WELCOME SHARKS! LET’S TALK ABOUT BENEFITS
NSU Belongs to the ICUBA Health Insurance Consortium ICUBA is comprised of 10 colleges and universities and 17 secondary schools Approximately 10,000 enrolled employees covering 16,000 lives NSU’s 3,200 enrolled employees represent 34% of ICUBA’s participating employees Products and Services Provided by ICUBA Medical Insurance Prescription Drug Coverage Behavioral Health Coverage Dental Insurance Vision Plan Health/Dependent Care FSA Health Reimbursement Account COBRA/Retiree Health Administration Benefit Enrollment Site Health Care Compliance Administration Rally Wellness Program Employee Assistance Program
Visit the Benefits Website https://www.nova.edu/hr/benefits
How do I enroll in Benefits? -Sharklink
Login to the ICUBA Portal http://icubabenefits.org medical – den ta l – vis ion flexible spen din g accou n ts gap in su ran ce – pet assu re option al life -legal sh ield If you have questions while enrolling for benefits Emma is a decision support tool designed to help you make an informed decision about benefits for you & your family. Emma will guide you through a short series of questions about how you use your benefits and estimates your annual costs using real-life scenarios based on the answers you provide.
Dependent Verification Who is an eligible dependent? • Your legally recognized spouse or domestic partner; • Your natural child, stepchild, legally adopted child, your legal ward, foster child or a child covered by a Qualified Medical Child Support Order (QMCSO); • Your child is considered an eligible dependent until the end of the calendar year in which they turn 26; • Your adult child who is disabled and incapable of self- support may be considered an eligible dependent if documented by SSI or SSA.
Deductible Medical Plan Highlights In-Network Benefits * After Deductible ** After Limited Deductible: $2,000 of the $4,000 Individual In-Network Benefit Summary Comparison Preferred PPO Premier Copay PPO $4,000/$8,000 Ded PPO Deductible (Individual/Family) $2,500/$5,000 $2,500/$5,000 $4,000/$8,000 Coinsurance 20% 20% 30% Out-of-Pocket Maximum (Individual/Family- medical copays, deductibles & coinsurance) $4,000/$8,000 $4,000/$8,000 $5,350/$10,700 Physician Office Visits 20% $25 Copay $35 Copay Specialist Office Visits 20% $50 Copay $70 Copay Urgent Care Center $30 Copay $50 Copay $70 Copay Outpatient Therapy - PT, ST and OT 20% $30 Copay $40 Copay Emergency Room Services (Copay waived if admitted) $300 Copay $300 Copay $500 Copay Durable Medical Equipment and Prosthetic Appliances 20% AD* 20% AD* 30% ALD** Hospital Inpatient 20% AD* 20% AD* 30% AD* 0% - Quest 0% - Quest 0% - Quest Independent Clinical Labs (free standing facilities and office visits) 20% - Outpatient Setting 20% - Outpatient Setting 30% - Outpatient Setting Mental Health & Substance Abuse Inpatient 30% AD* 20% AD* 20% AD* Outpatient $35 Copay 20% $25 Copay Blue Distinction Total Care PCP $0 Teladoc (1-800-Teladoc) $5 Copay Convenient Care Clinics $10 Copay Preventive Care 0% Outpatient Diagnostic Imaging (MRI, MRA, CAT Scan, PET Scan) Up to $500 Copay Ambulance $250 Copay
Medical Premium Preferred PPO Monthly Premium $4K/$8K PPO Monthly Premium Premier PPO Monthly Premium Coverage Monthly HRA Coverage Monthly HRA Coverage Monthly HRA Election Tier Premium from NSU Election Tier Premium from NSU Election Tier Premium from NSU Employee Only $97 $50 Employee Only $102 $50 Employee Only $257 $50 + Spouse $598 $100 + Spouse $702 $100 + Spouse $1,000 $100 + Child(ren) $219 $100 + Child(ren) $450 $100 + Child(ren) $738 $100 + Family $615 $100 + Family $889 $100 + Family $1,278 $100 + Dual Enrolled $313 $150 + Dual Enrolled $554 $150 + Dual Enrolled $996 $150 The Dual Enrolled tier is for married employees who cover themselves & eligible dependent children. This tier combines the premium for Employee Only and Employee plus Child(ren). This way Dual Enrolled NSU families aggregate the deductible and out-of-pocket expenses which eliminates the need to meet an extra deductible.
Medical Premium IMPORTANT POINTS TO KEEP IN MIND ABOUT COLLECTION OF PREMIUMS: • Coverage and premium collection begin on the hire date • The new hire enrollment period starts on the hire date and ends 30 days later • A premium payment may be missed when enrollment occurs later in the enrollment period – BEFORE 03/31/2020 • Should this happen, the missed premium will be collected retroactively
Do I get no-cost services with any of the NSU plans?
Eliminating Barriers to Care is available to all per plan year counseling sessions FREE face-to-face Receive up to 6 household members of your Assistance Program Living EAP Our Employee Visits Primary Care BDTC Breast Ultrasounds of the NO-COST BENEFITS Call the Resources for 24-hours a day at Bone Mineral for adults Prescribed generic pregnancy vitamins for generic prenatal folic acid and Prescribed generic Prescribed Aspirin 1-877-398-5816 and syringes solution, needles, test strips, control devices, lancets, meters, lancing supplies including Prescribed diabetic Density Tests statins (if eligible) Quest Diagnostics may apply beginning Urinalysis Colorectal Lab Tests Screenings Prostate Cancer Screenings Please note: Lab tests performed at an in- network physicians office and not sent to Allergy Injections be subject to coinsurance Pap Tests (deductible does not 04/01/1). Sigmoidoscopies Electrocardiograms Echocardiograms Immunizations Mammograms Colonoscopies and • • • • • • • • • • • • • • • • • • • •
Surgeon Quality Knee throughout your healthcare journey You have access to a dedicated care advocate ENT Cardiac Bariatric GYN Gastroenterology General Surgery Spine Wrist & Elbow Foot & Ankle Financial Incentive Hip Shoulder Full-Service Concierge applicable. You have access to the elite S+ Surgeons of Excellence Network. The surgeons are: criminal records WAIVED , so your procedure is at NO COST to you; and travel benefits are INCLUDED , if Your DEDUCTIBLE and COINSURANCE are Medical Plan - No Cost SurgeryPlus (855) 200 – 2119 Call your Care Advocate for more information Covered Surgical Procedures Licensed Board certified Fellowship trained Screened for malpractice, sanctions & • • • • • • • • • • • •
13 infection used as an alternative to Urgent sure you share your Teladoc records with your PCP! Ear infection Urinary tract infection Upper respiratory Nasal congestion ongoing relationship Restrictions apply - number of annual consults and severity of condition for consultation – available nationwide, excluding Arkansas. Take a doctor with you - 1-800-TELADOC Single Sign-On through MyHealthToolkit! Telemedicine and Video Consultations available anytime – when your doctor is unavailable, when you have no time for an appointment, when you are on vacation, when your child is away at college! Members must establish an account prior to seeking treatment; Company: ICUBA Teladoc physicians are a national group of NCQA qualified physicians, contracted with Teladoc. with a PCP and be Care. Please make to supplement an NEEDED Sinus problems Pink eye Bronchitis Allergies Flu Cough This benefit is meant TOP DIAGNOSES PRESCRIPTIONS AS Medical Plan - No Deductible Teladoc Member convenience through e-prescribing Appropriate prescribing following CDC No controlled substances, psychiatric or lifestyle drugs guidelines • • • • • • • • • • • • • • • • • •
Co-Pay Tier Maximum diabetic supplies including meters, lancing devices, lancets, test strips, control solution, needles, and syringes; prescribed Aspirin for adults, prescribed generic folic acid and generic prenatal vitamins for pregnancy, and prescribed generic statins (if eligible). RX Out-of-Pocket In-network Prescription Drug FREEBIES! Rx copays will be applied toward an individual maximum out-of-pocket of $2,000 and $4,000 for family. Prescribed N/A 30-day Co-Pay $5 (Retail Only) 90-Day saves $$$! (Retail & Mail) Preferred Generics at NSU Pharmacy $0 $0 (available on-site only, no mail order) Preferred Generics $10 $75 Non-Preferred Generics $10 $20 Preferred Brands $40 $80 Non-Preferred Brands $75 $150 Specialty (BriovaRx)* Medical Plan - No Deductible Pharmacy Benefit
requirement? These are all great reasons to call ICUBAcares Rally Incentive: If you are a candidate for a qualified medication change, the ICUBAcares team will assist with your transition to a medication less costly to the plan and reward once complete. Call for a prescription check-up to find out more! Free Pharmacist Advocate Program • Do you have side effects from a new medication? • Do you need help obtaining a prior authorization? • Do you need help understanding the step-therapy • Do you want to save money by switching to a generic?
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