All current UC medical plans will be available in 2017. UC employees and retirees continue to have a broad choice of plan designs and providers — including UC medical center doctors, hospitals and medical groups — to fit their needs. UC continues to cover most of the cost of the premiums.
If you're considering changing to a different plan, view the Medical Plan comparison video above to help you find the plan that best meets your needs. You'll also find details on each plan's web page.
There are a few significant changes this year, including new options for HMO members and new administrators for UC’s PPO plans.
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 expanding into Santa Cruz County, with 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.
- Health Net Blue & Gold 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. 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.
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.
UC has worked to minimize disruption for members, but there will be some changes to medical and behavioral health provider networks and to pharmacy costs. Our Transition Checklist can help you prepare for the change.
Kaiser and Western Health Advantage issue ID cards only to new members. All Health Net Blue & Gold members will receive new ID cards.
Members of Core, UC Care and UC Health Savings Plan (HSP) will receive new ID cards from Anthem Blue Cross. You’ll use one card to access medical, behavioral health and pharmacy benefits. New HSA debit cards will be issued by HealthEquity to all new members of the UC HSP and current members whose debit cards are expiring this year. HSA debit cards are good for three years from the issue date.
Members of UC High Option Supplement to Medicare and UC Medicare PPO with Prescription Drugs will receive separate ID cards from Anthem (to access their medical and behavioral benefits) and from OptumRx (to access the pharmacy/prescription drug benefits). Members of UC Medicare PPO without Prescription Drugs will receive ID cards from Anthem only.
Some plans have additional changes specific to the plan. Visit your medical plan's page for the details: