The UC Health Savings Plan (HSP) is a high-deductible PPO (preferred provider organization) paired with a health savings account (HSA), a federal tax-free account maintained by HealthEquity, to help pay your out-of-pocket costs.

Use the HSA comparison tool (comparemyhsa.com/UC) to find out whether UC HSP is right for you. (Please note that scenarios and calculations presented in this tool are example estimates only and are not intended as tax or financial advice. Individual costs and savings may vary.)

The IRS and UC have rules in place that limit who can enroll in this plan. You are not eligible to enroll in UC HSP if you:

  • Are already enrolled in Medicare. Medicare eligibility usually begins at age 65 and you can be retroactively enrolled in Medicare Part A, unless you can postpone your Medicare enrollment. Medicare Part A is mandatory for those who receive Social Security income. Check with Social Security to determine your eligibility to postpone Medicare enrollment.
  • Are a retiree who was not enrolled in UC HSP while you were employed by UC. If you are enrolled in UC HSP when you retire, you may continue your enrollment in the plan as long as you are not enrolled in Medicare.
  • Are a retiree otherwise eligible for enrollment in UC HSP and you cover a family member who is enrolled in Medicare, unless you de-enroll your Medicare-enrolled family member from your coverage. 
  • Plan to enroll in UC’s Health Flexible Spending Account (FSA), or have any balance as of December 31, 2017, in UC's Health FSA. You may forfeit any unused Health FSA funds for 2017, including carryover funds, by faxing your signed, completed Health FSA Carryover Waiver Form to WageWorks by Dec. 31, 2017 at 888-866-3312. 

Plan changes 

Pharmacy benefits changes

Beginning Jan. 1, 2018, Anthem Blue Cross will administer pharmacy benefits for UC HSP and UC’s other preferred provider organization (PPO) medical plans, and will continue to administer medical and behavioral health benefits. The administrator of your plan processes claims, creates a network of health care providers or pharmacies and sets clinical policies and guidelines.

If you are continuing your enrollment in UC HSP, you and each of your family members will get a new ID card from Anthem Blue Cross that you can use to access medical care, behavioral health services and prescription medications. Your Anthem Health Guide will now be able to answer questions about all of your benefits, at the same number: 844-437-0486. You’ll have a new member website for all of your benefits: ucppoplans.com.

UC and Anthem are working to minimize disruption during this transition. For the most part, open prescriptions will transfer automatically, and prior authorizations will remain in effect after the transition. Anthem will reach out with more information about changes that may affect you.

Still, to make sure you’re prepared for the change, it’s a good idea to:

  • Refill your prescriptions before the end of the year.
  • Check the Anthem formulary and prescription drug costs.

Your current covered medications will continue to be covered, but the cost of your medications may change. You may want to talk to your doctor about an alternative drug that is on the formulary to help you manage your costs.

UC HSP members will have more options for prescription refills next year. You can get a 90-day supply of prescriptions at CVS and selected Anthem Retail90 pharmacies, as well as at UC Medical Center pharmacies, Walgreens, Safeway/Vons and Costco. Oral contraceptives may now be dispensed up to a 12-month supply at one time.

Live Health Online to include psychiatrists

The Live Health Online network of board-certified doctors has been expanded to include psychiatrists. Appointments are available through Live Health Online 24/7, with cost sharing of 20 percent after the deductible. See ucppoplans.com for information about cost, requirements and how to get started.

Cost sharing eliminated for some preventive care

Low- to moderate-dose statins will be covered at $0 copay for cardiovascular disease prevention, provided certain criteria are met. Screenings for preeclampsia using blood pressure measurement throughout pregnancy will also be covered at $0 copay.

Health Savings Account (HSA) changes

The individual contribution limit for the UC HSP Health Savings Account (HSA) will increase from $3,400 to $3,450. The family limit will increase from $6,750 to $6,900.

If you are covering your domestic partner under this plan, both you and your partner can establish an HSA and you may both contribute up to $3,450 (for an individual HSA) or $6,900 (if you also enroll an additional family member) for the year. People age 55 and over can make an additional “catch-up” contribution of $1,000.

UC will continue to contribute to the HSA annually up to $500 for individual coverage and $1,000 for all other coverage. This one-time UC contribution to your HSA is based on your coverage level as of Jan. 1, and will not be adjusted midyear if your coverage level changes.

How the HSP plan works with the HSA

  • As an HSP member, you can use your HSA funds now to pay for your plan’s deductible and/or out-of-pocket maximum for all eligible health care expenses. For a complete list of eligible expenses, read the IRS Publication 502 on the IRS website. You can also save your HSA funds until you turn 65.
  • For your convenience, all your claims from UC plans under Anthem, VSP and Delta Dental will be sent to HealthEquity. Make sure you only request reimbursement for those claims that are incurred after you have established your HSA.
  • After you receive services, your provider will bill your plan (Anthem Blue Cross, VSP or Delta Dental). Your plan will send you an Explanation of Benefits explaining what’s covered, and your provider will send you an invoice for what you owe. If you choose to pay your invoice using HSA funds, you can:
    • pay your bill with your HSA debit card
    • pay your provider directly through the HealthEquity portal
    • use another method of payment and request reimbursement through the HealthEquity portal
  • When you fill or refill a prescription, the pharmacy will verify your coverage and prescription costs. You can choose to pay with your HSA debit card, pay for the prescription through the HealthEquity portal or use another method of payment and request reimbursement through the HealthEquity portal.
  • You can choose any doctor or hospital you wish, but services obtained from providers in the Anthem Blue Cross PPO network cost less.
  • Preventive care from in-network providers is covered at 100% without the need to meet your deductible.
  • For all other services and prescriptions, you pay 100% of the cost, until you meet the deductible.
  • Once you meet the deductible, you pay 20% for Anthem Blue Cross PPO network providers and 40% for out-of-network providers.
  • The in-network deductible is $1,350 for individual coverage and $2,700 for family coverage; the out-of-network deductible is $2,550 for individual coverage and $5,100 for family coverage.
  • Annual out-of-pocket maximums limit what you pay for covered services. If you reach the annual maximum, the plan pays 100% of your medical and prescription drug costs for the rest of the year. The maximums for in-network services are $4,000 for individual coverage, $6,400 for family coverage; out-of-network maximums are $8,000 for individual, $16,000 for family.
  • Behavioral health benefits from both in-network and out-of-network providers are provided by Anthem Blue Cross. Anthem in-network providers generally cost less, but you may also use out-of-network providers. Costs are included in your deductible and out-of-pocket maximums.
  • If you are already enrolled in Medicare, you cannot enroll in this plan, according to the IRS. Medicare eligibility usually begins at age 65 and you can be retroactively enrolled in Medicare Part A, unless you can postpone your Medicare enrollment. Medicare Part A is mandatory for those who receive Social Security income. Check with Social Security to determine your eligibility to postpone Medicare enrollment.
  • Due to the UC contribution to your HSA, if you cover a family member and he/she is enrolled in Medicare, you cannot enroll in this plan unless you de-enroll your Medicare-enrolled family member from your coverage. Remember that the entire UC contribution is deposited automatically at the beginning of the year and is based on your coverage level.

The Health Savings Account

  • The Health Savings Account (HSA) by HealthEquity allows you to pay for your out-of-pocket health care expenses with tax-free dollars. You can use the funds at any time for qualified medical expenses or save them for future health care needs. For a complete list of eligible expenses, read the IRS Publication 502 on the IRS website.
  • You file claims directly with Health Equity. You can save your receipts or upload them to the HealthEquity website.
  • Your HSA has a “use-it-or-keep-it” feature, so your account balance rolls over annually and continues to grow tax-free.
  • The IRS sets the contribution limits each year. For 2018, it is $3,450 if you only cover yourself under the HSP and $6,900 if you cover at least one other family member. This contribution limit includes funds from all sources, including the UC contribution.
  • UC contributes to the HSA (up to $500 for individual coverage/$1,000 for all other coverage) and you can, too, with pre-tax payroll deductions, subject to payroll deadlines. Remember to reduce your total contribution by the amount UC contributes to your HSA to comply with the IRS. Individuals age 55 and older can make an additional "catch-up" contribution of $1,000 using the UPAY850 form PDF (employees only).
  • Retirees make after-tax contributions directly to HealthEquity and take the tax benefit when filing federal income taxes.
  • You own the account, so the money goes with you when you leave the HSP or when you end your employment with UC. You can continue to contribute to it as long as you are enrolled in a qualifying high-deductible health plan — even into retirement. You can also continue to use your funds for eligible health care expenses even if you can no longer contribute to the HSA.
  • When you’re ready to use your funds, you can take them out of your HSA without paying any federal taxes.
  • You earn interest on your account, and can invest any funds in excess of your $1,000 balance — the same way you invest funds in retirement savings accounts, except interest accrues federal tax-free.
  • Contributions and earnings are currently subject to California income tax.
  • You must have a valid Social Security number and U.S. address to establish your HSA.
  • You cannot enroll or have any balance as of December 31 in UC's Health Flexible Spending Account (FSA) if you enroll in the UC Health Savings Plan effective January 1 of the following year.
  • If your coverage through UC Health Savings Plan begins any time after January, your HSA will be prorated for the calendar year based on this schedule. However, the plan deductible is not prorated. If you continue the plan the following year, you will receive the full HSA beginning January 1.
  • Here are a few things to keep in mind if you decide to become an HSP member. You are responsible in administering your Health Savings Account (HSA). As an HSA owner, you decide:
    • Whether you are eligible to make contributions to an HSA
    • The amount of the eligible contribution to the HSA for any calendar year
    • The withdrawal of any excess contributions
    • How funds in your HSA will be spent, and
    • Whether the distributions from your HSA are taxable or non-taxable.
  • You cannot delegate these responsibilities to either the University or to HealthEquity. Since as HSA owner you are in control of the HSA, you are responsible for reporting all contributions and distributions to the IRS on your Form 1040. If you make any errors and do not correct them timely, you must pay additional tax and/or penalties to the IRS.

Best fit for you if:

  • You want direct access to all providers without need for referrals
  • You want federal tax-free savings for current and future health care costs
  • You are able to risk incurring greater out-of-pocket costs
  • You want to build a retirement savings for future health care costs for you and your eligible family members

Monthly plan costs for faculty and staff

Retiree plan costs chart »

Pay Band
(per annum)
Self Self +
Child(ren)
Self +
Adult
Family
$54,000 and under $19.83 $35.70 $43.44 $59.29
$54,001–$107,000 $55.88 $100.59 $125.74 $170.43
$107,001–$161,000 $92.88 $167.19 $199.50 $273.79
$161,001 and above $131.19 $236.15 $275.92 $380.86

Typical out-of-pocket costs

Once you've met the deductible, you pay:

  • Office visit/urgent care visit: preferred provider: 20%; non-preferred provider: 40%; (in-network preventive care has no charge)
  • Emergency room: 20%
  • Hospital stay: 20% in-network; 40% out-of-network
  • Prescription drugs: 20% if purchased from in-network pharmacy; 40% from out-of-network pharmacy