UCSB
Human 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”
AYS Online
New Employees
Rehired Employees
Status/Appointment Change
Social Security Number
Username
Date of Birth
Password
Your Benefits at a Glance
ucnet.universityofcalifornia.edu
atyourserviceonline.ucop.edu/ayso
Click on
New to UC
atyourserviceonline.ucop.edu/ayso
Enter your
Date of Birth
as password
MMDDYYYY
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 select
Primary 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 30miles 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
Predictable, low cost copays for services and drugs
Service
Copay
Office Visit
Labs, radiology
Urgent Care Visit
Outpatient Surgery
Inpatient Hospital
Emergency Room
$20
$0
$20
$100
$250
$75
No Deductible
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
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
25
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
UC Care Providers – You choose any provider
UC Select
(Tier 1)
Blue Shield
Preferred
(Tier 2)
Non-Preferred
Out-of-Network
(Tier 3)
UC Medical
Centers
In CA
Blue Shield PPO
Not contracted with
Blue Shield in US
Other local
providers
In US
Blue Cross/Blue Shield
Outside US
BlueCard Network or
any provider
You have access to providers in all three tiers
28
UC Care – Network providers near UCSB
UC Select
(Tier 1)
Blue Shield Preferred
(Tier 2)
Santa Barbara limited to:
Blue Shield PPO
physicians & facilities
Sansum Clinics
Quest Labs & Unilab
A few other specialists
Pacific Diagnostic Lab
More complete networks in:
Pueblo Radiology
Cottage Hospitals
Ventura
Santa Maria
Lompoc
29
Provider Directory: http://uc-care.org
UC Care Costs
UC Select
(Tier 1)
Blue Shield
Preferred
(Tier 2)
Non-Preferred
Out-of-Network
(Tier 3)
Copays
Deductible
Deductible
20% Coinsurance
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
30
Deductible, Coinsurance, Out of Pocket Max
UC Care Example
Individual Coverage
Blue Shield Preferred (Tier 2)
You pay
You share cost with plan
Plan pays
100% after
you pay
$250
Individual
Deductible
20% Coinsurance
$3000 OOPM
31
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
Blue Shield Health Savings Plan
Combines high deductible PPO with
savings account to pay out-of-pocket expenses
+
Medical Coverage
Blue Shield PPO
35
Health Savings Account
HealthEquity
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
$1,300
$2,600
$2,500
$5,000
20%
• Plan pays 60%
of allowed rate
• You pay balance
$4,000
$6,400
$8,000
$16,000
Deductible
Single
Family (2 or more)
Member Cost Sharing
(Coinsurance for
medical services & drugs)
Out-of-Pocket Max
(includes deductible)
Single
Family (2 or more)
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
2015 IRS Annual Limit
UC Annual Contribution
(plans starting in January)
Single
Family
(2 or more)
$3,350
$6,650
$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
Prescription Drugs
Preferred Drug List (Formulary) is different for each carrier
HMO
UC Care
Retail (30 day)
• Generic
• Brand
• Non-formulary
Mail Order (90 day)
Retail (Maintenance)
• Generic
• Brand
• Non-formulary
45
$5
$25
$40
$10
$50
$80
Blue Shield HSP
CORE
You pay full cost of
medication until you
satisfy the deductible
After deductible,
you pay 20%
at preferred pharmacies
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
46
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 Net
Kaiser
UC Care
Blue 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)
Save taxes on
eligible expenses
Health FSA
medical, dental, vision,
prescription drugs, etc
Dependent Care FSA
child care
adult day care

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
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
Retire at age 65 with 20 years of UCRP Service Credit
Pension Benefit = .5000 of HAPC
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
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
 457(b)
403(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