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OPEN ENROLLMENT FOR 2008 is NOVEMBER 1 – 27, 2007. ♦ Medical costs tend to rise faster than inflation. In 2008, UC systemwide costs will exceed $1 billion. ♦Goals during last spring’s bid process included…. The obvious: access, quality, sustainability, affordability, and choice.
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OPEN ENROLLMENT FOR 2008 is NOVEMBER 1 – 27, 2007 ♦ Medical costs tend to rise faster than inflation. In 2008, UC systemwide costs will exceed $1 billion.
♦Goals during last spring’s bid process included… • The obvious: access, quality, sustainability, affordability, and choice. • Managing benefits costs to preserve employee pay increases. • Support UC recruitment and retention needs. • Provide wellness and mental health benefits to employees and their families. • Improved options for addressing benefit needs as they change over time.
To cut costs… • UC consolidated its HMO’s and introduced a new type of plan. Changes are expected to result in lower cost increases for UC and employees in 2008. • UC will continue to pay the majority of the cost of medical care and continue salary-based premiums. • Lower-paid employees will pay less for their benefits; premium pay bands will be adjusted for inflation. • Most co-pays for office visits and prescriptions remain the same.
Here’s what’s changing… Pacificare will be discontinued 12/31/07. Health Net replaces Pacificare. Benefits and primary care doctors are virtually the same. Employees should choose their new plan rather than allow the default to Health Net to keep their same primary doctor. Find available plans through your zip code using Open Enrollment link http://atyourservice.ucop.edu. If you are in a course of treatment (including pregnancy), and are maintaining your same physician with the new plan, no action is necessary; otherwise, contact your new plan in late December for transition assistance. Added to Health Net is new, improved mental and substance abuse benefits through United Behavioral Health.
More health plan notes… • WHA will not change except for addition of United Behavioral Health benefits. • Blue Cross POP, PPO, and Core plans will be offered with the same co-pays, but the Core Plan will include behavioral health benefits for the first time.
Cigna’s new… • UC added a new type of plan. The CIGNA plan is a health reimbursement account funded by UC to pay claims plus a PPO. Offered for the first time systemwide; piloted and well-received by UCSB and UCSF. PCP not required and no referrals necessary to see specialists. Patient manages care more so than with HMO. (Do not confuse HRA with HCRA.) • See website for details: http://atyourservice.ucop.edu. To summarize, UC pays an HRA amount, then member pays balance of annual deductible, before CIGNA PPO coverage kicks in. At that point, there’s a choice of in-network (80%) or out-of network (60%) providers up to an out-of-pocket maximum that’s based on several factors. See Cigna website for comparison of costs.
Ask yourself… • This is potentially the next wave of insurance. Offers coverage in more California counties and states (all of U.S. except Hawaii) – Using a Cigna doctor is not limited to a service area as with HMO’s with their 50 mile-radius. Retirees can’t enroll but active employees who have it can take it with them. • In considering plans, look at worse case scenarios. Ask yourself, “do I want more choice?” and “do I want to pay more?”
Cigna reps will be there… • Cigna will be conducting 3 breakout sessions during the Wellness Fair on November 7. Log in at www.mycignaplans.com to see full summary of benefits, list of providers in your area, and the cost comparison tool. • User ID: “UofCA”; Password “choice” or call 1-800-401-4041, 8am-8pm for pre-enrollment info. Try Cigna’s RX & cost comparison tools.
New wellness program… • New wellness program through StayWell Health Management, paid 100% by UC. Includes smoking cessation, weight control, health risk assessments, health club discounts, health coaching and other wellness tools. • There’s a $75 gift card free for signing up and taking the voluntary, confidential online health assessment. Available to all except Kaiser which has its own wellness programs.
Mental health benefits consolidated… • UC standardized mental health and substance abuse benefits as United Behavioral Health becomes carrier for all plans, including Kaiser (Kaiser members will have 2 options now). • First 3 in-network visits covered with no copayment (except Kaiser). Employees currently in a course of treatment with a non-UBH provider should contact UBH after November 1 for transition assistance: 1-888-440-8225.
New perks… • Co-pays discontinued for preventive office visits and immunizations (except Kaiser). • RX’s: 90-day prescriptions are now available at UC Medical Center pharmacies, in Davis and Sac, all plans except Kaiser. Same cost as mail-order programs (90-day supply for 2 co-pays). Tip for those changing plans: refill your 90-day prescriptions in December and get new written prescriptions of maintenance drugs. Be sure to use new plan’s ID card in the new year!
I see… • Vision Program still fully paid by UC. 20% discount now includes non-prescription glasses/sunglasses. New voluntary retiree coverage available July 1, 2008; full cost paid by retirees. • Dental – minor changes to certain copays and oral surgeries. PMI name changed to DeltaCare USA HMO.
♦Actions you can take during OE… • Change to a different medical plan • Change to a different dental plan (California residents only). • Enroll eligible family members in your health plans. • Enroll or re-enroll in the Health Care Reimbursement Account (HCRA) and/or Dependent Care Reimbursement Account (DepCare). Even if you are currently enrolled in these plans, you must re-enroll to participate in 2008. “Use it or lose it” the year it’s deducted. • Enroll in the ARAG Legal Plan, or if already enrolled, add family members. Not open every year; last offered in 2005. • Opt out of your medical, dental, or vision plan, or enroll in a new plan if you previously opted out. • Change participation in the Tax Savings on Insurance Premiums (TIP) program (enrollment is automatic unless you opt out).
More actions you can take… • Life Insurance not tied to OE. An accelerated benefit option has been added to dependent life for spouse/domestic partner coverage to pay a living benefit with terminally ill employees. • No AD&D rate increases for 2008. Not part of Open Enrollment. • Disability not part of Open Enrollment. 15% plan rate increase in 2008. • Taking into account plan changes for 2008, if you are satisfied with your current coverage and do not need to make any changes for next year, you need not take any Open Enrollment action (except for HCRA and DepCare enrollment). • Be sure your beneficiary designations are up to date on in the system for • 1) UCRP, CAP, Life, Dep Life, AD&D: http://atyourservice.ucop.edu • 2) DCP, 403b and 456B through Fidelity website: http://netbenefits.com
Tool around… • Open Enrollment announcements were mailed to active employees mid-October. There are 10 campus benefits presentations in November. • Open Enrollment actions will be effective as of January 1, 2008. http://atyourservice.ucop.edu for more information and to enroll or make Open Enrollment changes. Very Cool Website tools to try: • Medical Plan Chooser • Find a Doctor • Medical Plan Summaries • Medical Plan rates • HCRA/DepCare Calculator • Password resets