Administered by Via Benefits

UC sponsors a Medicare Coordinator Program for Medicare-eligible retirees and their eligible family members who live outside California. Via Benefits is the administrator for the Medicare Coordinator Program.

This program offers retirees:

  • Choice: more local plans, including Kaiser, where available
  • Value: plans to fit every budget
  • Flexibility: family members can choose plans to meet their individual needs
  • Personalized support from Via Benefits

The Health Reimbursement Account

If you are eligible, your enrollment in an individual medical plan through Via Benefits will be paired with a Health Reimbursement Account (HRA), with a maximum annual contribution of $3,000 from UC. 

In most cases, the HRA funds provided by UC will cover the cost of the premiums as well as some additional out-of-pocket health care costs (such as Medicare Part B premiums and copays for your medical care). You pay your eligible expenses first, and then request reimbursement from your HRA.

If Medicare-eligible family members – such as a spouse or domestic partner – are covered, UC will also contribute up to an additional $3,000 towards their combined HRA. There is one HRA account per family. The amount of the HRA contribution from UC is based on graduated eligibility rules.

To qualify and maintain eligibility for HRA funding, you must continue paying your Medicare Part B premiums to Social Security and enroll through and work with Via Benefits to make any changes to your medical plan at all times. Working directly with a carrier, except with Kaiser Permanente, will terminate your HRA funding. See Enrolling in Kaiser for more information about the steps you need to take to enroll in Kaiser and set up your HRA funding.

Eligibility

To be eligible for this program, retirees and all covered family members must:

  • Be eligible for and enrolled in Medicare Parts A and B
  • Live outside California but within the U.S.
  • Be eligible for UC retiree health insurance

You are not eligible for this program if you are a recipient of UCRP Disability income, or if your eligibility for Medicare is due to a disability such as end stage renal disease (ESRD).

Via Benefits

To assist retirees, UC has retained Via Benefits, a specialist in helping retirees choose individual Medicare plans and providing support after enrollment, including help with coverage, claims, and network questions. UC remains committed to providing your retiree health benefits and believes this arrangement with Via Benefits provides you with improved benefits and service.  

How the program works

Current members

The Open Enrollment for Via Benefits occurs annually in the fall during the Medicare Open Enrollment period, which is October 15 to December 7. Watch your mail for information from your current plan and Via Benefits. If you are happy with the plan you have, you do not need to take any action. Your Open Enrollment plan election becomes effective January 1 of the following year. 

New members

As of January 2020, eligibility for the Medicare Coordinator Program is determined on a monthly basis, whether you become eligible because you retire, move out of California or turn 65.

If you cover yourself only, Via Benefits will reach out to you as soon as you are identified to be potentially eligible for the program. Communications may begin the year you turn 64, to ensure you have plenty of time to prepare. 

If you are covering one or more family member, you will start to receive regular communication from Via Benefits as soon as your entire family is identified to be potentially eligible for the program. Your family's eligibility is based on the youngest family member's Medicare-eligibility date, or the date your child becomes ineligible for UC group coverage.

What to expect

Depending on the time of the year you turn 64, within months before your 65th birthday you'll receive:

  • A series of quarterly letters preparing you for your Medicare plan enrollment through Via Benefits
  • A Via Benefits Enrollment Guide which will provide you with information on what to expect and how to best prepare for your enrollment
  • Phone calls from Via Benefits customer service representatives to ensure you have Medicare Parts A & B in place before your 65th birthday, and to answer any initial questions you may have

After your Medicare enrollment through Via Benefits, you will receive an HRA Funding Guide to Reimbursement with important information and all relevant documents necessary to access your HRA funds.

What you need to do

  • Make sure your address and contact information is current. To make corrections, visit UC Retirement At Your Service Online.
  • Enroll in Medicare as soon as you become eligible. If you do not qualify, check and see if you may be eligible under a former, current or deceased spouse. Call Social Security for more information.
  • Read all correspondence from UC and Via Benefits to best prepare you for your continued medical plan insurance after your 65th birthday.
  • Remember that your enrollment through Via Benefits qualifies you for the HRA. Therefore, work directly with Via Benefits to enroll and or to make changes to your plan or coverage to ensure you do not lose your HRA funds. Do not enroll directly with the carrier unless it is Kaiser Permanente (see Enrolling in Kaiser).  
Contact the UC Retirement Administration Service Center (RASC) if you believe you are eligible and did not receive an enrollment packet from Via Benefits, or if you believe you are not eligible for the Medicare Coordinator Program.

Enrolling in Kaiser

Kaiser Permanente Medicare Plus is available if you live in a zip code that offers Kaiser Medicare plans. Your Kaiser enrollment makes you eligible to receive the UC contribution to the HRA. It is important that you follow the process below for enrolling in a Kaiser plan to set up your HRA:
  • Call Via Benefits and tell them you are interested in enrolling in Kaiser.
  • The Via Benefits benefit advisor will give you the appropriate Kaiser number to call.
  • Call Kaiser and complete the enrollment.
  • Once enrolled, call Via Benefits to let them know you are enrolled with Kaiser.  Be prepared to provide your Kaiser identification number.
  • Via Benefits will then set up your HRA.
Note: UC does not permit direct enrollment through any other carrier/broker outside of the Via Benefits Individual Marketplace, only Kaiser.

Reimbursement requests

After enrollment, Via Benefits will send a Funding Guide to Reimbursement with the instructions and forms you need to manage your HRA and request reimbursement for your eligible expenses.

You can submit reimbursement requests to Via Benefits for out-of-pocket expenses as you incur charges, or you can provide them later. The deadline to submit reimbursement requests for a plan year is Dec. 31 of the following year. For example, claims for charges incurred in 2019 should be submitted to Via Benefits by Dec. 31, 2020.

Keep your original receipts and documents; you only need to provide copies to Via Benefits for reimbursements. 

Questions?

If you have questions, contact Via Benefits at 855-359-7381 (TTY: 711) Monday through Friday from 5 a.m. to 6 p.m. Pacific Time. Alternatively, go online at my.viabenefits.com/uc

Notice of incorrect notifications

In March and April of 2019, certain retirees covering a spouse or domestic partner under 65 years old or a child under the age of 26 may have received notification advising that your UC group medical plan would end on December 31, 2019, and you would be required to enroll in Via Benefits for January 1, 2020. This letter was sent in error.

If you have received this letter, please disregard and know that your family remains eligible in the UC group medical plan. UC’s eligibility criteria has not changed for split families — families that consist of both a Medicare and non-Medicare member. To transition to the Medicare Coordinator Program through Via Benefits, all covered members of the family need to have enrolled in Medicare.

If you and/or your spouse or domestic partner acted on the original information received and one of you enrolled through Via Benefits, please contact UC’s Retirement Administration Service Center toll-free at 800-888-8267 immediately.   

On behalf of UC, please accept our apology for this misinformation and confusion. Know that your record was updated with the correct effective date for your transition to Via Benefits.