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Plan Year April 1, 2013 - March 31, 2014 New Employee Benefit Orientation.

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Presentation on theme: "Plan Year April 1, 2013 - March 31, 2014 New Employee Benefit Orientation."— Presentation transcript:

1 Plan Year April 1, March 31, 2014 New Employee Benefit Orientation

2 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

3 3 ICUBA Schools

4 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

5 How to Enroll To enroll, login to the benefits enrollment portal at  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 at or by calling  HR Representatives are available Monday – Friday, 8:30am to 5:00pm


7 NSU / ICUBA Health and Wellness Benefits Member Cards *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. Humana Dental PlanAdvantica Eyecare Plan Catamaran Prescription Drug Plan ICUBA Cares MasterCard™ Florida Blue Medical Insurance

8 NSU WELLNESS SERVICES The NSU Pharmacy provides free health screenings monthly call or log in to NSU Employee Sick Call Clinic open every morning from 8:15 am until 11:00 am, walk in or call , 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 , fees based on a sliding scale AHEC offers a free 6 week Quit Smoking Program call

9  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 VIPS (8477) NSU’S WELLNESS MADE SIMPLE Makes Keeping Healthy Simple!!

10  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 ICUBA Cares™

11 Saving Tips – Use Your Plan Wisely Free In-Network Wellness Benefits Aspirin for adults with a physician prescription Better You From Blue TM 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 11

12 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 12 Saving Tips – Use Your Plan Wisely Free In-Network Wellness Benefits

13 BlueCross BlueShield Health Dialog®  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 BlueCross BlueShield Care Coordination Monday - Thursday 8AM – 6PM Fridays 9AM – 6PM TTY

14 BLUE CROSS BLUE SHIELD - BLUE365 ® Discount Program Access Blue365® 1) Visit Log onto MyBlueService Discounts & Rewards Discounts 2)Visit 3)Offers change frequently 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

15 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

16 Member Health Statement 16

17 Saving Tips – Use Your Plan Wisely Pay 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 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 and pay your provider based on the information indicated on the statement 17

18 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

19 MEDICAL PLANS Florida Blue Network Name

20 MAKING A CHOICE Plan Comparison

21 MAKING A CHOICE Employee Premiums Coverage Tier Total Monthly Premium NSU Contribution Employee Contribution Monthly Premium MonthlyHRA Bi-weekly Premium PPO 70 Blue Options Employee $ $ $ $ $ Employee & Spouse $ 1, $ $ $ $ Employee & Child(ren) $ 1, $ $ $ $ Employee & Family $ 1, $ $ $ 1, $ Dual Enroll (Husband & Wife Employed by NSU) Family $ 1, $ $ $ $ PPO Risk & Rewards Blue Options Employee $ $ $ $ $ Employee & Spouse $ $ $ $ $ Employee & Child(ren) $ $ $ $ $ Employee & Family $ 1, $ $ $ $ Dual Enroll (Husband & Wife Employed by NSU) Family $ 1, $ $ $ $

22 MAKING A CHOICE Calculate 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.

23 Coverage/Tier Coverage/Tier ANNUAL ANNUAL PREMIUM PREMIUM OUT OF POCKET MAXIMUM (OOP) MAXIMUM (OOP)MEDICAL OUT OF POCKET MAXIMUM MAXIMUMPHARMACY PREMIUM + PREMIUM + OOP OOP NSU HRA NSU HRA CONTRIBUTION CONTRIBUTION ESTIMATED ESTIMATED IN-NETWORK IN-NETWORK FINANCIAL RISK FINANCIAL RISK EMPLOYEE ONLY PPO 70 Blue Options$2,712.00$3,000.00$2,000.00$7,712.00$300.00$7, PPO Risk Reward Blue Options $ $3,500.00$2,000.00$6,436.00$600.00$5, EMPLOYEE & SPOUSE PPO 70 Blue Options$9,924.00$6,000.00$4,000.00$19,924.00$ $19, PPO Risk Reward Blue Options $6,000.00$7,000.00$4,000.00$17,000.00$1,200.00$15, EMPLOYEE & CHILD(REN) PPO 70 Blue Options$7,776.00$6,000.00$4,000.00$17,776.00$ $17, PPO Risk Reward Blue Options $4,176.00$7,000.00$4,000.00$15,176.00$1,200.00$13, EMPLOYEE & FAMILY PPO 70 Blue Options$13,488.00$6,000.00$4,000.00$23,488.00$ $22, PPO Risk Reward Blue Options $8,220.00$7,000.00$4,000.00$19,220.00$1,200.00$18, Making a Choice Estimating Your Financial Risk 23

24 MAKING A CHOICE (1) Personalized Cost Estimator

25 Personalized Cost Estimator (2) Fill in Estimated Usage Numbers

26 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.

27 Did you know? $20.2 Million Annual NSU Contribution Tier Tier Annual Amount Paid by NSU Premium HRA HRA Total Annual Contribution PPO 70 Employee$4,800.00$300.00$5, PPO 70 Employee / Spouse $5,100.00$600.00$5, PPO 70 Employee / Child(ren) $5,760.00$600.00$6, PPO 70 Family$7,560.00$600.00$8, PPO R&R Employee$4,920.00$600.00$5, PPO R&R Employee / Spouse $5,700.00$1,200.00$6, PPO R&R Employee / Child(ren) $6,360.00$1,200.00$7, PPO R&R Family$8,160.00$1,200.00$9,  NSU will contribute approximately 20.2 million dollars to employee healthcare coverage costs in the plan year!  Annual premium for plan year: $17,882,  Annual HRA for plan year: $2,346,  Total NSU Contributions plan year: $20,228,848.00


29 MHNet Mental 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: 29  Informative articles  Interactive health and wellness instruments  Health assessments and videos  On-line seminars  Financial  Family  Personal  Mental health information  Discounts Visit or call Online Services Login - Username: ICUBA, Password: MHNet contact information also found on the back of the BCBSFL card

30 MHNet Provider Search


32  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 CATAMARAN Pharmacy Benefit Plan 24/7 customer service for members  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

33 Catamaran™ Pharmacy Benefits Catamaran™ Pharmacy Benefits Benefit Tiered Copays 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 Tier Co-pay 30 day Retail/Mail Order/ 90 day Retail Definition 1 st Tier: Generics $5/10/10 Generics contain the same active ingredient as their brand-name equivalents and offer the same effectiveness and safety. Some generics use a brand name instead of a chemical name. Both have the lowest co-pay. 2 nd Tier: Preferred $27/50/60 Medications in this tier have been selected by your pharmacy benefit plan as preferred brand drugs. These drugs have higher co- pays than generics but are less costly than non-preferred medications on the third tier. 3 rd Tier: Nonpreferred $60/120/145 Because a generic version or a second-tier alternative is available, non-preferred medications have the highest co-pays and are not listed on the Preferred Medication List. Visit or call Member Services at Use 90 day mail order and save money! Call

34 MyCatamaran members 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


36 Catamaran™ Pharmacy Benefits Mobile App Catamaran Member Portal:  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 36 Note: Must register for an account on Catamaran Member Portal prior to accessing member information on the mobile app

37 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: Web address:


39 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.

40 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-it rule Incur expenses through June 15 th, file claims by June 30 th File your claims online at 40


42 Members should choose a Primary Care Dentist at the time of new hire/rehire enrollment. Make your provider selection through or contact Humana Customer Service for assistance locating a provider. Visit to 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 1 st 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 PLAN DHMO PREPAID 250 CS PLAN


44 Humana Dental Plans Monthly Dental Premium High Option PPO Plan Low Option Preventive Plus Plan DMO CS250 Plan Employee$36.68$19.48$10.98 Employee + 1$73.04$45.28$22.02 Family$122.84$74.96$ Benefits can be obtained at the NSU Dental Faculty Practice Clinic PPO Plans Accepted Only (PPO) (DMO)


46 Rates Services can be obtained at the NSU Eye Care Institute or national network optometrists, ophthalmologists, opticians and retail providers (866)

47 Basic Employer Provided Life Insurance Optional Life Insurance Short Term Disability Long Term Disability Identity Theft Protection Emergency Travel Assistance LIFE AND DISABILITY BENEFITS

48 BASIC AND OPTIONAL TERM LIFE INSURANCE Basic – EmployerOptional - Employee Benefits-eligible employees must work at least 19.2 hours weekly and are U.S. citizens or U.S. residents and foreign nationals Eligible after 3-months of employmentEligible after a 3-month waiting period Benefit is one times annual salary up to a maximum of $300,000 Elect amounts between $10,000 and $200,000 in $10,000 increments Term life insurance Convertible at age 65 /portable up to age 65 and younger Benefit reduces to 65% at age 65 and to 50% at age 70 No medical exam for this period only (Optional Life Insurance) Complete a beneficiary form at and update as needed

49 OPTIONAL TERM LIFE INSURANCE Rate Chart (1) Amount of coverage Age

50 OPTIONAL TERM LIFE INSURANCE Rate Chart (2) Amount of coverage Age

51 SHORT-TERM AND LONG-TERM DISABILITY This is an overview of benefits available under the University STD Program & LTD Plan. It is not intended to modify, in any way, the plan documents or Summary Plan Description that, in the case of any difference, will govern.

52 IDENTITY THEFT PROTECTION  Your Life Insurance carrier provides this service if you become a victim of identity theft  24/7 telephone support and step-by-step guidance by anti- fraud experts  Expert case worker assigned to you to assist with notification to credit bureaus and paperwork to correct credit reports  Preventative measures- register up to 10 credit or debit cards for 24/7 surveillance  Call SecurAssist® at

53 EMERGENCY TRAVEL ASSISTANCE Your Life Insurance carrier provides this service when you travel more than 100 miles away from home and need medical assistance All services must be provided and arranged by Assist America No claims for reimbursement will be accepted Call Assist America at within USA or outside the USA See brochure in your packets


55 NSU 401(k) RETIREMENT PLAN (RETIREMENT MANAGER)  A secure way to enroll and make changes to the NSU Retirement accounts at https://www.myretirementmanager.com  Comprehensive source for financial planning and determine if your financial plan is on track

56 NSU 401(k) RETIREMENT PLAN  Must be 21 years of age, full time employee and not be in an excluded class (e.g. Temporary, Part-Timer, Cluster, Union, Non Resident Aliens, etc.) to be eligible for NSU Retirement Savings Plan  Full-time employees eligible to receive matching contributions in the NSU 401(k) Retirement Savings Plan after one year of service  Eligible to make voluntary contribution into the NSU 401(k) Plan on the first of the month following your hire date  NSU Safe Harbor matching contribution immediately vested  NSU Basic 2% and matching contribution (above basic 2%) is vested after 3 years of service  Employees who attain the age of 50 can defer additional amounts (“catch-up” contributions) up to the annual limit of $23,000 ($17,500 under age 50)

57 401(K) CONTRIBUTIONS University matching contributions begin after one year of service Enroll and make changes to the NSU Retirement accounts by visiting

58  “Safeguard for Minors” identity theft protection for dependents for an extra $1.00 a month  Real Estate, Family Law, Estate Planning, Traffic Issues  Legal Shield premium deductions once a month. Deductions will be taken in the second pay period of each month  Voluntary employee benefit - no employer contribution  Contact Kelley Kaupas-Rheault at (954) or John Broadbent at (954) or visit  View additional information on benefits webpage s/index.html s/index.html  Offers various insurance plans, accident insurance, hospital indemnity, short-term disability and cancer indemnity  Voluntary employee benefit - no employer contribution  View PowerPoint presentation on benefits webpage  Contact AFLAC representative Joe Evans at (954) for more information. Employee Discount Provided by Abenity  View additional information on benefits webpage /index.html /index.html

59 NSU / ICUBA Health and Wellness Benefits Member Cards *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. Humana Dental PlanAdvantica Eyecare Plan Catamaran Prescription Drug Plan ICUBA Cares MasterCard™ Florida Blue Medical Insurance

60 ICUBA Partners 60 CompanyBenefitContactID Card? Health Insurance OR Yes Prescription Drug Plan (formerly Walgreens & Catalyst) Member Services: Mail Order: Yes Mental Health, Substance Abuse and Employee Assistance Program Back of BCBS Card 60

61 ICUBA Partners 61 : CompanyBenefitContactID Card? Flexible Spending Plans: Health Care Spending Account Dependent Care Spending Account Health Reimbursement Account Phone: Fax: P.O. Box Orlando, FL ICUBA Benefits MasterCard® Benefit elections, information and access to ICUBA Benefits Card account information No Dental Insurance (DHMO) (PPO) Yes Eye Care Plan Yes Term Life, AD&D and Short and Long Term Disability Insurance Contact Benefits Department No 61

62 ENROLLMENT REMINDER Employees have thirty days (30) from their date of hire or eligibility to enroll in ICUBA benefits Enrollment is made online at Premiums are charged from the date of hire Enrollment instructions are posted on the benefits web page If you do not enroll during this period you may enroll during the next annual enrollment or qualifying status change Employees working at least 19.2 hours per week are eligible for retirement supplemental, dental and vision plans Employees working 28 hours or more per week are eligible for *retirement matching, medical, dental, and vision plans *Employee must be classified as full-time to be eligible for the retirement matching plan

63 FOR VIEWING THE NOVA SOUTHEASTERN UNIVERSITY NEW HIRE ENROLLMENT PRESENTATION If you have any questions, please the Office of Human Resources Shared Services at or call (954)262-HR4U (4748)

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