A biweekly publication for faculty and staff

Changes, New Opportunities for Benefits Highlighted During Open Enrollment

October 19, 2016

A nurse monitors a patient's blood pressure reading.Open enrollment for 2017 benefits begins at 8 a.m. Oct. 27 and ends at 5 p.m. Nov. 22, and significant changes and new options are in store for employees.

“There’s a lot of good news this year,” said Dwaine Duckett, vice president of human resources for the University of California Office of the President. “We’ve worked hard to manage costs, and offer the protection of disability insurance to more faculty and staff than ever before. I encourage everyone to take a careful look at their options this year, to make sure they’re taking full advantage of their UC benefits.”

UC Merced will host its annual Open Enrollment Benefits Fair for faculty and staff members from 11 a.m. to 2 p.m. Friday, Oct. 28, in the Joseph Edward Gallo Gymnasium. At the fair, participants can ask questions of insurance carrier representatives and vendors. UC Merced Benefits Office staff members also will be available to answer questions. Those who RSVP by Thursday (Oct. 20) will receive free lunch.

Among the benefits highlights coming in 2017:

  • Employees will see small increases, or even decreases, in their contributions toward medical premiums this year. More than 90 percent of employees will see increases of less than $10 a month and no increases are more than $12 a month. The news is even better for members of UC Care, whose monthly contributions will decrease. Dental and vision plans are still offered by UC at no cost for employees.
  • Employees have a one-time opportunity to change or add UC’s Voluntary Disability Insurance during Open Enrollment with no statement of health required. UC has expanded eligibility for this coverage, so this is a good opportunity to enroll. Disability coverage can help protect your income if you miss work because of a pregnancy, illness or injury.
  • UC’s preferred provider organization (PPO) medical plans — Core, UC Care and UC Health Savings Plan, as well as UC High Option Supplement to Medicare, UC Medicare PPO and UC Medicare PPO without Prescription Drugs — will have new administrators next year for behavioral health and prescription drug benefits. UC has worked to minimize disruption for members, but there are a few steps employees should take to make sure they are prepared for the change. Look for additional details during open enrollment.
  • Health Net Blue & Gold has added several new provider groups in Northern California.

More Disability Insurance Options

If you’ve never thought about disability insurance, this is the year to take a look as UC is changing its disability insurance offerings to give all benefits-eligible employees (full, mid-level or core) new options for protecting their finances.

During open enrollment, eligible employees have a one-time opportunity to enroll in voluntary short-term disability (benefits up to six months), long-term disability (benefits after six months, up to your Social Security retirement age) or both.

Time away from work because of illness, injury or pregnancy could mean months without a paycheck. While UC’s basic employer-paid disability insurance offers some protection — a benefit capped at $800 per month for six months — it probably isn’t enough to cover expenses. For a modest monthly premium, UC’s Voluntary Disability Insurance replaces much more income — 60 percent of eligible pay up to $15,000 per month — for additional financial security when it’s needed the most.

The flexibility of UC’s new disability options allows employees to tailor coverage to their needs and budget. For example, choosing only Voluntary Long-Term Disability Insurance might be a good option for faculty members eligible for paid medical leave (see APM 710-11) or employees with a substantial balance of accrued sick leave. Choosing both short- and long-term disability provides the most comprehensive protection for all types of disability leaves.

During open enrollment, no employee can be denied coverage due to an existing medical condition. Those who wait to enroll after the open enrollment period ends will need to submit statements of health, which could affect qualification. To ensure continuing protection, those who are currently enrolled in supplemental disability and don’t take action during open enrollment will be automatically enrolled in both short- and long-term voluntary disability insurance. This change will affect premium costs, so take the time to choose coverage that best suits your needs. Coverage can reduced or discontinued at any time.

Visit the UCnet 2017 disability page for more information about how the plans work.

PPO Administrator Changes

For 2017, a number of administrators will change for UC’s PPO plans (Core, UC Care and UC Health Savings Plan, as well as UC High Option Supplement to Medicare, UC Medicare PPO and UC Medicare PPO without Prescription Drugs). Plan administrators process claims, create networks of health care providers or pharmacies, and set clinical policies and guidelines. Among the changes:

  • Medical — Anthem Blue Cross replaces Blue Shield as the administrator of medical benefits for UC’s PPO plans. HealthEquity will continue as the health savings account custodian.
  • Behavioral health — Anthem Blue Cross replaces Optum as the administrator of behavioral health benefits for UC Care and UC Health Savings Plan. Anthem replaces Blue Shield as the administrator of behavioral health benefits for Core, UC High Option Supplement to Medicare and UC Medicare PPO.
  • Prescription drugs — OptumRx replaces Blue Shield as the administrator of prescription drug benefits for UC’s PPO plans.

Plan members will learn more about how best to prepare for the change during open enrollment. For example, employees will want to confirm their current doctors and other providers — including behavioral health — are in-network in 2017, and check the OptumRx formulary to confirm prescription medication costs. Those currently receiving treatment may be eligible for transition assistance depending on the situation.

Growing HMO Options

There will be no significant HMO plan changes in 2017, but some new choices may make an HMO plan a better option for some members. Health Net Blue & Gold members in the Merced area who use Direct Network will have access to physicians located at Dignity Health Medical Group.

The open enrollment website and booklet will be available the week of Oct. 24 and will include details about options and costs. Open enrollment ends at 5 p.m. Nov. 22.