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Open Enrollment Highlights. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan.

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Presentation on theme: "Open Enrollment Highlights. This presentation is intended for communication purposes only, it is not a guarantee of benefits. Please see insurance plan."— Presentation transcript:

1 Open Enrollment Highlights

2 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. http://ucnet.universityofcalifornia.edu/OE

3 Agenda Open Enrollment Basics Communication & Events 2015 Medical Plans Medical Plan Rates Other Plans

4 Dates & Actions Open Enrollment ends – Tuesday, November 25 at 5pm 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

5 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” link –Select the tab for the change you desire –Confirm your selection –Print your confirmation

6 Resetting Passwords on AYSO https://atyourserviceonline.ucop.edu/ayso/ Use the “forgot password” and “forgot username” options on At Your Service Online If that doesn’t work, call or email: Edna Arellano edna.arellano@hr.ucsb.edu x4048 edna.arellano@hr.ucsb.edu

7 Open Enrollment Resources  Booklets mailed to home  Open Enrollment Website http://ucnet.universityofcalifornia.edu/oe http://ucnet.universityofcalifornia.edu/oe o Benefit Education Videos o News stories on UCnet o Medical Plan Chooser  Insurance Plan Websites o Provider directories o Plan booklets

8 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 https://uc.a.guidespark.com/ News Stories  OE Overview and Rates  Medical Plan Satisfaction Survey  Changes to Disability  Benefit Education Videos

9 Campus Events – See hr.ucsb.edu 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

10 Medical Plan Comparison Video https://uc.a.guidespark.com/videos/5937

11 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 http://ucnet.universityofcalifornia.edu/oe//medical/index.html

12 90 Day Maintenance Drug – Retail Option CURRENT2015 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 sharingMembers 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.

13 Chiropractic/Acupuncture CURRENT2015 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)

14 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.

15 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. 15

16 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

17 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

18 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 +

19 Blue Shield HSP & You may NOT be enrolled in Medicare Parts A or B and the Blue Shield Health Savings Plan If you are age 65 or older, check your Medicare enrollment status with Social Security. –Some people are automatically enrolled in Medicare Part A If you are enrolled in Medicare Parts A or B, the IRS does not allow you to contribute to a Health Savings Account. MEDICARE

20 Blue Shield Health Savings Plan Limits IRS annually increases definition of “high deductible” and Health Savings Account maximum annual contribution amounts. 20 20142015Change In-Network Deductible Single 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 Contribution Single Family $3,300 $6,550 $3,350 $6,650 $50 $100 UC HSA Contribution Single Family $500 $1,000 No change

21 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

22 UC Care PPO UC Select Tier 1 Copays Blue Shield Preferred Tier 2 Deductible 20% Coinsurance Non-Preferred Out-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

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

24 Ambulance – UC Care Covered Service UC Select Tier 1 Blue Shield Preferred Tier 2 Non-Preferred (out-of-network) Tier 3 NEW FOR 2015: Changing from coinsurance to a flat copay Ambulance ServicesN/A (services covered under Blue Shield Preferred) $200 per transport

25 Vaccinations – UC Care  Coverage for the following vaccinations expanded to in-network pharmacy  Adults may receive services from an in-network physician or in- network pharmacy for zero copay Per medical plan Preventive Health Benefits (based on age and gender requirements) tetanus, whooping cough (pertussis) pneumococcal, meningococcal, cervical cancer (HPV) and shingles (herpes zoster).

26 UC Care - Santa Barbara Network Update ProviderStatus Sansum Clinic  UC Select/Tier 1 Quest Diagnostic Lab Unilab  UC Select/Tier 1 Cottage Hospital  Blue Shield Preferred/Tier 2 Pacific Diagnostic Lab  Blue Shield Preferred/Tier 2 Pueblo Radiology  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.

27 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) Top 10 Diagnoses Sinus Problems Urinary Tract Infection Pink Eye Bronchitis Upper Respiratory Infection Nasal Congestion Allergies Flu Cough Ear Infection 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 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

28 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.

29 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%.

30 Dental & Vision – No changes  Dental o Delta Dental PPO o DeltaCare HMO  Vision o Vision Services Plan  No contributions for employee dental and vision

31 Legal - ARAG  The plan will be open for new enrollments this year.  No increase in rates.  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.

32 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

33 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.

34 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

35 Supplemental Disability Employee paid insurance – provides income if you are disabled and can’t work  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 who are currently enrolled can increase their waiting period through At Your Service Online (AYSO) during Open Enrollment with an effective date of January 1, 2015. OR anytime other time using a paper form  Premium calculator tool available on UCnet.

36 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:

37 Supplemental Disability: AYSO Example: Options presented to someone with 7-day waiting period currently. On AYSO: Can only change coverage with waiting period longer than current.

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