Transcript Open Enrollment - Florida Institute of Technology
Appreciation and Thanks
Human Resources Team ICUBA Information Technology Auxiliary Services Property Management Conference Services Facilities Management
CIGNA Life & Disability Insurance
Florida Tech provides life insurance at no cost to benefit-eligible employees in an amount equal to one times annual compensation.
Employees may purchase additional life insurance for themselves & their dependents at a discounted group rate.
Coverage above $150,000 subject to Evidence of Insurability Short-term disability (66 2/3%) & long-term disability (60%) coverage are provided at no cost to benefit-eligible employees.
Short-term disability provides 11-weeks income.
Short-term disability automatically transitions to long-term disability, if the employee can not return to work.
Long-term disability buy-up option provides an additional 6 2/3% benefit. Premiums are paid through payroll deduction.
Tuition Remission
Florida Tech continues to provide the following benefits: 100% tuition remission for all benefit-eligible employees up to six credit hours per semester.
90% tuition remission for IRS-defined dependents for unlimited credit hours towards one degree.
100% University Alliance tuition remission for all benefit eligible employees AND eligible dependents See HR Website http://www.fit.edu/hr for policies or go to the Online Learning website http://online.fit.edu
403(b) Retirement Plan for 2013
IRS Maximum Employee Contribution =
$17,500
If Age 50+ employee may contribute
$5,500
more.
Florida Tech will
MATCH 1%
- up to
5%
each paycheck.
for each
1%
of employee contributes Employees may contribute to Lincoln Financial Group or TIAA CREF.
Local representatives available for one-on-one financial planning: Contact Richard Phelan with Lincoln Financial Group at [email protected]
Contact Richard Chandres with TIAA CREF at [email protected]
Mid-Year Changes
If you experience a qualifying event as defined by the IRS during the plan year, i.e. marriage, divorce, birth, or your spouse loses or gains coverage you may request a pre-tax benefit election change. Request must by made within 30 days of the qualifying event.
Notify Human Resources in writing by submitting a “Pre-Tax Qualifying Event Change Request Form.” Supporting legal documentation, such as a marriage license, divorce decree, birth certificate, or certificate of prior coverage will be necessary to process the change.
Members of the ICUBA Team
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Company
ICUBA Brand Partners
Benefit Health Insurance Prescription Drug Plan Contact
www.bcbsfl.com
www.floridablue.com
800-664-5295
or www.walgreenshealth.com
(thru 3/31/13)
www.mycatamaranRx.com
(after 4/1/13) 800-207-2568
:
Will I Receive an ID Card?
Yes Yes - Catamaran ID cards will be mailed by end of March 2013. Walgreens Health Initiatives ID card will still be accepted
www.walgreens.com/wcard
866-922-7312 Yes Walgreens Discount Card Mental Health, Substance Abuse and Employee Assistance Program (EAP) Health Care Spending Account Dependent Care Spending Acct.
Health Reimbursement Account
www.mhnet.com
877-398-5816
http://icubabenefits.org
866-377-5102 Dental Insurance Eye Care Plan
www.humanadental.com
800-979-4760 (DHMO) 800-233-4013 (PPO)
www.advanticabenefits.com
866-425-2323 Back of BCBS Card ICUBA Benefits MasterCard® Yes Yes
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Plan Design Changes 2013 - 2014
Blue Choice Medical Plans: No NEW enrollees accepted for Plan Year 4/1/13 – 3/31/14. Choice plans will be discontinued effective 4/1/14.
Blue Choice PPO 80 Medical Plan: Discontinued effective 4/1/13.
Humana Dental Plans: New Preventive Plus Plan and new High Option PPO Plan. The DHMO Plan remains the same.
Wellness: Cash incentives to Health Reimbursement Account available. Health coaching available.
Summary of Benefits and Coverage (SBC): New healthcare reform document to assist you in comparing plans.
Save Money… Get the most out of your plan!
o o o o o o o Choose generics; many generic drugs offer the same quality as brand-name drugs Use 90-day mail order for prescription refills. Call Member Services at 1-800-207-2568 or go to www.mycatamaranRx.com
Use Florida Blue™ “Know Before You Go” at 888-476-2227 FREE ICUBA Cares™ In-Network Benefits through Florida Blue: Annual Physical Annual Gynecological Exam Lab Tests Pap Tests Mammograms Urinalysis Immunizations o o o o o o o Electrocardiograms Echocardiograms Colonoscopies & Sigmoidoscopies Colorectal Screenings Prostate Cancer Screenings Bone Mineral Density Tests Allergy Injections Request prescribed generic folic acid and generic pre-natal vitamins for pregnancy Healthy Additions $25 incentive for expectant mothers Request prescribed diabetic supplies including meters, lancing devices, lancets, test strips, control solution, needles, and syringes Employee Assistance Program (EAP) available to all employees and household members $25 incentive for participating in a Personal Health Assessment at the health fair 10
View Your Benefits at http://icubabenefits.org
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Monthly Premiums
ICUBA rates increased 3% for Blue Options Plans compared to 9 - 11% in the Florida market.
Employee Employee + Spouse Employee + Child(ren) Family
PPO 70 Blue Choice *
Employee Contribution Employer Contribution HRA $175.00
$525.00
$60 $349.50
$315.00
$489.25
$1048.50
$945.00
$1467.75
$120 $120 $120
PPO 70 Blue Options
Employee Contribution Employer Contribution $156.50
$469.50
HRA $60 $313.00
$282.00
$438.50
$939.00
$846.00
$1315.50
$120 $120 $120 Employee Employee + Spouse Employee + Child(ren) Family
PPO Risk /Reward Blue Choice
Employee Contribution $138.50
$277.00
$249.25
$387.50
Employer Contribution $415.50
$831.00
$747.75
$1162.50
*
HRA $100 $200 $200 $200
PPO Risk/Reward Blue Options
Employee Contribution Employer Contribution HRA $122.00
$366.00
$100 $243.75
$219.50
$341.25
$731.25
$658.50
$1023.75
$200 $200 $200 *NO NEW enrollees accepted for Plan Year 4/1/13 – 0/31/14. Blue Choice Plans will be discontinued effective 4/1/14.
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Plan Definitions
Deductibles: The cumulative amount that you must pay in the plan year before benefits will be paid by the Plan. If the Plan has a $1000 deductible, the Plan begins to pay after you have paid the first $1,000 for services in which the deductible is required. Coinsurance: The percentage of a covered expense that you pay after the satisfaction of any applicable deductible. It is a defined percentage of the covered charges for services rendered. For example, the plan may pay for 70% of covered services and you pay 30%.
Co-pays (Co-payments): The fixed dollar amount you are required to pay each time a particular service is used. The co-pay does apply to your out-of-pocket maximum, but does not reduce amounts applied to the deductible or co insurance. Annual Out-of-Pocket Maximum: The maximum amount of deductible and co insurance during any plan year that you pay before the plan begins to pay 100% of covered expenses for the remainder of the plan year. Flexible Spending Account: A medical care or dependent care spending account in which you put aside pre-tax dollars to pay for eligible expenses.
Centers of Excellence: Preferred places of care with the best outcomes, finest operational standings and best patient care.
Deductible
Individual/Family
Coinsurance
Side-by-Side Medical Plan Comparison
2013-2014 Plan Year PPO 70 Blue Choice & Blue Options Network Non Network
$1,000/$2,500 $1,500/$4,000
PPO Risk/Reward Blue Choice & Blue Options Network Non Network
$2,000/$4,000 $3,500/$9,750 30% after deductible 50% after deductible 20% after deductible 40% after deductible
Out of Pocket Maximum (includes all medical co-pays, deductibles, and coinsurance) Physicians Office Visit and Behavioral Health) (includes General Practice, Internal Medicine, Family Practice, Pediatrician, OB/GYN Specialist Office Visit, including Chiropractors and Therapists Wellness Exam Outpatient Diagnostic Imaging
$3,000/$6,000 $20 co-pay; no deductible $30 co-pay; no deductible $0 $100 co-pay and 30% after deductible $6,000/$12,000 50% after deductible 50% after deductible Not Covered 50% after deductible $3,500/$7,000 20% no deductible 20% no deductible $0 20% after deductible $7,000/$14,000 40% after deductible 40% after deductible Not Covered 40% after deductible
Urgent Care Emergency Room Services Hospital Inpatient
$30 co-pay; no deductible $100 co-pay (waived if admitted) no deductible $250 co-pay, and 30% after deductible $30 co-pay; no deductible $100 co-pay (waived if admitted) no deductible $500 co-pay and 50% after deductible 20%; no deductible $100 co-pay (waived if admitted) no deductible 20% after deductible 20%; no deductible $100 co-pay (waived if admitted) no deductible 40% after deductible 14
Minimize Out-of-Pocket Expenses
Avoid un-necessary fees for lab work, always use QUEST Labs Verify coverage with your provider PRIOR to appointment If you are billed a facility fee for an office visit or are billed for an annual physical or annual gynecological exam, please advocate on your behalf and contact Florida Blue™ Customer Service at 1-800-664-5295 to have the claim properly adjusted Pay your provider based on the Member Health Statements available at www.floridablue.com
Use your ICUBA MasterCard for office visit copays and other out-of-pocket expenses Use your Walgreens Discount Card at Walgreens retail stores to purchase Walgreens brand products and earn cash credit 15
Florida Blue™ Mobile Apps
Features
• • • • • • • • • •
Find A Doctor & Map – GPS based View ID Card Fax or email ID Card Claims Accessibility Health Coach 24-hour Nurse line & Care Consultants Rx Shopping & Price Comparison Coverage Benefits & Accumulators Health News & Views Health Check Guidelines
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Catamaran Prescription Benefit Tiered Copays
Your Catamaran pharmacy benefit plan offers three tiers of drugs.
Bring the Preferred Medication List with you to the doctor to receive the lowest cost generic or brand prescription medications available for your therapy.
Call member services at 1-800-207-2568 or visit www.mycatamaranRx.com
Tier Co-pay 30 day Retail/Mail Order/ 90 day Retail
$5/10/10
Definition 1 st Tier: Generics 2 nd Tier: Preferred 3 rd Tier: Nonpreferred
$27/50/60 $60/120/145 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.
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.
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.
Maximum annual plan year out-of-pocket for prescription drug co-pay is $2,000 per individual; $4,000 for family.
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Catamaran Prescription Enhancements
March 2013: New Catamaran ID cards will be sent by the end of March. Walgreens Health Initiatives cards will still be accepted.
April 2013: Catamaran Member Portal www.mycatamaranRx.com
Obtain a list of preferred medications to maximize savings Refill prescriptions for home delivery Perform test co-pays for prescriptions View prior authorization history April 2013: Catamaran Mobile App Free of charge 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.
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MHNet 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 employees and everyone in an employee’s 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. Contact MHNet call 1-877-398-5816.
To access the website, go to www.mhnet.com
Username: ICUBA Password: 8773985816 MHNet contact information is on the back of your Blue Cross Blue Shield of Florida ID card, or contact Human Resources if not a participating member.
HRA and HCSA – What’s the difference?
Health Care Reimbursement Account (HRA)
Funded by Florida Tech Available for PPO 70 and Risk/Reward Plans Funds rollover at the end of each plan year indefinitely Account is portable after 36-months of continuous participation Employee can have HRA alone without HCSA Amount funded depends on medical plan Funds deposited monthly
Health Care Spending Account (HCSA)
Funded by employee’s pre-tax dollars Funds available first day of plan year Can be used for qualified employee and eligible dependent medical expenses No carry-over of funds from year to year (by IRS law)
lose-it”
“Use-it-or- HCSA funds expended before tapping into HRA funds Employee can have HCSA without HRA Maximum annual contribution limited to $2,500 for 2013-2014 under Health Care Reform 20
Flexible Spending Account for Dependent Care Expenses (DCSA)
Funded by employee’s pre-tax cdollars Funds used to pay for qualified dependent care expenses Maximum annual contribution limit for plan year 2013 – 2014 is $5,000 Qualified dependents are under age 13, or physically/mentally challenged adults who are unable to care for themselves Funds are available as deducted from your paycheck Funds available by using the ICUBA Benefits MasterCard File your claims online at http://icubabenefits.org
Funds do not carry-over from year to year (by IRS law) “Use-it-or-lose-it” OE 2010 21
Humana Dental
Low Option PPO Plan Replacement
The Low Option PPO Plan will be replaced, effective 4/1/13, with the “
Preventive Plus
” Plan. This new plan provides coverage for preventive services, some basic services, and no major services.
Enhancements to High Option PPO Plan
Two additional preventive cleanings for a total of four cleanings per year.
Two periodontal cleanings per year to be covered at preventive levels of benefits.
Coverage for composite fillings on all teeth.
Addition of an Extended Annual Maximum Benefit paying 30% coinsurance after the annual maximum benefit is met.
Refer to the Dental Insurance Benefits Guide (handout) for information on how to find a dentist and How to select or switch a Primary Care Dentist (PCD) in the DHMO Plan.
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Employee Employee + 1 Family
Humana Dental Rates
2013-2014 Monthly Dental Rates* *Ask a member of the Human Resources team for per pay period amounts.
High Option PPO Plan Preventive Plus Plan DHMO CS250 Plan $36.68
$19.48
$10.98
$73.04
$45.28
$22.02
$122.84
$74.96
$34.20
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High Option PPO Plan Plan Year Deductible – Single / Family Deductible Waived for Preventive Plan Year Maximum (excludes orthodontia services) Preventive Services Basic Services Major Services Orthodontia – Adult & Child Orthodontia Lifetime Maximum In-Network $50 / $150 Yes $2,000 0% 20% 50% 50% $2,000
Refer to your Dental Summary Plan Description (SPD) for full benefit description
.
Refer to your dental SPD for full benefit description
Out-of-Network $50 / $150 Yes $2,000 20% 50% 70% 50% $2,000
Preventive Plus Plan In-Network Out-of-Network Plan Year Deductible – Single / Family $50 / $150 $50 / $150 Yes Yes Plan Year Maximum (excludes orthodontia services) $1,000 $1,000 Preventive Services Basic Services* 0% 20% 0% 20% Major Services** Discount Not Covered *Services include amalgam/resin restorations and simple extractions. **These services are not covered under this plan; receive a discount on these services if you see a participating dentist. Out-of-pocket expenses do not apply to deductible and annual maximum.
Refer to your Dental Summary Plan Description (SPD) for full benefit description.
Refer to your dental SPD for full benefit description
D DHMO CS250 Plan Plan Year Deductible Out of Pocket Maximum Office Visit Copays – (during normal business hours) Preventive Services Basic Services Major Services Orthodontics – Adult & Child In-Network Only No deductible No maximum $5 copay per visit Please refer to dental schedule for copay amounts Please refer to dental schedule for copay amounts Please refer to dental schedule for copay amounts $2,000 Adult; $1,800 Child fixed copay
Advantica Eyecare Plan
Vision Exam Standard Frames Single Vision, Bifocal, Trifocal, and Lenticular Lenses Standard Progressive Lens Single Vision (SV) Polycarbonate UV Coating Lens Contact Lenses - Medically Necessary (in lieu of eyeglasses and elective contact lenses)
$5 co-pay
In-Network
$100 allowance Covered After $15 co-pay $50 co-pay Included with Lens co-pay up to age 19; over age 19, $30 co-pay $12 co-Pay $15 co-pay; $250 materials allowance; $30 fitting fee allowance
Out-of-Network
Up to $40 Reimbursement (less applicable co-pay) Reimbursed up to $40 (no co-pay if included with eyeglass lenses) Up to $20 for Single Vision, $40 for Bifocal, $60 for Trifocal, $100 for Lenticular Reimbursement less co-pay Up to $45 reimbursement less co-pay Up to $10 reimbursement less co-pay under age 19 Up to $5 reimbursement less co-pay Up to $250 reimbursement less applicable co-pay
Contact Lenses – Elective (in lieu of eyeglasses) Frequency Limitations - Vision Exams Frequency Limitations - Eyeglass Lenses
$15 co-pay; $100 materials allowance; $30 fitting fee allowance Up to $60 reimbursement less applicable co-pay Once every 12 months Once every 12 months
Frequency Limitations - Frames
Once every 24 months
Frequency Limitations - Contact Lenses
Once every 12 months
Employee Monthly Premium: $3.98 Family Monthly Premium: $10.18
Lower rates than last year and guaranteed for 4 years!
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What you need to do next…
• • • • • • Enroll by logging onto http://icubabenefits.org
Select the Open Enrollment icon Your elections are effective 4/1/2013 and will remain in effect until 3/31/2014 Any eligible dependents may enroll during this open enrollment period
You MUST actively elect your Flexible Spending Account(s) – HCSA and DCSA - if you wish to continue
Access the Predictive Modeling Tool by clicking on the link labeled
“View Detailed Plan Comparison”
on the Medical Election Page. Use this tool to assist you with your elections.
• • Then, select the tab
“Personalized Cost Estimator” You MUST complete your enrollment before February 28, 2013.
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Additional After-Tax Benefits
Sickness, Accident and Cancer Plans available through AFLAC Cristy McCullough [email protected]
Identity Theft Protection and Basic Legal Services available through Pre Paid Legal Yvette Mayo [email protected]
Additional Life Insurance through CIGNA Long Term Care Insurance through UNUM Note: A separate application is required to elect these benefits, so please visit the representatives at their tables for more information.
What to expect
New Florida Blue ID cards for current enrollees in PPO 80 who choose a new plan.
New Florida Blue ID cards for anyone moving from a Blue Choice plan to a Blue Options plan.
New Catamaran ID card.
New Humana Dental ID card for the Preventive Plus plan and the High Option PPO plan.
More focus on Wellness.
Continued Consumer Directed Focus.
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Benefit Plan Year 2013 -2014 Please log into http://icubabenefits.org
to make changes to your benefits. Deductions take effect on your April 5
th
pay check. Your HR professionals will gladly assist you with your elections!
Thursday, Changes MUST be submitted by February 28, 2013
Human Resources Website http://www.fit.edu/hr/open enrollment/
Click on “Choose a Topic” to view:
• Plan Descriptions • Benefit Information • Premium Information • Links to Insurance Websites