1. No category

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 Services
Lisa 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 Arellano
[email protected]
x4048
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 UCnet
o Benefit Education Videos
o 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 Program
13 vendors > 26 plan renewals > $2 billion annual premium
Medical
(6 plans)
Medicare Retirees
(6 plans)
Blue Shield of CA
 UC Care* (self-insured)
 Health Savings Plan
 Core (self-insured)
Non-Medical
(13 plans)
Blue Shield of CA
 Medicare PPO (self-insured)
 Medicare PPO no Rx (selfinsured)
 High Option Supplement (selfinsured)
Delta Dental
 Delta Dental PPO
 DeltaCare USA
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
Western Health Advantage
One Exchange (outside CA)
ARAG - Group Legal Plan
Behavioral Health – Optum
Wellness - Optum
Vision Service Plan
 Actives, Retirees
 Supplemental Life
 Dependent Life
(basic/expanded)
AIG – AD&D
 Actives, Retirees
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
Pharmacy
2015
 Mail order pharmacy  Current mail order and UC
 UC Medical Centers  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/Acupuncture
CURRENT
2015
 Not covered
 $20 copay
 24 visits yearly for self-referral (combined)
 American Specialty Health providers
 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
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)
Health Net
Blue & Gold
Kaiser
 OR $20 copay through Kaiser provider for
acupuncture only
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 Changes
2015 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
NEW FOR 2015
 UC Care will have two separate
Out of Pocket Maximums

No Rx out of pocket max.


Medical OOP max
(individual/family >3)
Medical:
No change to OOP max amounts

Rx:
OOP max – In-Network Pharmacies
-
UC Select: $1,500/$4,500
-
Preferred: $3,000/$9,000
-
Non-Preferred: $5,000/$15,000
$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 Plan
Combines high deductible PPO with
account to pay out-of-pocket expenses
+
Medical Coverage
Blue Shield PPO
Health Savings Account
HealthEquity
Blue Shield Health Savings Plan Limits
IRS annually increases definition of “high deductible” and
Health Savings Account maximum annual contribution amounts.
In-Network Deductible
In-Network
Out-of-pocket Max
Max HSA Contribution
UC HSA Contribution
2014
2015
Change
Single
$1,250
$1,300
$50
Family
$2,500
$2,600
$100
Single
$4,000
Family
$6,400
No change
Single
$3,300
$3,350
$50
Family
$6,550
$6,650
$100
Single
$500
Family
$1,000
No change
24
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.
HealthEquity
 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/
UC Care PPO
UC Select
Tier 1
Blue Shield
Preferred
Tier 2
Non-Preferred
Out-of-Network
Tier 3
Copays
Deductible
Deductible
20% Coinsurance
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 Service
UC Select
Tier 1
Blue Shield
Preferred
Tier 2
Non-Preferred
(out-of-network)
Tier 3
$100 per visit
$100 per visit
(not subject to the
calendar year
deductible)
(not subject to the
calendar year
deductible)
20%
20%
(not subject to the
calendar year
deductible)
(not subject to the
calendar year
deductible)
CURRENT
Emergency facility
(not resulting in an
admission)
ER Physician
Services
$100
per visit
20%
For ER Services resulting in admission – ER fees waived, $250 hospital copay
Emergency – UC Care
Covered Service
UC 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)
ER Physician
Services
$200
per visit
No Charge
$200 per visit
$200 per visit
(not subject to the
calendar year
deductible)
(not subject to the
calendar year
deductible)
No Charge
No Charge
For ER Services resulting in admission – no change; remains $250 copay.
Ambulance – UC Care
Covered Service
UC Select
Tier 1
Blue Shield
Preferred
Tier 2
Non-Preferred
(out-of-network)
Tier 3
20%
20%
CURRENT
Ambulance Services
N/A
(services covered
under Blue
Shield Preferred)
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
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)
CURRENT
Covered at a $0 copay
NEW FOR 2015
Covered at a $0 copay


Services received from an
in-network physician
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 Lab
Unilab
 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 Shield
Telemedicine 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)
Prescription Management
Top 10 Diagnoses
•
•
•
•
•
•
•
•
•
•
Sinus Problems
Urinary Tract Infection
Pink Eye
Bronchitis
Upper Respiratory Infection
Nasal Congestion
Allergies
Flu
Cough
Ear Infection
•
•
•
•
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
2015
Pay Band
Definition of Range for
Medical Contribution
Base Using Full-Time
Salary As of Jan. 2014
1
$51,000 & under
1
$51,000 & under
2
$51,001 to $101,000
2
$51,001 to $101,000
3
$101,001 to $151,000
3
$101,001 to $152,000
4
$151,001 & over
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 prorated salary base (instead of highest rate)
Dental & Vision – No changes
 Dental
o Delta Dental PPO
o DeltaCare HMO
 Vision
o 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 Miles
[email protected] 805-893-4263
Supplemental Disability - Examples
Rates are based on age, salary and waiting period elected.
Examples:
Age 40, $100k salary,
30 day waiting period
Age 50, $100k salary,
30 day waiting period
Rate increase of $6.97
($36.67 to $43. 64)
Rate increase of $10.45
($55.00 to $65.45)
Supplemental Disability: AYSO
Via AYSO: Can only change coverage with waiting period longer than current.
Example:
Options presented
to someone with
7-day waiting
period currently.
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 Partners
UC 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