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2014 Overview. Overview. Michael Baptista, Executive Director Benefits Programs & Strategy. Why Change? Projected Increases. What is the new line-up?. Sustainable Cost (For Members and UC) Comprehensive Care Distinct Value. What are the new plans?. UC Care Health Savings Plan.
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Overview Michael Baptista, Executive Director Benefits Programs & Strategy
Why Change? Projected Increases
What is the new line-up? • Sustainable Cost (For Members and UC) • Comprehensive Care • Distinct Value
What are the new plans? • UC Care • Health Savings Plan
UC Care: Network & Plan Design • PPO plan that offers wide choices • Blue Shield of California – claims administrator and network provider
Blue Shield Health Savings Plan • New high deductible medical plan paired with a Health Savings Account (HSA) Health Savings Account Blue Shield PPO • Special account to pay medical expenses • UC funds $500/$1,000 • You can contribute pre-tax • Portable * High deductible medical plan * Wide provider network access * Out-of-network coverage * Network preventive care covered at 100% +
Health Net Full Network Health Net Full Network Kaiser Health Savings Plan Blue & Gold UC Care
Anthem PLUS Anthem PLUS Kaiser Health Savings Plan Blue & Gold UC Care
Anthem PPO Anthem PPO Kaiser Health Savings Plan Blue & Gold UC Care
Anthem Lumenos HRA Anthem Lumenos HRA Kaiser Health Savings Plan Blue & Gold UC Care
What do I need to think about? Member Priority • Dollars & Delivery • Monthly cost, fixed copay vs. cost exposure, savings option, administrative ease • Find preferred plan type, select best available physician choice • Doctor • Specific physician, hospital, or least restricted choice • Find preferred doctor in best available benefit/value option
A look at the new plans
UC Care. Your care. Your choice. • New self-funded PPO plan for 2014 • Created for UC employees and non-Medicare retirees to provide them with greater choice and flexibility • Can get care from UC physicians and medical centers, the Blue Shield Preferred network of providers, or out-of network providers • We are able to leverage UC Health to benefit employees and the University: • Offer a preferred discount for UC Care participants • Offer a plan that promotes care at UC medical centers
UC Care cost comparison Monthly Contributions * 2014 Pay Band 2 range is $51,001-$101,000.
UC Care network – in network • UC Select • All UC medical centers, facilities and physicians • Additional preferred Blue Shield providers in areas where UC medical centers and physicians may not be accessible • Chosen based on quality, location and cost • Blue Shield Preferred Network • 376 hospitals • 22,061 primary care physicians • 50,197 specialists • BlueCard Network coverage outside of CA and the U.S. • 97% of Anthem contract providers are in the Blue Shield Preferred network • 88% of providers in California are in the Blue Shield Preferred network
UC Care tool – UC Select providers blueshieldca.com/uccareppo When you type this url, you are automatically. defaulted to UC Select. To change the to Blue Shield Preferred, click on the “Change selection” link.
UC Care tool – Preferred providers blueshieldca.com/uccareppo Once you click on the link for “Change selection,” you will see a pop up window. Click on the radio button “Blue Shield Preferred”. Click on the “done” button.
UCLA (3 of 3) • Some providers were excluded from UC Select, but are in Blue Shield Preferred: • Los Robles Medical Center – excluded due to high cost. Lower cost alternative providers available in the area • West Hills Medical Center – excluded due to high cost. Lower cost alternative providers available in the area
UC Care information • Looking for more details? Visit uc-care.org • To find a provider, visit blueshieldca.com/uccareppo • Have questions? Shield Concierge can help: • 1-855-201-2087 • Monday through Friday7:00 a.m. to 7:00 p.m. (Pacific) • Questions?
The Blue Shield Health Savings Plan Mark Esteban, Director Health & Welfare Planning and Financials
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)
HSA Funding 2014 IRS Maximums for HSA: $3,300 $6,550
How does the HSA work? • UC funds your HSA account with $500 for individual and $1,000 for family • You can contribute up to $2,800/individual $5,550 family • If you’re 55 or older, you can contribute more • Use HSA $ to pay for your • Deductible • Coinsurance (e.g., your 20%) • Any IRS Publication 502 Expenses
Things to consider….. • You can’t participate in the Blue Shield Health Savings Plan and UC’s Flexible Spending Account (Conexis) at the same time • You can’t be anyone’s tax dependent • Health Savings Account only allowed for High Deductible Health Plans
Why is it better than an HRA? Your Health Savings Account: You own the account You can contribute to it It has triple tax advantages It comes with a HSA Debit Card Currently enrolled in Anthem Lumenos and have an HRA balance? You’ll keep it as long as you enroll in the Health Savings Plan.
Using Your Health Savings Plan Go to your doctor. Later – check your HealthEquity account online to see required payment to the doctor. Pay with your HSA funds through your HealthEquity online account. Give doctor’s office your Blue Shield card so BSC can… process the claim and get you their special provider discounts and send info about your amount of claim responsibility to Health Equity
Using Your Health Savings Plan Go to your pharmacy. 2a. Pay for your Rx immediately if you want to use your HSA Debit Card, OR 2b. Pay with personal funds (e.g., AMEX to get your points) and later go to your HealthEquity account online and reimburse yourself. Give Pharmacist your Blue Shield Card so they can apply the Blue Shield Rx discounts.
Questions? atyourservice.ucop.edu/oe/medical