaries
Enrollment Assistance
Rollins Open Enrollment Information website available Tuesday, 2/7
Predictive Modeling Tool
Click on the link labeled “View Detailed Plan Comparison” on the Medical Election Page
Human Resources
46. Open Enrollment Checklist Review Open Enrollment Information on HR website for basic information
Log into the ICUBA benefits site
Review plan information in the Benefits Library section
Review current benefits and covered dependents
Review beneficiaries for life insurance
Complete the online open enrollment process on the ICUBA benefits site
Must click “I Agree” for elections to be saved!!
Review & print confirmation
Can be retrieved later by logging back into ICUBA Benefits Site
Submit forms to HR by 2/17/2012 if:
Elect Long Term Care Insurance; or
Add domestic partner or child of domestic partner to coverage
Submit EOI to HR or CIGNA if:
Elect Voluntary Life Insurance over the guaranteed issue amount ($150,000 employee / $50,000 spouse)
47. Agenda Benefit Plans
Wellness
Plan Experience
2012/2013 Benefits
Open Enrollment
Healthcare tips
Summary
Questions
48. Healthcare Tips Preventive care
FREE ICUBA Cares™ In-Network Benefits:
Aspirin for adults with a physician prescription
Prescribed folic acid and generic pre-natal vitamins for pregnancy
Prescribed diabetic supplies (meters, lancing devices, lancets, test strips, control solution, needles, and syringes)
Dental preventive exams/cleanings
49. Healthcare Tips Urgent care vs. ER vs. Clinics
Blue Cross Blue Shield of Florida “Know Before You Go”
www.bcbsfl/com
888-476-2227
Clinical Care Consultant
888-476-2227
Employee Assistance Program (EAP)
All full time and part time employees and household members
Generic or mail order prescriptions
Wellness incentives
Better You From Blue™ Health Fairs
$25 annual incentive for health risk assessment online or at health fair
Healthy Additions $25 incentive for each pregnant member enrolled in program
Free on-site fitness facility and classes
50. Agenda Benefit Plans
Wellness
Plan Experience
2012/2013 Benefits
Open Enrollment
Healthcare tips
Summary
Questions
51. Summary Changes
Medical: Premium increase by 6% & Deductible increase by $250
Pharmacy: Expansion of free prescribed diabetic supplies to all brands
Vision: Reduced premium
Life: New carrier (CIGNA) with same premium
Health Care Savings Account: Maximum annual contribution reduced to $2,500
Open Enrollment
2/7 - 2/17
Save your changes!
52. Plans
53. Questions?
HR staff and plan representatives are available to discuss plan details and questions