Download presentation
Presentation is loading. Please wait.
Published byLinda Owens Modified over 9 years ago
1
FOR ONLINE PARTICIPANTS During today’s event, Town Hall Benefits Open Enrollment meeting, submit your questions online at ReadyTalk.com 1)Go to ReadyTalk.com 2)Enter Access Code 4866997
2
2014 Overview
3
Overview Michael Baptista, Executive Director Benefits Programs & Strategy
4
Why Change? Projected Increases Anthem PLUS (Single/Family) Anthem PPO (Single/Family) Health Net Full Network HMO (Single/Family) Salary Band 2 (Neutral Band) 2013: $111 / 3782013: $143 / 4692013: $144 / 473 2014: $175 / 5612014: $189 / 6022014: $208 / 655 2014 Increase Monthly Annual $64 / 183 $768 / 2,196 $46 / 133 $552 / 1,596 $64 / 182 $768 / 2,184
5
What is the new line-up? Sustainable Cost (For Members and UC) Comprehensive Care Distinct Value 2013 (8 plans) 2014 (6 plans) Anthem PPO UC Care (Blue Shield) Anthem PLUS Core Anthem HRA-PPOHealth Savings Plan (Blue Shield) Health Net Blue & Gold HMO Health Net Full Network HMO Kaiser HMO WHA HMO (Davis area)
6
What are the new plans? UC Care Health Savings Plan
7
UC Care: Network & Plan Design Customized for UC Care UC Network + Select Blue Shield providers UC Select Providers Similar to the standard in network cost-share of the previous Anthem PPO plan Blue Shield Preferred Providers Flexibility to use services from any provider outside the Blue Shield Preferred network Out of Network Providers PPO plan that offers wide choices Blue Shield of California – claims administrator and network provider
8
Blue Shield Health Savings Plan New high deductible medical plan paired with a Health Savings Account (HSA) Blue Shield PPO Health Savings Account * High deductible medical plan * Wide provider network access * Out-of-network coverage * Network preventive care covered at 100% *Special account to pay medical expenses *UC funds $500/$1,000 *You can contribute pre-tax *Portable +
9
Health Net Full Network Blue & Gold UC Care Health Savings Plan Kaiser
10
Anthem PLUS Blue & Gold UC Care Health Savings Plan Kaiser Anthem PLUS
11
Anthem PPO Blue & Gold UC Care Health Savings Plan Kaiser
12
Anthem Lumenos HRA Blue & Gold UC Care Health Savings Plan Kaiser
13
What do I need to think about? Member Priority Doctor Specific physician, hospital, or least restricted choice Find preferred doctor in best available benefit/value option Dollars & Delivery Monthly cost, fixed copay vs. cost exposure, savings option, administrative ease Find preferred plan type, select best available physician choice
14
A look at the new plans
15
Presented by: Kathy Hajopoulos
16
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: o Offer a preferred discount for UC Care participants o Offer a plan that promotes care at UC medical centers UC Care. Your care. Your choice.
17
UC Care plan overview
18
UC Care cost comparison Monthly Contributions * 2014 Pay Band 2 range is $51,001-$101,000. Anthem PLUS (Single/ Family) Anthem PPO (Single/ Family) UC Care (Single/ Family) $50,001 – $98,000*2013: $111 / $3782013: $143 / $469 2014 Monthly: $108 / $366 Annual: $1,296/ $4,392 2014 Projected Increase Monthly Annual $64 / 183 $768 / 2,196 $46 / 133 $552 / 1,596 UC Care rates lower than current Anthem PLUS and PPO rates
19
UC Care plan design comparison Anthem PLUSAnthem PPO Deductible In-network Out-of-network None $500 / $1,500 $250 / $750 $500 / $1,500 Out-of-Pocket Max$5,000 / $15,000$3,000 / $9,000 Member Share Office visits In-network Out-of-network $25 30% 20% 40% Outpatient In-network Out-of-network $0 30% 20% 40% Hospitalization In-network Out-of-network $250 30% 20% 40% Rx$10 / $30 / $45 UC Care Blue Shield Preferred (In/Out)UC Select $250/$750 $500/$1,500 No Deductible $3,000 / $9,000$5,000 / $15,000$1,500 / $4,500 Member Share 20% 50% $20 20% 50% $20 / 20% (depends on service) 20% 50% $250 $5 / $25 / $40
20
UC Care plan design
21
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
22
UC Care tool – UC Select providers 1.When you type this url, you are automatically. defaulted to UC Select. 2.To change the to Blue Shield Preferred, click on the “Change selection” link. blueshieldca.com/uccareppo
23
UC Care tool – Preferred providers 1.Once you click on the link for “Change selection,” you will see a pop up window. 2.Click on the radio button “Blue Shield Preferred.” 3.Click on the “done” button. blueshieldca.com/uccareppo
24
UC Berkeley UC Select Providers Children's Hospital and Research Center at Oakland San Ramon Regional Medical Center Sutter - Alta Bates Herrick Campus Sutter - Alta Bates Summit Medical Center - Alta Bates Campus Sutter - Alta Bates Summit Medical Center - Summit Campus Sutter Delta Medical Center (Antioch) Sutter Eden Hospital (Castro Valley) ValleyCare Medical Center (Pleasanton) Some providers were excluded from UC Select, but are in Blue Shield Preferred: John Muir – Lower cost alternative providers available within the area Washington Hospital – Lower cost alternative providers available within the area
25
UC San Francisco Some providers were excluded from UC Select, but are in Blue Shield Preferred: California Pacific Medical Center – Lower cost alternative providers available in the area UC Select Providers Marin General (Marin) Saint Francis Memorial Hospital (Dignity) St Mary's Medical Center (Dignity) UCSF Medical Center UCSF Medical Center - Mount Zion
26
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 Friday 7:00 a.m. to 7:00 p.m. (Pacific) Questions?
27
The Blue Shield Health Savings Plan Mark Esteban, Director Health & Welfare Planning and Financials
28
Blue Shield Health Savings Plan Health Savings Account (HealthEquity) Medical Coverage (Blue Shield PPO) + Combines high deductible PPO with account to pay out-of-pocket expenses
29
Medical PPO Plan Design Medical Plan Coverage *Network preventive care covered at 100% In NetworkOut of Network Deductible* Single Family $1,250 $2,500 $5,000 Out-of-Pocket Max (includes deductible) Single Family $4,000 $6,400 $8,000 $16,000 Member Cost Sharing (coinsurance after deductible is met) 20%40%
30
HSA Funding Contribution Types IndividualFamily UC Contribution$500$1,000 Employee Pre- Tax (optional) up to $2,800up to $5,550 2014 IRS Maximums for HSA: $3,300 $6,550
31
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
32
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
33
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. Why is it better than an HRA?
34
1.Go to your doctor. 2.Later – check your HealthEquity account online to see required payment to the doctor. 3.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
35
1.Go to your pharmacy. 2a. Pay for your Rx immediately if you want to use your HSA Debit Card, OR Using Your Health Savings Plan Give Pharmacist your Blue Shield Card so they can apply the Blue Shield Rx discounts. 2b. Pay with personal funds (e.g., AMEX to get your points) and later go to your HealthEquity account online and reimburse yourself.
36
Questions? atyourservice.ucop.edu/oe/medical
Similar presentations
© 2025 SlidePlayer.com. Inc.
All rights reserved.