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New Employee Benefit Orientation. Plan Year April 1, 2013 - March 31, 2014. 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, 2013 - March 31, 2014
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
Eligibility • Employees working at least 19.2 hours per week are eligible for retirement supplemental plan, and 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.
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 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 • 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 • AHEC offers a free 6 week Quit Smoking Program call 954-262-5860
NSU’S WELLNESS MADE SIMPLE Makes Keeping Healthy Simple!! • Provides comprehensive primary health care to employees and family members insured by ICUBA, who are 18 years of age and older • Promotes preventive medicine, identifies patient health risks, provides treatment and strives to prevent a more serious condition in patients with health risks • Receive FULL WELLNESS BENEFITS at NSU by completing a physical examination, including blood work (covered by your ICUBA insurance) • No copayments or coinsurance Register & make an appointment - Call the NSU Health Care Centers at 954-262-VIPS (8477)
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
Saving Tips – Use Your Plan WiselyFree In-Network Wellness Benefits • Aspirin for adults with a physician prescription • Better You From BlueTM Health Fairs with $50 incentive for participation, and Healthy Additions $25 incentive for each pregnant member • Use 90 day mail order for maintenance prescription refills • Prescribed diabetic supplies including meters, lancing devices, lancets, control solution, syringes, test strips and needles - ALL BRANDS • Employee Assistance Program (EAP) available to all employees and members of their household
Saving Tips – Use Your Plan WiselyFree In-Network Wellness Benefits • Colonoscopies & Sigmoidoscopies • Colorectal Screenings • Prostate Cancer Screenings • Abdominal Aortic Aneurysm Screening – age 60+ • Electrocardiograms & Echocardiograms • All covered at 100% • Annual Physical & Gynecological Exam • Lab Tests (Quest Diagnostic) • Pap Tests • Immunizations • Mammograms • Bone Mineral Density Tests • Allergy Injections • Urinalysis NO Deductible FOR THE FOLLOWING in-network SERVICES Therapy OFFICE Visits EMERGENCY ROOM VISITS PHYSICIAN OFFICE VISITS URGENT CARE VISITS
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) Certificate of Creditable (Prior) Coverage: document detailing the period of prior coverage for a new employee. It is used for the purpose of determining creditable coverage under HIPAA regulations. If there is a break of 63 days or more since prior coverage, Pre-existing limitation will apply to participants over19 years of age 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) 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
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 • Deductible: A dollar amount that must be paid by the insured for health or dental services before a claim becomes payable by the carrier. The deductible DOES accumulate toward out-of-pocket maximum • 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 • Centers of Excellence: Preferred places of care with the best outcomes, finest operational standings and best patient care
MEDICAL PLANS Florida Blue Network Name
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 be possible to change election during the new Plan Year.
MAKING A CHOICE (1)Personalized Cost Estimator http://icubabenefits.org
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?$20.2 Million Annual NSU Contribution • NSU will contribute approximately 20.2 milliondollars to employee healthcare coverage costs in the 2013-2014 plan year! • Annual premium for 2013-2014 plan year: $17,882,280.00 • Annual HRA for 2013-2014 plan year: $2,346,568.00 • Total NSU Contributions 2013-2014 plan year: • $20,228,848.00
MHNet MENTAL HEALTH BENEFITSEMPLOYEE ASSISTANCE PROGRAM
MHNetMental Health Benefit & EAP Provider EAP AVAILABLE TO ALL EMPLOYEES AND MEMBERS OF THEIR HOUSEHOLD AT NO COST MEDICAL PLAN ENROLLMENT IS NOT REQUIRED • Up to six counseling sessions per issue - per plan year • Inpatient services must be pre-authorized by MHNet • Client Connect® provider matching service for assistance in locating an appropriate provider • Visit the MHNet website and access helpful resources: • Informative articles • Interactive health and wellness • instruments • Health assessments and videos • On-line seminars • Financial • Family • Personal • Mental health information • Discounts • Visit www.mhneteap.comor call 1-877-398-5816 • Online Services Login - Username: ICUBA, Password: 8773985816 • MHNet contact information also found on the back of the BCBSFL card
MHNet Provider Search http://www.mhneteap.com
CATAMARAN (formerly WALGREENS HEALTH INITIATIVE) 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. 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
Catamaran™ Pharmacy BenefitsBenefit Tiered Copays Visit www.mycatamaranrx.comor call Member Services at 1-800-207-2568 • Pharmacy benefit plan offers three tiers of drugs – these determine your copay • Have your doctor consult the Preferred Medication List for the lowest cost generic or brand medications available for your therapy • Out of pocket maximum is $2,000 per individual and $4,000 per family Use 90 day mail order and save money! Call 1-877-615-6331.
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
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 through the ICUBA website.
Humana Dental Plans Benefits can be obtained at the NSU Dental Faculty Practice Clinic PPO Plans Accepted Only www.humanadental.com 1-800-233-4013 (PPO) 1-800-979-4760 (DMO)
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
LIFE AND DISABILITY BENEFITS Basic Employer Provided Life Insurance Optional Life Insurance Short Term Disability Long Term Disability Identity Theft Protection Emergency Travel Assistance
BASIC AND OPTIONAL TERM LIFE INSURANCE No medical exam for this period only (Optional Life Insurance) Complete a beneficiary form at http://icubabenefits.org and update as needed
OPTIONAL TERM LIFE INSURANCERate Chart (1) Amount of coverage Age
OPTIONAL TERM LIFE INSURANCERate Chart (2) Amount of coverage Age