ICUBA Membership 2014

ICUBA Membership 2014
A Non-Profit, Self-Funded Employee Health Insurance Plan
Created by Educators for Educators
“Better Benefits Through Collaboration”
Celebrating Our 12th Year of Service
Joining ICUBA…….
In order to become a member of ICUBA, you must meet the due diligence criteria and sign a three year membership agreement commitment giving ICUBA the right to assess you beyond premiums collected. 2
The ICUBA plan year for all benefits is 04/01 – 03/31, which means your first year with ICUBA could be a short year ________ ‐ 03/31/15
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ICUBA is in compliance with Health Care Reform
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Flexibility
ICUBA understands that each of our Member Institutions have different campus cultures. ICUBA allows your school to decide:
 Which medical plans you choose to offer
 When new employees are eligible to participate in the plan
 When employees are eligible for retiree benefits
 What the employer contributes towards the medical plan or Health Reimbursement Account
 Whether you choose to offer sensitive benefits such as Abortion coverage or Domestic Partner coverage
 Whether to offer ICUBA endorsed voluntary benefits
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Children
ICUBA covers Children up through the end of the calendar year in which they attain age 26 6
Collaboration
Who are the Members of ICUBA?
 As a Multiple Employer Welfare Arrangement (MEWA), each employer is a Member
 As a Voluntary Employees’ Beneficiary Association (VEBA), each employee is a Member
Collaboration happens through……
 ICUBA Board of Directors
 Human Resources Advisory Committee
 Medical/Rx Committee
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As ICUBA celebrates its 12th year, membership has continued to grow, with
24 member educational institutions and more than 14,000 people enrolled in an
ICUBA sponsored health and wellness plan.
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ICUBA Monthly Premium Medical Rates 4/1/2014‐ 3/31/2015
All members of ICUBA ALWAYS pay the same monthly premiums UBA.
PPO 70 Blue Options
Preferred PPO Blue Options
Employee
$656
$511
Employee and Spouse
$1,312
$1,022
Employee and Child(ren)
$1,182
$920
Family
$1,838
$1,431
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ICUBA Health Benefits and Services
Included in the Cost of Medical Insurance Premiums:  BCBS Global Medical Network with PPO Provider In and Out of Network coverage and NO Gatekeeper
 Best‐In‐Class Prescription Drug Benefit Management
 Better You From Blue™ Culture of Wellness
 Retiree Coverage
 Employee Assistance Program  Single Web Portal Access
 COBRA Administration
 Strategic Customer Service and Call Centers
 Billing Services
 Compliance
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Additional Costs beyond Medical Insurance Premiums:
 Dental
 Vision
 Life
 Disability
 Flexible Spending Accounts – Health Care and Dependent Care
 Health Reimbursement Accounts
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ICUBA self‐insures Medical, Prescription Drug and Behavioral Health Benefits, and fully‐ insures dental, vision, life, and disability benefits.
Self‐insuring allows ICUBA to use more than 92% of premium dollars directly on benefits. This exceeds Health Reform standards by 7%.
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ICUBA Brand Partners
ICUBA has assembled a value cluster of partners to offer state of the art benefits:
ICUBA Benefits MasterCard®
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ICUBA FREE In‐Network Wellness Benefits:
ICUBA 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:
Employee Assistance Program is
for all benefit-eligible employees
and members of your household.
 Prescribed diabetic supplies
including meters, lancing
devices, lancets, test strips,
control solution, needles, and
syringes
Call your EAP 24-hours a day
at 1.877.398.5816
 Aspirin for adults with a
physician prescription
 Electrocardiograms
 Echocardiograms
 Lab Tests
 Mammograms
 Pap Tests
 Colonoscopies and
 Urinalysis
 Colorectal Screenings
 Prostate Cancer Screenings
Sigmoidoscopies
 Immunizations
 Allergy treatment/ Injections
 Bone Mineral Density Tests
Receive up to six free face-to-face
counseling sessions per
presenting issue per plan year.
 Prescribed generic folic acid
and generic pre-natal vitamins
for pregnancy
$0 copay for all office visits to Blue
Physician Recognition™ provider
$0 copay for all office visits to Blue Physician Recognition™ provider
$0 copay for two courses of treatment per plan year for tobacco cessation
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FREE OFFICE VISITS FOR ALL CARE
When you are using a Blue Physician Recognition™ provider, all office visits are FREE. Your doctor should not collect a co‐payment.
How to locate a Blue Recognition Provider™:
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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).
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ICUBA Recognition
2008 Empower Award
presented by:
2010 Employee Health
Benefit Leadership
Award presented by:
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Consumer Directed Healthcare
Health Reimbursement Accounts (HRAs)
allow healthy Members to accrue benefit dollars in their HRAs rather than merely “consume” in premium.
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Health Reimbursement Accounts (HRA)
Rollover
Vest
Earn Interest
Ties to MasterCard®
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HRA and HCSA Differences
Health Reimbursement Account
Health Care Spending Account
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Funded by School
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Available for PPO 70 and
Risk/Reward Plan
Funded by employee pre-tax
dollars

Funds rollover at the end of
each plan year
No enrollment in a plan
required

No carry-over of funds from
year to year
- Use-it-or-lose-it

HCSA funds expended before
tapping into HRA funds

Can have HCSA and no HRA
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Portable after 36 months of
continuous participation
Can have HRA alone with
no HCSA
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Dependent Care Spending Account
 Funds available to employee as deducted from payroll to pay for eligible child and adult care services
 Can submit claims for reimbursement or use the ICUBA MasterCard®  Annual Limit of $5,000
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ICUBA MasterCard®
 Can be used for eligible medical and dependent care expenses with flexible
spending accounts and health reimbursement accounts
 Funds available through ICUBA Benefits Card™ administered by ICUBA
 Electronic debit at point of service/sale or submit hard copy reimbursement
 Smartcard technology-card will use flex spending account funds first, and
then health reimbursement account funds
 For each HCSA and HRA, ICUBA deposits the employee’s annual election on
the card on day one and bills the employer monthly (reconciliation is
performed in July/August of the year following the Plan Year)
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Administration Fee
ICUBA charges $7.00 per month per employee enrolled
in any combination of the following:
– HRA
– HCSA
– DCSA
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ICUBA Cares™
 The purpose of ICUBA Cares™ is to identify and utilize best clinical
and administrative practices to improve quality of life and lower
medical costs. ICUBA Cares™ helps Member Institutions develop a
WELLNESS CULTURE that will improve the health status of their
employees and reduce direct/indirect costs.
 5% of people spend 50% of Premium Dollars
 A healthy Employee is more productive
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Health Dialog®
Health Dialog, provides members with round-the-clock access to a wealth of medical information.
Health Coaches are available 24 hours a day, 7 days a week and are specially trained health care
professionals that can answer your questions about health conditions, diet, exercise and
understanding your medications.
A few reasons Members may call a Health Coach are:
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Your doctor recommended a certain medical test.
You have been diagnosed with a particular illness.
Your doctor suggests surgery and you want information about possible alternatives.
You are scheduled for hospital admission and need assistance in planning.
Web Tools – The Dialog Center ®, is a website operated and maintained by Health Dialog that provides
members access to health content
and support tools for education, information and decision making. Members will also have access to:
 Healthwise® Knowledgebase which provides 27,000 pages of up-to-date, easy-to-understand,
in-depth information on more than 1,900 clinical topics, including
 Health Crossroads®—health information organized by health care decision points covering
options and choices.
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Care Coordination (Large Case Management)
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 Care Manager.
Some examples of when Members may wish to access such services are when:
 Long term complex home health care needs, such as intravenous medications
and/or wound care exist.
 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.
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Blue365®Discount Program
• Blue365®, BlueCross BlueShield’s national member discount
program, delivers health and wellness tools and services,
information and discounts to help members manage their
healthcare experience and make healthy choices.
• Save on fitness clubs (e.g., Gold’s Gym), exercise equipment,
nutrition and weight management programs (e.g., Jenny
Craig®, Nutrisystem®, Curves International®) massages,
vitamins and so much more.
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A convenient way to verify the cost of an office visit
or procedure.
Members have a choice when accessing the tool:
Call: The Care Consultant Team at 1 (888) 476‐2227
Click: Visit www.floridablue.com and click on Members, login with your user name and password, then select compare medical costs
Visit: A Florida Blue Center Call 1 (877) 352‐5830 for a location
near you
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™
Catamaran Member Portal
Catamaran Mobile App:
 Free of charge
 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.
Web‐enabled access: 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
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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.
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.
Get the app by searching for Catamaran at the Apple App Store or
the Google Play Store or scanning the QR code.
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Mobile Apps
App Features
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Find a doctor, hospital and Map of location (GPS based)
Get your plan details on the go
Access and view an image of your Member ID card.
Fax or email ID Card
Claims Accessibility
Health Coach
24-hour Nurse Line/Care Consultants
Health News & Views
Health Check Guidelines
.
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https://benefitsolver.com
Login to:
https://benefitsolver.com
Username: gclooney123
Password: gclooney123
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Access Links to individual Benefit Providers
ICUBA Benefits MasterCard™
For information or claims associated with your Blue Cross Blue Shield account, please click on the image.
To access your Humana Dental account online, please click the image.
For information associated with your Advantica Eye care Vision account, please click on the image.
For information on your FSA or HRA please click on the image.
To view your Catamaran account online click on the image.
To access your MHNet Behavioral Health account online, click the image.
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Implementation
 ICUBA will…..
• Provide overall project management of implementation with all vendors
• Ensure that the data feeds and card distributions are timely
• Perform benefits presentations to employees • Support during implementation including enrollment support
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Timeline
1.
ICUBA Performs Due Diligence 2.
School decides
3.
ICUBA Board approves
4.
School signs membership agreement
5.
Account Set‐up
6.
ICUBA Conducts Enrollment Meetings
7.
Employees elect coverage on web portal
8.
Benefit Cards Distributed
9.
ICUBA continues to provide customer service and communication support
10. ICUBA provides COBRA, compliance and billing services
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Contact Information
Mark Weinstein, J.D., CPA., CEBS, LL.M, MPH
Mary Jo Hatch, GBA
President & CEO
Phone: (407) 354-4646
Email: [email protected]
Tim Czerniec, MBA
Marketing Consultant
Phone: (305) 775-6674
Email: [email protected]
Chief Operating Officer
Phone: (407) 354-4664
Email: [email protected]
ICUBA
4850 Millenia Blvd., Suite 329
Orlando, FL 32839
Fax 407-354-4929
www.icuba.org
Visit ICUBA’s YouTube Channel:
Go to YouTube, search for ICUBA and click on the ICUBA icon
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THANK YOU!

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