UC provides Medicare-eligible retirees and their families who live outside California a Medicare Coordinator program, administered by Via Benefits (formerly OneExchange).

This program offers retirees:

  • Choice: more local plans, including Kaiser, where available
  • Value: plans to fit every budget
  • Flexibility: each family member can choose a plan to meet his/her needs
  • Personalized support from Via Benefits

This program has two components:

  • Enrollment in an individual medical plan through Via Benefits
  • A Health Reimbursement Account (HRA) funded by UC

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
  • Be eligible for UC retiree health insurance

Via Benefits

To assist retirees, UC has partnered since 2014 with Via Benefits (formerly OneExchange), 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. Please note that OneExchange was renamed Via Benefits in March of 2018. Only the name has changed, not the services retirees receive or the processes they follow.

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.

How the program works

Beginning in March 2019, Via Benefits will begin sending regular mailings to UC retirees who are at least 64 years old — the year before they become eligible for the Medicare Coordinator Program — informing them of their medical plan choices when they turn 65.

Via Benefits will help prepare you and your covered family member(s) for enrollment by age 65 and provide you with plan choices, flexibility, and competitively-priced individual Medicare health insurance plans. Through Via Benefits licensed benefits counselors, you also receive personalized and unbiased guidance to help you choose and enroll in a Medicare plan that meets your health care needs and budget.

After you and/or your eligible spouse/domestic partner enroll in Medicare health care coverage through Via Benefits, you become eligible to receive UC funding through a Health Reimbursement Arrangement (HRA). Funds from this HRA help pay for your eligible out-of-pocket health-related expenses such as insurance, Part B premiums and copays through a reimbursement process — you pay for these expenses first and then get reimbursed. 

Enrolling in an individual plan through Via Benefits when you first become Medicare eligible will allow a smoother transition into Medicare and a plan that meets your individual needs. Working directly with a carrier (except with Kaiser) will terminate your HRA funding.

What you can expect

Depending on the time of the year you turn 64 and UC notifies Via Benefits, here is what you can expect within months before your 65th birthday:

  • A series of quarterly letters preparing you for your Medicare plan enrollment through Via Benefits (you’ll receive your first letter when you turn 64).
  • 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, as well as 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 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 don’t lose your HRA funds. Do not enroll directly with the carrier unless it is Kaiser Permanente.  
  • 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. However, 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’re 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 2018 should be submitted to Via Benefits by Dec. 31, 2019.

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