UCSBHuman Resources - Benefits

New Employee Orientation

Benefits Office Hours 8:00 - Noon & 1:00 - 4:00

893-2489

July 2015

Overview Eligibility Enrollment Health and Welfare Plans Retirement and Savings Plans

Welcome folder

Benefits Packages Full Benefits Mid-Level Core

Special Groups UC Transfers Rehired Retirees Postdoctoral Scholars

A Complete Guide to Your UC Health Benefits, pages 9 – 11

Benefits of Belonging - Video

http://ucnet.universityofcalifornia.edu

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 – pages 12-13

Life Events & Family Benefits

Add an eligible family member 31 days to enroll

Family member loses eligibility Notify Benefits Office to cancel coverage

Family Changes Checklist on UCnet A Complete Guide to Your UC Health

Benefits – pages 7-8

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 6

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

Your family members may be de-enrolled if you fail to respond to Secova’s request for documentation.

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

How To Enroll – Period of Initial Eligibility UCnet ucnet.universityofcalifornia.edu

Sign-in to At Your Service Online = Select “Benefit Enrollment”

Your Benefits at a Glance

New Employees Rehired EmployeesStatus/Appointment Change

Social Security Number

Date of Birth

Username

Password

AYS Online

ucnet.universityofcalifornia.edu

atyourserviceonline.ucop.edu/ayso

Click on New to UC

atyourserviceonline.ucop.edu/ayso

MMDDYYYYEnter your Date of Birth as password

More information

Insurance Plan Websites

Find a doctor or participating provider Summary of Benefits booklets Prescription drug list

Contact information insert -A Complete Guide to Your UC Health Benefits

Health Plans Medical Dental Vision

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

Which medical plan is right for you?

Medical Plans Summary of services Cost of care Monthly premiums Union Members

Rates may be different

HMO – Health Maintenance Organizations

Health Net Blue & Gold HMO Sansum Clinic - Santa Barbara, Lompoc, Santa Ynez SB Select IPA - Santa Barbara Regal - Ventura Physician’s Choice - Santa Maria

Kaiser HMO closest facilities Ventura & Los Angeles County

Using the Health Net or Kaiser HMO Plan

You selectPrimary Care Physician

(PCP)

When you need care go to your PCP

PCP refers you to specialist, x-ray, lab,

hospital

Find a Doctor on UCnet

Live or work within 30-

miles of medical group,

in most cases

Care is coordinated by

PCP and medical group

If away from group, plan

will only cover urgent

and emergency care

Cost of Care with Health Net & Kaiser HMOs

No Deductible

Predictable, low cost copays for services and drugs

Service Copay

Office Visit $20

Labs, radiologyUrgent Care Visit

$0$20

Outpatient Surgery $100

Inpatient Hospital $250

Emergency Room $75

Why select an HMO?

Like lower monthly premiums

Like low cost, predictable copays for care

Like having a Primary Care Physician who helps manage your care

Are satisfied with the specialists in the HMO medical group

Don’t have family members living outside the California HMO service area

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PPO – Preferred Provider Organization 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

PPO Plans for 2015

UC Care Blue Shield Health Savings Plan Core (default)

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 – You choose any provider

UC Select(Tier 1)

UC Medical Centers

Other local providers

Blue ShieldPreferred

(Tier 2)

In CA Blue Shield PPO

In USBlue Cross/Blue Shield

Outside USBlueCard Network or

any provider

Non-PreferredOut-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 – Network providers near UCSB

UC Select(Tier 1)

Santa Barbara limited to:

Sansum ClinicsQuest Labs & Unilab

A few other specialists

More complete networks in:

VenturaSanta Maria

Lompoc

Blue Shield Preferred(Tier 2)

Blue Shield PPO physicians & facilities

Cottage Hospitals

Pacific Diagnostic Lab

Pueblo Radiology

Provider Directory: http://uc-care.org

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UC Care Costs

UC 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

• 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

You pay You share cost with planPlan pays100% after

you pay$250

Individual Deductible

20% Coinsurance $3000 OOPM

UC Care ExampleIndividual Coverage

Blue Shield Preferred (Tier 2)

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

Limited number of UC Select/Tier 1 providers in Santa Barbara

Large network of Preferred PPO providers

Higher premium than HMO

You can live outside of California

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

Combines high deductible PPO with savings account to pay out-of-pocket expenses

Medical CoverageBlue Shield PPO

Health Savings AccountHealthEquity

+

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) Use the pre-tax HSA funds to pay the deductible and

other health expenses including dental and vision.

UC makes an annual contribution to this account

You may also make pre-tax contributions (optional)

Funds rollover; you keep money in the account

Who is eligible for HSP?

Health Savings Account “owners”

Must live in US

You can’t be enrolled in: Health Flexible Spending Account (FSA)

Other traditional health plan

Medicare Part A or B

Can’t be claimed as a dependent on someone else’s tax return

HSP – Provider Networks & Coverage

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 Use any provider

Blue Shield PPO – Medical Plan Design

In Network Out of Network

Deductible Single Family (2 or more)

$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 (2 or more)

$4,000 $6,400

$8,000 $16,000

Preventive Care by in-network providers is paid in full by plan

How does HSA work? UC makes one annual contribution to HSA

UC contribution is prorated based on the month the plan starts (see chart on UCnet)

You may contribute to HSA up to annual max (optional):

Pre-tax payroll deduction

Post-tax contributions paid to HealthEquity

Pay expenses or reimburse yourself from HSA using:

HealthEquity debit card

HealthEquity website

Funds rollover; you can invest HSA dollars over $2000

Annual Contributions to HSA

Single Family (2 or more)

2015 IRS Annual Limit $3,350 $6,650

UC Annual Contribution (plans starting in January)

$500 $1,000

Catch-up contribution, age 55+: $1000

Call HealthEquity if you have questions about contribution limits.

Why select the Blue Shield HSP?

You like lower monthly premiums

You like the tax advantages of the HSA

You want to build-up a saving account for future expenses

You have few medical or drug expenses and expect to rollover HSA dollars

You have many medical or drug expenses and will contribute to HSA so you can save taxes on health expenses

You like managing your own care

You don’t mind managing medical accounts

Core - Fee for Service

Catastrophic medical plan (default) PPO plan design Premium paid in full by UC $3,000 annual deductible per individual 20% co-insurance for medical and drug OOPM: Individual $6,350; Family $12,700 You select Blue Shield PPO providers or

non-Blue Shield provider

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Prescription Drugs

HMOUC Care

Blue Shield HSP CORE

Retail (30 day)• Generic• Brand• 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)Retail (Maintenance) • Generic• Brand• Non-formulary

$10$50$80

Preferred Drug List (Formulary) is different for each carrier

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Preventive Care

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

Optum – Behavioral Health Counseling and substance abuse treatment

Care by therapists, psychologist, psychiatrist

Plans have different provider options and benefits

Optum Only Optum & Non-Optum

Health NetKaiser

UC CareBlue Shield HSP

Call Optum to confirm provider is in-network

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 22 – 25

Dental Plan Comparison

Delta Dental PPO Delta Care USA (HMO)

Worldwide Coverage California Service Area

Choose Delta PPO or non-Delta • Large network in

Santa Barbara

Assigned to dental group• Small network in

Santa Barbara

Coinsurance 20% - 50% Copays - upgrades cost more

Maximum benefit up to $1700 No maximum benefit

Preventive care covered 100%

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

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

You or a family member needs orthodontic services

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 Find VSP Choice providers: www.vsp.com

Other Insurance

Disability Life Flexible Spending Accounts

See the booklet for these plans Accidental Death and Dismemberment – page 39 Legal – page 43

A Complete Guide to Your UC Health Benefits

Disability Insurance

Disability Insurance replaces lost income while you are away from your job due to a non-work related illness or injury, including childbirth.

Disability Insurance – Overview of Plans

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)

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

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

Why enroll in Supplemental Disability now?

After PIE – statement of health is required and you can be denied coverage

Can’t enroll during annual Open Enrollment

If you can’t work, can you afford to live on $800/month?

You are planning a pregnancy?

Calculating Your Premiums

Example: Supplemental Disability & Supplement Life

Flexible Spending Accounts (FSA)

Make monthly payroll contribution with pre-tax earnings

Submit claims for reimbursement or use Health Spending Card

Effective date is the 1st of the month following enrollment; subject to payroll deadlines

Blue Shield HSP members may not enroll in Health FSA

Save taxes on eligible expenses

Health FSA

medical, dental, vision, prescription drugs, etc

Dependent Care FSA

child careadult day care

A Complete Guide to Your UC Health Benefits, pages 45-46

Flexible Spending Account – Use it or lose it

Expenses incurred in 2015 will be reimbursed from your 2015 contributions

If you do not use all your funds by 12/31/15:

Health FSA

You can carry over up to $500 of unused funds into 2016. Even if you do not enroll in the 2016 plan

You will forfeit unclaimed funds above the $500

Dependent Care FSA

You forfeit any unclaimed funds

Estimate your expenses carefully

Retirement Plans

Mandatory Plans University of California Retirement Plan (UCRP)

OR Defined Contribution Plan (DCP for Safe Harbor)

Voluntary Retirement Savings Programs Tax-Deferred 403(b) 457(b) Deferred Compensation

A Complete Guide to Your UC Retirement Benefits

University of California Retirement Plan (UCRP) 2013 Tier Members

Vesting = 5 years of Service Credit (100% full-time)

Minimum age 55

Defined Benefit Plan:

Age x Years of UCRP Service Credit x

Highest Average Plan Compensation (HAPC)

Coordination with Social Security

Example: Benefit Percentages

Years of UCRP Service Credit

Retirement Age

55 60 65

5 .0550 .0900 .1250

10 .1100 .1800 .2500

20 .2200 .3600 .5000

30 .3300 .5400 .7500

40 .4400 .7200 1.000

Retire at age 65 with 20 years of UCRP Service Credit

Pension Benefit = .5000 of HAPC

UCRP Contributions – 2013 Tier

Mandatory pre-tax contributions Employees contribute 7% of gross earnings Contribution is subject to collective bargaining

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

Contributions default to UC-managed “Savings

Fund”

You may invest in other Fidelity funds

Retirement Savings Plans

Voluntary employee pre-tax savings programs Tax-Deferred 403(b)

457(b) Deferred Compensation

Administered by Fidelity

Maximum annual contribution limits

Investment options: Core Funds and other expanded options

www.netbenefits.com

Enroll at any time – NOT subject to PIE

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

After You Enroll

Check your Earnings Statement on AYSO Are enrollments and deductions correct?

Attend Retirement Workshops UCnet - UCRP Fidelity – DCP, 457b, 403b