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New Employee Benefit Orientation. Plan Year April 1, 2014 - March 31, 2015. Meeting Overview. Introduction to ICUBA Eligibility Online Enrollment Wellness/Preventative Benefits Employee Assistance Program Medical Insurance Pharmacy Benefits
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New Employee Benefit Orientation Plan Year April 1, 2014 - March 31, 2015
Meeting Overview • Introduction to ICUBA • Eligibility • Online Enrollment • Wellness/Preventative Benefits • Employee Assistance Program • Medical Insurance • Pharmacy Benefits • Flexible Spending Accounts and Health Reimbursement Accounts • ICUBA Benefits Card TM • Dental and Vision Plans • Life Insurance • Optional Life Insurance • Short Term Disability • Long Term Disability • Emergency Travel Benefit • Identity Theft Protection • Retirement Plans • Voluntary benefits and Legal Plan
Health Care Reform • Enrollment in an ICUBA Medical Plan satisfies the requirement for having coverage • ICUBA Medical Plans are equivalent to Gold Plans offered on the Public Marketplace Exchanges • ICUBA has lower out-of-pocket costs, broader networks of providers, pre-tax benefits, employer contributions into HRA’s, and more generous FREE wellness benefits. • No pre-existing condition limitations effective April 1, 2014 • All other requirements of Health Care Reform are in place
Eligibility • Employees working at least 19.2 hours per week are eligible to elect dental and vision coverage • Employees working 28 hours or more per week are eligible for *retirement match, and to elect medical, dental, Vision coverage, and can establish a flexible spending account • Premiums are charged from your date of hire or date of eligibility • If you do not enroll during this period you may enroll during the next annual enrollment or if you experience a qualifying status change • You have thirty days (30)from your date of hire or date of eligibility to make your benefit elections *Employee must be classified as full-time to be eligible for the retirement matching plan
How to Enroll • To enroll, login to the benefitsenrollment portal at http://icubabenefits.org • The enrollment portal is available 24 hours a day • First time user instructions can be found in the “Benefits Information” box on the Benefits web page • If you need assistance, please contact the Office of Human Resources by email at HR4U@nova.edu or by calling 954-262-HR4U • HR Representatives are available Monday – Friday, 8:30am to 5:00pm
NSU / ICUBA Health and Wellness BenefitsMember Cards Catamaran Prescription Drug Plan Florida Blue Medical Insurance Advantica Eyecare Plan Humana Dental Plan ICUBA Cares MasterCard™ *Our mental health and substance abuse benefit, and Employee Assistance Program is provided by MHNet The toll free phone number and website can be found on back of Florida Blue ID card.
ICUBA Cares™ • The ICUBA Cares™ programs are offered by ICUBA plans with our provider partners • The programs promote early treatment with the goal to prevent disease and incidences of critical care • These plans can also save you and the plan money - that helps keep premium costs lower for everyone
NSU WELLNESS SERVICES • The NSU Pharmacy provides free health screenings monthly call 954-262-4550 or log in to http://pharmacy.nova.edu/home.html • NSU Center for Psychological Studies Guided Self Change Programs can help you Lose Weight, Stop Smoking, Stop Gambling, and Stop Procrastinating! Call 954-262-5969, fees based on a sliding scale • NSU Employee Sick Call Clinic open every morning from 8:15 am until 11:00 am, walk in or call 954-262-2181, health plan billed for services • Your NSU Primary/Family Care / Internal Medicine and Pediatric Physicians are participating providers in the Blue Physician Recognition Provider; therefore you will receive 100% coverage for services received from your NSU BPRphysician. Call the NSU Health Care Centers at 954-262-4100 to schedule an appointment
3 When you are using a Blue Physician Recognition™ provider, all office visits are FREE. Your doctor should not collect a co-payment. FREE OFFICE VISITS FOR ALL CARE • How to locate a Blue Physician Recognition Provider™: • Go to Florida Blue at www.floridablue.com • Click the Find a Doctor tab • Select a Primary/Family Care Doctor • Check the box for Blue Physician Recognition™ providers in order to narrow down your search to National Committee on Quality Assurance (NCQA) Primary Care Physicians (PCP). • NSUPrimary/Family and Pediatric physicians participate in this program
Electrocardiograms • Echocardiograms • Mammograms • Colonoscopies and Sigmoidoscopies • Immunizations • Allergy Injections • Bone Mineral Density Tests Employee Assistance Program for available to all benefit-eligible employees and household members. Call the EAP 24-hours a day at 1.877.398.5816 Receive up to six free face-to-face counseling sessions per presenting issue per plan year. • Lab Tests • Pap Tests • Urinalysis • Colorectal Screenings • Prostate Cancer Screenings • Prescribed diabetic supplies including meters, lancing devices, lancets, test strips, control solution, needles, and syringes • Aspirin for adults with a physician prescription • Prescribed generic folic acid and generic pre-natal vitamins for pregnancy FREE ICUBA Cares™ In-Network Benefits ICUBA medical plans provide generous wellness benefits beyond those required by law. Each plan year you may receive a FREE Annual Physical and/or FREE Annual Gynecological Exam. All of the following benefits are alwaysFREE to Members regardless of your health condition, age, gender or number of times you receive the medically necessary service: NO Deductible FOR THE FOLLOWING in-network SERVICES Therapy Office Visits Emergency Room Visits Physician Office Visits Urgent care visits $0 copay for all office visits to Blue Physician Recognition™ provider $0 copay for two courses of treatment per plan year for tobacco cessation
Tobacco Cessation Program * NEW Free Prescription Medications • Member chooses to participate in the Tobacco Cessation program • Member calls to enroll with • “Next Steps” program with • Florida Blue • Member calls “Next Steps” Health Coach and obtains an Rx from physician • Florida Blue notifies Catamaran of Member participation • Member obtains Tobacco Cessation medications at • $0 co-pay, 2 cycles per • Plan Year
THE IQUIT TOBACCO PROGRAM PROVIDED BY FLORIDA AHEC NETWORK Free over-the-counter nicotine replacement therapy (NRT) and face-to-face support To locate/register for an IQuit Tobacco Program in your area call 877-848-6696 (1-87-Quit Now-6) or visit www.ahectobacco.com/calendar
BlueCross BlueShield Health Dialog® BlueCross BlueShield Care Coordination • HEALTH DIALOG® supports members and their covered dependents by providing information to help members better understand their medical condition and their treatment options • Health coaches are available 24 hours a day, 7 days a week to provide you and your family with medical information. You can speak with the same coach each time you call • Use BCBS Nurse Case Managers to coordinate services when you need: • To receive intravenous medications or wound care at home • To find nursing services • To coordinate complicated medical treatment plans • To plan your surgical discharge and follow up treatment Monday - Thursday 8AM – 6PM Fridays 9AM – 6PM 877-789-2583 TTY 877-900-4304
BLUE CROSS BLUE SHIELD - BLUE365 ® Discount Program • BCBS national member discount program delivering health and wellness tools, services, information and discounts to help members make healthy changes. • fitness clubs • exercise equipment • nutrition and weight management programs • massages • vitamins • Access Blue365® • 1) Visit www.bcbsfl.com • Log onto MyBlueService • Discounts & Rewards • Discounts • Visit www.blue-365.com • Offers change frequently
COMMONLY USED TERMS (1) Contracted Rate or Allowed Amount: The discounted rate that an in-network provider has agreed to accept for services rendered. The contracted rate is subject to deductibles and coinsurance whenever applicable Member Health Statement (MHS): Comprehensive monthly statement of claim activity in last 28 days, explanation of benefits (EOB) paid sent by insurance companies to enrollees. MHS provides necessary information about claim payment information and patient responsibility amounts, deductible and out-of-pocket accumulation, and tips to live healthier Preauthorization: An authorization that must be obtained from carrier prior to inpatient medical procedures only. (This is not the same as referral – PPO’s do not require referral)
Saving Tips – Use Your Plan WiselyPay Only the Contracted Amount of Your Out-of-Pocket Expenses! • Recently, hospital systems have been purchasing office practices and billing insurance for outpatient hospital visits instead of an office visit • If billed for a “facility fee” for an office visit OR billed for an annual physical/annual gynecological exam, please advocate on your behalf and contact Florida Blue™ Customer Service at 1-800-664-5295 and have the claims properly adjusted • For wellness visits, make sure you have a discussion with your doctor/office staff to have the visit filed as a wellness claim • Review Member Health Statements available to you at www.floridablue.com, and pay your provider based on the information indicated on the statement
COMMONLY USED TERMS (2) • Co-pay: A flat fee charged to an insured employee as specified by the plan. A Co-pay accumulates towards the out-of-pocket maximum, but not the deductible • Co-insurance: The employee portion of the health expense for services such as, but not limited to, facility/hospital charges, laboratory charges, physician services (surgery, anesthesia, radiology, pathology, etc.). Co-insurance DOES accumulate toward out-of-pocket maximum • Deductibles: The cumulative 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. • Flexible Spending Account: A Health Care or Dependent Care Spending account in which you put aside pre-tax dollars to pay for eligible expenses. • Plan Year: April 1, 2014 through March 31, 2015 • Plan Year Out-of-Pocket Maximum: The maximum amount of deductible and coinsurance during any Plan Year that you pay before the Plan begins to pay 100% of Covered Expenses for the balance of the Plan Year
, PPO Plan Comparison One Network-Blue Options [Network Blue] Making a Choice
The ICUBA premium increases are 3.6% + 1.2% in new taxes = a total of 4.8%.Rate increases in the Florida market are averaging 9% this year. Preferred PPO and PPO 70 Plan Premiums
MAKING A CHOICECalculate Your Maximum Financial Risk Annual Premium + Out of Pocket Maximum + Co-pays (you estimate these) - HRA Contributions = Total Financial Risk Select carefully, if your election is too costly it is not possible to change election during the new Plan Year.
MAKING A CHOICE (1)Personalized Cost Estimator http://icubabenefits.org
Personalized Cost Estimator (2)Fill in Estimated Usage Numbers
Personalized Cost Estimator (3)See Total Estimated Annual Costs All Plans This value estimates what your annual cost would be based on the values you entered on the table. This total is ONLY an estimate used to help you in the decision-making process. These costs are not guaranteed and are only based on the assumptions you provided.
Did you know?$20.3 Million Annual NSU Contribution • NSU will contribute approximately 20.3 milliondollars to employee healthcare coverage costs in the 2014-2015 plan year! • Annual premium for 2014-2015 plan year: $18,093,468.12 • Annual HRA for 2014-2015 plan year: $2,140,386.00 • Total NSU Contributions 2014-2015 plan year: • $20,233,854.12
MHNet MENTAL HEALTH BENEFITSEMPLOYEE ASSISTANCE PROGRAM
Behavioral Health, Substance Abuse and EAP Benefits • Free Employee Assistance Program (EAP) services (up to six counseling sessions per issue per plan year) are available to ALL benefit-eligible employees and members of your household. You do not need to be enrolled in any ICUBA benefit plan in order for you or a household member to access EAP services. • Client Connect® Provider Matching Service assists members in locating an appropriate provider for their current situation. • The MHNet website has many helpful resources including informative 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. • To contact MHNet, call 1-877-398-5816. • To access the website, go to www.mhnet.com Username: ICUBA - Password: 8773985816 • MHNet contact information can be located on the back of the Florida Blue ID card.
MHNet Provider Search http://www.mhneteap.com
CATAMARAN Pharmacy Benefit Plan
CATAMARAN Pharmacy Benefit Plan • Pick up prescriptions at any one of the 62,000 retail pharmacies in the Walgreens network • Advantage90™ Network of 39,000 retail pharmacies nationwide can dispense a 90 day prescription in store, you can reduce your co-payments by using this program • Order a 90 day supply through the Catamaran Rx Mail Order Program by phone or on-line. Or 90 at retail. This is the least expensive way to obtain your prescriptions! • You are not required to use a Walgreens pharmacy and the NSU Pharmacy is in the network • Same pharmacy benefits for both plans • No deductible required only co-payments • Out of pocket maximum is $2,000 per individual and $4,000 per family • There is a separate ID card for pharmacy benefits • The NSU Pharmacy is in the network, and they will help you transfer your prescriptions from other pharmacies • NSU Pharmacy provides ALL generic drugs at a zero ($0) co-pay • 24/7 customer service for members • 1-800-207-2568 • www.walgreenshealth.com
Pharmacy Benefit: Understanding Your Tiered Copays • Your Catamaran™ pharmacy benefit plan offers three categories or tiers of drugs that determine your cost share or copay. • 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.mycatamaranRx.com or call member services at 1-800-207-2568. Maximum annual plan year out-of-pocket for prescription drug co-pay is $2,000 per individual; $4,000 for family. 90-day prescriptions are available at the same co-pay at retail and mail order. Remember 90 day prescriptions save you money!
CATAMARAN www.mycatamaranrx.com • MyCatamaranmembers can: • Create an online account to access Rx information • Check drug coverage and cost • Check eligibility • Search and download, plan drug list • Locate a nearby pharmacy • Review prescription history and refill information • Print a temporary ID card
Catamaran™ Pharmacy BenefitsMobile App Catamaran Member Portal:www.mycatamaranRx.com • Refill Rxs from Catamaran Home Delivery • Obtain a list of preferred medications to maximize savings • Perform test co-pays for Rxs • View prior authorization history Catamaran Mobile App: • Free of charge (Check data usage with service provider) • Find the lowest cost drug and pharmacy options • View prescription history • Key Features: • Fill-My-Scripts is a reminder to fill prescriptions • Take-My-Meds is a reminder to take medications • Mobile Advocate is designed to mimic behavior of provider • to elicit action and participation Note: Must register for an account on Catamaran Member Portal prior to accessing member information on the mobile app
Catamaran Mobile App Good health is in your hands. The Catamaran™ Mobile App provides easy, on-the-go access to your personalized health information. Once you receive your pharmacy ID card, download the app to take advantage of the benefits your pharmacy plan offers. With the Mobile App in your pocket: • Never miss a dose! Set reminders to take your prescription or over-the-counter medications. • Stay on top of medication refills. See when refills are due, get refill reminders and quickly contact your pharmacy. • Show your doctor exactly what medications you are taking. • Pull up your medication history anytime. • Learn about medication side effects and interactions. • Find network pharmacies by zip code or location, then check and compare current prescription prices. • Keep your mind sharp with a Brain Quiz and brain games. • Have one-touch access to your electronic pharmacy ID card. • Order refills from Catamaran Home Delivery. Get the app by searching for Catamaran at the Apple App Store or the Google Play Store or scanning the QR code.
NSU CLINIC PHARMACY • Full service pharmacy • Accepts NSU/ICUBA prescription plan • FREE generic drugs for NSU/ICUBA Healthcare subscribers • Open: Monday – Friday 9:00 AM – 6:00 PM Saturday 9:00 AM – 1:00 PM For questions and appointments please call: 954.262.4550 Web address: http://pharmacy.nova.edu/clinic/index.html
HEALTH CARE & DEPENDENT CARE FLEXIBLE SPENDING ACCOUNTS HEALTH REIMBURSEMENT ACCOUNTS
Health Reimbursement Account &Flexible Spending Account Flexible Spending Account Voluntary, funded by employee pre-tax dollars – Maximum $2,500 Available for medical and dependent care expenses No carry-over of funds from year to year (by law) Use-it-or-lose-it Incur expenses through June 15th, and file by June 30th FSA funds used before HRA funds Health Reimbursement Account Funded by the University Comes with all medical plans Funds rollover at the end of each plan year indefinitely Can have HRA alone with no FSA Portable after 36 months of continuous HRA participation No cash distribution Over the counter (OTC) medication cannot be purchased without a prescription from a physician.
Dependent Care Flexible Spending Account • Funded by employee with pre-tax contributions • Pay for qualified dependent care expenses, such as day-care or after-school care – NOT MEDICAL EXPENSES • Maximum annual limit of $5,000 – per family • Eligible dependents under age 13, physically or mentally challenged adult children who are unable to care for themselves • Funded each pay date, and available using the ICUBA Benefits MasterCard® • Subject to use-it-or-lose-itrule • Incur expenses through June 15th, file claims by June 30th • File your claims online at http://icubabenefits.org
HUMANA DENTAL PLAN DHMO PREPAID 250 CS PLAN • Members should choose a Primary Care Dentist at the time of new hire/rehire enrollment. • Make your provider selection through www.humanadental.com or contact Humana Customer Service for assistance locating a provider. • Visit http://icubabenefits.orgto elect or change your primary care dentist. • Click on the “Start Here: Change My Benefits” button. • Select “Basic Info”, then click “Change my Primary Care Dentist” • Enter the effective date of change, then the dentist ID • Changes to your dentist election must be submitted by the 1st of the month to ensure you and your dependent’s name appear on the dentist’s roster on the first of the following month. • Dentist elections can only be changed by the member by calling HUMANA Customer Service. • NSU Faculty Practice and NSU Dental Clinic Do NOT participate in this plan.
HUMANA DENTAL PLAN – PPO PLANS The NSU Faculty Dental Practice participates in the PPO Plans - not the DHMO The NSU Dental (Student) Clinic DOES NOTparticipate in any of the plans.
Humana Dental Plans Benefits can be obtained at the NSU Dental Faculty Practice PPO Plans Accepted Only www.humanadental.com 1-800-233-4013 (PPO) 1-800-979-4760 (DMO)
The NSU Eye Care Institute participates in this plan Advantica Base Vision Plan
ADVANTICA EYE CARE PLAN Rates Services can be obtained at the NSU Eye Care Institute or national network optometrists, ophthalmologists, opticians and retail providers (866) 425-2323 http://www.advanticaeyecare.com