Big changes and new choices: Five things you need to know before Open Enrollment
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Open Enrollment is from 8 a.m. on Thursday, Oct. 30, through 5 p.m. on Friday, Nov. 21, and there are some big changes to UC’s medical plans and premiums. If you sometimes ignore Open Enrollment, this is the year to take another look at your options.
Vice President Cheryl Lloyd reached out last week with a preview, along with some background about how UC is responding to rising costs. You can also learn more in the 2026 Benefits Changes Fact Sheet and Frequently Asked Questions.
Bottom line: The medical plan you have this year may not be available, or your best choice, for next year. Here are five things to know — and one thing to do — to make sure you’re prepared:
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HealthSavings+ is replacing CORE and UC Health Savings Plan.
HealthSavings+ will be UC’s lowest premium medical plan, and you’ll get a tax-advantaged Health Savings Account (HSA) with a higher contribution from UC (up to $750 for individuals and $1,500 for families).
CORE and UC Health Savings Plan members can enroll in any of UC’s medical plans during Open Enrollment. If you don’t act, you’ll be automatically enrolled in HealthSavings+ if you’re eligible.
Learn more:
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If you don’t choose a new plan during Open Enrollment, your premiums may change a lot.
UC is balancing premiums more equitably next year, paying about the same percentage of total premium costs for Kaiser HMO as for UC Blue & Gold HMO.
Plans that offer flexibility and choice, including in-network UC Health providers, will be more affordable. Monthly premiums will be higher for most Kaiser HMO members and most CORE members moving to HealthSavings+.
You’ll have all the details on the Open Enrollment website beginning Monday, October 27. ALEX, your virtual benefits counselor, can show you 2026 medical plan premiums (specific to your plan, location and union group) beginning October 29.
Learn more:
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Blue Shield of California will be the plan administrator for HealthSavings+ and UC Care.
Nearly 98% of Anthem’s in-network providers are also in Blue Shield’s network, and you’ll have more in-network providers overall. Accolade Care Advocates and Navitus will continue as our partners.
Learn more:
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Your coverage through Delta Dental PPO is expanding.
To make it easier to see the dentist of your choice, we’re expanding coverage for out-of-network providers from 75% to 80% of allowed costs for some services. Since in-network providers agree to set costs, visiting a network dentist gives you the highest level of coverage and helps keep your out-of-pocket costs as low as possible.
Learn more: My dentist has left Delta Dental. Has UC considered other dental plan administrators.
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Coverage for weight loss medications and infertility services is changing.
Access to weight loss and appetite suppressant medications (for example, drugs known as GLP-1s) will be more limited across all UC medical plans. Following a state mandate, benefits for infertility services and prescriptions will be expanded and made more affordable for Kaiser HMO and UC Blue & Gold HMO members trying to grow their families.
Learn more:
What you need to do
Before you enroll or make changes — on UCPath from 8 a.m. on Thursday, Oct. 30 through 5 p.m. on Friday, Nov. 21 — consider all your options!
Resources to help you choose:
- The Open Enrollment website launches Oct. 27 with details about choices, changes and costs.
- ALEX is live on Oct. 29 with customized comparisons of medical plan premiums (including any caps or subsidies that may apply to your bargaining unit contract or location), out-of-pocket costs, and in-network providers.
- Your Open Enrollment packet, mailed from UC, and emails from UCPath and your medical plan are coming your way – so open your mail! (Note: The brochure in your packet has a typo that incorrectly states that HealthSavings+ will have the same premium as Kaiser CA HMO. As stated elsewhere in the brochure, HealthSavings+ premiums will be lower than premiums for Kaiser HMO next year. We apologize for the error!)
- Events at your location offer opportunities to ask questions.
- Represented employees: Your collective bargaining agreements and unions have more information about how these changes apply to you.
Frequently asked questions about 2026 benefits changes
UC’s response to rising costs
How much is UC contributing to medical plan costs?
UC is making a much bigger financial contribution than they have in the past — up by 9.5% from last year. Next year, UC will cover 83% of the total cost of medical premiums — on top of paying 100% of dental and vision premiums. This contribution is in addition to $55.5 million in subsidies and caps negotiated in bargaining unit contracts.
What else is UC doing to manage costs?
Systemwide Human Resources brought together representatives from groups such as the Academic Council and Employee and Labor Relations, along with outside experts, to look for new strategies to manage costs. The first step is increasing UC’s investment in benefits by 9.5%, for a contribution of 83% of the total cost of medical premiums. In addition:
- UC’s academic health centers are absorbing a significant part of their rising operating expenses, rather than passing those increases along in the cost of providing care to members of UC medical plans.
- UC is making big changes to medical plans and premiums that are designed to make plans with provider choice and flexibility more affordable and sustain our benefits program for the long term. These changes will bring a new low-premium PPO plan option along with lower premiums for some employees and higher premiums for others.
Though UC is paying more for medical premiums next year, these strategies are keeping overall premium increases lower for UC employees than they would otherwise be.
About HealthSavings+
Why is HealthSavings+ replacing CORE and UC Health Savings Plan?
UC Health Savings Plan members have seen unprecedented increases in their premiums over the last few years, while CORE members have missed out on the tax advantages of a health savings account (HSA). HealthSavings+ will be UC’s lowest premium medical plan, and it will be compatible with a health savings account (HSA).
To help HealthSavings+ members start saving for their medical expenses, UC is increasing its annual HSA contribution from $500 to $750 for individuals and from $1,000 to $1,500 for families.
UC contributes every year employees remain enrolled in the plan, and funds in the HSA carry over from year to year. The account belongs to the employee, whether they change jobs or medical plans or retire.
The benefits of HealthSavings+, such as the deductibles and coinsurance, are different than for the current plans. Learn more on the HealthSavings+ page.
What are the advantages of a Health Savings Account (HSA)?
Your HSA belongs to you, whether you change jobs or medical plans or retire. Funds in the HSA, along with earnings from interest or investments, carry over from year to year with no limit on the size of your account. (There are limits to how much you can contribute each year.) As you build your savings, you benefit from three significant tax advantages:
- Pretax contributions — Money is deducted from your paycheck before taxes, lowering your taxable income.
- Tax-free earnings — You can invest the money in your HSA, and your earnings are not subject to federal taxes.
- Tax-free withdrawals — As long as you use the funds for qualified medical expenses, you can withdraw the money from your HSA without paying any taxes, even in retirement.
I’m enrolled in CORE/UC Health Savings Plan. What happens if I don’t act during Open Enrollment?
Members of CORE and UC Health Savings Plan who don’t act during Open Enrollment will be automatically enrolled in HealthSavings+ if they’re eligible. If you cover a family member in a UC Medicare plan, you aren’t eligible for HealthSavings+ and will be automatically enrolled in UC Care.
Note that the benefits of HealthSavings+, such as the deductibles and coinsurance, are different than for the current plans. Make sure to take advantage of the many resources available to you to review how each plan works and choose the right medical plan for you and your family.
What are the out-of-pocket costs for HealthSavings+?
For in-network care, HealthSavings+ has 30% coinsurance for office visits and hospital stays, a $2,500 deductible ($5,000 for more than one person), and $6,700 out-of-pocket maximum ($13,400 for more than one person).
I have a Health Flexible Savings Account (FSA). What will happen to my money if I switch to HealthSavings+ with a Health Savings Account?
If you participated in the Health FSA and have a carryover balance $25 or more at the end of the year and you enroll in HealthSavings+ for the following plan year, a Limited Purpose Flexible Spending Account (LPFSA) will be created for you automatically and the balance of your Health FSA that is eligible for carry-over will be placed in the LPFSA. The following rules apply:
- Contributions are limited to the Health FSA balance; you may not contribute additional funds.
- Generally, eligible expenses are restricted to dental, vision and preventive care services.
- Participation is limited to one year; you may not re-enroll in the LPFSA for a subsequent plan year.
- Any balance remaining in the LPFSA at the end of the run-out period for the plan year is forfeited.
For more information, see the Health FSA Summary Plan Description PDF
Medical plan premium changes
How are medical plan premiums changing next year?
Beginning next year, UC is balancing premiums across comparable health plans. Monthly premiums for UC Care will be lower, and HealthSavings+ premiums will be lower than 2025 premiums for UC Health Savings Plan.
Some members moving from CORE to HealthSavings+ will see premiums that are up to $20 a month higher for single coverage and up to around $94 higher for family coverage. These premium increases will be offset by UC’s contribution to the Health Savings Account.
Kaiser HMO members in the up to $73,000 salary range (as of Jan. 1, 2025) who pay for single coverage may see increases up to $36 a month, while those who pay for family coverage may see increases up to $169 a month. The effect of increases to Kaiser premiums for some represented employees will be mitigated by existing caps and subsidies.
The Open Enrollment website launches Oct. 27 with details about premiums for each medical plan and level of coverage. ALEX will be live on Oct. 29 with customized comparisons of medical plan premiums (including any caps or subsidies that may apply to your bargaining unit contract or location), out-of-pocket costs, and in-network providers.
Why are premiums increasing for most members of Kaiser HMO?
In recent years, UC subsidized a larger share of the total cost for the Kaiser HMO compared to other UC plans with similar benefits, particularly for employees with salaries up to $145,000. Beginning next year, UC is balancing premiums across comparable health plans. UC will pay roughly the same percentage of total premium costs for Kaiser HMO as it does for UC Blue & Gold HMO.
As part of this change, UC is adjusting its premium subsidy structure to make plans that include in-network UC Health providers more affordable. UC Blue & Gold HMO, UC Care and our new HealthSavings+ plan connect employees with the extensive network and expertise of UC’s academic health centers across the state. These plans provide access to leading specialists, advanced treatments, and coordinated care at UC medical campuses, ensuring high-quality, integrated care within California’s premier public health system.
Premiums for represented employees will be implemented consistent with applicable collective bargaining agreements and the law.
I’m represented by a union. How will my medical plan premiums be affected by these changes?
If you’re a represented employee, your medical premiums for next year will be implemented consistent with the collective bargaining agreements that apply to you, and with the law. For example, the effect of increases to Kaiser premiums for some represented employees will be mitigated by existing caps and subsidies.
To see rates specific to your location and bargaining unit (if represented), visit ALEX or sign in to your UCPath account during Open Enrollment.
Plan benefit changes
How is coverage for weight loss medications changing?
Across the faculty/staff PPO and HMO plans, access to weight loss and appetite suppressant medications (for example, drugs known as GLP-1s) will only be available for members with a body mass index (BMI) of 40 or higher. Some members who are currently using these medications may be able to continue their coverage — consult your health plan or plan documents for more information. These medications will continue to be covered at current eligibility criteria for members with diabetes.
How is coverage for Infertility services and prescriptions changing?
In response to a California state mandate, benefits for infertility services and prescriptions will be expanded and made more affordable for Kaiser CA HMO and UC Blue & Gold HMO members trying to grow their families. Coverage will expand to include up to three completed oocyte (egg) retrievals per lifetime and unlimited embryo transfers of IVF, GIFT and ZIFT per member. Infertility services and prescriptions will be covered at the plan-specific cost share.
Plan administrator changes
Why is Blue Shield of California replacing Anthem as administrator for employee PPO plans?
An important part of our responsibility for overseeing UC’s benefits is regularly reviewing the insurance carriers who administer our plans to ensure we’re getting the best service and provider networks at a reasonable cost. We’ve completed thorough reviews of the administrators for our employee PPO plans, Medicare supplement plans and dental plans.
Blue Shield of California is replacing Anthem Blue Cross as the administrator of UC Care and will be the administrator for HealthSavings+. Blue Shield was selected as our best choice by a committee with representatives from UC’s stakeholder groups.
Is Blue Shield replacing Accolade and Navitus, too?
No. Accolade Care Advocate will provide member services for UC Care and HealthSavings+. Navitus will continue to be the pharmacy benefit administrator for the faculty/staff PPO and Medicare Supplement PPO plan members.
How will I know if my provider is not in the Blue Shield network?
Almost 98% of Anthem’s in-network providers are in-network for Blue Shield. The transition to Blue Shield will increase the total number of providers who will be in-network for UC Care and HealthSavings+.
If your current provider is not in the Blue Shield network, you will receive a letter from UC in early October explaining your options. You can also search for a new provider by using the Blue Shield provider search tool at www.blueshieldca.com/networkppo.If you need assistance finding a nearby provider or confirming if you can continue treatment with a current provider, an Accolade Care Advocate can help. Call (866) 406-1182, Monday through Friday, from 5 a.m. to 8 p.m. PT.
We’ve spent well over a year getting ready for the implementation of Blue Shield as our new plan administrator, and our partners — Blue Shield, Navitus and Accolade — are working together closely to make sure our members have a smooth transition.
Were UC’s other medical plan administrators evaluated, too?
UC follows the best practices advised by UC Procurement in evaluating administrators for its benefits plans. In parallel with UC’s review of the employee PPO plans, another group of stakeholders reviewed our options for administering UC High Option Supplement and UC Medicare PPO (with and without prescription drugs) plans and determined that Anthem Blue Cross remains our best choice.
UC plans to review other medical plan partners in the coming years.
My dentist has left Delta Dental. Has UC considered other dental plan administrators?
We heard from many employees that their providers are leaving the Delta Dental network. UC conducted a thorough review to determine if another administrator would better serve the UC community. Our review found that Delta Dental does remain our best choice — changing administrators would put the providers of about 20% (80,000) of our members out of network.
To help members who can’t find an in-network provider, PPO plan out-of-network coverage for select services is increasing from 75% to 80% of allowed amounts. Note: in-network dentists agree to set charges for covered services, so your costs will be lower in-network.
Getting help
With so many changes, how can I decide which medical plan makes the most sense for me and my family?
People make decisions in many ways, so we’re offering all sorts of resources to help you understand your new options. Here are a few to consider:
- Visit UCnet, the Open Enrollment website (launching Oct. 27) and ucal.us/facultystaffppo to learn all about HealthSavings+ and how it compares to UC’s other medical plans. You can check out a quick video, comprehensive comparison tools and everything in between.
- Let ALEX guide you through your benefits decisions. ALEX will ask you a few questions and provide a customized comparison of medical plan premiums (including any caps or subsidies that may apply to your bargaining unit contract or location), out-of-pocket costs, and in-network providers. ALEX can tell you about dental, vision and non-health benefits, too (2026 plan information will be available in ALEX by October 29, 2025).
- Keep an eye out for your Open Enrollment packet from UC, along with important emails from UCPath and your medical plan.
- Get help from experts at your location. Check your location’s benefits website or visit the Open Enrollment website beginning Oct. 27 for a schedule of webinars, events and information sessions.
Where can I go for more help?
If you need more support, please contact your local benefits office or health care facilitator.