OPEN ENROLLMENT 2016 Introduction

3% overall cost increaseo 34% will see a rate reduction o 50% will see increases of < $6o 16% will see increases of $18 to $53

Key to cost containmento Plan designs that promote efficiency

and appropriate cost sharingo UC Health System collaboration

Medical program – great rates in 2016

3

Health Net Blue & Gold

Travel Immunizations/Vaccines

CURRENT NEW FOR 201620% coinsurance Covered in full

4

Health Net Blue & Gold

Quit for Life Smoking Cessation Program

CURRENT Online program – web based learning and support toolsNo telephonic coaching

NEW FOR 2016Online program – web based learning and support toolsTelephonic coaching – phone based behavioral coaching

5

Health Net Blue & Gold

Omada Prevent Program

CURRENT Health improvement program targeting members at risk for diabetesNEW FOR 2016Health improvement program expanded to target members at risk for diabetes and/or heart disease

6

Kaiser

No Changes for 2016

7

Health Savings Plan (Blue Shield)

Travel Immunizations/Vaccines

CURRENT NEW FOR 2016Not Covered If ACA Preventive, in-network covered in full and not subject to deductible/40% out-of- network after deductible*

If not ACA Preventive, 20% in-network/40% out- of-network after deductible

*According to federal Affordable Care Act (ACA) guidelines for

preventive services. For additional details see www.blueshield.com/uc

8

Health Savings Plan (Blue Shield)

Health Spending Account (HSA)

CURRENT NEW FOR 2016HSA Contribution Limit HSA Contribution LimitIndividual $3,350 Individual $3,350Family $6,650 Family $6,750 (IRS

mandate)

9

Health Savings Plan (Blue Shield)

New Programs

WelvieOnline surgery support tool for members

Oncology Practice of the FutureProgram is an innovative approach predicated upon deep partnerships with providers to ensure best care for members in need

10

Core Medical

Travel Immunizations/Vaccines

CURRENT NEW FOR 2016Not Covered If ACA Preventive, in-network covered in full and not

subject to deductible/20% out- of-network after deductible*

If not ACA Preventive, 20% in/out-of- network after deductible

*According to federal Affordable Care Act (ACA) guidelines for preventive services. For additional detail see www.blueshield.com/uc

11

Core Medical

Applied Behavioral Analysis (ABA)Autism Support

CURRENT NEW FOR 2016Not Covered 20% in/out-of-

networkafter

deductible

12

Core Medical

New Program

Oncology Practice of the FutureProgram is an innovative approach predicated upon deep partnerships with providers to ensure best care for members in need

UC Care

Covered Service UC Select Blue Shield Preferred

Non- Preferred(out-of-network)

CURRENT

Outpatient Surgery performed at an Ambulatory Surgical Center

N/A(Services covered under Blue Shield Preferred) 20% 50%

NEW FOR 2016: Adding coverage at the UC Select level

Outpatient Surgery performed at an Ambulatory Surgical Center

$100 per surgery 20% 50%

Ambulatory Surgical

UC Care

Covered Service UC Select and Participating Pharmacies

Blue Shield Preferred and Participating Pharmacies

Non- Preferred(out-of-network)

CURRENT

Travel Immunizations/Vaccines Not covered Not covered Not covered

NEW FOR 2016: Adding coverage to the UC Care medical and pharmacy benefit

Travel Immunizations/Vaccines No charge No charge 50%

Travel Immunizations/Vaccines

Location Provider

Santa Barbara Area • Cottage Hospital- Santa Barbara and Goleta• Pacific Diagnostics Labs• Pueblo Radiology

Orange County • Orange County Foot and Ankle• Aurora Breast MRI of Orange County

*Professional providers must have a PPO contract with Blue Shield

UC CareSelect Network Additions – Effective 1/1/2016

16

Optum Behavioral Health

No Changes for 2016

Continues as carve-out for Health Net, UC Care, Health Savings Plan, and Western Health Advantage.Continues as supplemental overlay for Kaiser.

17

2016 UC Living Well ProgramA healthy, engaged, and productive workforce

is essential to support UC’s academic and research mission

Highlight local wellness programs

Local wellness coordinators serve as SMEs

Build on current system-wide policies and partnerships that support healthy workforce and culture

Consistent communications strategy

Discontinue health assessment, coaching and incentive program (Optum)!

Leverage health plan wellness programs

Non-Medical Benefit Plans2016 Renewal Summary

19

Dental PPO

– No changes to dental benefits– The Dental PPO plan will be self-funded by UC beginning in 2016– Cost decreases, as self-funding will save UC $2.7M per year in fees

imposed by the Affordable Care Act on fully-insured health plans– “Automatic” enrollment in PPO for eligible new hires will cease (similar

to Core Medical)

DHMO – Rates will decrease by 7.9%– Some slight benefit enhancements due to dental coding changes

Both plans continue to be paid by UC on behalf of employees Delta Dental continues as the carrier

20

Vision Active Employees

– No benefit changes – Plan continues to be fully paid by UC on behalf of employees– “Automatic” enrollment in Vision for eligible new hires will cease (similar to

Core Medical)

VSP continues as the carrier

21

DisabilityUC-Paid Short-Term DisabilitySupplemental Short- and Long-Term Disability

No benefit changes for 2016 to either plan UC continues to provide limited STD plan at no cost to employees Supplemental coverage cost to employees remains the same in 2016 Liberty Mutual continues as the disability partner Plan redesign coming in 2017 – more on that this afternoon

22

LifeBasic and Core LifeEmployee Supplemental LifeDependent Basic and Expanded Life

No benefit or premium changes to the plans in 2016 Not open for enrollment Prudential continues as the carrier

23

Legal

Slight changes to benefits which result in fewer limitations and higher benefit maximums for certain services - strengthening benefits overall – Example: Limitation of one claim per benefit year per family unit is

being eliminated Premium remains the same Open for enrollment ARAG continues as carrier

24

Personal Accident Insurance (AD&D)

No benefit changes Premium remains the same AIG continues as carrier Not open for enrollment

25

Flexible Spending Accounts

The Health FSA annual maximum contribution amount will be $2,550 – an increase of $50 in 2016

The Dependent Care FSA annual maximum contribution remains at $5,000

AFFORDABLE CARE ACT 2016 Introduction

27

Affordable Care Act

1. Per Diems and Limited appointment employees will receive free Core benefits effective 1/1/16 if they worked at least 1566 hours this past year.

2. When managers hire per diems and limited appointment staff, they MUST create the req using the ACTUAL FTE the employee will most likely be working—not an artificial FTE.

3. Penalties for hiring employees in with an artificially low FTE will create a penalty for the organization.

4. More info to follow