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DBR Benefits Briefing
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.
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
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
Agenda for DBR Briefing
• Open Enrollment Basics• Communication & Events• 2015 Medical Plans• Medical Plan Rates• Other Plans• Administrative Actions• Fidelity Retirement Services
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
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
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
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]
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
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
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
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.
2015 Medical Plan Updates & Mandates
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
2014 Medical Plan Enrollment
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.
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)
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.
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
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
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
Blue Shield Health Savings PlanCombines high deductible PPO with
account to pay out-of-pocket expenses
Medical CoverageBlue Shield PPO
Health Savings AccountHealthEquity
+
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
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
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
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
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.
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
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
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.
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
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.
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%.
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)
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
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.
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
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
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.
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
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
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:
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.
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.
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.
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
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