1. Open Enrollment for 2016 11/2015

2. 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. 3 Are You Covered?  What do you need?  What are your priorities? – Monthly cost of plan – Cost of care – Choice of provider – Ease to manage

4. 4 Agenda  Open Enrollment Basics  2016 Health Plans and Programs  Other Plans

5. 5 Open Enrollment Dates Start: Thursday, October 29 at 8:00 AM End: Tuesday, November 24 at 5:00 PM All changes effective on January 1, 2016

6. 6 Actions  Change or enroll in medical, dental, vision or legal  Enroll eligible family members in medical, dental, vision or legal plans  Enroll in Health or Dependent Care Flexible Spending Account (reenroll each year)  Change contribution to Blue Shield Health Savings Account

7. 7 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 2016” link – Select the tab for the change you desire – Confirm your selection – Print your confirmation

8. 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

9. 9 Resources  Booklets mailed to your home  Open Enrollment Website http://ucnet.universityofcalifornia.edu/oe http://ucnet.universityofcalifornia.edu/oe o News stories on UCnet o Benefit Education Videos o Medical Plan Chooser  Insurance plan websites o Provider directories o Benefit Summaries

10. 10 Videos and News Stories on UCnet  Medical Plan Comparison  English and Spanish  Medical Terms and Concepts  Making the Most of Your Medical Benefits  Disability Benefits  OE Overview and Rates  Medical Plan Satisfaction Survey News StoriesBenefit Videos

11. 11 Campus Events Mini-Fair & Presentations – November 12 at UCEN  Fair participants - Medical plans, Optum, Delta Dental, ARAG Legal, Fidelity  Presentations by medical plan representatives Presentations by Benefits Staff in November  Medical Plan Comparison  Blue Shield Health Savings Plan Help Desks in November  Farmers Market  Q&A with Computer Lab

12. 12 Health Plans & Programs Medical Behavioral Health Dental Vision UC Living Well Health Programs

13. 13 All Health Plans Continue in 2016  Health Net Blue & Gold HMO  Kaiser HMO  UC Care PPO  Blue Shield Health Savings Plan  Core  Delta Dental PPO  DeltaCare USA  Vision Services Plan (VSP)

14. 14 Few Changes to Medical Plans  Some enhanced benefits – Travel Immunizations/Vaccine coverage improved and included in all medical plans.  Provider networks – UC Care expands UC Select/Tier 1 network in Santa Barbara  Additional wellness and health resources

15. 15 HMO vs PPO  HMO - Health Net Blue & Gold & Kaiser o Low cost, predictable copays for service and drugs o Primary Care Physician coordinates care; referrals o Network providers limited to assigned Medical Group  PPO – UC Care, Health Savings Plan & Core o Your costs are based on the network that the provider is in and the service that you receive o You direct your own care; no referrals o You choose “in-network” or “out-of-network” providers

16. 16 HMO – Health Net & Kaiser You select Primary Care Physician (PCP) When you need care go to your PCP PCP refers you to specialist, x-ray, lab, hospital Find a Doctor on UCnet Live or work within 30- miles of medical group, in most cases Care is coordinated by PCP and medical group If away from group, plan will only cover urgent and emergency care

17. 17 Cost of Care with Health Net & Kaiser HMOs No Deductible Predictable, low cost copays for services and drugs ServiceCopay Office Visit$20 Labs, radiology$0 Urgent Care Visit$20 Outpatient Surgery$100 Inpatient Hospital$250 Emergency Room$75

18. You may select any provider. 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 UC Care PPO UC Select Tier 1 Copays Blue Shield Preferred Tier 2 Deductible 20% Coinsurance Non-Preferred Out-of-Network Tier 3 Deductible Plan pays 50% of allowed rate; you pay balance

19. UC Care - Santa Barbara Network Update ProviderStatus Sansum Clinic  UC Select/Tier 1 Quest Diagnostic Lab Unilab  UC Select/Tier 1 Cottage Hospital  UC Select/Tier 1 as of 1/1/16 Pueblo Radiology  UC Select/Tier 1 as of 1/1/16 Pacific Diagnostic Lab  UC Select/Tier 1 as of 1/1/16 Santa Barbara Preferred Health Partners  Some physicians are in Blue Shield Preferred/Tier 2 No changes in the Ventura and Santa Maria networks.

20. UC Care - Ambulatory Surgical Centers UC Select (Tier 1) Blue Shield Preferred (Tier 2) Non- Preferred (out-of-network) CURRENT N/A 20%50% NEW FOR 2016: Adding coverage at the UC Select level $100 per surgery20%50% Outpatient Surgery performed at an Ambulatory Surgical Center (ASC).

21. Blue Shield Health Savings Plan 21 Combines high deductible PPO medical plan with a savings account to pay out-of-pocket expenses Medical Coverage Blue Shield PPO blueshieldca.com/uc Health Savings Account HealthEquity healthequity.com/ed/uc/ +

22. 22 What is different about the HSP?  High deductible PPO medical plan – Deductible and OOPM shared by all family members – Medical and drug expenses apply to deductible and OOPM  Health Savings Account (HSA) – Use the pre-tax HSA funds to pay the deductible and other health expenses including dental and vision. – UC makes an annual contribution to this account – You may also make pre-tax contributions (optional) – Funds rollover; you keep money in the account

23. HSP - Blue Shield PPO Medical Plan Blue Shield PPO In-Network Deductible 20% Coinsurance Non-Participating Out-of-Network Deductible 60% Coinsurance Your medical costs are based on the network that the provider is in and the service that you receive Deductible applies to prescription drug expenses, you pay in full until deductible is satisfied, they you pay 20%.

24. 24 Blue Shield PPO – Deductibles & OOPM In NetworkOut of Network Deductible Single Family (2 or more) $1,300 $2,600 $2,500 $5,000 Member Cost Sharing (Coinsurance for medical services & drugs) 20% Plan pays 60% of allowed rate You pay balance Out-of-Pocket Max (includes deductible) Single Family (2 or more) $4,000 $6,400 $8,000 $16,000

25. 25 Health Saving Account - Limitations Health Savings Account “owners”  Must live in US  You can’t be enrolled in: o Health Flexible Spending Account (FSA) o Other traditional health plan o Medicare Part A or B  Can’t be claimed as a dependent on someone else’s tax return

26. 26 Health Savings Account You keep the money even if you change jobs or insurance plans You can make contributions at any time HSA has triple tax advantage No Federal taxes on contributions No taxes when funds are used No taxes on earnings HSA funds rollover from year to year; no use it or lose it as with Health FSA You can invest funds to earn more

27. 27 Contributions to Health Savings Account  UC Contribution (1/1/16) – $500 individual – $1000 family (2 or more)  Employees can contribute up to (optional): – Single-coverage: $2,850 ($3,350 – $500) – Family-coverage: $5,750 ($6,750 – $1,000) – Catch-up contribution, age 55+: $1,000 Employees may elect to make contributions using the Open Enrollment application or throughout the year by submitting a UPAY 850 to Benefits.

28. 28 Core Medical Plan In NetworkOut of Network Deductible$3000 per individual Member Cost Sharing (Coinsurance for medical services & drugs) 20% Plan pays 20% of allowed rate You pay balance Out-of-Pocket Max (includes deductible) Individual Family (2 or more) $6,350 $12,700

29. 29 Optum Behavioral Health  No changes for 2016  Continues to provide mental health and substance abuse treatment for: – Health Net Blue & Gold HMO – Kaiser HMO (may also use Kaiser providers) – UC Care PPO (may also use non-Optum) – Blue Shield Health Savings Plan (may also use non-Optum)

30. 30 HSP & Behavioral Health  Optum provides in-network services  You pay deductible before Optum shares in the cost of services  After you pay the deductible, Optum pays – 80% of in-network Optum services – 60% of allowed rate for out-of-network services Medical and Behavioral Health deductible and OOPM comingle for all plans

31. 31 2016 UC Living Well Program A 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 Optum Wellness is being discontinued. ! Leverage health plan wellness programs

32. 32 Health Net Blue & Gold Quit for Life Smoking Cessation Program CURRENT Online program – web based learning and support tools No telephonic coaching NEW FOR 2016 Online program – web based learning and support tools Telephonic coaching – phone based behavioral coaching More information on: http://www.healthnet.com/uchttp://www.healthnet.com/uc

33. 33 Health Net Blue & Gold Omada Prevent Program CURRENT Health improvement program targeting members at risk for diabetes NEW FOR 2016 Health improvement program expanded to target members at risk for diabetes and/or heart disease More information on: http://www.healthnet.com/uchttp://www.healthnet.com/uc

34. 34 Blue Shield Health Savings Plan New Programs Welvie Online surgery support tool for members Oncology Practice of the Future Program is an innovative approach predicated upon deep partnerships with providers to ensure best care for members in need More information on http://www.blueshieldca.com/uchttp://www.blueshieldca.com/uc

35. 35 Core Medical New Program Oncology Practice of the Future Program is an innovative approach predicated upon deep partnerships with providers to ensure best care for members in need More information on http://www.blueshieldca.com/uchttp://www.blueshieldca.com/uc

36. 36 TeleHealth Programs  Designed to enhance the care you already receive from your personal physician: – When you are considering the ER or urgent care for nonemergency medical issues – After normal office hours – When your primary care physician is not available – With pediatric care, if your child’s primary care physician is not available  Doctors can also diagnose, recommend and prescribe medication for many of your non-emergent medical issues

37. 37 TeleHealth – How it works  24/7/365 access to consultations anywhere through online video, phone or secure email  Staffed by Board Certified Physicians  Preregistration on plan website is recommended – Health Net – MDLive – UC Care – Teledoc – Blue Shield Health Savings Plan – Teledoc – Core – Teledoc  See plan benefit summary for copay/coinsurance

38. 38 Dental  Dental plans continue with no benefit changes – Delta Dental PPO – DeltaCare USA (HMO)  Both plans continues to be fully paid by UC on behalf of employees

39. 39 Dental Plan Comparison Delta Dental PPODelta Care USA (HMO) Worldwide CoverageCalifornia Service Area Choose Delta PPO or non-Delta Large network Assigned to dental group Small network in Santa Barbara (4 groups) Coinsurance 20% - 50% Copays - upgrades cost more Maximum benefit up to $1700No maximum benefit Preventive care covered 100%

40. 40 Vision  Vision Services Plan (VSP) – No benefit changes – Plan continues to be fully paid by UC on behalf of employees – Routine eye exams and eye wear; some coverage for contact lenses

41. 41 Other Plans Health FSA Dependent Care FSA Legal

42. Flexible Spending Accounts (FSA) payroll contribution Make monthly payroll contribution with pre-tax earnings Submit claims or use Health Spending Card Submit claims for reimbursement or use Health Spending Card enroll or reenroll Must enroll or reenroll during Open Enrollment Blue Shield HSP members may not enroll in Health FSA Save taxes Save taxes on eligible expenses Health FSA medical, dental, vision, prescription drugs, etc Dependent Care FSA child care adult day care CONEXIS http://UC.conexisfsa.com 1-800-482-4120http://UC.conexisfsa.com

43. 43 Health Flexible Spending Account (FSA)  2016 maximum annual contribution will be $2,550 – Minimum annual contribution is $180  Effective in 2015, new carryover rule – NO grace period – All 2015 expenses must be incurred by Dec 31, 2015 – You may carry-over $500 of unused funds into 2016, even if you don’t reenroll for 2016 – Unused funds greater than $500 will be forfeited – You will have access to the carryover funds in May 2016, after run-out period to process all 2015 claims

44. Health Flexible Spending Account (FSA) Dec 31 2015 April 15 2016 May 2016 Plan year Deadline to submit 2015 claims Jan 2015 Deadline to incur 2015 expenses End of runout period Can access 2015 carryover $ Each year $500 can be carried over, indefinitely Can continue to use debit card, even if not enrolled in 2016

45. 45 Dependent Care Flexible Spending Account  2016 maximum annual contribution will be $5,000 – $2500 if married filing a separate tax return – If spouse is also eligible to make contributions, combined amount should not exceed annual maximum – Minimum annual contribution is $180  You may incur expenses during plan year and grace period in the following year  Submit claims by April 15 of the following year  Any money left in account will be forfeited

46. Dependent Care Flexible Spending Account Dec 31 2015 Mar 15 2016 April 15 2016 Plan year + grace period Jan 2015 Deadline to incur 2015 plan expenses Deadline to submit 2015 plan claims

47. 47 Legal - ARAG  OPEN for new enrollments  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

48. Legal – ARAG Identity Theft Protection REMINDER - Benefits added in 2015 include: - 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.

49. 49 Other Insurance  These plans are not part of Open Enrollment  Employees may apply to enroll or change coverage levels in these plans at any time.  They may be required to submit a Statement of Health. Supplemental Life Supplemental Disability Accidental Dealth and Dismemberment (AD&D)