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UCSB Human Resources - Benefits New Employee Orientation Benefits Office Hours 8:00 - Noon & 1:00 - 4:00 893-2489
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Overview Eligibility Enrollment Health and Welfare Plans Retirement and Savings Plans Welcome folder
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Benefits Packages Full Benefits Mid-Level Core Special Groups UC Transfers Rehired Retirees Postdoctoral Scholars A Complete Guide to Your UC Health Benefits, pages 8 – 10
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Eligible Family Members Legal spouse, same sex/opposite sex domestic partner Child(ren) under 26 Legal Ward(s) under 18 Overage disabled child A Complete Guide to Your UC Health Benefits – page 11-12
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Imputed Income Your taxable income may increase if you enroll a same sex domestic partner not declared as a dependent on your federal taxes. Taxed on value of employer-paid medical A Complete Guide to Your UC Health Benefits – page 5
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Your Responsibility Check eligibility requirements before enrolling a family member Family Member Eligibility Verification SECOVA will request documents to verify eligibility within a 30-60 days You and your family members may be de- enrolled if you fail to respond to Secova’s request for documentation.
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UCnet Benefits Video The Benefits of Belonging
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Life Events & Benefits Add an eligible family member 31 days to enroll Family member loses eligibility Notify Benefits Office to cancel coverage Family Changes Checklist http://ucnet.universityofcalifornia.edu/forms/pdf/family-changes.pdf A Complete Guide to Your UC Health Benefits – page 6-7
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When to Enroll Period of Initial Eligibility (PIE) PIE is first 31 days of employment If you miss PIE, 90 day delay for medical plan Open Enrollment Period Opportunity to change plans in November for next year Statement of Health
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How To Enroll – Period of Initial Eligibility UCnet ucnet.universityofcalifornia.edu Sign-in to At Your Service Online = AYS Online Select “Benefit Enrollment” Your Benefits at a Glance New EmployeesRehired Employees Status/Appointment Change Social Security Number Date of Birth Username Password
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atyourserviceonline.ucop.edu/ayso Click on New to UC
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atyourserviceonline.ucop.edu/ayso MMDDYYYY Enter your Date of Birth as password
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More information
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Insurance Plan Websites Find a doctor or participating provider Summary of Benefits booklets Prescription drug list A Complete Guide to Your UC Health Benefits – Contact information insert
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Health Plans Medical Dental Vision
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Which medical plan is right for you? Medical Plans Summary of services Cost of care Monthly premiums Union Members Rates may be different
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What are your priorities? Cost to enroll – monthly premium Cost of care Predictable, low cost copays Pay a % of each service Worst case scenario – Out of pocket maximum Choice of providers HMO medical group physicians PPO preferred network or any provider Effort to manage – coordinating care & bills
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HMO – Health Maintenance Organization 20 Predictable, low cost copay for services and drugs Insurance plan delegates your care to a “medical group” Care is coordinated by Primary Care Physician (PCP) and medical group Emergency and urgently needed care when away
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HMO Plans for 2015 Health Net Blue & Gold HMO Sansum Clinic or SB Select IPA Regal in Ventura Physician’s Choice in Santa Maria Kaiser HMO closest facilities Ventura & Los Angeles County
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Using the Health Net or Kaiser HMO Plan You select Primary Care Physician (PCP) When you need care go to your PCP PCP refers you to specialist, x-ray, lab, hospital Copayments Medical Services Office visit: $20 Surgical Center $100 Inpatient Hospital: $250 Emergency Room: $75
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HMO Limitations Coverage area is local Live or work within 30-miles of provider Must use Primary Care Physician and specialists in your assigned medical group If away from your medical group, plan will only cover health threatening emergencies
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PPO – Preferred Provider Organization 25 You direct your own care, you decide where to receive services You pay annual deductibles before plan pays After deductible, you share the cost of each service with the plan - coinsurance Your costs are lower if you select preferred providers “Out-of-pocket Maximum” limits your financial liability
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PPO Plans for 2015 UC Care Blue Shield Health Savings Plan Core (default)
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UC Care PPO PPO plan designed for UC Administered by Blue Shield of California Blue Shield PPO network Claim administrator International plan Employee & family members may live anywhere Comprehensive coverage worldwide
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UC Care Providers 28 UC Select (Tier 1) UC Medical Centers Select local providers Blue Shield Preferred (Tier 2) In CA Blue Shield PPO In US Blue Cross/Blue Shield Outside US BlueCard Network or any provider Non-Preferred Out-of-Network (Tier 3) Not contracted with Blue Shield in US You have access to providers in all three tiers
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UC Care: UC Select near UCSB 29 UC Select (Tier 1) providers in Santa Barbara – Sansum Clinic, Quest Lab, Unilab Santa Maria Lompoc Ventura There are limited UC Select providers in Santa Barbara area High cost hospital and medical groups Check the UC Care directory for providers important to you http://uc-care.org/
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UC Care Costs 30 UC Select (Tier 1) Copays Blue Shield Preferred (Tier 2) Deductible 20% Coinsurance Non-Preferred Out-of-Network (Tier 3) Deductible 50% Coinsurance Your costs are based on the tier/network that the provider is in Not all services are covered at the UC Select benefit tier Some services are covered only at the Blue Shield Preferred and Non-Preferred tiers
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Deductible, Coinsurance, Out of Pocket Max 31 You pay You share cost with plan Plan pays 100% after you pay $250 Deductible 20% Coinsurance $3000 OOPM UC Care Example Individual Coverage Blue Shield Preferred (Tier 2)
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UC Care - Overview No HMO option, no PCP, no referrals – you select physicians and manage care You pay a copay or a percentage of fee for services depending on the provider you select Large network of Preferred PPO providers Higher premium than HMO You can live outside of California
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Why select UC Care? You like managing your own care You like being able to select any physician You don’t mind paying more for a larger choice of physicians You’re living outside of California OR out of the HMO service areas
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Blue Shield Health Savings Plan 35 Combines high deductible PPO with account to pay out-of-pocket expenses Medical Coverage Blue Shield PPO Health Savings Account HealthEquity +
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What’s 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) UC makes an annual contribution to this account You may also make pre-tax contributions You use the HSA funds to pay medical and other health care expenses Funds rollover; the money in the account is yours to keep You are not eligible to have a HSA if enrolled in Medicare Part A or B
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Blue Shield Health Savings Plan The employee must live in US When in US Comprehensive coverage Blue Shield PPO network in CA Blue Cross Blue Shield network outside CA When traveling out of US Emergency and urgent care only NO routine care
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Blue Shield PPO – Plan Design In NetworkOut of Network Deductible Single Family $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 $4,000 $6,400 $8,000 $16,000
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Health Savings Account 39 Blue Shield PPO + Health Savings Account The Health Savings Account is a separate account that can be used to pay eligible medical, dental, vision, and other health expenses. Administered by HealthEquity
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How does HSA work? UC makes annual contribution for plans that start on January 1, prorated for plans starting later You may contribute through pre-tax payroll deduction or make post-tax contributions to HealthEquity HSA debit card Use a HSA debit card to pay for health expenses HealthEquity website Use HealthEquity website to pay medical and other health claims Invest HSA dollars Invest HSA dollars when account balance reaches $2000 – no fees to invest
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Annual Contributions to HSA SingleFamily (2 or more) 2015 IRS Contribution Limit$3,350$6,650 UC Contribution on 1/1/15$500$1,000 Employee Contribution (Optional) pretax payroll deduction post-tax payment to HealthEquity $2,850 $5,650 Catch-up contribution, age 55+: $1000
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Advantages of an HSA 42 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 Federal taxes on earnings HSA funds rollover from year to year; no use it or lose it as with Health FSA
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Who is eligible for HSA? To own an HSA you need to: Be covered ONLY by an HSA-qualified health plan Other health coverage may disqualify you, including Health FSA, Medicare or traditional health plan Not be claimed as a dependent on someone else’s tax return
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Blue Shield HSP - Overview No PCP, no referrals – you select physicians and manage care UC contributes to your Health Savings Account You can contribute pre-tax dollars to HSA HSA belongs to you even if you separate from UC May submit claims to HSA to reimburse medical, dental, vision, and other health expenses Higher deductible than UC Care Must live in US
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Why select the Blue Shield HSP? You like managing your own care You have few medical or drug expenses and expect to rollover HSA dollars You have many medical or drug expenses and will contribute pretax dollars to HSA You don’t mind managing medical accounts
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Core - Fee for Service Catastrophic medical plan (default) PPO plan design $3,000 annual deductible per individual 20% co-insurance for medical and drug OOPM: Individual $6,350; Family $12,700 Premium paid in full by UC You select Blue Shield PPO providers or non- Blue Shield provider
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Prescription Drugs 48 HMO UC Care Blue Shield HSP CORE Retail (30 day) Generic Generic Brand Brand Non-formulary Non-formulary$5$25$40 You pay full cost of medication until you satisfy the deductible After deductible, you pay 20% at preferred pharmacies Mail Order (90 day) Generic Generic Brand Brand Non-formulary Non-formulary$10$50$80 Preferred Drug List (Formulary) is different for each carrier
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Preventive Care 49 All medical plans cover preventive care at 100% with in-network providers Preventive care includes: Annual well visit and labs Well woman visits and labs Preventive screening tests Immunizations See list of preventive services on the plan websites
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Optum – Behavioral Health Counseling and substance abuse treatment Care by therapists, psychologist, psychiatrist Different provider options and benefits Health Net, Kaiser HMOs – use Optum clinicians UC Care and Blue Shield Health Savings Plan– use Optum or Non-Optum clinicians Call Optum to confirm provider is in-network
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Dental Insurance Plans Choice of two plans Delta Dental PPO DeltaCare USA (HMO) Premium paid in full by UC A Complete Guide to Your UC Health Benefits, Pages 20 – 23
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Delta Dental PPO Worldwide coverage Preventive dentistry covered 100% Basic dentistry covered 80% $50 annual deductible for basic dentistry Plan pays up to $1700 annual maximum benefit (In-Network PPO dentists) Delta PPO Providers - Lower out of pocket costs
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Delta Dental PPO Why select this plan? You like being able to select any dentist You don’t mind paying more for a larger choice of dentists You don’t expect to exceed the annual maximum benefit of $1,700 You’re living outside of California
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DeltaCare USA (HMO) Must use DentalCare HMO dental group Assigned to a dental group Limited number of dental groups in Santa Barbara No deductibles Preventive dentistry covered 100% Co-payments for basic dentistry Additional fees for upgrades on materials No annual maximum benefit
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DeltaCare USA (HMO) Why select this plan? You don’t mind having a limited choice of dentists You like lower out of pocket costs You expect to have major dental work that will exceed the Delta PPO maximum benefit, or plan on orthodontic services
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VSP - Vision Service Plan Routine vision care Exam – 1 per calendar year ($10 co-pay) Lenses - one set every year Frames every other year ($130 allowance) OR Contact lenses ($110 allowance) per calendar year Select VSP doctor for lower costs Limited reimbursements for non-VSP doctor Premium paid in full by UC Visit the website to access In-Network providers www.vsp.com
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Other Insurance Disability Life Accidental Death and Dismemberment Legal Flexible Spending Accounts
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Disability Insurance Liberty Mutual Insurance Company Short-Term Disability Employer-paid Short-term benefits only Supplemental Disability Voluntary / employee-paid Short-term supplement and long-term benefits No State Disability Insurance (SDI) coverage Worker’s Compensation (work related only)
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Short-Term Disability Enrollment is automatic; paid by UC 7-day waiting period - (if you have accrued sick leave, you must first use up to 22 working days of sick leave before benefits start) Monthly benefit = 55% up to $800/mo. maximum 26 week disability period Provides benefits for non-work related disabilities Does not include long-term coverage
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Supplemental Disability Enroll during PIE or with Statement of Health Employee paid - premium based on age, waiting period and full-time salary rate Choice of 7, 30, 90, or 180-day waiting period If you have accrued sick leave, you must first use up to 22 working days of sick leave before benefits start Coverage for duration of disability up to age 65 Supplements other income to 70% up to $15,000/month maximum Video Summary Video Summary
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Life Insurance Enroll during PIE or with Statement of Health Choice of electing coverage for up to 4 x your annual salary Dependent Life Insurance Option Please see more information in A Complete Guide to Your UC Health Benefits pages 32 - 35
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Calculating your premiums
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Supplemental Disability & Supplement Life
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Flexible Spending Accounts (FSA) Health FSA & Dependent Care FSA Save taxes on eligible expenses Contribute to plan with pre-tax earnings Submit claims for reimbursement for eligible out- of-pocket expenses or use Health Spending Card Effective date is the 1 st of the month following enrollment; subject to payroll deadlines *Read the Summary Plan Description Booklet *Estimate carefully - “Use it or lose it”
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Maximum Annual Contribution = $2,500.00 Minimum = $180.00 New provision for 2015– can carry over $500 from 2015 to 2016 however funds not available until April 2016 Plan start date Dec. 31 st April 15 th Plan year (From 1 st of the month following enrollment to Dec. 31 st ) Period to submit claims from 2015
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Retirement Plans University of California Retirement Plan (UCRP) Defined Contribution Plan (DCP for Safe Harbor) Voluntary Retirement Savings Programs Tax-Deferred 403(b) 457(b) Deferred Compensation
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University of California Retirement Plan (UCRP) 2013 Tier Members Vesting = 5 years (100% full-time) Minimum age 55 Defined Benefit Plan: Age x Years of UCRP Service x Highest Average Plan Compensation (HAPC) Coordination with Social Security 1976 Tier members minimum age 50
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Example: Benefit Percentages Years of UCRP Service Credit Retirement Age 556065 5.0550.0900.1250 10.1100.1800.2500 20.2200.3600.5000 30.3300.5400.7500 40.4400.72001.000 Retire at age 65 with 20 years of UCRP Service Credit Pension Benefit =.5000 of HAPC
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UCRP Contributions 2013 Tier: Employees contribute 7% of gross earnings. July 1, 2014 8% * Subject to collective bargaining
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Defined Contribution Plan (DCP Safe Harbor) Mandatory monthly pre-tax employee contributions of 7.5% (in lieu of paying Social Security taxes) Administered by Fidelity Defaults to UC-managed “Savings Fund” Voluntary DCP after-tax /rollover account
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Tax-deferred 403(b) and 457(b) Plans Voluntary employee pre-tax savings programs Administered by Fidelity Maximum annual contribution limits Investment options: Core Funds and other expanded options www.netbenefits.com
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Next Steps Explore benefit options UCnet – plan descriptions, cost calculator tools, medical plan chooser Health Plans – providers lists, coverage details, preferred drug lists (formulary) Enroll before end of “PIE” Medical, dental, vision insurance Life, Disability, AD&D, Legal insurance Flexible Spending Accounts
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After You Enroll Check your Earnings Statement on AYSO Are enrollments and deductions correct? Attend Retirement Workshops At Your Service - UCRP Fidelity – DCP, 457b, 403b
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Bright Horizons Care Advantage ServicesHow it works Child Care Nannies Elder Care Tutors Dog Walkers/Sitters Housekeepers You register with Sittercity UC pays membership fee You make all the arrangements including hiring and payment of care giver Online care giver profile includes background check, picture, references, reviews Online referral service for in-home caregivers
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