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Plan Year April 1, 2014 - March 31, 2015 New Employee Benefit Orientation
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Plan YearApril 1, 2014 - March 31, 2015
New Employee Benefit Orientation
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
ICUBA Schools
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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
Health Care Reform
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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 benefits enrollment 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 [email protected] or by calling 954-262-HR4U
HR Representatives are available Monday – Friday, 8:30am to 5:00pm
NSU / ICUBA HEALTH AND WELLNESS BENEFITS
NSU / ICUBA Health and Wellness BenefitsMember 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
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™
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 BPR physician. Call the NSU Health Care Centers at 954-262-4100 to schedule an appointment
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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).
NSU Primary/Family and Pediatric physicians participate in this program
FREE OFFICE VISITS FOR ALL CARE
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When you are using a Blue Physician Recognition™ provider, all office visits are FREE. Your doctor should not collect a co-payment.
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FREE ICUBA Cares™ In-Network BenefitsICUBA 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 always FREE to Members regardless of your health condition, age, gender or number of times you receive the medically necessary service:
$0 copay for all office visits to Blue Physician Recognition™ provider$0 copay for two courses of treatment per plan year for tobacco cessation
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
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.
NO DEDUCTIBLE FOR THE FOLLOWING IN-NETWORK SERVICESTHERAPY OFFICE VISITS EMERGENCY ROOM VISITSPHYSICIAN OFFICE VISITS URGENT CARE VISITS
Tobacco Cessation Program
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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
* NEW
Florida Blue notifies Catamaran of Member
participation
Member obtains Tobacco Cessation medications at
$0 co-pay, 2 cycles per Plan Year
Free Prescription Medications
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Free over-the-counter nicotine replacement therapy (NRT) and face-to-face support
THE IQUIT TOBACCO PROGRAM PROVIDED BY FLORIDA AHEC NETWORK
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 BlueShieldHealth 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 BlueShieldCare Coordination
Monday - Thursday 8AM – 6PM
Fridays 9AM – 6PM
877-789-2583
TTY 877-900-4304
BLUE CROSS BLUE SHIELD - BLUE365 ® Discount Program
Access Blue365®
1) Visit www.bcbsfl.com • Log onto MyBlueService• Discounts & Rewards• Discounts
2) Visit www.blue-365.com
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
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)
Member Health Statement
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
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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
,
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Plan Similarities Plan Differences
Catamaran Prescription Drug Benefit (Same low co-pays for 90-day fill by mail or retail)
All Free ICUBA Cares™ Wellness Benefits
24/7 Health Information Hotline
ER & Urgent Care Benefits
Plan Rules
Free office visits to Blue Physician Recognition™ providers
Free Tobacco Cessation Benefit
Same $20 copay for initial Maternity Visit
Premiums
Deductibles
Coinsurance
Co-pays (except maternity visits)
Annual Out-of-Pocket Maximums
HRA Contributions
PPO Plan Comparison One Network-Blue Options [Network Blue]Making a Choice
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2014-2015 Plan Year PPO 70 Blue Options Preferred PPO Blue Options
Network Non Network Network Non Network
Deductible Individual/Family$1,000/$2,500 $1,500/$4,000 $2,000/$4,000 $3,500/$9,750
Coinsurance30% after deductible
50% after deductible
20% after deductible
40% after deductible
Out of Pocket Maximum (includes all medical co-pays, deductibles, and coinsurance) $3,000/$6,000 $6,000/$12,000 $3,500/$7,000 $7,000/$14,000
Blue Recognition Office Visits (includes General Practice, Family Practice, Internal Medicine, and Pediatrics)
$0 N/A $0 N/A
Physicians Office Visit(includes General Practice, Internal Medicine, Family Practice, Pediatrics, and OB/GYN)
$20 co-pay; no deductible
50% after deductible
20%no deductible
40% after deductible
Maternity Office Visits$20 co-pay per plan year; not subject to
deductible50% after deductible
$20 co-pay per plan year; not subject to
deductible40% after deductible
Side by Side Plan Comparison
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
Coverage TierTotal
Monthly Premium
NSU Contribution Employee Contribution
Monthly Premium
Monthly HRA
Monthly Premium
Bi-weekly Premium
Preferred PPO Blue Options
Employee $ 511.00 $ 429.50 $ 50.00 $ 81.50 $ 40.75
Employee & Spouse $ 1,022.00 $ 511.00 $ 100.00 $ 511.00 $ 255.50
Employee & Child(ren) $ 920.00 $ 555.50 $ 100.00 $ 364.50 $ 182.25
Employee & Family $ 1,431.00 $ 715.50 $ 100.00 $ 715.50 $ 357.75
Dual Enroll (Husband & Wife Employed by NSU) Family
$ 1,431.00 $ 985.50 $ 150.00 $ 445.50 $ 222.75
PPO 70-Blue Options
Employee $ 656.00 $ 419.00 $ 25.00 $ 237.00 $ 118.50
Employee & Spouse $ 1,312.00 $ 445.50 $ 50.00 $ 866.50 $ 433.25
Employee & Child(ren) $ 1,182.00 $ 503.00 $ 50.00 $ 679.00 $ 339.50
Employee & Family $ 1,838.00 $ 660.00 $ 50.00 $ 1,178.00 $ 589.00
Dual Enroll (Husband & Wife Employed by NSU) Family
$ 1,838.00 $ 922.00 $ 75.00 $ 916.00 $ 458.00
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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.
Coverage/Tier ANNUAL PREMIUM
OUT OF POCKET MAXIMUM (OOP)
MEDICAL
OUT OF POCKET MAXIMUM PHARMACY
PREMIUM + OOP
NSU HRA CONTRIBUTION
ESTIMATED IN-NETWORK
FINANCIAL RISK
EMPLOYEE ONLY
PPO 70 Blue Options $2,844.00 $3,000.00 $2,000.00 $7,844.00 $300.00 $7,544.00
Preferred PPO Blue Options $ 978.00 $3,500.00 $2,000.00 $6,478.00 $600.00 $5,878.00
EMPLOYEE & SPOUSE
PPO 70 Blue Options $10,398.00 $6,000.00 $4,000.00 $20,398.00 $ 600.00 $19,798.00
Preferred PPO Blue Options $6,132.00 $7,000.00 $4,000.00 $17,132.00 $1,200.00 $15,932.00
EMPLOYEE & CHILD(REN)
PPO 70 Blue Options $8,148.00 $6,000.00 $4,000.00 $18,148.00 $ 600.00 $17,548.00
Preferred PPO Blue Options $4,374.00 $7,000.00 $4,000.00 $15,374.00 $1,200.00 $14,174.00
EMPLOYEE & FAMILY
PPO 70 Blue Options $14,136.00 $6,000.00 $4,000.00 $24,136.00 $ 600.00 $23,536.00
Preferred PPO Blue Options $8,586.00 $7,000.00 $4,000.00 $19,586.00 $1,200.00 $18,386.00
Making a ChoiceEstimating Your Financial Risk
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
TierAnnual Amount Paid by NSU
Premium HRA Total Annual Contribution
PPO 70 Employee $5,028.00 $300.00 $5,100.00
PPO 70 Employee / Spouse $5,346.00 $600.00 $5,700.00
PPO 70 Employee / Child(ren) $6,036.00 $600.00 $6,360.00
PPO 70 Family $7,920.00 $600.00 $8,160.00
Preferred PPO Employee $5,154.00 $600.00 $5,520.00
Preferred PPO Employee / Spouse $6,132.00 $1,200.00 $6,900.00
Preferred PPO Employee / Child(ren)
$6,666.00 $1,200.00 $7,560.00
Preferred PPO Family $8,586.00 $1,200.00 $9,360.00
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NSU will contribute approximately 20.3 million dollars 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
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.
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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.
Behavioral Health, Substance Abuse and EAP Benefits
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CATAMARANPharmacy 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
CATAMARANPharmacy Benefit Plan
24/7 customer service for members1-800-207-2568
www.walgreenshealth.com
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
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.
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TierCo-pay
30 day Retail/90 day Retail or Mail Order
Definition
1st Tier: Generics $5/10
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.
2nd Tier: Preferred $27/50
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.
3rd Tier: Nonpreferred $60/120
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.
Remember 90 day prescriptions save you money!
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.
Pharmacy Benefit: Understanding Your Tiered Copays
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 www.mycatamaranrx.com
CATAMARAN
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
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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.
Get the app by searching for Catamaran at the Apple App Store or the Google Play Store or scanning the QR code.
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.
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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: 954.262.4550Web address: http://pharmacy.nova.edu/clinic/index.html
HEALTH CARE & DEPENDENT CAREFLEXIBLE 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-it rule
• Incur expenses through June 15th, file claims by June 30th
• File your claims online at http://icubabenefits.org
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DENTAL / VISION / OPTIONAL BENEFITS
• 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.org 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 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 DHMO PREPAID 250 CS PLAN
HUMANA DENTAL PLAN – PPO PLANSPPO Low Option Preventive Plus High Option PPO
100 / 80 In-Network; Same benefit Out of Network but you may be
balanced billed on amounts over Usual and Customary
100 / 80 / 50 / 50 In-Network; Same benefit Out of Network but you may be
balanced billed on amounts over Usual and Customary; Endodontic and Periodontal Services covered under Basic
Services
$1000 Plan Year Maximum $2000 Plan Year Maximum [30% coinsurance on preventive, basic and major services after reach annual max]
Excludes Orthodontics and Major Services [i.e. crowns, dentures, endodontics and periodontics] $2000 Lifetime Maximum for Adult and Child Orthodontics
[additional 30% coinsurance not available]
Plan Year Deductible $50 per Individual up to $150 per Family for Type II. III and IV services
Plan Year Deductible $50 per Individual up to $150 per Family for Type II. III and IV services
No waiting periods No waiting periods
Claim forms may be required Claim forms may be required
You can use any dentist you choose You can use any dentist you choose. However, out-of-network services will be subject to higher coinsurance.
Major Services – Discount available In-Network and No coverage for Out-of-Network services
Out of Network Dentist reimbursed at 90% of Usual and Customary
The NSU Faculty Dental Practice participates in the PPO Plans - not the DHMO The NSU Dental (Student) Clinic DOES NOT participate in any of the plans.
Humana Dental Plans
Monthly Dental Premium
High Option PPO Plan
Low Option Preventive Plus
PlanDMO CS250
Plan
Employee $36.68 $19.48 $10.98
Employee + 1 $73.04 $45.28 $22.02
Family $122.84 $74.96 $34.20
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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
April 1, 2014 – March 31, 2015 Monthly Base Vision Plan Premiums
Employee $ 3.98
Family $10.18
The NSU Eye Care Institute participates in this plan In-Network Out-of-Network
Vision Exam $5 Co-Pay Up to $40 Reimbursement (less applicable Co-Pay)
Standard Frames $15 Co-Pay; $100 allowance Reimbursed up to $40 (no Co-pay if included with eyeglass lenses)
Single Vision, Bifocal, Trifocal, and Lenticular Lenses
Covered After $15 Co-Pay Up to $20 for Single Vision, $40 for Bifocal, $60 for Trifocal, $100 for Lenticular Reimbursement less Co-Pay
Standard Progressive Lens $50 Co-Pay Up to $45 reimbursement less Co-pay
Single Vision (SV) Polycarbonate Included with Lens Co-Pay up to age 19; over age 19, $30 Co-Pay
Up to $10 reimbursement less Co-pay under age 19
UV Coating Lens $12 Co-Pay Up to $5 reimbursement less Co-pay
Contact Lenses - Medically Necessary (in lieu of eyeglasses and elective contact lenses)
$15 Co-pay; $250 materials allowance; $30 fitting fee allowance
Up to $250 reimbursement (less applicable Co-pay)
Contact Lenses – Elective (in lieu of eyeglasses)
$15 Co-pay; $100 materials allowance; $30 fitting fee allowance
Up to $60 reimbursement (less applicable Co-pay)
Frequency Limitations - Vision Exams Once every 12 months
Frequency Limitations - Eyeglass Lenses Once every 12 months
Frequency Limitations - Frames Once every 24 months
Frequency Limitations - Contact Lenses Once every 12 months
Advantica Base Vision Plan
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In-Network Out-of-Network
Vision Exam $5 Co-Pay Up to $40 Reimbursement (less applicable Co-Pay)
Standard Frames $15 Co-Pay; $100 allowance Reimbursed up to $40 (no Co-pay if included with eyeglass lenses)
Single Vision, Bifocal, Trifocal, and Lenticular Lenses
Covered After $15 Co-Pay Up to $20 for Single Vision, $40 for Bifocal, $60 for Trifocal, $100 for Lenticular Reimbursement less Co-Pay
Standard Progressive Lens $50 Co-Pay Up to $45 reimbursement less Co-pay
Single Vision (SV) Polycarbonate Included with Lens Co-Pay up to age 19; over age 19, $30 Co-Pay
Up to $10 reimbursement less Co-pay under age 19
UV Coating Lens $12 Co-Pay Up to $5 reimbursement less Co-pay
Contact Lenses - Medically Necessary (in lieu of eyeglasses and elective contact lenses)
$15 Co-pay; $250 materials allowance; $30 fitting fee allowance
Up to $250 reimbursement (less applicable Co-pay)
Contact Lenses – Elective (in lieu of eyeglasses)
$15 Co-pay; $100 materials allowance; $30 fitting fee allowance
Up to $60 reimbursement (less applicable Co-pay)
Frequency Limitations - Vision Exams Once every 12 months
Frequency Limitations - Eyeglass Lenses Once every 12 months
Frequency Limitations - Frames Once every 12 months
Frequency Limitations - Contact Lenses Once every 12 months
April 1, 2014 – March 31, 2015 Monthly Buy Up Vision Plan PremiumsEmployee $ 4.78 ($9.60 in additional annual premium for frames once every 12 months)
Family $12.22 ($24.48 in additional annual premium for frames every 12 months)
The NSU Eye Care Institute participates in this plan 49
Advantica Buy-Up Vision Plan
BASIC MONTHLY BI-WEEKLYEmployee $3.98 $1.99
Family $10.18 $5.09
ADVANTICA EYE CARE PLANRates
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
Employee $4.78 $2.39
Family $12.22 $6.12
BUY UP MONTHLY BI-WEEKLY
Basic Employer Provided Life Insurance
Optional Life Insurance
Short Term Disability
Long Term Disability
Identity Theft Protection
Emergency Travel Assistance
LIFE AND DISABILITY BENEFITS
BASIC AND OPTIONAL TERM LIFE INSURANCE
Basic – Employer Optional - 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 employment Eligible after a 3-month waiting period
Benefit is one times annual salary up to a maximum of $350,000
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 http://icubabenefits.org and update as needed
OPTIONAL TERM LIFE INSURANCERate Chart (1)
10,000 20,000 30,000 40,000 50,000 60,000 70,000 80,000 90,000 100,000
00-24 0.47 0.94 1.41 1.88 2.35 2.82 3.29 3.76 4.23 4.70
25-29 0.57 1.14 1.71 2.28 2.85 3.42 3.99 4.56 5.13 5.70
30-34 0.76 1.52 2.28 3.04 3.80 4.56 5.32 6.08 6.84 7.60
35-39 0.85 1.70 2.55 3.40 4.25 5.10 5.95 6.80 7.65 8.50
40-44 0.95 1.90 2.85 3.80 4.75 5.70 6.65 7.60 8.55 9.50
45-49 1.42 2.84 4.26 5.68 7.10 8.52 9.94 11.36 12.78 14.20
50-54 2.18 4.36 6.54 8.72 10.90 13.08 15.26 17.44 19.62 21.80
55-59 4.08 8.16 12.24 16.32 20.40 24.48 28.56 32.64 36.72 40.80
60-64 6.26 12.52 18.78 25.04 31.30 37.56 43.82 50.08 56.34 62.60
65-69 12.50 25.00 37.50 50.00 62.50 75.00 87.50 100.00 112.50 125.00
70-74 25.00 50.00 75.00 100.00 125.00 150.00 175.00 200.00 225.00 250.00
75+ 25.00 50.00 75.00 100.00 125.00 150.00 175.00 200.00 225.00 250.00
Amount of coverage
Age
OPTIONAL TERM LIFE INSURANCERate Chart (2)
00-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75+
Amount of coverage
Age 110,000 120,000 130,000 140,000 150,000 160,000 170,000 180,000 190,000 200,000
5.17 5.64 6.11 6.58 7.05 7.52 7.99 8.46 8.93 9.40
6.27 6.84 7.41 7.98 8.55 9.12 9.69 10.26 10.83 11.14
8.36 9.12 9.88 10.64 11.40 12.16 12.92 13.68 14.44 15.20
9.35 10.20 11.05 11.90 12.75 13.60 14.45 15.30 16.15 17.00
10.45 11.40 12.35 13.30 14.25 15.20 16.15 17.10 18.05 19.00
15.62 17.04 18.46 19.88 21.30 22.72 24.14 25.56 26.98 28.40
23.98 26.16 28.34 30.52 32.70 34.88 37.06 39.24 41.42 43.60
44.88 48.96 53.04 57.12 61.20 65.28 69.36 73.44 77.52 81.60
68.86 75.12 81.38 87.64 93.90 100.16 106.42 112.68 118.94 125.20
137.50 150.00 162.50 175.00 187.50 200.00 212.50 225.00 237.50 250.00
275.00 300.00 325.00 350.00 375.00 400.00 425.00 450.00 475.00 500.00
275.00 300.00 325.00 350.00 375.00 400.00 425.00 450.00 475.00 500.00
SHORT-TERM AND LONG-TERM DISABILITY
Short-Term Long-Term
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-month waiting period andbenefits paid at 60% of employee’s salary
Eligible after 6-month waiting period and benefits paid up to 60% of employee’s salary
7 calendar-day elimination period (amount of time the employee must be disabled before benefits become payable)
180-day elimination period (amount of time the employee must be disabled before benefits become payable)
180 day benefit period – followed by Long Term Disability
Pre-existing limitations may apply and conversion available on termination
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.
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 1-877-409-9597
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 1-800-872-1414 within USA or 301-656- 4152 outside the USA
• See brochure in your packets
NSU 401(k) RETIREMENT PLAN
www.tiaa-cref.org www.valic.com/nova
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
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)
401(K) CONTRIBUTIONS
EMPLOYEE EMPLOYER BASIC
EMPLOYERSAFE HARBOR
MATCHING
EMPLOYERMATCHING
EMPLOYERTOTAL
EMPLOYER &
EMPLOYEETOTAL
0% 2% 0% 0% 2% 2%
1% 2% 1% 1% 4% 5%
2% 2% 2% 2% 6% 8%
3% 2% 3% 3% 8% 11%
4% 2% 4% 4% 10% 14%
100% Vested Immediately
3 yr. Vesting from Date of
Hire
100% Vested Immediately
3 yr. Vesting from Date of
Hire
University matching contributions begin after one year of service
Enroll and make changes to the NSU Retirement accounts by visiting https://www.myretirementmanager.com
“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)-214-0327 or John Broadbent at (954)-881-1296 or visit http://www.legalshield.com/cp/
View additional information on benefits webpage http://www.nova.edu/cwis/hrd/benefits/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) 560-6000 for more information.
Employee Discount
Provided by Abenity View additional information on
benefits webpage http://www.nova.edu/cwis/hrd/benefits/index.html
NSU / ICUBA Health and Wellness BenefitsMember 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
ICUBA Partners
64
Company Benefit Contact ID Card?
Health Insurance
www.bcbsfl.com ORwww.floridablue.com
800-664-5295Yes
Prescription Drug Plan(formerly Walgreens &
Catalyst)
www.mycatamaranRx.com
Member Services: 800-207-2568Mail Order: 877-615-6331 Yes
Mental Health, Substance Abuse and Employee Assistance
Program
www.mhnet.com
877-398-5816 Back of BCBS Card
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ICUBA Partners
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:Company Benefit Contact ID Card?
Flexible Spending Plans:Health Care Spending AccountDependent Care Spending AccountHealth Reimbursement Account
http://icubabenefits.orgPhone:866-377-5102
Fax: 866-377-5180P.O. Box 616927
Orlando, FL 32861-6927
ICUBA Benefits MasterCard®
Benefit elections, information and access to ICUBA Benefits
Card account information
http://icubabenefits.org
866-377-5102No
Dental Insurance
www.humanadental.com
800-979-4760 (DHMO)800-233-4013 (PPO)
Yes
Eye Care Planwww.advanticabenefits.com
866-425-2323Yes
Term Life, AD&D and Short and Long Term Disability Insurance
Contact Benefits DepartmentNo
65
ENROLLMENT REMINDER
• Employees have thirty days (30) from their date of hire or eligibility to enroll in ICUBA benefits
• Enrollment is made online at http://icubabenefits.org
• 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 to enroll in 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
FOR VIEWING THE NOVA SOUTHEASTERN UNIVERSITY NEW HIRE ENROLLMENT PRESENTATION
If you have any questions, please email the
Office of Human Resources Shared Services at [email protected]
or call (954)262-HR4U (4748)
