Open Enrollment Highlights

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.

Agenda

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

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

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

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 Arellanoedna.arellano@hr.ucsb.edux4048

Open Enrollment Resources Booklets mailed to home

Open Enrollment Websitehttp://ucnet.universityofcalifornia.edu/oe o Benefit Education Videoso News stories on UCneto Medical Plan Chooser

Insurance Plan Websites o Provider directorieso Plan booklets

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

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

Medical Plan Comparison Videohttps://uc.a.guidespark.com/videos/5937

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

90 Day Maintenance Drug – Retail Option

CURRENT 2015

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 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/AcupunctureCURRENT 2015

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)

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 Changes2015 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

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

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 PlanCombines high deductible PPO with

account to pay out-of-pocket expenses

Medical CoverageBlue Shield PPO

Health Savings AccountHealthEquity

+

Blue Shield HSP &

• You may NOT be enrolled in Medicare Parts A or B and theBlue 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

Blue Shield Health Savings Plan LimitsIRS annually increases definition of “high deductible” and

Health Savings Account maximum annual contribution amounts.

20

2014 2015 Change

In-Network DeductibleSingle

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 ContributionSingle

Family

$3,300

$6,550

$3,350

$6,650

$50

$100

UC HSA ContributionSingle

Family

$500

$1,000

No change

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

UC Care PPOUC Select

Tier 1

Copays

Blue ShieldPreferred

Tier 2

Deductible

20% Coinsurance

Non-PreferredOut-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

Emergency – UC Care

Covered ServiceUC 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

$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 No Charge No Charge

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

Ambulance – UC Care

Covered ServiceUC 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 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

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).

UC Care - Santa Barbara Network Update

Provider Status

Sansum Clinic UC Select/Tier 1

Quest Diagnostic LabUnilab

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.

Teladoc – Blue ShieldTelemedicine 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

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

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

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%.

Dental & Vision – No changes Dental

o Delta Dental PPOo DeltaCare HMO

Visiono Vision Services Plan

No contributions for employee dental and vision

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.

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• 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.

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:

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.