Blue Choice - Florida Institute of Technology

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BENEFIT
OPEN ENROLLMENT
Plan Year
4/1/2010- 3/31/2011
Appreciation
Human Resources:
HR Team
ICUBA:
Mark Weinstein, President & CEO
Robin Long, Chief Operating Officer
Information Technology
Auxiliary Services
Property Management
Florida Tech Plan Offerings
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Group Life Insurance
Short-Term and Long Term Disability
Tuition Remission
Retirement
AFLAC
Prepaid Legal Services
Additional Life Insurance with AD&D
Long term care
Medical
Dental
Vision
Employee Assistance Program
Group Life Insurance
Critical Update Request*
• Florida Tech continues to provide Group Life Insurance, at no
cost, to all benefits-eligible employees in an amount equal to
your annual salary rounded to the next highest $1,000. The
maximum group life insurance amount is $150,000.
• Benefits are payable to your named beneficiary(ies).
* To ensure all beneficiary(ies) designations are current and
complete, it is critical that we have updated information.
Disability Insurance
Short-Term and Core Long-Term Disability coverage
is provided at no cost to benefits-eligible employees.
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Long-Term Disability Buy-Up coverage is available and
is purchased by the employee through payroll
deduction. This plan provides a benefit of 66 2/3% of
salary up to a maximum of $14,000 per month.
Tuition Remission
Florida Tech continues to provide tuition remission
to all benefits-eligible employees and eligible
dependents.
For more information regarding tuition remission
policy and procedures please refer to the policy
located at: www.fit.edu/hr.
403(b) Retirement Plan for 2010
Maximum Annual Employee Contribution
 Under age 50 $16,500
 At least age 50 (12/31) - $22,000
 *Age 50 with 15 years
$25,000
of continuous service
Employer Match is 1% for each 1% you
contribute up to 5% per pay period.
* Additional criteria may be required.
AFLAC Insurance
Personal Sickness Indemnity
 Personal Accident Indemnity
 AFLAC Cancer policy
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For detailed information you may visit our AFLAC
representative at her table.
Prepaid Legal Services
Two plans are offered:
 Life Events Legal Plan
 Identity Theft Plan
 Life Events Legal Plan & Identity Theft Plan
Additional Life Insurance with AD&D
You have the opportunity to purchase Additional Life
Insurance for yourself, your spouse, and your children.
 Employee: Up to 5 times salary in increments of
$10,000. Not to exceed $500,000.
 Spouse: Up to 50% of employee amount in
increments of $5,000. Not to exceed $250,000.
 Child: Up to 50% of employee coverage amount in
increments of $2,000. Not to exceed $10,000.
Long Term Care
You have the opportunity to purchase Long Term
Care for yourself, your spouse, or other family
members.
Three plans are offered:
 Plan A: 2 Years benefit duration.
 Plan B: 4 Years benefit duration.
 Plan C: 6 Years benefit duration.
Welcome ICUBA
Better Benefits through Collaboration
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We are pleased to be here for Florida Tech’s Open
Enrollment presentation.
The mission of our partnership with Florida Tech is to
provide high quality, cost effective health and
welfare benefits to the employees of Florida Tech.
ICUBA now has twelve member Institutions
Plan Enhancements for 2010
Addition of PPO 70 Blue Options Plan
 No limits on eligible Mental Health or Substance
Abuse Benefits
 Free Labs at In-Network Freestanding Laboratory
 Reduction in Generic Drug co-payments
 New MHNet Integrated Behavioral Health and
Employee Assistance Program
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PPO 80 & PPO 70 Blue Choice
PPO 80
Blue Choice
PPO 70
Blue Choice
Florida Tech cost of total premium – 70%
Staff/Faculty cost of total premium - 30%
Premium increase
Does NOT include Health Reimbursement
Account (HRA)
Florida Tech cost of total premium – 75%
Staff/Faculty cost of total premium - 25%
Premium increase
Continue current monthly HRA
PPO 70 Blue Options
with HRA
Florida Tech cost of total premium – 75%
Staff/Faculty cost of total premium - 25%
PPO 70
Monthly HRA
Blue Options
$ 60 employee only
$120 employee + spouse
$120 employee + child(ren)
$120 family
The difference between the Blue Choice and Blue Options is the
provider network and a lower per pay premium.
To locate an in-network provider, please visit Blue Cross Blue
Shield of Florida’s website at www.bcbsfl.com.
PPO Risk/Reward Blue Choice &
PPO Risk/Reward Blue Options
PPO Risk/Reward
Blue Choice
PPO Risk/Reward
Blue Options
Florida Tech cost of total premium – 75%
Staff/Faculty cost of total premium - 25%
Premium increase
Continue current monthly HRA
Florida Tech cost of total premium – 75%
Staff/Faculty cost of total premium - 25%
Premium increase
Continue current monthly HRA
In-Network Plan Comparison
19
PPO 80 Blue Choice
PPO 70 Blue Choice
PPO 70 Blue
Options
PPO Risk/Reward
Blue Choice
PPO Risk/Reward
BlueOptions
Deductible
$300/$900
$500/$1,500
$500/$1,500
$1,500/$4,500
$1,500/$4,500
Coinsurance (after Ded)
80/20%
70/30%
70/30%
80/20%
80/20%
Out-of-Pocket Limits
$2,500/$5,000
$3,000/$6,000
$3,000/$6,000
$3,500/$7,000
$3,500/$7,000
Primary Physician Services
$15 co-pay- No Ded
$20 co-pay – No Ded
$20 co-pay – No
Ded
80/20% - No Ded
80/20% - No Ded
Routine Wellness Exams
$15 or $25 copayNo Ded
$20 or $30 co-payNo Ded
$20 or $30 co-payNo Ded
80/20% - No Ded
80/20% - No Ded
Specialist Physician
$25 co-pay- No Ded
$30 co-pay – No Ded
$30 co-pay – No
Ded
80/20% - No Ded
80/20% - No Ded
Outpatient Surgery in Drs’ Office
$15 or $25 copayNo Ded
$20 or $30 co-payNo Ded
$20 or $30 co-payNo Ded
80/20%- No Ded
80/20%- No Ded
Outpatient Surgery in Outpatient
Facility
$100 co-pay,
Ded, 80/20%
$100 co-pay,
Ded, 70/30%
$100 co-pay,
Ded, 70/30%
Ded, 80/20%
Ded, 80/20%
Outpatient Pre-Admission
Ded, 80/20%
Ded, 70/30%
Ded, 70/30%
Ded, 80/20%
Ded, 80/20%
MRI, MRA, CAT, PET
$100 co-pay, Ded,
80/20%
$100 co-pay,
Ded, 70/30%
$100 co-pay,
Ded, 70/30%
Ded, 80/20%
Ded, 80/20%
Chiropractor
$25 co-pay per dayNo Ded
$30 co-pay per dayNo Ded
60 visits
$30 co-pay per dayNo Ded
60 visits
80/20% - No Ded
60 visits
80/20% - No Ded
60 visits
OE 2010
In-Network Plan Comparison
20
PPO 80 Blue
Choice
PPO 70 Blue
Choice
PPO 70 Blue
Options
PPO
Risk/Reward
Blue Choice
PPO Risk/
Reward
BlueOptions
Physical, Speech and
Occupational Therapy
$25 co-pay per dayNo Ded
30 visits each
$30 co-pay per dayNo Ded
30 visits each
$30 co-pay per
day-No Ded
30 visits each
80/20% - No
Ded
30 visits each
80/20% - No
Ded
30 visits each
Inpatient Hospital Services
$250 co-pay, Ded,
80/20%
$250 co-pay,
Ded, 70/30%
$250 co-pay,
Ded, 70/30%
Ded, 80/20%
Ded, 80/20%
Emergency Room
$100 co-pay- No Ded
$100 co-pay – No
Ded
$100 co-pay –
No Ded
$100 co-pay –
No Ded
$100 co-pay –
No Ded
Urgent Care
$25 copay- No Ded
$30 co-pay – No
Ded
$30 co-pay – No
Ded
80/20% - No
Ded
80/20% - No
Ded
Maternity Care
$25 initial- No Ded
$30 initial – No Ded
$30 initial – No
Ded
80/20% - No
Ded
80/20% - No
Ded
Inpatient
$250 co-pay, Ded,
80/20%
$250 co-pay,
Ded, 70/30%
$250 co-pay,
Ded, 70/30%
Ded, 80/20%
Ded, 80/20%
Mental Health & Substance Abuse
Inpatient
$250 co-pay, Ded,
80/20%
$250 co-pay,
Ded, 70/30%
$250 co-pay,
Ded, 70/30%
Ded, 80/20%
Ded, 80/20%
Mental Health & Substance Abuse
Outpatient
$25 co-pay- No Ded
$30 co-pay – No Ded
$30 co-pay – No
Ded
80/20%- No
Ded
80/20%- No Ded
Full Benefits Summaries available at http://icubabenefits.org
OE 2010
Plan comparisons
What is the difference between the plans?
Similarities
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Prescription Drug Benefit
Annual Wellness Benefit
Plan Rules
24/7 Health Info Hotline
ER & Urgent Care
(in-network)
Differences
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Premiums
Blue Options Provider
Network
Annual Out-of-Pocket
Maximums
HRA contributions
Definitions
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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 $500 deductible, the Plan begins to pay after you
have paid the first $500 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 not apply to out-of-pocket, and does not
reduce amounts applied to the deductible or coinsurance. A co-pay may be $20 for an
office visit.
Annual 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.
Flexible Spending Account: A Medical Care or Dependent Care Savings account in which
you put aside pre-tax dollars to pay for eligible expenses.
$2 Million Lifetime Maximum: The total dollars you can receive in Medical Benefits in your
lifetime.
Centers of Excellence: Preferred places of care with the best outcomes, finest operational
standings and best patient care.
Medical Costs & Your Decision
You may want to consider the following when making your decision
for which plans to choose and how much to fund your Health Care
Spending Account (HCSA):
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Total premiums for your health insurance which are deducted on
a before-tax basis
Out-of-pocket maximum (OOP) which is the maximum cost you
could be responsible for in a year (co-pays are not included)
Co-pays
Put these pieces together as follows to determine your total financial
risk In a worst case scenario, one where your expenses would hit the
OOP maximum:
Premiums + OOP Max + Co-pays = Total OOP Risk
Remember to use Urgent Care when
appropriate
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According to some estimates, more than three-quarters of the people who visit emergency rooms do
not need to be there. Many of these patients are likely better candidates for a visit to an urgent care
center.
An emergency is defined as a condition that may cause loss of life or permanent or severe disability if
it isn’t treated immediately. You should go directly to the nearest emergency room if you experience
any of the following:
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Chest pain
• Serious burns, cuts, or infections
Shortness of breath
• Inability to swallow
Severe abdominal pain following an injury
• Seizure
Uncontrollable bleeding
• Paralysis
Poisoning or suspected poisoning
• Broken Bones
Confusion or loss of consciousness, especially after a head injury
Urgent care centers are usually located in clinics or hospitals, and like emergency rooms, offer afterhours care. They are not equipped to handle life-threatening situations but are designed to handle
situations which require immediate attention – those where delaying treatment could cause serious
problems or discomfort. Urgent care centers are usually more cost-effective than ERs for these
conditions. In addition, the waiting time in urgent care centers is usually much shorter. Some examples
of conditions that require urgent care are:
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Ear infections
Urinary tract infections
Vomiting
• Sprains
• High fever
Free Services available to You
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In-Network Labs at a free standing facility
Wellness Benefits
Health Dialog®
Care Coordination
Blue 365and MyBlueService at www.bcbsfl.com
$25 Health Incentives
Diabetic Supplies
5% Walgreens Discount Card
MasterCard® Health Debit Card
MHNet EAP for everyone
Free Wellness Benefits
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ICUBA covers all these services:
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NEW for 2010 - All lab work done at an in-network freestanding laboratory
Bone Mineral Density Screenings
Mammograms
Colorectal Cancer Screenings
Colonoscopies
Sigmoidoscopies
Venipunctures
Electrocardiograms
Urinalysis
Echocardiograms
PAP tests
Prostrate Cancer Screenings
Adult Immunizations
Child Immunizations
Health Incentives
Health incentives available to you:
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$25 upon completion of the Personal Wellness Profile Online
$25 upon completion of the Maternity Wellness Profile Online
Take it today on www.bcbsfl.com
HEALTH DIALOG®
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Health Coaching is available 24 hours a day, 7 days a week by
calling 1-877-789-2583.
Immediate Health Care Assessment - You can also phone Health
Dialog® about an immediate Illness or injury. When you do so, the
Health Coach can perform a comprehensive health care assessment
to help you determine your next step.
Please take advantage of this program offered to you through
Blue Cross and Blue Shield of Florida!
You may contact a Health Coach at Health Dialog at 1-877-789-2583.
You may also access the Dialog CenterSM website through My Blue
Service at www.BCBSFL.com
Care Coordination
If you have questions, call Blue Cross Blue Shield’s 24-hour Health
Care Assistance number for access to nurses who provide health
education and support services is 1-877-789-2583.
 An
important benefit all members enrolled in an ICUBA Blue
Cross Blue Shield Medical Plan receive is free access to Care
Coordination Services from a Nurse Case Manager. Some
examples of when you or your family member may wish to
access such services are when:
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Skilled nursing facility services are needed or contemplated
Complex health issues develop, with medical conditions such as
cancer, diabetes, heart disease or musculoskeletal conditions
Major surgical procedures are planned, such as a total hip
replacement, organ or bone marrow transplant
Blue
®
365 Discount
Program
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Blue 365® replaces Blue Complements Two convenient ways to access:
1) www.bcbsfl.com
as the BCBS national member discount
•Log onto MyBlueService
program delivering health and wellness
•Member Resources
tools and services, information and
•Member Discounts
discounts to help members manage their 2) www.blue-365.com
healthcare experience and make healthy
choices.
Save on fitness clubs (i.e., Gold’s Gym)
exercise equipment, nutrition and weight
management programs (i.e., Curves
International®, Jenny Craig®,
Nutrisystem®, ) massages, vitamins and
much more.
OE 2010
Blue Cross Blue Shield/MHNet Card
31
For mental health or
EAP use MHNet
information on the
back of the BCBS card
OE 2010
Prescription Plan provides you
value based RX drugs
32
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Same co-pays for Specialty Drugs
$5 (30 day supply) or $10 (90 day supply) Generic Copays
No deductible EVER for drugs
Same benefits for all plans
90-Day supply at Retail
Mail Order
Free diabetic supplies
- One Touch Brand meters, lancets, and strips
- Novofine® needles
OE 2010
Diabetic Supply Overview
33
Every Florida Tech Medical Rx Plan covers
diabetic supplies at NO cost
 Ask your Pharmacist for information regarding
diabetes, and access resources such as the
American Diabetes Association for additional
resources regarding Diabetes
 You can also call WHI at 1-800-207-2568
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OE 2010
Understanding Your Pharmacy Benefit
Tiered Co-pays
34
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Your pharmacy benefit plan offers three categories— or tiers—of drugs that determine
your cost share or co-pay
Whenever possible, have your doctor consult your formulary guide for the lowest cost
generic or brand medications available for your therapy.
You may visit www.mywhi.com
or callDefinition
the Walgreens Health Initiatives Customer Care Center
Co-pay
toll free at 1-800-207-2568.
30 day Retail/ Mail
 Tier
Order/90 day
Retail
1st Tier:
$5/10/10
Generics contain the same active ingredient as their brandname 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.
$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 nonpreferred medications on the third tier.
$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 WHI Preferred Medication List.OE 2010
Generics
2nd Tier:
Preferred
3rd Tier:
Non preferred
Employee Assistance Program
35
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Confidential assistance is available every hour of every
day. MHNet offers information on hundreds of topics,
including: health and wellness, child and elder care, family
or parenting issues, anxiety, depression and many more.
To access 24 hour care, call MHNet at 1-877-398-5816.
There is a new website www.mhnet.com to search for
providers.
OE 2010
MHNet Transition of Care for Behavioral Health/
Substance Abuse and EAP
36
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Effective April 1, 2010, Mental Health and Substance Abuse (MH/SA)
benefits will be provided by MHNet. You will no longer access these
services through the BlueCross BlueShield (BCBS Network).
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Your new BCBS card will provide the MHNet phone number on the back.
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All EAP and inpatient services must be pre-authorized by calling MHNet.
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If you are currently utilizing MH/SA or EAP benefits, MHNet guarantees a
smooth transition of care:
 Any member in active treatment will be authorized to continue treatment
from their current provider.
 For members receiving services from a non MHNet provider, MHNet will
continue to authorize care as long as there is not greater than a six
month gap in services.
 MHNet continues to actively recruit providers.
OE 2010
ICUBA Benefits
TM
Card
37
 Login to http://icubabenefits.org
 P.O. Box 616927, Orlando, FL 32861-6927
 Email: benefitsadministration@icuba.org
 Phone: 866-377-5102
 Fax: 866-377-5180
 You must re-enroll in your HCSA and
DCSA
OE 2010
HRA and HCSA Differences
38
Health Care Spending Account
(HCSA)
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Funded by employee pre-tax
dollars
Funds available first day of
Plan Year
Available for eligible medical
expenses
No carry-over of funds from
year to year (by law)
- Use-it-or-lose-it
HCSA funds are used before
using the HRA funds
Can have HCSA and no HRA
Health Reimbursement Account
(HRA)
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Funded by Florida Teach
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Available for PPO 70 and
Risk/Reward Plans
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Funds roll over at the end of
each plan year indefinitely
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Portable after 36 months of
continuous participation in the
PPO 70 or Risk/Reward Plan
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Can have HRA alone with no
FSA
OE 2010
39
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FSA- Flexible Spending Account
Health Care and Dependent Care
Funded by employee with pre-tax contributions and used to pay for qualified
health care or dependent care expenses
Health Care Spending Account Allowable expenses defined in Plan Document
accessed at icubabenefits.org
Maximum annual limit of $5,000
Dependent Care Spending Account is for qualified expenses for care of
dependents under age 13, physically or mentally challenged adults who are
unable to care for themselves; cannot earn more than $3,200 a year
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Dependent Care Funds available as deducted from your paycheck
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Funds available by using the ICUBA Benefits CardTM
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File your claims online at http://icubabenefits.org
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Direct Deposit Available
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Subject to use-it-or-lose-it rule
OE 2010
Dental
Managed Care CS-250
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No benefit changes
No waiting period
Co-payments per Schedule CS-250 Benefits
No Annual or Lifetime Maximums
Select and use participating network dental
providers and specialists
Dental
PPO Low
No benefit changes
 Annual Deductible
$50/year/person
 Maximum Benefits
$1,000/year/person
 $1,000 lifetime maximum for adult and child
orthodontia
 No waiting period
 You can use any dentist you choose
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Dental
PPO High
No benefit changes
 Annual Deductible
$50/year/person
 Maximum Benefits
$2,000/year/person
 $2,000 lifetime maximum for adult and child
orthodontia
 No waiting period
 You can use any dentist you choose
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Vision Insurance
No premium changes
 $5 co-pay for comprehensive eye exam
 Covers an eye exam every 12 months
 Covers prescription lenses every 12 months
 Covers eyeglass frames every 24 months
 Covers contact lenses every 12 months
Please visit our website at www.advanticaeyecare.com to
view our entire provider network, or contact our Service Center at
1-866-425-2323.
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YOUR ICUBA BENEFIT CARDS
BlueCross BlueShield
of Florida *
Walgreens Prescription
Advantica Eyecare
Humana Dental
Walgreens Product
Discount
ICUBA Debit MasterCard™
HumanaDental
CS250
Member Number
999999999
Member Last Name
Member Name
Suzie Q
John D
Effective Date
MM/DD/YY
Example
Group Number
777777
Clinic/Provider
Happy Teeth
Lasting Smiles
* MHNet Behavioral Health for mental health, substance abuse, and Employee Assistance Program – toll free phone number and website on back of BCBSFL ID card.
Open Enrollment Recap
45
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April 1, 2010 through March 31, 2011
- addition of the PPO 70 Blue Options Plan is being offered.
- no limits on Mental Health or Substance Abuse Benefits
- free labs at In Network, freestanding facilities
- Rx Coverage will continue with Walgreens Health Initiatives
MHNet Behavioral Health/ Substance Abuse/ EAP
No change in ICUBA MasterCard® Health Debit Card; new
elections are required for Health Care Spending Account and
Dependent Care Spending Account
Humana Dental Plans- same rate as last year
Advantica Vision Plan- same rate as last year
Benefits Website is http://icubabenefits.org
Remember there are two BCBSFL Provider Networks: Blue
Choice and Blue Options
OE 2010
Important In-Network Access Reminder
46
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REMEMBER TO ALWAYS VERIFY THAT YOUR MEDICAL OR
PHARMACY PROVIDER IS IN NETWORK FOR YOU TO
RECEIVE THE LOWEST OUT-OF-POCKET COSTS
Blue Cross Blue Shield’s dedicated ICUBA customer service
number is 1-800-664-5295 or My Blue Service at
www.BCBSFL.com
 The hours of operation are Monday through Thursday
8AM – 6PM Eastern, and 9AM – 6PM Eastern on
Fridays.
WHI 24/7 Customer Service is 1-800-207-2568 or WHI
member website: www.mywhi.com
OE 2010
Plan Year 2010-2011
Benefit Plan Year Elections Cover:
4/1/2010 – 3/31/2011
Premium changes will be effective
In your April 9th Paycheck
HR will gladly assist you with your elections!
Mid-Year Changes
If you experience a qualifying change in family
status as defined by the IRS during the Benefit
Plan Year, i.e. marriage, divorce, birth - you may
request a change in your pre-tax benefit elections
 This request must by made within 31 DAYS of
the qualifying event.
 Notify Human Resources in writing.
Flexible spending account
***Re-enroll EACH Plan Year***
Accounts are Administered By ICUBA
HCSA
Health Care Spending Account
DCSA
Dependent Care Spending Account
Human Resources Website
Visit www.fit.edu/hr under
“Open Enrollment” for:
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Plan Comparisons
Benefit Summaries
Enrollment Forms
Premiums
Links to Insurance Websites
Presentation
Frequently Asked Questions
We are here for you!
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Blue Cross Blue Shield
Walgreens Health Initiatives
MHNet Services
HUMANA Dental Insurance
ADVANTICA Vision Insurance
UNUM Supplemental Life Insurance
AFLAC
Pre-Paid Legal Services
Please visit representatives at their tables to learn more
about their products…
DEADLINE
Return Benefit Enrollment Forms to the
Office of Human Resources by
Tuesday, February 26th, 2010
Employees who return completed Benefit Enrollment
Forms to HR by Friday, Feb. 19, 2010, will be eligible
to participate in the “Open Enrollment Raffle”.
Questions
Questions
Interested in a one-on-one meeting?
 A Human Resources representative will be available in
the Hartley Room, Wed., Feb.17, 2010 from 8am-5pm.
 A conference call is scheduled for the offsite locations
on Thu., Feb.18, 2010 from 2pm-3pm. A Human
Resources representative will be available during this
call.
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