The date has been set for UC’s open enrollment period for 2025 benefits: Thursday, Oct. 31 to Friday, Nov. 22, 2024, at 5 PM (PT). You’ll get all the news about your choices and any changes in the November New Dimensions, but this is a good time to brush up on the basics so you’re prepared to make the right decisions this fall.
To help you get ready, here are answers to a few frequently asked questions about your UC retiree health and welfare benefits.
What benefits choices will I have during Open Enrollment?
During Open Enrollment, you can enroll in or make changes to your medical, dental, vision and/or legal coverage. You can enroll in pet and/ or accidental death and dismemberment insurance at any time.
I’m happy with the benefits I have. Do I need to do anything during Open Enrollment?
It’s important to pay attention to Open Enrollment communications even if you want your current coverage to continue automatically into the next year. Here are a few reasons why:
- Medical plan premiums are subject to change each year — sometimes significantly. Making sure you understand your 2025 costs during Open Enrollment will help you avoid surprises.
- The factors that are important to your benefits decision may have changed since you last considered them. For example, you may need new prescription medications or medical care, or be interested in changing providers.
- If you or a family member are enrolling in Medicare in 2025, think carefully about the medical plan you choose during Open Enrollment. Your non-Medicare plan will determine which partner Medicare plan you will be transferred into when you turn 65. Unless you are enrolled in the UC Health Savings Plan, UC does not allow you to change plans mid-year.
I’m enrolling in Medicare in 2025 — are there any resources to help me understand my choices and what I need to do?
Yes! UC offers many helpful resources, including the Medicare Fact Sheet, Medicare FAQs and Medicare office hours and webinars. For more information about these resources, see What to do when you’re enrolling in Medicare at ucal.us/medicare.
How can I find out whether a drug prescribed by my doctor is covered by my medical plan, or by a plan I’m considering during Open Enrollment?
The prescription drugs covered by each medical plan are included in the plan’s formulary (a list of generic and brand name prescription drugs covered by a plan) which is developed by the plan’s administrator or pharmacy benefit manager.
Each plan’s formulary can be slightly different, so if you’re considering a new medical plan it’s a good idea to check the plan’s formulary. You can call the customer service number on your ID card to find out whether a particular drug is on the formulary, or you can search the formulary on your plan’s or pharmacy benefit manager’s website.
Go to ucal.us/plancontacts for information about who manages pharmacy benefits for UC’s plans and how to find the formulary.
What factors affect UC’s medical plan premiums?
Medical plan premiums reflect a combination of administrative costs — what UC pays the health plan to manage the provider network, administer claims, etc. — and projected health care costs — payments for members’ medical treatments and prescription drugs.
UC negotiates with our health plan partners to keep administrative costs as low as possible. For the most part, UC’s medical plan premiums reflect the projected costs for providing the health care that is covered by the plan.
Inflation is going down. Does it look like health care costs and premiums will go down, too?
Unfortunately, it doesn’t.
Health care utilization in the U.S. (how much medical care people receive) continues to rise as our population ages and more people
manage costly chronic health conditions. With a population of employees and retirees that’s older than average, this is particularly true for UC.
Costs for health care also continue to rise in large part due to steadily increasing costs for new drugs and treatments.
What is UC doing to keep premium costs down for retirees?
In addition to UC’s contribution to retiree medical plan premiums, the Systemwide Human Resources team works closely with our health plan partners to manage costs. This year, we’ve expanded our evaluation of our medical plan offerings and plan designs to look for every opportunity to keep premiums as low as possible while continuing to offer high-quality, comprehensive medical coverage.
Are there any changes coming to Medicare that could influence my costs in 2025 or beyond?
A couple of significant changes are coming for Medicare in the next few years that may influence costs for some people:
- A provision of the Inflation Reduction Act will go into effect in 2025 capping the annual out-of-pocket costs for prescription drugs at at $2,000 for people with Medicare Part D.
- Another provision of the Inflation Reduction Act gives Medicare the right to negotiate directly with drug companies to improve access to some of the costliest single-source brand-name Medicare Part B and Part D drugs. Negotiations with participating drug companies are ongoing, and any negotiated prices for the first cycle of negotiation will become effective beginning in 2026.