Some big changes and new choices in medical plans are coming to Open Enrollment this fall.

UC is offering a revamped menu of plans for 2014 that offers better value and clearer choices, including two new plans: Blue Shield Health Savings Plan, which features a UC-funded health savings account; and UC Care, UC's own three-tier PPO plan that offers members access to UC doctors and hospitals as well as the Blue Shield PPO network.

Health Net Blue & Gold, Kaiser Permanente, Western Health Advantage and Core (administered by Blue Shield) will still be available. Four plans — Anthem Blue Cross PPO and PLUS, Anthem Lumenos with HRA and Health Net Full HMO — are being discontinued.

  2013 Plans 2014 Plans
HMO HealthNet Blue & Gold Health Net Blue & Gold
Health Net (full network)* Kaiser
Kaiser WHA
WHA  
PPO Anthem Blue Cross PPO* UC Care**
Anthem PLUS* Blue Shield Health Savings Plan**
Anthem Lumenos*  
Catastrophic Core Core

  *Discontinued plans
**New plans

"The 2014 plans provide clear and distinct choices to meet our employees and retirees' diverse and changing needs," said Michael Baptista, executive director of benefits programs and strategy. "The designs of these plans have very little overlap. Everyone can choose a plan based on what's most important to him or her, whether that's having predictable costs or the widest choice of doctors."

Key Dates

Oct. 21 Open Enrollment booklets mailed to your home

Oct. 28 – Nov. 26 Open Enrollment period for making plan changes

Oct. & Nov. Local presentations including Town Hall meetings, brown bags and help desks.

For all the details visit atyourservice.ucop.edu/oe/medical.

UC employees and retirees will continue to have a broad choice of providers — including UC medical center doctors, hospitals and medical groups — and plan designs to fit their needs. The provider networks for both the Blue Shield Health Savings Plan and UC Care include 97 percent of the providers in the current Anthem Blue Cross network, so most people in those discontinued plans should be able to keep their doctor.

Employees currently in Anthem Blue Cross PPO, Anthem Blue Cross PLUS and Health Net HMO will also pay smaller monthly premiums next year, regardless of the new plan they choose. Savings will depend on the new plan, salary band and dependents covered.

The Blue Shield Health Savings Plan premiums are expected to be similar to the premiums for Anthem Lumenos PPO with HRA. Premiums for Health Net Blue & Gold, Kaiser and WHA are expected to increase from $2 to $10 per month, depending on the plan, salary band and dependents covered. UC will continue to cover an average of about 85 percent of the cost of the premiums. The final premiums will be available in early October.

The 2014 plan offerings are the result of a comprehensive review of UC's medical plan portfolio aimed at providing high quality medical insurance that is more specific to individual needs, while limiting cost increases to employees and the university. The review also offered an opportunity to leverage UC's outstanding medical centers and take advantage of the changing medical-insurance marketplace.

"We know how important quality medical insurance is to our employees and retirees, and we are continually looking for ways to ensure good benefits while limiting cost increases for employees and the university," said Baptista. "Health care reform and a changing medical-insurance marketplace provided a good opportunity to rethink our benefits while still maintaining choice and quality."

Two Plans In, Four Plans Out

The two new plans offer broad, nationwide networks of doctors and hospitals through Blue Shield, including UC's medical centers, and both are expected to have lower monthly premiums than Anthem Blue Cross PPO, Anthem Blue Cross PLUS and Health Net HMO.

  • UC Care is a new health plan created just for UC employees, retirees and families with coverage wherever you live, worldwide. You can get care from UC doctors and medical centers as well as the entire Blue Shield network of providers. You pay a fixed copayment when you use UC and other select providers near all UC campuses and coinsurance when using the other 65,000 Blue Shield providers. You also have coverage for out-of-network care.

  • The Blue Shield Health Savings Plan is a high-deductible PPO plan paired with a health savings account (HSA) that lets you pay your out-of-pocket health care costs with tax-free dollars. UC provides an initial contribution and you can also make pre-tax contributions. You can use the funds any time for qualified medical expenses or save them for future health care needs. Your HSA balance carries over from year-to-year and you own the balance in the account, even if you transfer to another medical plan or leave UC. Blue Shield's large PPO provider network offers a wide choice of doctors and hospitals or you can see out-of-network providers if you want to pay more.

UC is eliminating the Anthem Blue Cross PPO and PLUS plans and the Health Net full HMO plan because they no longer provide the right value. "The costs for these plans continue to increase at a much faster rate than the other plans," Baptista said. "Neither the university nor employees can continue to absorb double-digit annual increases."

The Anthem Lumenos PPO with HRA is being replaced with the Blue Shield Health Savings Plan. Employees are finding plans with health savings accounts to be more popular because of the tax advantages, the portability of the account and the ability to use the account to save for future retirement insurance needs.

New for retirees

Retirees and employees planning to retire in 2014 will have similar choices as employees. All six employee plans will be available to retirees not yet eligible for Medicare.

Medicare-eligible retirees in California will have five plan options: Kaiser Senior Advantage, Health Net Seniority Plus, Blue Shield PPO, Blue Shield PPO without prescription drug coverage and Blue Shield High Option Supplement to Medicare. The Blue Shield Medicare plans are very similar to the current Anthem Blue Cross Medicare plans.

For Medicare-eligible retirees living outside California, UC is taking a new approach. For those Medicare-eligible retirees with all covered family members in Medicare, UC will fund a Health Reimbursement Arrangement (HRA) which retirees will use to purchase individual coverage through Extend Health, a company that sponsors a Medicare Exchange.

With the assistance of Extend Health's licensed and trained benefit advisors, each covered family member will choose an individual Medicare plan that's best for them. That includes Kaiser and other Medicare Advantage plans available in the retiree's location. With the growing market for individual plans, many retirees will have more choices, many of which could meet their needs better than the UC plans currently available. In 2014, due to other changes in the UC-sponsored medical plan portfolio, only the Medicare PPO and the High Option Supplement to Medicare plans would have been available to those outside of California.

UC plans extensive communication and education about medical plan choices throughout the fall to help faculty, staff and retirees make good choices. Watch for additional news stories, in-home mailings and campus events where you can learn more.