2014 Open Enrollment Benefits

2014 Medical Plans

2013 (7 plans) 2014 (5 plans)

• Anthem PPO• Anthem PLUS• Anthem HRA-PPO

• UC Care• Blue Shield Health Savings Plan

• Health Net Blue & Gold HMO• Health Net Full Network HMO• Kaiser HMO

• Health Net Blue & Gold HMO• Kaiser HMO

• Core • Core

2014 Medical Plans

UC Care plan design comparisonAnthem PLUS Anthem PPO UC Care

Blue Shield In/Out UC Select

DeductibleInOut

None$500/$1,500

$250/$750$500/$1,500

$250/$750$500/$1,500

None

Out-Of-Pocket Max $5,000/$15,000 $3,000/$9,000 $3,000/$9,000$5,000/$15,000

$1,500/$4,500

MD Visits (member share)InOut

$2530%

20%40%

20%50%

$20

Outpatient (member share)InOut

$030%

20%40%

20%50%

$20/20%(depending on service)

Hospitalization (member share)InOut

$25030%

20%40%

20%50%

$250

Rx (member share) $10/30/45 $10/30/45 $5/25/40

UC Care plan design

UC Care networkDifferences across locations

• A customized network of UC facilities and other high quality, low cost providers because every campus does not have a UC facility nearby

In-network• UC Select• Blue Shield Preferred• BlueCard network coverage outside of CA and the U.S.

Out-of-network• PPO providers not contracted within UC Select and Blue

Shield Preferred

UC Care network

UC Select• All UC medical centers, facilities and physicians• Additional select Blue Shield providers in areas where UC medical

centers and physicians may not be accessible• Chosen based on quality, location, cost and contracts (with

Blue Shield)• See appendix for facilities in UC Select

Blue Shield Preferred Network• 376 hospitals• 22,061 primary care physicians• 50,197 specialists

BlueCard Network coverage outside of CA and the U.S.

• 97% of Anthem contract providers are in the Blue Shield Preferred network

• 88% of providers in California are in the Blue Shield Preferred network

UCLA (1 of 3)UC Select Providers

Citrus Valley Medical Center - Queen of the ValleyDowney Regional Medical CenterGarfield Medical Center (San Gabriel Valley)Glendale Adventist Medical Center Good Samaritan Hospital (Los Angeles)Henry Mayo Newhall Hospital (Santa Clarita Valley)Huntington Memorial Hospital (Pasadena)Northridge Medical Center (Northridge)Providence Little Company of Mary (Torrance)Providence Little Company of Mary Medical Center San PedroProvidence Tarzana Medical Center

UCLA (2 of 3)UC Select Providers

Simi Valley Adventist Hospital(Dignity) St. Mary Medical Center (Long Beach)Torrance Memorial Medical CenterUCLA/Mattel Children's HospitalUCLA/Resnick Neuropsychiatric HospitalUCLA/Ronald Reagan UCLA Medical CenterUCLA/Santa Monica UCLA Medical CenterWhite Memorial Medical CenterWhittier Hospital Medical CenterSan Antonio Community Hospital

UCLA (3 of 3)

Some providers were excluded from UC Select, but are in Blue Shield Preferred:

• Los Robles Medical Center – excluded due to high cost. Lower cost alternative providers available in the area

• West Hills Medical Center – excluded due to high cost. Lower cost alternative providers available in the area

The Blue Shield Health Savings Plan

Mark Esteban, DirectorHealth & Welfare Planning and Financials

Blue Shield Health Savings Plan

Health Savings Account(HealthEquity)

Medical Coverage(Blue Shield PPO)

+

Combines high deductible PPO with account to pay out-of-pocket expenses

Your Health Savings Account:

You own the account

You can contribute to it

It has triple tax advantages

It comes with a HSA Debit Card

Currently enrolled in Anthem Lumenos and have an HRA balance? You’ll keep it as long as you enroll in the Health Savings Plan.

Why is it better than an HRA?

How does the HSA work?

UC funds your HSA account with $500 for individual and $1,000 for family

You can contribute up to $2,800/individual $5,550 family

If you’re 55 or older, you can contribute more

You can’t participate in this plan and UC’sFlexible Spending Account at the same time

You can’t be anyone’s tax dependent

Medical PPO Plan Design

Medical Plan Coverage

*Network preventive care

covered at 100%

In Network Out of Network

Deductible*SingleFamily

$1,250$2,500

$2,500 $5,000

Out-of-Pocket Max(includes deductible)

SingleFamily

$4,000 $6,400

$8,000 $16,000

Member Cost Sharing(coinsurance after deductible is met)

20% 40%

HSA Funding

HSA Funding

Contribution Types Individual Family

UC Contribution $500 $1,000

Employee Pre-Tax (optional) up to $2,800 up to $5,550

1. Go to your doctor.

2. Later – check your HealthEquity account online to see required payment to the doctor.

3. Pay with your HSA funds through your HealthEquity online account.

Give doctor’s office your Blue Shield card so BSC can…

process the claim and get you their special provider discounts and

send info about your amount of claim responsibility to Health Equity

Using Your Health Savings Plan

1. Go to your pharmacy.

2a. Pay for your Rx immediately if you want to use your HSA Debit Card,

OR

2b. Pay with personal funds (e.g., AMEX to get your points) and later go to your HealthEquity account online and reimburse yourself.

Give Pharmacist your Blue Shield Card so they can apply the Blue Shield Rx discounts.

Using Your Health Savings Plan

Transition of Care Policy – Overview

• All plans provide temporary transition of care services so members may complete a course of treatment and arrange for a safe transfer from a non-plan provider.

• Bridges gap between old and new plans. Important for those currently under care from providers who will no longer be in-network under member’s new plan.

• However, eligibility is limited; not every member will qualify• Employees who change plans voluntarily do not qualify

Pay bands adjusted annually, based on change in California consumer price index from February of prior year to February of current year (determined by the California Department of Finance).

Use index for urban wage earners and clerical workers (CPI-U). Change from Feb 2012 to Feb 2013 was 2.4%.

Updated Pay Bands

2013 Pay Band

Definition of Range Using Full-Time Salary As of Jan 2012

1 $50,000 & Under

2 $50,001 to $98,000

3 $98,001 to $147,000

4 $147,001 & Over

2014 Pay Band

Definition of Range Using Full-Time Salary As of Jan 2013

1 $51,000 & Under

2 $51,001 to $101,000

3 $101,001 to $151,000

4 $151,001 & Over

California Plans2013-2014

2013 ContributionsPay Band 1

($50,000 and Under)Pay Band 2

($50,001 to $98,000)Pay Band 3

($98,001 to $147,000)Pay Band 4

($147,001 and Over) U UC UA UAC U UC UA UAC U UC UA UAC U UC UA UAC

Health Net B&G HMO $25.26 $45.47 $101.25 $121.45 $61.31 $110.36 $183.55 $232.59 $98.31 $176.96 $257.31 $335.95 $136.62 $245.92 $333.73 $443.02

Health Net HMO $108.28 $194.91 $275.59 $362.21 $144.33 $259.80 $357.89 $473.35 $181.33 $326.40 $431.65 $576.71 $219.64 $395.36 $508.07 $683.78

Kaiser $9.67 $17.41 $20.31 $28.04 $45.72 $82.30 $102.61 $139.18 $82.72 $148.90 $176.37 $242.54 $121.03 $217.86 $252.79 $349.61

WHA $9.67 $17.41 $20.31 $28.04 $45.72 $82.30 $102.61 $139.18 $82.72 $148.90 $176.37 $242.54 $121.03 $217.86 $252.79 $349.61

Anthem PLUS $75.43 $135.77 $206.61 $266.94 $111.48 $200.66 $288.91 $378.08 $148.48 $267.26 $362.67 $481.44 $186.79 $336.22 $439.09 $588.51

Anthem PPO $106.76 $192.17 $272.40 $357.80 $142.81 $257.06 $354.70 $468.94 $179.81 $323.66 $428.46 $572.30 $218.12 $392.62 $504.88 $679.37

Anthem CDH $9.67 $17.41 $20.31 $28.04 $45.72 $82.30 $102.61 $139.18 $82.72 $148.90 $176.37 $242.54 $121.03 $217.86 $252.79 $349.61

2014 ContributionsPay Band 1

($51,000 and Under)Pay Band 2

($51,001 to $101,000) Pay Band 3

($101,001 to $151,000)Pay Band 4

($151,001 and Over) U UC UA UAC U UC UA UAC U UC UA UAC U UC UA UAC

Health Net B&G HMO $29.49 $51.17 $109.50 $131.18 $65.54 $116.06 $191.80 $242.32 $102.54 $182.66 $265.56 $345.68 $140.85 $251.62 $341.98 $452.75 Kaiser $11.78 $21.20 $25.80 $35.21 $47.83 $86.09 $108.10 $146.35 $84.83 $152.69 $181.86 $249.71 $123.14 $221.65 $258.28 $356.78 WHA $11.78 $21.20 $25.80 $35.21 $47.83 $86.09 $108.10 $146.35 $84.83 $152.69 $181.86 $249.71 $123.14 $221.65 $258.28 $356.78 BSC–HSP $9.67 $17.41 $21.19 $28.92 $45.72 $82.30 $103.49 $140.06 $82.72 $148.90 $177.25 $243.42 $121.03 $217.86 $253.67 $350.49 UC Care $71.96 $127.83 $198.99 $254.87 $108.01 $192.72 $281.29 $366.01 $145.01 $259.32 $355.05 $469.37 $183.32 $328.28 $431.47 $576.44

$ Difference Pay Band 1 Pay Band 2 Pay Band 3 Pay Band 4 U UC UA UAC U UC UA UAC U UC UA UAC U UC UA UAC

Health Net B&G HMO $4.23 $5.70 $8.25 $9.73 $4.23 $5.70 $8.25 $9.73 $4.23 $5.70 $8.25 $9.73 $4.23 $5.70 $8.25 $9.73

Kaiser $2.11 $3.79 $5.49 $7.17 $2.11 $3.79 $5.49 $7.17 $2.11 $3.79 $5.49 $7.17 $2.11 $3.79 $5.49 $7.17

WHA $2.11 $3.79 $5.49 $7.17 $2.11 $3.79 $5.49 $7.17 $2.11 $3.79 $5.49 $7.17 $2.11 $3.79 $5.49 $7.17

BSC–HSP* $0.00 $0.00 $0.88 $0.88 $0.00 $0.00 $0.88 $0.88 $0.00 $0.00 $0.88 $0.88 $0.00 $0.00 $0.88 $0.88

UC Care vs. PPO ($34.80) ($64.34) ($73.41) ($102.93) ($34.80) ($64.34) ($73.41) ($102.93) ($34.80) ($64.34) ($73.41) ($102.93) ($34.80) ($64.34) ($73.41) ($102.93)

UC Care vs. POS ($3.47) ($7.94) ($7.62) ($12.07) ($3.47) ($7.94) ($7.62) ($12.07) ($3.47) ($7.94) ($7.62) ($12.07) ($3.47) ($7.94) ($7.62) ($12.07)

UC Care vs. HNHMO ($36.32) ($67.08) ($76.60)($107.34

) ($36.32) ($67.08) ($76.60)($107.34

) ($36.32) ($67.08) ($76.60)($107.34

) ($36.32) ($67.08) ($76.60)($107.34

)

* BSC-HSP was compared to Anthem Lumenos

2013 & 2014 Contribution Rates

New plan provisions for medical plans

21

Smoking Cessation ProgramsBlue Shield: Quit For Life

– 1-866-QUIT-4-LIFE (1-866-784-8454)– www.quitnow.net/blueshieldca

Health Net: Decision Power (for smoking cessation)– www.healthnet.com/uc

Kaiser: Quitsmoking– www.kp.org/quitsmoking

Optum (Wellness): Quit Power– coming in 2014

Rx – Mandatory Generic• Generic will automatically be dispensed

• Brand-name drug when generic is available costs member:– $5 generic copay* + (brand price – generic price)

• Brand available if medically necessary (e.g., allergic to inactive ingredient)– Preauthorization required to determine if medically necessary– DAW, DNS or similar wording does NOT = medically necessary– Member pays brand copay*

* For BSC Health Savings Plan & Core - When a generic drug is available and you choose the brand-name drug, you must pay coinsurance on the cost of the generic drug plus the difference between the cost of the brand-name drug and the generic equivalent. With prior authorization, exceptions for medical necessity can be made and you pay coinsurance on the cost of the brand-name drug.

Kaiser

These additional preventive care benefits will be available at no charge:

– Genetic testing for breast cancer susceptibility– Women’s contraceptive items that by law do not require a

prescription– Aspirin to reduce heart attack risk– Folic acid supplements for pregnant women to reduce the

risk of birth defects– Fluoride supplements for children to reduce the risk of

tooth decay– Iron supplements for children

New plan provisions for non-medical plans

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UC Living Well – Relaunch UC will relaunch UC Living Well wellness program in 2014 with Optum

Continue to earn points toward an incentive award by participating in activities and wellness coaching

– Available to all actives and retirees and their spouses / DP’s enrolled in UC medical plans – including Kaiser!

– Focus on campus-based activities– Health Assessment – $75 gift cards incentive for actives and retirees only– Spouses and domestic partners no longer eligible for

incentive award; they may use wellness website and online tools

Dental/Vision Plan Changes

DeltaCare USA • Added Benefits

– Procedures to assess the level of risk associated with dental decay

– Gingival irrigation, a procedure to treat gums with medical solutions for health purposes

Vision Service Plan• Diabetic Eye Care Plus Program

– Now extended to cover both Type I & II Diabetic members. – Provides diabetic eye exam in addition to the routine vision

examination ($20 copay)• Retiree Vision open for Enrollment

Group Legal Plan – Benefit Enhancements

1. Real Estate Disputes• Legal disputes about contracts or obligations for purchase, sale or financing of the named

insured’s primary residence.• Example: Member purchases primary residence and the seller is not making needed

repairs per the sales agreement.

2. Personal Property Protection• Legal disputes about contracts or obligations for the transfer of personal property or legal

disputes about personal property rights.• Example: Plan member sold their car and only received half of the purchase price.

Beginning 1/1/2014: Covered in full if using ARAG Attorney – Limits apply otherwise

4. Estate Administration and Closing – up to 9 hours• Legal services for an insured in administering an estate when named as the executor.

5. Small Claims Court• Legal services for an insured to obtain advice and counseling to bring a claim or defend an

action in Small Claims Court.

3. Minor Traffic• Legal defense for an insured in the defense of a traffic offense, as long as conviction

would not result in suspension or revocation of license.

Flexible Spending Accounts

Health FSA• Enroll or re-enroll

• $2,500 annual limit

• Blue Shield Health Savings Plan members not eligible to participate in UC’s Health FSA

• If employee enrolls in the Blue Shield Health Savings Plan during this Open Enrollment, Health FSA must have a $0 balance on Dec. 31, 2013 (complete any claims reimbursement by Dec. 31, 2013)

DepCare FSA  • Enroll or re-enroll

• $5,000 ($2,500 if married and filing a separate tax return) annual limit

Important Dates

Open Enrollment Period • October 28th at 8:00 am to November 26th at 5:00 pm

Benefits Fair -- October 29 • Westwood – RRUCLA & RNPH B-Level Café 7:30 am – 1:00 pm• Santa Monica Conference Center 2:30pm – 4pm

Management Forum – October 22• Open Enrollment presentation

Open Enrollment Education Schedule

Presentations with Q & A Oct 15 & Oct 18: HR Department Contact Meeting Oct 24: FPG presentation with Q & A 10:30am – 2pm Nov 4: FPG presentation with Q & A 10:30am – 2pm Nov 8: RRUCLA 3-3102 2pm – 5pm Nov 12: SMUCLA Room 1 G350 1:30pm – 2:30pm Nov 14: 200 Med Plaza 547 11am – 2pm Nov 18: SMUCLA Room G360 3pm – 4pm Nov 20: RRUCLA B-Level Café 11:30a – 1:30p