Frequently Asked Questions

Navitus Health Solutions (Navitus) is replacing Anthem IngenioRx as the administrator of prescription drug benefits for CORE, UC Care, UC Health Savings Plan, UC High Option Supplement to Medicare and UC Medicare PPO. As the pharmacy benefit manager, Navitus sets clinical policy and guidelines for medications and for the processing of pharmacy-related claims.

Navitus offers convenient options for filling prescription drugs, including participating University of California Health pharmacies, a large retail network (Costco, CVS, Walgreens, Walmart, and Safeway/Vons), mail order delivery through Costco (even if you're not a member) and access to specialty medications through Lumicera and participating UC specialty pharmacies.

Navitus will also provide robust support to help you better understand and manage your prescription drug benefit, including:

• 24/7 customer care
• A pre-enrollment website with tools for finding participating pharmacies, checking drug prices at the pharmacy of your choice, and looking up drugs included in the formulary (the list of drugs that are covered by the plan)
• A member portal for easy access to all your prescription medication information

There are no changes to the prescription drug copay for the UC Care plan, UC High Option Supplement, UC Medicare PPO or coinsurance amounts for the UC Health Savings Plan and CORE plan.

However, every prescription benefit manager uses its own formulary, which is a list of drugs that are covered by the plan. While the Anthem IngenioRx and Navitus formularies are similar, there are some differences, which could affect your individual medication costs. Visit the Navitus pre-enrollment website to access the formulary and benefit information, compare medication prices to find the lowest-cost option, and locate convenient network pharmacies.

Questions? If you can't find an answer to your question on the Navitus pre-enrollment website, call the Navitus 24/7 customer care team (closed Thanksgiving and Christmas):

• Medicare members: 866-270-3877 
• Non-Medicare members: 855-673-6504

• Employee plan costs
• Retiree plan costs

Each medical plan carrier contracts with doctors, medical groups, hospitals and other providers. One plan may negotiate a lower rate than another, and so be able to include a doctor or medical group in its lowest cost network while another cannot. That's one of the reasons UC offers a choice of medical plans: to provide the widest choice of doctors and facilities at the lowest cost possible.

Due to IRS regulations, the HSA must be combined with a qualifying high deductible medical plan, so it’s only available to you if you enroll in the UC Health Savings Plan. If you enroll in any of UC’s other medical plans, you’re eligible to enroll in the Health FSA. You are not allowed to contribute to both an HSA and a Health FSA at the same time.
With an HSA (Health Savings Account), both UC and you can contribute to the account, up to the limits set by the IRS. Your contributions are pretax and lower your taxable income. You can use the money in the account to pay eligible medical expenses for you and your eligible tax dependents, and when you withdraw funds for qualified medical expenses, the funds continue to be tax-free. Funds in the account earn interest and carry over at the end of the year. If you leave UC or retire, the account goes with you and you can continue to use the money in it to pay for eligible medical expenses.
The Health FSA also allows you to make pretax contributions to an account to pay for eligible medical expenses for you and your eligible family members. You can carry over up to $550 from one year to the next, but the account does not go with you if you leave UC or retire.

CORE, UC Care and the UC Health Savings Plan are three convenient plan options for those with children at out-of-state colleges. All three plans allow members to access the nationwide Anthem provider network at the Preferred level of coverage (in-network). To find a provider, visit the provider directory.

The detailed benefits summary on each plan's website provides information on specific procedures.

Yes, UC’s medical coverage includes behavioral health benefits for mental health services and substance abuse treatment. Here are a few things you should know:

• If you select Kaiser, you may access care from Kaiser behavioral health providers or from Optum in-network providers.
• If you select UC Blue and Gold HMO, you may access care from MHN in-network providers.
• If you select a PPO plan, you may access care from Anthem Blue Cross in-network providers. You may also access care from out-of-network providers, but your costs will be higher and you may need to pay your provider directly for services and submit a claim for reimbursement.
• Even if you are a member of an HMO plan, you do not need a referral from your primary care provider to see a behavioral health provider. Some services require preauthorization.

The IRS defines who can establish an HSA. The IRS has strict guidelines to determine who is eligible to own and contribute to an HSA. Under the law, you are eligible if:

• You are covered by a single or family high-deductible health plan — the only qualifying UC plan is UC Health Savings Plan.
• You are not covered by any other health plan, unless it is also a qualifying high-deductible health plan.
• You are not enrolled in Medicare.
• You are not claimed as a dependent on another person’s tax return, excluding your spouse.

You do.

Anyone can contribute to your HSA. However, only the account holder receives tax deductions on monies contributed. 

You don’t have to claim contributions you receive from others as gross income on your annual federal tax return. However, UC’s contribution to your HSA is subject to California income tax.

For 2022, the maximum annual contribution as set by the IRS for an individual account is $3,650 and the maximum contribution for family coverage is $7,300. You must take into account UC’s contribution (up to $500 for individuals and up to $1,000 for families) to your HSA to determine your personal contribution for the year.

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 $3,650 (for an individual HSA) or $7,300 (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, using the HSA, Life Insurance Voluntary Disability and AD&D Change Form.

You take that money with you wherever you go. The HSA is in your name. It’s your account. If you’re on Medicare or go to another employer that doesn’t have a qualified high deductible health plan similar to the UC Health Savings Plan, you can still use your HSA money to pay for co-pays and qualified medical expenses, but you won’t be able to continue to make contributions to your HSA.

The money rolls over from year to year. You don’t lose the money left in your HSA or the interest it’s earned. It’s your money.

No, IRS rules limit the use of both accounts simultaneously. If you are enrolling in the UC Health Savings Plan during Open Enrollment and are currently participating in a Health FSA, you must have a balance of $0 in your Health FSA on Dec. 31, 2021. If you think you will still have a balance in your Health FSA on Dec. 31, you should not enroll in this plan because you will not meet the IRS requirements. You may forfeit any unused Health FSA funds, including carrryover funds, by completing the Health FSA Carryover Waiver form (available on UCnet) by Dec. 31, 2021.

Yes. You can take money out anytime tax-free and without penalty as long as it’s to pay for qualified medical expenses. If you take money out for other purposes, however, you’ll have to pay income taxes on the withdrawal plus a 20% penalty.

Yes, and the interest is tax-free. HealthEquity calculates, compounds and credits interest monthly. The interest rate is based on your account balance. For current rates see the interest rate page in the HealthEquity online resource center.

Yes. Similar to an IRA, many HSAs let you choose to invest your account balance in stocks, bonds, mutual funds, CDs, and/or annuities. With your HealthEquity® HSA, you can typically invest in pre-selected mutual funds after you reach a $1,000 balance in your account.

Yes. However, if you choose to invest your account balance, those investments are not FDIC-insured.

Yes. You can make a one-time rollover from your IRA into your HSA. You can’t, however, roll money into your IRA from your HSA. Note that a rollover will count toward your annual contribution amounts.

Qualified medical expenses are those that generally would qualify for the medical and dental expenses income tax deduction as outlined in IRS Publication 502─Medical and Dental Expenses. See www.irs.gov/publications/p502/index.html for a current complete list.

Yes. The money in your HSA can be used to pay for qualified medical expenses of any family member who qualifies as your tax dependent. However, if the tax dependent isn’t covered under your plan, his/her expenses won’t be applied toward your deductible.

If your domestic partner meets the IRS qualifications of a tax dependent, you can legally use your HSA funds for his or her medical expenses. Otherwise, your domestic partner whom you cover in the UC-sponsored Health Savings Plan will need to establish his/her own HSA and can contribute up to $7,200.

You’re responsible to pay the amount your insurance has contracted to pay your doctor, typically a discounted rate, until your deductible is met. You can use your HSA for this expense. You may also choose to use your personal funds to pay for this expense and reimburse yourself later. There is no claims submission deadline under the HSA. The IRS allows you to reimburse yourself for any and all eligible claims incurred in the future.

It’s best to have your doctor’s office put the charge through to your insurance, so that you receive credit toward your deductible and know exactly what to pay.

Some doctors may require that you pay up front, but most bill your insurance, and then bill you once the claim has been processed. Make sure you don’t pay more than your portion shown on the explanation of benefits you receive from your insurance carrier.

Insurance premiums generally are NOT considered IRS-qualified medical expenses unless they are for:

• Continuing COBRA coverage
• Certain long-term care insurance
• Health coverage during unemployment
• Coverage over age 65, including Medicare or employer retirement health benefits

Yes. If you are under 65, though, you’ll be taxed on the amount you use and assessed a 20% penalty. Once you’re 65, you’ll be taxed for monies used for non-medical expenses, but you won’t pay a penalty.

The HSA can be used for cosmetic surgery only if prescribed by a physician as being medically necessary.

Retirees enrolled in UC Health Savings Plan may contribute to the HSA.

It depends, per UC rules. If your spouse who is on Medicare is covered under your UC plan, you may not enroll in or remain enrolled in UC Health Savings Plan and you may not contribute to the HSA. If you are not covering your spouse, you may enroll in or remain enrolled in UC Health Savings plan, and you may contribute to the HSA.

You’ll enroll in benefits through UCPath online beginning at 8 a.m. on Thursday, Oct. 28, 2021, by clicking the “Enroll Now” button at the top of the page. You can continue to make changes until Open Enrollment closes at 5 p.m. on Friday, November 19. Please note, you can only submit changes once each day.

The following plans will be available during Open Enrollment this year:

• Medical
• Dental
• Vision
• Supplemental Health Plans (complete your enrollment at ucplus.com)
• ARAG Legal
• Health Savings Account (paired with UC Health Savings Plan)
• Health Flexible Spending Account
• Dependent Care Flexible Spending Account
• Accidental Death and Dismemberment (open year-round)
• Pet Insurance (open year-round; enroll through Nationwide at petinsurance.com/uc)

The Supplemental and Dependent Life insurance plans, as well as Short-Term and Long-Term Voluntary Disability insurance plans, are open all year for enrollment; however, outside of your Period of Initial Eligibility (usually when you are first hired), evidence of insurability is required, except for children added to Dependent Life.

If you don’t take action, your current 2021 benefits will carry over to the 2022 plan year with the exception of enrollment in your Health and Dependent Care Flexible Spending Account (FSA). You will need to re-enroll if you would like to continue participating in an FSA in 2022.

You must re-enroll in your FSA during Open Enrollment each year if you wish to continue participating.

You will receive a Submission Statement via email upon submitting your elections. Allow 24 hours to receive your statement.

You can also sign in to UCPath online at ucpath.universityofcalifornia.edu the day after you have submitted your changes to confirm that your elections went through as intended.

Go to Employee Actions> Health and Welfare > Benefits Summary, change the date to January 1, 2022, and click Go. If you don’t see your changes recorded, please submit an inquiry by clicking on “Ask UCPath.” Select “Open Enrollment” as the topic in the dropdown.

You will receive a final email Confirmation Statement for your 2022 benefit choices by the second week of December, regardless of whether you made changes during Open Enrollment.

You will see your new benefit premium rates on January 4, 2022, for monthly employees and December 9, 2021, for bi-weekly employees. For disability, monthly employees can expect to see their new premiums on February 1, 2022, paycheck and bi-weekly employees on January 6, 2022, paycheck.

If you are on a leave of absence with pay, you will have the opportunity to make open enrollment elections online via UCPath during the Open Enrollment period. Your benefits will be effective Jan. 1, 2022.

If you are on a leave of absence without pay, you will also have the opportunity to make open enrollment elections. However, the effective date and method of enrollment depends on whether you elected to continue benefits while on leave without pay.

• If you are not enrolled in direct billing, you will select your open enrollment changes when you return from leave. Contact the UCPath Center for more information. 

• If you are enrolled in direct billing, you will submit your open enrollment elections via the Open Enrollment form which you should receive by mail. Contact the UCPath Center for more information.

If you are a new hire you will receive your New Hire packet along with an Open Enrollment packet with instructions on submitting your Open Enrollment benefits for the 2022 plan year.

If you are hired during the Open Enrollment period, you may see multiple benefit events in the Open Benefit Events Section in UCPath. If this is the case, you must complete the New Hire event before you complete the Open Enrollment event. 

Please note:

• If you only complete your new hire event, your 2021 elections automatically roll over to 2022, with the exception of your FSA elections (you must re-enroll in the FSA every year).
• If you only complete the 2022 Open Enrollment event, you will not have benefits until Jan. 1, 2022, when those elections become effective.

While making your Open Enrollment elections, you may select the “Waive” option for any benefit that you want to cancel. You may cancel/waive any plan that is editable during Open Enrollment. To cancel/waive a plan that is not listed in the Open Enrollment event, you may contact the UCPath Center.

Some Google Chrome browser users will encounter an error message when trying to access UCPath online. This is caused by updates that Google has been releasing to the browser across all major platforms (Windows, Mac, Android, and iOS).

What to do if you encounter this error message:

• Manually enter the URL ucpath.universityofcalifornia.edu into your web browser
• If the error message persists (after taking the above action), use another browser to access UCPath online

First-time users will see the following steps:

1. Go to UCRAYS at retirementatyourservice.ucop.edu.
2. At your first login, and after agreeing to UC's privacy statement and terms of use, you will be asked questions to confirm your identity.
3. Create a new password for your UCRAYS account.
4. If you’re using a computer or smartphone that is secure, register your trusted device. This can reduce the steps in the login process.
5. Add your cell phone number and personal email address, if they’re not already on file.

It may be helpful to clear your browser’s cache/cookies/browsing history and open a new browsing session before you start your login or registration process – especially if you just received a one-time password. To find out how, search “clear browsing history” in your browser’s help bar.

If you’re still receiving an error message, please call the RASC at 800-888-8267.