New Employee Orientation - University of California, Santa
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Transcript New Employee Orientation - University of California, Santa
UCSB
Human Resources - Benefits
New Employee Orientation
Benefits Office Hours
8:00 - Noon & 1:00 - 4:00
893-2489
June 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
You and 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
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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
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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
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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
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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
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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
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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
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$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