Medical Insurance & HRA

ICUBA

Four health plan options are offered through the Independent College and University Benefits Association (ICUBA).  BlueCross BlueShield of Florida (BCBSFL) administers the medical plan, processes claims, and provides the worldwide PPO network.

The health plan options are:


Both of these plans are preferred provider network (PPO) plans and do not require primary care physicians or referrals to specialists.  All plans cover the same services, provide both in and out-of-network coverage, have the same prescription and emergency room copays, the same plan rules and pre-certification requirements and access to BlueCross BlueShield amenities.  The plans have different deductibles, coinsurance, copays, annual out of pocket maximums and college funded Health Reimbursement Account (HRA) amounts.   Both the Risk/Reward Blue Options and PPO 70 Blue Options use the Blue Options (Network Blue) prover network.

CatamaranRx (formerly Walgreens Health Initiative and CatamaranRx) administers the pharmacy benefit for all of the medical plans.  The pharmacy benefit is separate from the Florida Blue medical plan, but included in the medical premiums.  A separate identification card is issued for pharmacy benefits.

Members are not limited to only utilizing Walgreens pharmacies and may choose from thousands of retail in-network pharmacies nationwide.   There are three ways to fill a prescription (each with a different copay):  30 days supply at the retail pharmacy; 90 days supply at the retail pharmacy; or 90 days supply through mail order.

MHNet administers the behavioral health/substance abuse benefit for all of the medical plans.  The benefit includes unlimited outpatient visits at the primary physician copay.  The plan also covers an unlimited number of days in an inpatient facility (deductible applies).  For further information on network and benefits, visit www.mhnet.com (user name ICUBA, password 8773985816). There is not a separate card for MHNet. The BCBS card should be used for accessing services and MHNet's phone number is included on the back.    

Health insurance is available to benefits eligible employees who work at lest 1,462 hours per year.  Covered dependents include:

  • A legal spouse
  • Children up to age 26 (coverage ends December 31st of the year they turn 26 and they will be offered COBRA). This includes a natural child, step-child, legally adopted child if adopted before age 18, a child required to be covered  by a QMCSO, and a child with proof of legal guardianship
  • Children beyond age 26 incapable of self-sustaining employment by reason of mental disability or physical handicap.
  • Certified domestic partners
  • Children of certified domestic partners subject to the same eligibility standards applicable to dependents



ICUBA Health Reimbursement Accounts (HRA)

HRAs were set up by the Federal government to allow employers to contribute to an account for their employees in conjunction with high deductible, consumer-directed health plans.  These arrangements allow employers to provide funds on a monthly basis to employee accounts that pay for out of pocket costs medical expenses (health, dental, vision, etc.).

A college funded HRA account is included with all of the medical plans.  The monies in the HRA can be used only by the employee and dependents covered on the ICUBA medical plans. 

Members enrolled on a medical plan will receive an ICUBA Benefits MasterCard in addition to their BCBSFL and CatalystRx identification cards.  You can request additional debit cards for dependents through http://icubabenefits.org.  The debit card is issued by Metavante and administered by ICUBA.  It is a MasterCard, which makes it easy to use as your method of payment at most provider offices and pharmacies.

Most retail merchants use an inventory control system that separates eligible expenses from ineligible expenses at the point of purchase.  Since your eligible expenses will be reported automatically, you will receive very few requests for receipts.  If you shop at a retail merchant that is not using the required technology, you will have the option to make your purchase using another form of payment and file a claim for reimbursement online at http://icubabenefits.org or by fax or mail.

Even if you use the MasterCard to access funds, it is recommended that you keep all receipts and documentation in the event that substantiation is required for an expense.  If substantiation is required, ICUBA will send you a letter or Email and you will have to provide the Explanation of Benefits from the insurance carrier and/or any applicable receipts and documentation.  The card is a debit card with stored values, and not a credit card, so the card cannot be overspent.  If the funds are not available through the HRA, the transaction is simply denied.  However, to the merchant, it is a Mastercard credit card and transactions should be credit, not debit. There is no pin number associated with the card. 

Monies accumulated in the HRA account may be used by the employee to pay for eligible medical expenses, such as: deductibles, out of pocket medical, dental, or vision expenses not reimbursed by insurance (coinsurance, copays, costs above annual limits), prescription drug copays, dental and orthodontia expense, lasik, eyeglasses, contact lenses, hearing aid costs, retiree or COBRA premiums, long term care premiums and any medical expense eligible under the Health Care Spending Account (HCSA).   

Ineligible expenses include: non-medical expenses, over the counter medications without a prescription, life and disability premiums, cosmetic or weight loss expenses, vitamins (unless prescription), nutritional supplements, non-retiree or non-COBRA medical plan premiums, dental or vision premiums or any medical expense incurred by an individual that is not covered on the ICUBA medical plan.

HRA balances roll over each year you are actively employed and enrolled in an ICUBA health plan.  The rollover dollars are held in a secure trust and earn interest on a quarterly basis.  These funds are never taxed for dependents as long as the rules regarding HRA funds are followed.  These funds are portable with 36 months of continuous participation. They can never be converted to cash, but can be accessed beyond separation from employment for an annual fee.  If you drop the health plan or leave employment and do not have 36 months continuous participation, you forfeit the balance in the HRA account and access will end on your last day of coverage or employment.  If you re-enroll during a later enrollment period, you start a new HRA account and a new 36 month vesting period.

For more information on this benefit, please visit this insurance vendor’s website by selecting their name from the quick links dropdown or login to your ICUBA Benefits site and visit the Benefits Library or ICUBA News and Information section.

For More Information:


Jennifer Addleman
Benefits Administrator
jaddleman@rollins.edu
407.975.6453

 

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