Open Enrollment – What’s Changing? Plan Year April 1, 2018 ‐ March 31, 2019
Same great benefits – Enhanced! 2
Preferred PPO Medical Plan Benefits Summary In ‐ Network Out ‐ of ‐ Network Deductible (Individual/Family) $2,000/$4,000 $3,500/$9,750 Coinsurance 20% 40% Out ‐ of ‐ Pocket Maximum (Individual/Family—Includes $3,500/$7,000 $7,000/$14,000 all medical copays, deductibles and coinsurance) Blue Distinction Total Care PCP $0 N/A Teladoc (1 ‐ 800 ‐ Teladoc) $5 Copay Convenient Care Clinics $10 Copay New! Urgent Care Center $30 Copay Physician/Specialist Office Visits 20% 40% AD* Outpatient Therapy ‐ PT, ST and OT 20% 40% AD* Independent Clinical Labs 0% ‐ Quest 40% AD* (free standing facilities and office visits) 20% ‐ Outpatient Setting Preventive Care 0% Not Covered Outpatient Diagnostic Imaging Up to $500 Copay 40% AD* (MRI, MRA, CAT Scan, PET Scan) Emergency Room Services $300 Copay (waived if admitted) Ambulance $250 Copay Durable Medical Equipment and Prosthetic Appliances 20% AD* 40% AD* Hospital Inpatient 20% AD* 40% AD* Mental Health & Substance Abuse Inpatient 20% AD* 40% AD* * After Deductible Outpatient 20% 40% AD* 3
BCBS ID Card! You can now access your BCBS of Florida ID card on MyHealthToolkit ! Remember: Member ID: ICI + 12 digit • number National Alliance claims • administration and web portal are based in South Carolina, however, ICUBA’s contract is with BlueCross BlueShield of Florida! 4
Medical Plan Premiums Employee Employer Total Premium HRA Cost Cost $222.74 Employee $602 $379.26 $125 Preferred $474.97 Employee + Spouse $1,281 $807.03 $150 PPO Employee + Child(ren) $1,084 $401.08 $682.92 $140 (Monthly) Employee + Family $1,687 $624.19 $1,062.81 $175 Employee Employer HRA Total Premium Cost Cost (monthly) Employee $277.85 $102.80 $175.05 $125 Preferred Employee + Spouse $591.23 $218.76 $372.48 $150 PPO $185.11 Employee + Child(ren) $500.31 $315.20 $140 (Biweekly) $288.09 Employee + Family $778.62 $490.53 $175 5
Medical Plan Premiums Change Employee Employee Change 2017/18 2018/19 Employee $214.60 $222.74 $8.14 Employee + Spouse $456.58 $473.97 $17.39 Preferred PPO (Monthly) Employee + Child(ren) $386.28 $401.08 $14.80 Employee + Family $601.25 $624.19 $22.94 Employee Employee Change 2017/18 2018/19 Employee $99.04 $102.80 $3.76 Preferred Employee + Spouse $210.73 $218.76 $8.03 PPO Employee + Child(ren) $178.28 $185.11 $6.83 (Biweekly) Employee + Family $277.50 $288.09 $10.76 6
BlueRewards powered by Rally 2018‐2019 Incentive Plan $250 ICUBA Dollars (redeemable for gift cards in Rally) + UNLIMITED Rally Coins & ICUBA Private Sweepstakes 7
Rally 2018‐2019 Incentive Plan Activity Incentives $250 ICUBA Dollars Rally Survey Gatekeeper to Rally $ (redeemable for gift cards in Rally) Biometric Screenings $25 Onsite/Campus Events $10 each (up to $50) Wellness Exams $25 Colonoscopy $50 Mammogram/PSA $50 ICUBAcares $50 TOTAL ICUBA $ $250 8
Rally Coins are WORTH MORE! Truly, UNLIMITED VALUE ! • Auctions • Win now (“Buy it now”) • Sweepstakes (Rally & ICUBA) • Donations The Coin Value is an exciting new feature for ICUBA Members beginning on April 1, 2018! 9
New ‐ Rally Auctions! Enter a Rally Auction! The great thing about bidding – If you bid on an item, but do not win, Rally will return your coins! Really want the Auction Item? Don’t take the chance of bidding on the item, try the win now feature. 10
Feeling charitable? Donate your coins! • Rally Donations give users the opportunity to donate their Rally Coins • Charities rotate on a quarterly basis and are pre‐selected by Rally • Members work together with other Rally users to reach quarterly donation goals • Once the coin threshold is met – Rally will make a stated financial donation to the charity 1 Million Coins = $1,000 Dollar Donation 11
ICUBA Private Sweepstakes! Ready to win? ICUBA is giving away $50 Amazon Gift Cards every 14 days ! Starting April 1, 2018 when you earn a City Challenge milestone, not only will you earn coins as you sync your tracking device, but you will be entered E V E R Y S I N G L E T I M E a m i l e s t o n e i s r e a c h e d ! No limits or restrictions and multiple entries are permitted! Private sweepstakes winners will also be featured in ICUBA’s BenefitsWise Newsletters. 12
Rally City Challenge – Mission Tracking Options 1. GoogleFit 8. Strava 2. Apple iOS Health 9. Misfit 3. Rally Mobile 10. Moves 4. Fitbit 11. Garmin 5. Jawbone UP 12. UA Record Need help? 6. RunKeeper 13. Nokia Health Go to helpcenter.werally.com 7. MapMyRun 13 Tracking devices as of January 2018. Tracking devices subject to change according to Rally agreements with vendors.
Health Care Reform Preventive Statin Coverage Statins for primary prevention of cardiovascular disease Under the Affordable Care Act (ACA), all non‐grandfathered health plans are required to provide $0 cost coverage for all evidence‐based items or services with an A or B rating from the United States Preventive Services Task Force (USPSTF), subject to reasonable medical management techniques. On Nov. 13, 2016, the USPSTF issued a B recommendation that adults without a history of cardiovascular disease (CVD) (i.e., symptomatic coronary artery disease or ischemic stroke) $0 use a low‐ to moderate‐dose statin for the prevention of CVD events and mortality when all of the following criteria are met: (if eligible) 1 2 3 Calculated 10‐year risk of a AND AND One or more CVD risk factors Age 40 to cardiovascular event of 10% (i.e., dyslipidemia, diabetes, 75 years or greater. This requires hypertension, or smoking) universal lipid screening. 14 Confidential property of Optum. Do not distribute or reproduce without express permission from Optum.
ICUBAcares Pharmacist Advocate Program Real Pharmacists ‐‐ Real Advocates ‐‐ Real Solutions • Prescription Check‐up! • Preferred Brand vs. Non‐Preferred tier confusion • Prior Authorization, Step Therapy, Quantity Limits Member Testimonial: ICUBAcares helped the doctors get me on the right medication. They reached out to my Primary Doctor to request he change a prescription that appeared to be causing issues with one of my other medications. Due to that I was able to get my medication under control. 15
Behavioral Health Program Professional Psychiatric Applied Behavioral Intensive Services Counseling Medication Analysis Therapy Hospitalization Evaluation Detoxification Speak with a licensed Behavioral health Residential treatment clinician to manage a services related to Medication management diagnosed behavioral for diagnosed behavioral Autism Spectrum health condition over the health conditions Disorder (ASD) diagnosis phone, televideo or in the office 16
Condition Management Program Details How do I meet with my therapist and coach? • You choose • Meet via web‐based videoconferencing or over the telephone Health Life Breast and prostate Depression/anxiety What is the appointment frequency? • • cancer recovery Postpartum • • Meet once a week with your therapist, to Heart problems depression • address emotional challenges Diabetes Caregiver status • • • And meet once a week with a behavior coach, to Depression (child, elder, autism) • identify health goals and develop an action plan Digestive heath Grief and loss • • How long is the program? Pain management Military transition • • Respiratory problems • Eight weeks • Substance abuse • • Sixteen sessions 17
Vision Premium Change Employee Cost Employee Cost (Monthly) (Biweekly) $4.83 $2.23 Employee Enhanced Plan $12.36 $5.71 Employee + Family 18
Monthly Dental Plan Premiums Employee Cost Employee Cost Total Premium (Monthly) (Bi ‐ Weekly) Employee $11.72 $0 $0 HMO 250CS $11.78 $5.44 Employee + 1 $23.50 Dental Option Employee + Family $36.50 $24.78 $11.44 Employee $19.48 $7.76 $3.58 Preventive Plus Low Dental PPO Employee + 1 $45.28 $33.56 $15.49 Option Employee + Family $74.96 $63.24 $29.19 Employee $39.77 $28.05 $12.95 High Dental PPO Employee + 1 $79.21 $67.49 $31.15 Dental Option Employee + Family $133.21 $121.49 $56.07 19
Life and Disability During Open Enrollment, you may have the opportunity to increase your life insurance coverage. • If Evidence of Insurability (EOI) is required you will receive a notice: ACTION REQUIRED: You have selected a plan level which requires Evidence of Insurability (EOI). Please know: A representative from the insurance carrier’s medial underwriting department will reach out to you in the coming days for additional information as it relates to the EOI process. The EOI process must be completed and approved before this coverage takes effect. If and when the amount you have requested is approved, your payroll contributions will be adjusted accordingly. • You will receive an email from Symetra with instructions to complete the EOI process for the coverage(s) elected during Open Enrollment. • This EOI process must be completed and coverage approved by the insurance carrier prior to the coverage being active. 20
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