2014 Overview

Overview

Michael Baptista, Executive DirectorBenefits Programs & Strategy

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 / 378 2013: $143 / 469 2013: $144 / 473

2014: $175 / 561 2014: $189 / 602 2014: $208 / 655

2014 Increase

Monthly

Annual

$64 / 183

$768 / 2,196

$46 / 133

$552 / 1,596

$64 / 182

$768 / 2,184

What is the new line-up? Sustainable Cost (For Members and UC) Comprehensive Care Distinct Value

2013 (8 plans)

2014 (6 plans)

Anthem PPOUC Care (Blue Shield)

Anthem PLUS

Core Core

Anthem HRA-PPO Health Savings Plan (Blue Shield)

Health Net Blue & Gold HMOHealth Net Blue & Gold HMO

Health Net Full Network HMO

Kaiser HMO Kaiser HMO

WHA HMO (Davis area) WHA HMO (Davis area)

What are the new plans?

UC Care

Health Savings Plan

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

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

+

Health Net Full Network

Health Net Full Network

Blue & Gold UC CareHealth

Savings PlanKaiser

Anthem PLUS

Blue & Gold UC CareHealth

Savings PlanKaiser

Anthem PLUS

Anthem PPO

Anthem PPO

Blue & Gold UC CareHealth

Savings PlanKaiser

Anthem Lumenos HRA

Anthem Lumenos HRA

Blue & Gold UC CareHealth

Savings PlanKaiser

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

A look at the new plans

Presented by: Kathy Hajopoulos

• 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.

UC Care plan overview

UC Care cost comparisonMonthly 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 / $378 2013:  $143 / $469    2014Monthly:   $108 / $366  Annual:   $1,296/ $4,392

2014 Projected IncreaseMonthly Annual

$64 / 183$768 / 2,196

$46 / 133$552 / 1,596

UC Care rates lower than current Anthem PLUS and PPO rates

UC Care plan design comparison

Anthem PLUS Anthem PPO

DeductibleIn-networkOut-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-networkOut-of-network

$2530%

20%40%

Outpatient In-networkOut-of-network

$030%

20%40%

HospitalizationIn-networkOut-of-network

$25030%

20%40%

Rx $10 / $30 / $45 $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

UC Care plan design

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

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

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

UCLA (1 of 3)UC Select Providers

Citrus Valley Medical Center - Queen of the ValleyDowney Regional Medical CenterGarfield Medical Center (San Gabriel Valley)Glendale Adventist Medical Center Good Samaritan Hospital (Los Angeles)Henry Mayo Newhall Hospital (Santa Clarita Valley)Huntington Memorial Hospital (Pasadena)Northridge Medical Center (Northridge)Providence Little Company of Mary (Torrance)Providence Little Company of Mary Medical Center San PedroProvidence Tarzana Medical Center

UCLA (2 of 3)UC Select Providers

Simi Valley Adventist Hospital(Dignity) St. Mary Medical Center (Long Beach)Torrance Memorial Medical CenterUCLA/Mattel Children's HospitalUCLA/Resnick Neuropsychiatric HospitalUCLA/Ronald Reagan UCLA Medical CenterUCLA/Santa Monica UCLA Medical CenterWhite Memorial Medical CenterWhittier Hospital Medical CenterSan Antonio Community Hospital

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 Friday

7:00 a.m. to 7:00 p.m. (Pacific)• Questions? 

Thank you

The Blue Shield Health Savings Plan

Mark Esteban, DirectorHealth & Welfare Planning and Financials

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

Medical PPO Plan Design

Medical Plan Coverage

*Network preventive care

covered at 100%

In Network Out of Network

Deductible*SingleFamily

$1,250$2,500

$2,500 $5,000

Out-of-Pocket Max(includes deductible)SingleFamily

$4,000 $6,400

$8,000 $16,000

Member Cost Sharing(coinsurance after deductible is met)

20% 40%

HSA Funding

HSA Funding

Contribution Types

Individual Family

UC Contribution $500 $1,000

Employee Pre-Tax (optional)

up to $2,800 up to $5,550

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

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?

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

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.

Questions?

atyourservice.ucop.edu/oe/medical