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DBR Benefits Briefing

DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

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Page 1: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

DBR Benefits Briefing

Page 2: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

This presentation is intended for communication purposes only, it is not a guarantee of benefits.

Please see insurance plan documents and http://ucnet.universityofcalifornia.edu/OE

for complete information.

Page 3: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Thank you DBRs!

We rely on you to be an informed resource for the employees in your departments.

• Health insurance benefits• Other insurance and programs• Retirement benefits• Disability Services• Human Resources programs and events

Page 4: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Your Benefits and Disability Partners

Benefits Disability ServicesLisa Romero Elizabeth Hammond Delo

Gabe Suarez Christie Pryce

Cynthia Del Rosario Rachel Miles

Rachel Miles

Edna Arellano

Laura Morgan

Kevin Wilson-Smith

Page 5: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Agenda for DBR Briefing

• Open Enrollment Basics• Communication & Events• 2015 Medical Plans• Medical Plan Rates• Other Plans• Administrative Actions• Fidelity Retirement Services

Page 6: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Open Enrollment Dates

Start: Thursday, October 30 at 8:00 AM

End: Tuesday, November 25 at 5:00 PM

All changes effective on January 1, 2015

Page 7: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Actions

• Change medical or dental plans• Enroll eligible family members in medical, dental,

vision or legal plans• Enroll in Health or Dependent Care Flexible

Spending Account (reenroll each year)• Increase waiting period for Supplemental

Disability if currently enrolled

Page 8: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

How to make changes?

• Go to Open Enrollment website on UCnet

http://ucnet.universityofcalifornia.edu/OE – Select “Sign In”– Sign-in using your AYSO ID and password– Select “Open Enrollment for 2015” link– Select the tab for the change you desire– Confirm your selection– Print your confirmation

Page 9: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Resetting Passwords on AYSO

https://atyourserviceonline.ucop.edu/ayso/

• Encourage employees to use the “forgot password” and “forgot username” options on At Your Service Online

• If that doesn’t work, call or email:

Edna [email protected]

Page 10: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Booklets & Open Enrollment Website Oct. 27 - Booklets mail

o Cut-off date for mailing August 31

o Employees input in PPS after this date should be referred to web for OE materials

Oct. 27 - OE website launches http://ucnet.universityofcalifornia.edu/oe o News stories on UCneto Benefit Education Videoso Medical Plan Chooser

Page 11: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Videos & News Stories on UCnet

Benefit Education Videos

Medical Plan Comparison

English and Spanish

Disability Insurance

Medical Terms and Concepts

Use Your Medical Benefits Wisely

News Stories

OE Overview and Rates Medical Plan Satisfaction

Survey Changes to Disability Benefit Education Videos

Page 12: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Campus Events

Mini-Fair & Presentations – November 17 Fair participants - Medical plans, ARAG Legal, Fidelity Presentations by medical plan representatives

Presentations by Benefits Staff Medical Plan Comparison Blue Shield Health Savings Plan Health Flexible Spending Account

Help Desks Farmers Market Q&A with Computer Lab

Page 13: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

2015 Faculty/Staff/Retiree Program13 vendors > 26 plan renewals > $2 billion annual premium

Medical(6 plans)

Medicare Retirees(6 plans)

Non-Medical(13 plans)

Blue Shield of CA UC Care* (self-insured) Health Savings Plan Core (self-insured)

Blue Shield of CA Medicare PPO (self-insured) Medicare PPO no Rx (self-

insured) High Option Supplement (self-

insured)

Delta Dental Delta Dental PPO DeltaCare USA

Vision Service Plan Actives, Retirees

Health Net Blue & Gold HMO Health Net Seniority Plus Liberty Mutual - Disability UC paid short term disability Employee paid supplemental disability

Kaiser Kaiser Senior Advantage Prudential - Life Basic Life Core Life

Supplemental Life Dependent Life

(basic/expanded)

Western Health Advantage One Exchange (outside CA) ARAG - Group Legal Plan

Behavioral Health – Optum AIG – AD&D Actives, Retirees

Wellness - Optum Wellness - Optum CONEXIS - Flexible Spending Accounts Dependent Care, Health Care

• * UC Care is managed within UCOP Office of Risk Services; all other plans managed within UCOP Benefits Programs & Strategy.• Separate Postdoctoral Scholars program with different portfolio. 3 vendors, 9 plans, $59 million premium.

Page 14: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

2015 Medical Plan Updates & Mandates

Page 15: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

All medical plans continue in 2015

No major changes, several enhanced benefits

• Health Net Blue & Gold HMO• Kaiser HMO• UC Care PPO• Blue Shield Health Savings Plan• Core

Page 16: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

2014 Medical Plan Enrollment

Page 17: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

90 Day Maintenance Drug – Retail Option

CURRENT 2015

Pharmacy Mail order pharmacy UC Medical Centers

Current mail order and UC UC Care : Safeway/Vons,

Walgreens, Costco and others Health Net Blue & Gold: CVS

Cost sharing • Members pay two copayments (rather than three)

Same as current

• Kaiser members only receive extended supply for 2 copays through mail order.

• Core and Blue Shield HSP subject to deductible and coinsurance – convenient access but no cost savings.

Page 18: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Chiropractic/AcupunctureCURRENT 2015

Health Net Blue & Gold

Not covered $20 copay 24 visits yearly for self-referral (combined) American Specialty Health providers

Kaiser

Only acupuncture through Kaiser provider is covered ($20 Copay)

$15 copay for acupuncture or chiro 24 visits yearly for self-referral (combined) American Specialty Health providers

OR $20 copay through Kaiser provider for acupuncture only

UC Care Chiro/Acupuncture

covered as Tier 2 and 3

UC Care aligning Tier 3 coinsurance for chiropractic services to match other services – 50% coinsurance

Core

Both Acupuncture and Chiro subject to $500 max

Eliminate $500 maximum 24 visits yearly (combined)

Page 19: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Out-of-Pocket Maximum• The most the insurance plan requires you to pay in a year

• Once you have paid this amount, the insurance plan pays 100% of future expenses.

• Includes deductible, copay, coinsurance for medical services. Some plans also include drug expenses.

• Does not include amounts “not allowed” by insurance plan when using out-of-network providers.

• Currently, all UC plans have an out-of-pocket maximum for medical expenses.

Page 20: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Out of Pocket Maximum Changes2015 ACA Mandate:

Prescription drug (Rx) cost must apply towards an Out-of-Pocket (OOP) Maximum.

Blue Shield HSP and Core currently comply.

Plans changing to meet mandate:

Health Net Blue & Gold - Combined Medical and Rx OOP: $1,000 individual /$3,000 family (>3)

Kaiser Permanente- Combined Medical and Rx OOP: $1,500 individual /$3,000 family (>2)

UC Care updates described on next slide.

20

Page 21: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Out of Pocket Max – UC Care

CURRENT There is only one Out of Pocket

Maximum: Medical

No Rx out of pocket max.

Medical OOP max (individual/family >3)

- UC Select: $1,500/$4,500

- Preferred: $3,000/$9,000

- Non-Preferred: $5,000/$15,000

NEW FOR 2015 UC Care will have two separate

Out of Pocket Maximums

Medical: No change to OOP max amounts

Rx: OOP max – In-Network Pharmacies

$3,600 individual$4,200 family

Page 22: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Other ACA Mandated Changes

Nicotine Replacement Over the Counter (OTC) Products

- 2015 will be covered at no cost (currently $5 generic copay) when prescribed by a physician.

- Take OTC products with prescription to the pharmacy counter to purchase.

Women’s Preventive Health

- Cancer risk reducing medications for women at increased risk of breast cancer (e.g., Tamoxifen or Raloxifene)

- 2015 will be covered at no cost

Page 23: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Blue Shield Health Savings PlanCombines high deductible PPO with

account to pay out-of-pocket expenses

Medical CoverageBlue Shield PPO

Health Savings AccountHealthEquity

+

Page 24: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Blue Shield Health Savings Plan LimitsIRS annually increases definition of “high deductible” and

Health Savings Account maximum annual contribution amounts.

24

2014 2015 Change

In-Network DeductibleSingle

Family

$1,250

$2,500

$1,300

$2,600

$50

$100

In-Network Out-of-pocket Max

Single

Family

$4,000

$6,400

No change

Max HSA ContributionSingle

Family

$3,300

$6,550

$3,350

$6,650

$50

$100

UC HSA ContributionSingle

Family

$500

$1,000

No change

Page 25: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Blue Shield HSP - HSA Contributions Plan members can make pre-tax contributions to

the Health Savings Account (HSA)

2014 members - HSA contribution elections made through payroll deduction will automatically carry over into 2015 unless a change is made.

Current members and new members can make or change HSA contribution elections through AYSO during Open Enrollment (effective January 1).

Members may also make changes at anytime using UPAY850

Calculator tool is available on Health Equity website

http://healthequity.com/ed/uc/

HealthEquity

Page 26: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

UC Care PPOUC Select

Tier 1

Copays

Blue ShieldPreferred

Tier 2

Deductible

20% Coinsurance

Non-PreferredOut-of-Network

Tier 3

Deductible

50% Coinsurance

• Your costs are based on the tier/network that the provider is in and the service that you receive

• Not all services are covered at as a UC Select/Tier 1benefit • Some services are covered only at the Blue Shield

Preferred and Non-Preferred tiers

Page 27: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Emergency – UC Care

Covered ServiceUC Select

Tier 1

Blue Shield Preferred

Tier 2

Non-Preferred (out-of-network)

Tier 3

CURRENT

Emergency facility (not resulting in an admission)

$100 per visit

$100 per visit (not subject to the

calendar year deductible)

$100 per visit (not subject to the

calendar year deductible)

ER Physician Services

20% 20%(not subject to the

calendar year deductible)

20%(not subject to the

calendar year deductible)

For ER Services resulting in admission – ER fees waived, $250 hospital copay

Page 28: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Emergency – UC Care

Covered ServiceUC Select

Tier 1

Blue Shield Preferred

Tier 2

Non-Preferred (out-of-network)

Tier 3

NEW FOR 2015:

Combining ER facility and Physician services as one fixed copay amount

Emergency facility (not resulting in an admission)

$200 per visit

$200 per visit (not subject to the

calendar year deductible)

$200 per visit (not subject to the

calendar year deductible)

ER Physician Services

No Charge No Charge No Charge

For ER Services resulting in admission – no change; remains $250 copay.

Page 29: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Ambulance – UC Care

Covered ServiceUC Select

Tier 1

Blue Shield Preferred

Tier 2

Non-Preferred (out-of-network)

Tier 3

CURRENT

Ambulance Services N/A(services covered

under Blue Shield Preferred)

20% 20%

NEW FOR 2015: Changing from coinsurance to a flat copay

Ambulance Services N/A(services covered

under Blue Shield Preferred)

$200 per transport

$200 per transport

Page 30: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Vaccinations – UC Care

CURRENT

Covered at a $0 copay

Services received from an in-network physician

Coverage for the following vaccinations expanded to in-network pharmacy: tetanus, whooping cough (pertussis) pneumococcal,

meningococcal, cervical cancer (HPV) and shingles (herpes zoster).

Per medical plan Preventive Health Benefits (based on age and gender requirements)

NEW FOR 2015

Covered at a $0 copay

Allow adults to receive services from an in-network physician or in-network pharmacy

Page 31: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

UC Care - Santa Barbara Network Update

Provider Status

Sansum Clinic Sansum will remain in the UC Select/Tier 1

Quest Diagnostic LabUnilab

Will remain in the UC Select/Tier 1

Pueblo Radiology Pueblo Radiology is currently being reviewed

Cottage Hospital Cottage remains in Blue Shield Preferred/Tier 2

Pacific Diagnostic Lab PDL remains in Blue Shield Preferred/Tier 2

Santa Barbara Preferred Health Partners

Some physicians affiliated with SB Preferred Health Partners are in Blue Shield Preferred/Tier 2

No changes in the Ventura and Santa Maria networks.

Page 32: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Teladoc – Blue ShieldTelemedicine services available by phone, mobile applications or online video

Board certified physicians 24/7/365

UC Care: $20 copay (copay does NOT count towards deductible, does count towards OOP)

Core and Blue Shield Health Savings Plan: $40 copay until deductible met and then 20% coinsurance after (copay counts towards deductible and OOP)

Top 10 Diagnoses

• Sinus Problems• Urinary Tract Infection• Pink Eye• Bronchitis• Upper Respiratory Infection• Nasal Congestion• Allergies• Flu• Cough• Ear Infection

Prescription Management

• Electronic prescribing (SureScripts) or by phone,if needed

• Use of antibiotics limited to short durations

• No prescribing of DEA-controlled substances, medication for psychiatric illness, or lifestyle drugs

• Generic drugs are automatically recommended

Page 33: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

2015 Medical Plan Rates

• On average, UC pays 86.6 percent of the total cost of medical premiums.

• Medical plan premiums based on your full-time equivalent salary rate as of Jan. 1, 2014.

• Note for union-represented employees: Rates shown on chart indicate only proposed rates for some union-represented employees and are subject to ongoing collective bargaining as appropriate. Please contact your union for current rates.

Page 34: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

2015 Medical Pay Band Adjustments

2014 Pay Band

Definition of Range for Medical Contribution Base 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

2015 Pay Band

Definition of Range for Medical Contribution Base Using Full-Time Salary As

of Jan. 2014

1 $51,000 & under

2 $51,001 to $101,000

3 $101,001 to $152,000

4 $152,001 & over

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

The index used is that for urban wage earners and clerical workers (CPI-U). The change from February 2013 to February 2014 was 0.9%.

Page 35: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Definition of Covered Salary for Life, Disability and MCB

• UC changed the definition of covered salary for Life Insurance, Disability Insurance, and Medical Contribution Base (MCB) effective 1/1/2014. 

All definitions were simplified to “base salary” only

“Extra” pay such as stipends, shift differentials, overtime, etc. are excluded from all salary base calculations

Multiple appointments with different rates will receive pro-rated salary base (instead of highest rate)

Page 36: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Dental & Vision – No changes Dental

o Delta Dental PPOo DeltaCare HMO

Visiono Vision Services Plan

No contributions for employee dental and vision

Retiree vision open for 2015, no rate change

Page 37: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Legal - ARAG The plan will be open for new enrollments this year.

Claims experience has been consistent, thus rates are not increasing.

Expanded identity theft protection benefit added that includes:- Full service identity restoration

- Identity Theft Insurance up to $1million

- Lost wallet services

- Credit monitoring service, internet surveillance of personal information and child identity monitoring (register on website)

- Powered by CSID, leader of global enterprise level identity protection and fraud detection solutions.

Page 38: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

ARAG’s New Expanded ID Theft Protection Many of the new tools are full service/ concierge type, rather than just

information based

ARAG will work on the member’s behalf to completely resolve the ID theft problem

Free insurance covers members’ costs associated with ID theft restoration

- For example: child care expenses, unpaid time off work, mileage

Page 39: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Family Member Eligibility Verification

Employees adding a new family member during Open Enrollment will receive a notice from SECOVA in January.

Employees who add new family members to their health plans are required to participate in the Family Member Eligibility Verification (FMEV) program.

SECOVA asks for documentation to verify that the family member satisfies the UC eligibility criteria.

See UCnet for more information:– UC Group Insurance Eligibility Factsheet

– Family Member Eligibility Verification Process

Page 40: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Flexible Spending Accounts (FSA)• Tax savings on health and dependent care expenses• Must enroll or reenroll to participate in 2015

– Blue Shield Health Savings plan member may NOT enroll in a Health FSA

• DepCare – no changes• Health FSA

– The “use it or lose it” rules will be modified for the 2015 plan year.

• 2015 plan members will be able to “carry over” $500 into 2016

• See FSA workshops offered during Open Enrollment

• More information will be available on UCnet

– 2014 plan members must make eligible purchases prior to 3/15/15 or they will lose any remaining contributions.

Page 41: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

UC Living Well

• Wellness program

• Co-sponsored by Optum and campus wellness programs

• Program continues with few changes

• Spouses and domestic partners are no longer eligible for gift card

• See UCnet for complete eligibility and program information

Page 42: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Supplemental Disability 19% increase in Supplemental Disability Rates

- the first rate increase in 5 years.

Rates increase for 7 and 30 day waiting periods - NOT 90 and 180 day.

Employees can increase their waiting period through At Your Service Online (AYSO) during the OE period with an effective date of January 1, 2015.

Premium calculator tool will be available on UCnet during OE.

FAQ will be available in English and Spanish later this month.

New Disability Coordinator, Rachel [email protected] 805-893-4263

Page 43: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Supplemental Disability - Examples

Age 50, $100k salary, 30 day waiting period

Rate increase of $10.45 ($55.00 to $65.45)

Age 40, $100k salary, 30 day waiting period

Rate increase of $6.97 ($36.67 to $43. 64)

Rates are based on age, salary and waiting period elected.

Examples:

Page 44: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Supplemental Disability: AYSO

Example: Options presented to someone with 7-day waiting period currently.

Via AYSO: Can only change coverage with waiting period longer than current.

Page 45: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

ACA - Employer Shared Responsibility

Provision of Affordable Care Act (ACA) that defines the percentage of full time employees who must be offered insurance by an employer

2015 - UC meets requirements under our existing eligibility rules.

2016 - UC does not meet the requirements under our existing eligibility rules.

Eligibility will expand to appointment types that currently are not eligible.

More information and training will be coming in the new year.

Page 46: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

UCPath – Best Practices Best practices will be posted on http://

www.ets.ucsb.edu/projects/ucpath

Reminders: Use legal names in PPS - not “preferred” names. Enter full addresses with zip code Original hire date should never change and student employment

counts Most recent hire date (IGEN screen):

For UC transfers without a break in service - date should be the date provided by the previous campus. Do not use the date they are hired on this campus.

Page 47: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Our Retirement PartnersUC Retirement Administration Service Center (RASC)

Provides retirement counseling for staff and academic employees

Services include: Answering questions about service credit, retirement

estimator tool Retiree Health Insurance eligibility Service credit buyback inquires/processing

UCnet: Contact RASC Customer Service via Online Form

Phone: 1-800-888-8267 (in U.S.)

Phone: 1-510-987-0200 (from outside the U.S.)

Monday–Friday, 8:30 a.m.  4:30 p.m. (PT).

Fax: 1-800-792-5178

Page 48: DBR Benefits Briefing. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan documents

Our Retirement Partners

Fidelity Retirement Services Provides the record keeping, financial education and account

services for the UC Retirement Savings Programs Cesar Cap - Retirement Counselor for UC Santa Barbara

Workshops on campus and via webinar Department workshops/help desk

Lindsey Grainger –Fidelity Workplace Planning and Guidance Consultant In person One-on-One meetings available by appointment

1-800-558-9182

Netbenefits.com

1-866-682-7787