2016-2017 OPEN ENROLLMENT€¦ · 2016-2017 OPEN ENROLLMENT Membership in ICUBA allows Nova...
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2016-2017 OPEN ENROLLMENT Membership in ICUBA allows Nova Southeastern University to provide employees access to affordable healthcare designed to promote wellness and early access to preventive care. The coverage offered at NSU is comparable to gold level plans available on the healthcare marketplace.
Transcript of 2016-2017 OPEN ENROLLMENT€¦ · 2016-2017 OPEN ENROLLMENT Membership in ICUBA allows Nova...
2016-2017 OPEN ENROLLMENT
Membership in ICUBA allows Nova Southeastern University to provide employees access to affordable healthcare designed to promote wellness and early access
to preventive care. The coverage offered at NSU is comparable to gold level plans available on the healthcare marketplace.
PPO 70
NSU monthly contributions to medical premium & HRA
Employee contributions to medical coverage
Premium contribution
HRA contribution
Monthlypremium
Per pay period
Employee Only Coverage
$457 $25 $259 $129.50
Employee & Spouse Coverage
$517 $50 $1006 $503
Employee and Child(ren)
$549 $50 $741 $370.50
Family Coverage
$720 $50 $1286 $643
* Special rates apply for 2 eligible NSU employees with dependent children. Email [email protected] for information
about the premium and eligibility requirements
2016-2017 MEDICAL RATES
Preferred PPO
NSU monthly contributions to medical premium & HRA
Employee contributions to medical coverage
Premium contribution
HRA contribution
Monthlypremium
Per pay period
Employee Only Coverage
$471 $50 $87 $43.50
Employee & Spouse Coverage
$593 $100 $593 $296.50
Employee and Child(ren)
$624 $100 $381 $190.50
Family Coverage
$797 $100 $765 $382.50
* Special rates apply for 2 eligible NSU employees with dependent children. Email [email protected] for information
about the premium and eligibility requirements
Pharmacy Co-pay$0 Generic Rx at NSU Pharmacy
Generic $5/30 day $10/90 day
Preferred $27/30 day $50/90 day
Non-Preferred
$60/30 day $120/90 day
HRA contributions remain attached to each of the medical plans and are deposited monthly to your ICUBA Healthcare MasterCard by NSU
2016-2017 PLAN CHANGES
Transition to the National Alliance Platform
• Effective April 1, 2016
• New Member ID Number
• New ID card
• New Customer Service Phone Number (855) 258-9029
• Single sign-on through http://ICUBAbenefits.org
• User friendly, enhanced website
• Blue Rewards powered by Rally Health
• National Blue Physician Recognition
• BCBS Chiropractic Network
• Essential Advocate
NEW CARD for APRIL 1st
NEW CARDS FOR THE NEW PLAN YEAR!!
• Old cards will not work after March 31, 2016
• Update your healthcare provider
• Call to confirm new card receipt
• Old cards will be collected by Benefits for awesome raffle prize!
2016-2017 PLAN CHANGES
Make sure to inform your healthcare providers that you have new insurance cards for all visits after March 31, 2016
April 1st – Aetna Behavior Health and Substance Abuse• New provider for Behavioral Health/Substance Abuse• No change in benefits• Phone number stays the same - 1-877-398-5816!
• Option 1 for Employee Assistance Program• Option 2 for Behavioral Health
• Find a doctor at www.docfind.com• Continue without choosing a provider• ICUBA members have access to all Aetna providers for Behavioral
Health• Make sure to notify your provider of new coverage• Benefits can be verified using your new medical ID card
2016-2017 PLAN CHANGES
Transition from EAP assistance to medical is available to participating employees.
2016-2017 PLAN CHANGES
Changes for the new Plan Year
$0
• Hospice care will be covered at $0 out of pocket for participants in the NSU/ICUBA healthcare plan effective April 1, 2016
$10• Reduced copay for quick service retail locations like Walgreens and CVS
$30• Reduced copay for freestanding Urgent Care centers (check providers online)
$300• Increased copay for Emergency Room visits, copay is waived if admitted
PPO 70
• PPO 70 plan will be frozen for new enrollment effective April 1, 2016
• Current participants can remain in the plan until April 1, 2017
Dependent Verification Required for 2016 Plan Year• Your legally recognized spouse or domestic partner
• Your natural child
• Your legally adopted child
• Your stepchild who resides with you
• A child required to be covered pursuant to a Qualified Medical Child
Support Order
• A child with proof of legal guardianship who resides with you
• A foster child
A child is a dependent until the end of the calendar year in which the age of 26 is attained or is over 26 years of age and is no longer continuously incapable of
self-support because of a Disability.
2016-2017 REQUIRED ACTIONS
Beneficiary UpdatesIt is important to have updated and accurate beneficiary information on
file! In the unfortunate event of your death, you want to make sure your
loved ones have the financial support they need.
Beneficiary Information should include:
• Legal Name
• Contact Information
• Percentage of benefits
If you elect to name a minor under the age of 18 as a beneficiary, it is important
to establish a proxy or a trust.
2016-2017 REQUIRED ACTIONS
Flexible Spending Account
FSADependent Care Flexible Spending Account
DCFSA• Funded by employee with pre-tax $$$
• Available for immediate use
• Can be used for employee and eligible dependent medical expenses
• Subject to Use-it-or-lose-it, no annual carry
over
• FSA funds are used prior to HRA funds if enrolled in NSU healthcare coverage
• FSA maximum annual limit is $2,550
• Funded by employee pre-tax $$$
• Available each pay period
• Can be used for dependent children 13 and under and adult disabled dependents to facilitate work NOT FOR HEALTHCARE EXPENSES!!
• Used for daycare, aftercare, summer camp
• Subject to Use-it-or-lose-it, no annual carry
over
• DCFSA maximum annual limit is $5,000
Flexible Spending Account elections are required every year
2016-2017 REQUIRED ACTIONS
2016-2017 REQUIRED ACTIONS
Don’t forget…FSA ELECTIONS ARE FOR HEALTHCARE
*EXAMPLES OF HOW FSA FUNDS CAN BE USED:HEALTHCARE COPAYS
PRESCRIPTION COPAYSDENTAL & VISION CARE
DCFSA ELECTIONS ARE FOR CHILDCARE OR ADULT DISABLED DEPENDENTS*EXAMPLES OF HOW DCFSA FUNDS CAN BE USED:
PRESCHOOLAFTERCARE
SPRING AND SUMMER CAMP
HRA CONTRIBUTIONS ARE MADE BY NSU WHEN YOU ARE ENROLLED IN MEDICAL COVERAGE AND CAN ONLY BE USED FOR DEPENDENTS ON YOUR PLAN.
2016-2017 WHAT’S THE SAME?
Same Great Plan Design
No Deductible for:
• Prescription Drugs
• In-Network Primary Care Physician Office Visits
• In-Network Outpatient Therapy and Chiropractic Visits
• Retail or Urgent Care Visits
• Emergency Room Visits
• Emergency Transportation
• Wellness program has been enhanced
The marketplace exchange equivalent to the ICUBA Plan is GOLD level
2016-2017 WHAT’S THE SAME?
Know Before you Go
• Primary Care Blue Physician Recognition provider office visits are always FREE!
• If you have a wellness exam, have a discussion with your doctor to ensure the visit is coded correctly.
• All in-network maternity office visits are FREE after your initial visit copay.
• Starting April 1, 2016 - contact Essential Advocate 1-888-521-2583 if you need assistance or have maternity questions.
• Bring your benefits summary with you to see your healthcare provider!
Always pay your provider based on the Explanation of Benefits statement provided by BlueCross and BlueShield.
2016-2017 WHAT’S THE SAME?
PPO High Dental
Plan year maximum $2,000
In and out of network providers
Deductible$50 Individual/$150 Family
Plan paysIn & out of Network
Preventive 100%
Basic 80% after deductible
Major 50% after deductible
$2,000 lifetime maximum for orthodontia
Preventive Plus PPO
Plan year maximum $1000
In and out of network providers
Deductible $50 Individual/$150 Family
Plan paysIn & out of Network
Preventive ServicesCovered at 100%
Basic servicesCovered at 80% after deductible
Discount available for major servicesIn-network Only
*subject to provider discretion
Discounted orthodontia coverage
Dental HMO CS250
No charge for periodic exams
Resin based composite$40
Sealant - per tooth$15
Inlay – metallic$115
Crown - porcelain/ceramic$310 + lab fees
Complete denture – maxillary$325 + lab fees
2016-2017 WHAT’S THE SAME?
Advantica In-Network Coverage
Vision Exam $5 Copay
Standard Frames $15 Copay; $100 allowance
Single Vision, Bifocal, Trifocal,and Lenticular Lenses
$15 Copay
Standard Progressive Lens $50 Copay
Contact Lenses - Medically Necessary (in lieu of eyeglasses and elective contact lenses)
$15 Copay; $250 materials allowance; $30 fitting fee allowance
Contact Lenses – Elective (in lieu of eyeglasses)
$15 Copay; $100 materials allowance; $30 fitting fee allowance
Advantica Buy Up Option
Vision exams every 12 months
Eyeglass lenses every 12 months
Frames every 12 months
Contact lenses every 12 months
Advantica Basic Vision Care
Vision exams every 12 months
Eyeglass lenses every 12 months
Frames every 24 months
Contact lenses every 12 months
Advantica Eye Care
Vision Buy-Up Plan Option
Basic Vision Plan Option
Monthlypremium
Per pay period
Monthlypremium
Per pay period
Employee Only Coverage
$4.78 $2.39 $3.98 $1.99
Family Coverage
$12.22 $6.11 $10.18 $5.09Humana Dental
Dental PPO High Option
Dental PPO Low Option
Dental HMO-CS250 Option
Monthlypremium
Per pay period
Monthlypremium
Per pay period
Monthlypremium
Per pay period
Employee Only Coverage
$36.68 $18.34 $19.48 $9.74 $10.98 $5.49
Employee + One Dependent
$73.04 $36.52 $45.28 $22.64 $22.02 $11.01
Family Coverage
$122.84 $61.42 $74.96 $37.48 $34.20 $17.10
2016-2017 DENTAL & VISION RATES
2016-2017 ENROLLMENT PORTAL
Enroll online at
http://ICUBAbenefits.org
Ask Emma is a decision support tool in the enrollment portal and can be disabled when enrollment begins
2016-2017 OPEN ENROLLMENT
Thank you for attending our open enrollment information session.Please feel free to ask any questions – we are here to help.
