Open Enrollment is coming soon — Thursday, Oct. 27, 8 a.m. to Tuesday, Nov. 22, 5 p.m. — with some significant changes and new options for you and your eligible family members.
“There’s a lot of good news this year,” said Dwaine Duckett, vice president of human resources. “We’ve worked hard to manage costs, and offer the protection of disability insurance to more faculty and staff than ever before. I encourage everyone to take a careful look at their options this year, to make sure they’re taking full advantage of their UC benefits.”
- Employees will see small increases, or even decreases, in their contributions toward medical premiums this year. Over 90% of employees will see increases under $10 a month, and no increases are over $12 a month. The news is even better for members of UC Care, whose monthly contributions will decrease. Dental and vision plans are still offered by UC at no cost for employees. View 2017 rates for employees.
- Don’t miss your one-time opportunity to change or add UC’s Voluntary Disability Insurance during Open Enrollment, with no statement of health required. UC has expanded eligibility for this coverage, so this may be your best opportunity to enroll. Disability coverage can help protect your income if you miss work because of a pregnancy, illness or injury — see details below.
- UC’s preferred provider organization (PPO) medical plans (Core, UC Care and UC Health Savings Plan, as well as UC High Option Supplement to Medicare, UC Medicare PPO and UC Medicare PPO without Prescription Drugs) will have new administrators next year for behavioral health and prescription drug benefits. UC has worked to minimize disruption for members, but there are a few steps you should take to make sure you’re prepared for the change. Please look for further details during Open Enrollment.
- Kaiser Permanente is expanding into Santa Cruz County, with three new medical offices.
- Health Net Blue & Gold has added several new provider groups in Southern and Northern California, and members in the San Francisco Bay Area will benefit from the Canopy Health alliance formed between Hill Physicians-SF (UCSF), John Muir Health, Meritage Medical Network and the affiliated hospitals.
Disability insurance — Take this opportunity to protect your finances
Time away from work for an illness, injury or pregnancy could mean months without a paycheck. While UC’s basic employer-paid disability insurance offers some protection – a benefit capped at $800 per month for six months — it probably won’t be enough to cover your expenses. For a modest monthly premium, UC’s Voluntary Disability Insurance replaces much more of your income — 60 percent of your eligible pay up to $15,000 per month — for additional financial security when you need it most.
UC is changing its disability insurance offerings to give all benefits-eligible employees (full, mid-level or core) new options for protecting their finances. During Open Enrollment, you’ll have a one-time opportunity to enroll in Voluntary Short-Term Disability (benefits up to six months), Long-Term Disability (benefits after six months, up to your Social Security retirement age) or both.
The flexibility of UC’s new disability options allows you to tailor your coverage to your needs and budget. For example, choosing only Voluntary Long-Term Disability Insurance might be a good option for faculty eligible for paid medical leave (see APM 710-11) or employees with a substantial balance of sick leave accrued. Choosing both Short- and Long-Term Disability provides the most comprehensive protection for all types of disability leaves.
If you’ve never thought about disability insurance, this is the year to take a look. During Open Enrollment, you cannot be denied enrollment in Voluntary Disability Insurance due to an existing medical condition. If you wait to enroll (after Open Enrollment ends), you’ll need to submit a statement of health to enroll, and you may not qualify. To ensure continuing protection, those who are currently enrolled in Supplemental Disability and don’t take action during Open Enrollment will be automatically enrolled in both Short- and Long-Term Voluntary Disability Insurance. This change will affect your premium costs, though, so take the time to choose the coverage you need. You can reduce or discontinue coverage at any time.
Learn more about your 2017 disability insurance options here.
PPO administrator changes
The administrator of your plan processes claims, creates a network of health care providers or pharmacies and sets clinical policies and guidelines. For 2017, a number of administrators will be changing for UC’s PPO plans (Core, UC Care and UC Health Savings Plan, as well as UC High Option Supplement to Medicare, UC Medicare PPO and UC Medicare PPO without Prescription Drugs):
- Medical — Anthem Blue Cross replaces Blue Shield as the administrator of medical benefits for UC’s PPO plans. HealthEquity will continue as the health savings account custodian.
- Behavioral health — Anthem Blue Cross replaces Optum as the administrator of behavioral health benefits for UC Care and UC Health Savings Plan. Anthem replaces Blue Shield as the administrator of behavioral health benefits for Core, UC High Option Supplement to Medicare and UC Medicare PPO.
- Prescription drugs — OptumRx replaces Blue Shield as the administrator of prescription drug benefits for UC’s PPO plans.
During Open Enrollment, members will learn more about how best to prepare for the change. For example, you’ll want to confirm your current doctors and other providers (including behavioral health) are in-network in 2017, and to check the OptumRx formulary to confirm the costs of your prescription medications. If you’re currently receiving treatment, you may be eligible for transition assistance, depending on your situation.
Growing HMO options
There will be no significant HMO plan changes in 2017, but some new choices may make an HMO plan a better option for some members:
- Kaiser Permanente is opening new medical offices in Watsonville, downtown Santa Cruz and Scotts Valley. Local hospital services and inpatient care will be provided by Watsonville Community Hospital as well as at nearby Kaiser Permanente medical centers in Santa Clara and San Jose. Kaiser Permanente Santa Cruz County facilities provide services to non-Medicare members only, so this option is not available if one or more family members is enrolled in Medicare.
- The Canopy Health alliance formed between Hill Physicians-SF (UCSF), John Muir Health, Meritage Medical Network and the affiliated hospitals will increase access to providers for Health Net Blue & Gold members in the San Francisco Bay Area. If you choose a PCP within one of these medical groups, you will have access to the entire Canopy Health alliance and your PCP can offer referrals to any clinically appropriate specialist within Canopy Health.
- New Blue & Gold medical group choices in 2017 include Facey Medical Group in Los Angeles and Ventura counties, Monarch HealthCare Medical Group in Orange County, and Primary Care Associates Medical Group in San Diego County. Members of Direct Network — Merced will now have access to physicians located at Dignity Health Medical Group — Merced.
Your Open Enrollment website and booklet will be available the week of Oct. 24, with all of the details about your options and costs. Take time to review your choices, so you’ll have the right benefits for you and your family in 2017.