2014 - 2015 Plan Year Benefits

Open Enrollment PowerPoint Presentation

Open Enrollment Video Presentation

Please log into http://icubabenefits.org to make changes to your benefits. 

ICUBA First Time User

To access your Health Reimbursement Account (HRA), Health Care Spending Account (HCSA) and Dependent Care Spending Account (DCSA), login to http://icubabenefits.org  (no www) for step-by-step instructions.

How to Create your ICUBA online Account

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Benefit Brochure

Summary of Benefits and Coverage

 

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Health

Florida Tech offers comprehensive medical benefits provided by Florida Blue through customized plan designs by ICUBA. Here are the options: PPO 70 Blue Options, and Preferred PPO Blue Options. 

Employees are always encouraged to seek services from in-network providers. To locate an in-network provider in your area, visit Blue Cross Blue Shield of Florida’s website at www.bcbsfl.com.

Step-by-step instruction on how to find a doctor, hospital or other provider

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Autism

ICUBA Autism Benefit Overview

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Employee Assistance Program (EAP)

Florida Tech offers an Employee Assistance Program through MHNet, a partner with Blue Cross Blue Shield. Services include EAP counseling, caring for children or aging parents, dealing with conflict or violence, mind and body discount programs and online tools and information.

  • All benefits-eligible employees and members of their household can participate.You do not need to be enrolled in health insurance to use the EAP services.
  • There is no cost and no enrollment required. There is no charge for up to 6 visits per incident / illness.
  • To use the services, please call 1-877-398-5816 or www.mhnet.com.

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Catamaran Prescription

Catamaran administers the pharmacy benefit for all of the medical plans. The pharmacy benefit includes value based generics, medication therapy management and clinical management, and separate website and customer care line from the BCBS medical. A separate identification card is issued for pharmacy benefits. There are three ways to fill a prescription (each with a different copay schedule): 30 days supply at the retail pharmacy; 90 days supply at the retail pharmacy; or 90 days supply through mail order.

Eligible dependents include:

  • A legal spouse
  • Unmarried, dependent children for whom the employee provides principal support. Eligibility for coverage extends to age 26 if child is an IRS dependent AND living in the employee household OR a student. No child can remain on the plan beyond December 31st of the year in which they turn 26.
  • Uunmarried, dependent child incapable of self-sustaining employment by reason of mental retardation or physical handicap.
  • Certified domestic partners.
  • Children of certified domestic partners subject to the same eligibility standards applicable to dependents.

Catamaran 90-Day Mail Service Pharmacy If you are taking a maintenance prescription for conditions such as arthritis, high blood pressure, or diabetes, among others.  You can get a 90-day supply of medication mailed directly to your house and you save money! Standard shipping is free. Orders are shipped in confidential, tamper-evident packaging from Catamaran mail service pharmacies.

Catamaran 90-Day at Retail Program This program allows you to obtain a 90-day supply of your maintenance medication at more than 45,000 participating community pharmacies.

Free Over The Counter (OTC) Preventive Generics- The generic preventative OTC medications listed below will be covered as part of your pharmacy benefit with $0.00 copay.

Prescription required.

  • Iron supplement for babies
  • Prenatal vitamins or folic acid for women planning, or capable of pregnancy
  • Oral fluoride supplement for children
  • Aspirin for adults

Catamaran Customer Care Center If you have a question about your pharmacy benefit, call the Catamaran Customer Care Center toll-free at (800)207-2568, 24 hours a day, 7 days a week. TTY: (888)411-0767.

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Wellness

Free In-Network Services Available to You

  • Health Dialog®
  • Care Coordination
  • Better You From BlueSM
  • MyBlueService at www.bcbsfl.com 
  • Diabetic Supplies
  • MHNet Employee Assistant Program  for employees and their household members

Free In-Network Wellness Benefits Available to You

An Ounce of Preventive Care

There’s an easy way to stay healthy and discover potential health problems early, and that’s to take advantage of your medical plan’s preventive care benefit. The plan pays 100% of total costs for the following In-Network services:

Quest Diagnostics:

  • Lab Tests
  • Pap Tests
  • Urinanalysis
  • Colorectal Screenings
  • Prostate Cancer Screenings

Florida Blue:

  • Electrocardiograms
  • Echocardiograms
  • Mammograms
  • Colonoscopies and Sigmoidoscopies
  • Immunizations
  • Allergy Injections
  • Bone Mineral Density Tests

MHNet:

  • Employee Assistance Program (EAP) is for all employees and members of your household.  Call your 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.

Catamaran:

  • Prescribed diabetic supplies including meters, lancing devices, lancets, test stips, control solution, needles, and syringes
  • Aspirin for adults with a physical prescription
  • Prescribed generic folic acid and generic pre-natal vitamins for pregnancy

Free In-Network Screenings Available for You

  • Annual Employee Health Fair
  • Annual skin cancer screenings
  • Annual blood sugar screenings

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Flex Spending

To check your BALANCE on your HCSA or DCSA debit card, login to the http://icubabenefits.org site.

Please note that the company key is ICUBA.

Flexible Spending Account ICUBA CLAIM FORM

  • Allows employees to set aside pre-tax dollars, through payroll deductions, to cover allowable health care expenses incurred for self and qualified dependents.
  • Eligible HCSA Expenses
  • Dependent Care Spending Account allows employees to set aside pre-tax dollars, through payroll deductions, to cover dependent care expenses, incurred and paid, for qualified dependents.
  • Dependent Care Spending Account Summary
  • Reimbursement Request - Print the reimbursement form, complete, sign and forward, with receipts, to ICUBA, P.O. Box 616927, Orlando, FL   32861-6927.

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Dental

Dental Coverage is offered so that you and your family can receive the important dental care you need for good health. You can choose from three different fully insured dental plans that best fit your needs. HumanaDental offers a Dental Health Maintenance Organization(DHMO) and Preferred Provider Organization (PPO) plan.

Florida Tech provides employees and eligible dependents the opportunity to elect dental coverage through Humana Dental Plans. There are three plan options: DHMO, PPO High and Preventive Plus Plan. Eligible dependents include:

  • A legal spouse
  • Unmarried, dependent children for whom the employee provides principal support. Eligibility for coverage extends to age 26 if child is an IRS dependent AND living in the employee household OR a student. No child can remain on the plan beyond December 31st of the year in which they turn 26.
  • Uunmarried, dependent child incapable of self-sustaining employment by reason of mental retardation or physical handicap.
  • Certified domestic partners.
  • Children of certified domestic partners subject to the same eligibility standards applicable to dependents.

HumanaDental Prepaid 250CS DHMO Plan

You and each of your covered dependents must select and be assigned to a participating primary care dentist (PCD) who participates in the HumanaDental Prepaid/DHMO network. Your PCD will provide you with your dental needs. As a member you may see a network primary care dentist or network specialist as often as necessary. There are no claim forms to complete, no yearly maximums, no deductibles or no waiting periods to meet.

Should your PCD recommend that you see a participating specialist, (i.e., endodontist, oral surgeon, periodontist, pediatric dentist), no referral is necessary. You may select a HumanaDental DHMO participating specialist of your choice.

The 250CS copayments are applicable at either a participating general dentist or a participating specialist. Please see the schedule of benefits for a listing of procedures covered under the plan.

HumanaDental Traditional Preferred Plans

The High Option PPO and Preventive Plus Dental Plans offer you the convenience to see any dentist you choose. Keep in mind that using an In-Network dentist will cost you less than one that doesn’t participate in the dental network. The plans have a deductible which must be met before the plan coverage begins. That deductible is waived for Preventive care such as oral examinations, x-rays and cleanings. For other services, after your deductible is met, you pay a percentage of the allowed amount and the plan pays the rest.

There is an annual maximum benefit on the High Option PPO Plan of $2,000 per person. For the High Option PPO Plan, adult/child orthodontiapays 50% (no deductible) of the covered orthodontia services, up to $2,000 lifetime orthodontia maximum.

The annual maximum on the Preventive Plus Plan is $1,000 per person. The Preventive Plus Plan is designed for people that would like their Preventive and basic services covered, but not major treatment, with a lower premium than the High Option PPO Plan. Nonparticipating dentists can bill you for charges above the amount covered by your Preventive Plus Plan. To ensure you do not receive additional charges, visit a participating PPO Network dentist. If a member sees an out-of-network dentist, the coinsurance level will apply to the maximum allowable fee.

ICUBA has also enhanced the High Option PPO Plan benefits this year with the following improvements:

  • 4 regular cleanings per plan year covered under Preventive
  • 2 periodontal cleanings per plan year covered under Preventive
  • Availability of composite fillings
  • Extended annual maximum benefit that provides 30% coinsurance on preventive, basic, and major treatments after the annual maximum is met, per plan year.

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Vision

Florida Tech provides employees and eligible dependents the opportunity to elect vision coverage through Advanticaeyecare. The Advanticaeyecare Plan offers a benefit option to cover routine eye care, including exams and eyeglasses or contacts.

Eligible dependents include:

  • A legal spouse
  • Unmarried, dependent children for whom the employee provides principal support. Eligibility for coverage extends to age 26 if child is an IRS dependent AND living in the employee household OR a student. No child can remain on the plan beyond December 31st of the year in which they turn 26.
  • Uunmarried, dependent child incapable of self-sustaining employment by reason of mental retardation or physical handicap.
  • Certified domestic partners.
  • Children of certified domestic partners subject to the same eligibility standards applicable to dependents.

Vision Plan summary

Lasik Information

 To use Advanticaeyecare, call 1-866-425-2323 or visit www.advanticaeyecare.com.

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Additional Life Insurance

This year you may enroll in, or increase your additional life insurance up to five times your annual salary not to exceed $500,000. If the value of your coverage is $150,000 or less, evidence of insurability is not required.

  1. Rate Sheets for 20 pay employees -  
  2. Rate Sheets for 26 pay employees -
  3. Rate Sheets for 12 pay employees -
  4. Evidence of Insurability Form

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Long Term Care

Information available in the Office of Human Resources.

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AFLAC

Please visit the Aflac website for information on these benefit options.

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Prepaid Legal

Information available in the Office of Human Resources.

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Short-Term Disability

Short Term Disability coverage is provided at no cost to benefits-eligible employees. Under Short Term Disability, a disabled employee will receive 66 2/3%of salary up to a maximum benefit of $2,000 per week for a maximum of 11 weeks.

  • Short Term Disability Brochure
  • Short Term Disability Policy

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Long-Term Disability

  • Core Long Term Disability coverage is provided  at no cost to benefits-eligible employees.  This plan  provides a benefit of  60% salary up to a maximum of $2,000 per month.
  • 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% salary up to a maximum of $14,000 per month.

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