This season brings drastic changes to University of California (UC) health care plans for the upcoming 2014 year. For UC Davis employees, open enrollment started on Oct. 28.
Guerren Solbach, UC Davis health care facilitator, said that every one in five UC Davis employees must change medical plans during this open enrollment.
In Jan. 2014, the Affordable Care Act (ACA or “ObamaCare”) will be implemented. This legislation mandates each American citizen to buy health insurance and requires most employers to provide coverage.
To cut unnecessary costs, the UC is dropping the following health care plans: Anthem Blue Cross PLUS (point-of-service plan), Anthem Blue Cross PPO (preferred provider organization), Anthem Lumenos PPO with HRA (health reimbursement account) and Health Net full network HMO (health maintenance organization).
These present plans are estimated to yearly price increases which would negatively impact UC employees.
Employees who do not choose a plan automatically get enrolled in one that is most comparable to their current plan. Health care facilitator assistant Erika Castillo agrees with Solbach on the issue of default enrollment. A new plan may not offer the same current providers.
For instance, according to an article from Dateline UC Davis, “If Health Net full network HMO members who use Sutter Medical Group allow themselves to be defaulted into Health Net Blue and Gold, they will lose access to Sutter … Transition Assistance with UC Care may cost 20 percent out of pocket which is up to $3,000 per person.”
To compensate for the four medical plans that are being dropped, UC is going to offer two new medical plans — UC Care and Blue Shields Health Savings Plan.
The UC Human Resources and Benefits website states, “UC Care is a new health plan created just for UC employees, retirees and families with coverage … you can get care from UC doctors and medical centers as well as the entire Blue Shield network of providers.”
In the Blue Shields Health Savings plan, users can contribute money before taxes and use it any time for medical costs and for future medical care. The balance carries on annually, even if users leave the UC system or change plans. Furthermore, the PPO provider network contains an array of physicians and offers the choice of seeing providers out of the network for extra fees.
“The Blue Shields Health Saving plan is geared towards patients who do not see their primary physician often; our patients are generally healthy and intend to save money for future medical obligations such as unforeseeable surgeries and such,” said Julio M., a representative of Blue Shields, who did not want to release his full name due to privacy issues.
The UC plan aims to attract users who generally don’t have much concern for what doctor they see.
“It is the best co-payment plan and typically in this plan, users are looking to maximize annual deductible payments,” Julio said in regard to the UC Care plan.
The new UC Care plan is most similar to the dropped Anthem Blue Cross PLUS/PPO plan. The new Blue Shield Health Savings Plan is most similar to the dropped Anthem Lumenos PPO with HRA. The new Health Net Blue and Gold plan is most similar to the dropped Health Net HMO plan.
In spite of these significant reforms, the majority of UC employees will not see large increases for monthly premiums in their health care insurance for the upcoming year. Some employees’ medical insurance rates will actually decrease which is uncommon considering the trend of price increases in the previous decade.
For instance, the UC Office of the President’s Human Resources Department (UCOP) has calculated that for Health Net Blue and Gold customers, monthly increases will vary from $4 to $10 for family plans.
Another case calculated by the UCOP is that employees in pay band 2 presently covered by the Anthem PPO family plan will save $102.93 each month if they switch to UC Care during this enrollment period.
“Our goal was to provide UC employees with the best and most cost-effective medical insurance options available,” said vice president of systemwide human resources, Dwaine Duckett. “We’ve done that by eliminating plans that were headed for big price increases, doubling down on plans that are the most popular with our employees and offer good value. We are also benefitting from the launch of UC Care and the new Blue Shield Health Savings Plan.”