Medical plan premiums are increasing in 2024 due to a number of factors, including growing medical inflation, increased utilization of health care and more high-cost claims. To help keep medical coverage affordable for employees and retirees in the face of dramatic increases in costs, UC is boosting its contributions to medical plan premiums for 2024.
Despite UC’s higher investment, contributions from plan members will be higher next year for most plans. Look carefully at your choices to make sure you’re in the right plan for you and your family. If you're an employee, ALEX can help you compare your options and show you premium rates specific to your location and bargaining group (if represented).
To help protect UC employees, retirees and their families from the rising cost of health care, UC approved a significant budget increase for 2024 — an additional $84 million for employees and $9 million for Medicare-eligible retirees. These additional subsidies directly reduce member premiums. This follows an increase in 2023 of $29.5 million for employees and $5.5 million for retirees.
For Medicare-eligible retirees with 100% graduated eligibility, UC Medicare Choice and Kaiser continue to be free, with retirees receiving partial reimbursement to cover Part B premiums.
Yes, UC is honoring the commitments made in union contracts pertaining to employee contributions to health benefits.
Yes. UC’s existing health plan agreement with Anthem — in place until 2025 — will continue to ensure access to UC Health physicians and facilities through the UC plans that Anthem administers (CORE, UC Care, UC Health Savings Plan, UC High Option, UC Medicare PPO and UC Medicare PPO without prescription drugs).
UC continues to offer multiple medical plans for employees and for retirees, with a range of premium costs. For employees, this includes the CORE plan which has no monthly premium (but does have a higher deductible and greater out-of-pocket costs at the time of care).
UC’s benefits decision support tool, ALEX, is available to help employees determine which plan is the best fit for you and your family. ALEX will ask a few questions, then provide rates specific to each employee, as well as estimates of out-of-pocket costs for care and side-by-side plan comparisons.
Each medical plan carrier contracts with doctors, medical groups, hospitals and other providers. One plan may negotiate a lower rate than another, and so be able to include a doctor or medical group in its lowest cost network while another cannot. That's one of the reasons UC offers a choice of medical plans: to provide the widest choice of doctors and facilities at the lowest cost possible.
Due to IRS regulations, the HSA must be combined with a qualifying high deductible medical plan, so it’s only available to you if you enroll in the UC Health Savings Plan. If you enroll in any of UC’s other medical plans, you’re eligible to enroll in the Health FSA. You are not allowed to contribute to both an HSA and a Health FSA in the same tax year.
With an HSA (Health Savings Account), both UC and you can contribute to the account, up to the limits set by the IRS. Your contributions are pretax and lower your taxable income. You can use the money in the account to pay eligible medical expenses for you and your eligible tax dependents, and when you withdraw funds for qualified medical expenses, the funds continue to be tax-free. Funds in the account earn interest and carry over at the end of the year. If you leave UC or retire, the account goes with you and you can continue to use the money in it to pay for eligible medical expenses.
The Health FSA also allows you to make pretax contributions to an account to pay for eligible medical expenses for you and your eligible family members. You can carry over up to $610 from one year to the next, but the account does not go with you if you leave UC or retire. Unreimbursed funds in excess of the carryover amount are forfeited.
CORE, UC Care and the UC Health Savings Plan are three appropriate plan options for those with covered family members who live and/or study out-of-state. All three plans allow members to access the nationwide Anthem provider network at the Preferred level of coverage (in-network). To find a provider, visit the provider directory.
The detailed benefits summary on each plan's website provides information on specific procedures.
Yes, UC’s medical coverage includes behavioral health benefits for mental health services and substance abuse treatment. Here are a few things you should know:
- If you select Kaiser, you may access care from Kaiser behavioral health providers or from Optum in-network providers.
- If you select UC Blue and Gold HMO, you may access care from Health Net Behavioral Health in-network providers.
- If you select a PPO plan, you may access care from Anthem Blue Cross in-network providers. You may also access care from out-of-network providers, but your costs will be higher and you may need to pay your provider directly for services and submit a claim for reimbursement.
- Even if you are a member of an HMO plan, you do not need a referral from your primary care provider to see a behavioral health provider. Some services require preauthorization.