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UC Retiree Health Benefits
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  1. UC Retiree Health Benefits UCSB Health Care Facilitator Program Laura Morgan 893-4201 UC Retirement Administration Service Center (RASC) 800-888-8267 http://ucnet.universityofcalifornia.edu 9/25/14

  2. This presentation is intended for communication purposes only, it is not a guarantee of benefits. • Details about the UC policies and health plans are available on UCnet. http://ucnet.universityofcalifornia.edu/compensation-and-benefits/index.html

  3. Agenda • Future of retiree health benefits • Eligibility for retiree health benefits • Transition to retiree health plans • Health plan premiums • Overview of Medicare (Bill Batty, HICAP) • Enrolling in Medicare • Coordination with Medicare • How UC Medicare plans work

  4. Future of Retiree Health • Committed to ongoing health benefit • Retiree plan designs are likely to change over time • Retiree share of premium will increase • UC may reduce the overall level of contribution to retiree health programs by 3% per year, to a floor of 70%.

  5. Health Benefit – “fine print” • UC's contribution toward the monthly cost of medical and dental coverage is determined by UC and may change • Not a guaranteed benefit • Subject to California's annual budget appropriation

  6. Eligibility for Health Benefits Medical and dental benefits continue if: • You were enrolled when you left UC • You elect to continue coverage when you retire • Your coverage is continuous until the date your retirement benefit begins • Your monthly retirement income begins within 120 days of your separation from UC • You meet UC service credit requirements Benefits end if you select “lump sum cashout”

  7. 3 Eligibility Groups • UCRP entry prior to 1/1/1990 • UCRP entry or reentry on or after 1/1/1990 to 6/30/2013 • UCRP entry or reentry on or after 7/1/2013 Each group has specific service credit and/or age requirements

  8. 1. UCRP entry prior to 1/1/90 • Retire before 55 w/ 10 years service credit* • Retire at 55 or later w/ 5 years service credit * Five years for Safety members

  9. 2. UCRP entry/reentry 1/1/1990 to 6/30/2013 • Retire at age 50 or later w/ 10 years service credit OR • “Age + service credit = 75”

  10. 3. UCRP entry/reentry on/after 7/1/2013 • Retire at 56 or later w/ 10 years service credit

  11. 2013 “Grandfathering” Provision • Provision eliminated 6/2014 • Remain under current retiree health eligibility rules if by June 30, 2013: • five years of UCRP service credit and • age plus years of service credit is 50 or greater • Example: • Age 45 with 5 years = 50 (grandfathered) • Age 40 with 5 years = 45 (new eligibility rules)

  12. Transition to Retiree Health • At retirement, you and your enrolled family members transfer from the “employee” to the “retiree” insurance program • Employee insurance ends the month following your separation date – example: • Separate on June 27 • Employee insurance ends July 31 • Retiree insurance starts August 1

  13. Transition cont’d • Must enroll in Medicare, if eligible, and transfer to Medicare coordinated plan • May change plans during Open Enrollment or if you move out of your plan’s service area RASC counselor will help you with the transition and paperwork

  14. Dental • Delta PPO or DeltaCare USA • Coverage remains the same • Premium paid in full by UC OR subject to “graduated eligibility”

  15. Vision • Retiree Vision Services Plan (VSP) • Enroll in Retiree VSP to continue coverage • Pay full premium to VSP – see rate chart • Same coverage as employee plan • Routine eye exam and eye wear • Health Net Seniority Plus • Medicare version of Health Net • Vision benefit similar to VSP • No additional monthly premium

  16. Medical Plans • Non-Medicare Plans • Retirees and family members who are not 65 or are not eligible for Medicare • Same plans as employees • Medicare Coordinated Plans • Retirees or family members who are 65 or older, or disabled and eligible for Medicare • Must enroll in Medicare A & B • UC Medicare plans

  17. Medical Plans Same as employee plans Coordinated with Medicare

  18. Transition to Medicare Plan If you or a family member are eligible for Medicare when you retire, you will change plans at that time.

  19. Split Families – Partner Plans When a family has both non-Medicare & Medicare members Blue Shield Health Savings is not available to split family

  20. Behavioral Health • All plans cover mental health care and substance abuse treatment • Provider networks may change when enrolled in Medicare plan

  21. Behavioral Health Providers

  22. Are you moving? • Must live in California • Health Net, Kaiser • Available in US • UC Care • Blue Shield Health Savings Plan • Core • Blue Shield Medicare PPO (see Exchange One) • High Option (see Exchange One) • Available when LIVING out of US • UC Care, Core (without Medicare)

  23. Exchange One – Out of CA • Retirees living out of California in USA • ALL family members are enrolled in Medicare • UC makes annual contribution to a Health Reimbursement Account (HRA) for retiree and each family member • Retiree uses HRA funds to purchase individual Medicare supplement plan through Exchange One • UC contribution is subject to graduated eligibility • Can use extra HRA funds to pay medical expenses and Part B premium

  24. Exchange One – Enrollment • UC Retiree Insurance Program will notify you in September if you are required to transfer from the UC medical plan to a local Medicare plan • You will be directed to call an Exchange One counselor for information about plan options and assistance enrolling • You will select from Medicare Supplement plans and Part D (Drug) plans that are available where you are living

  25. Retiree Health Premiums • Each year UC determines the maximum amount that UC will pay toward a retiree’s medical and dental insurance • Some retirees receive the “maximum UC contribution” • Some retirees have “graduated eligibility” and receive a % of the maximum amount • The amount of the UC contribution depends on: • Retiree health eligibility rules • Years of UCRP service credit • Age – factor added in 7/1/2013 rules

  26. Maximum UC Contribution • Hired prior to 1/1/90 (UCRP entry date) • Hired on/after 1/1/90 with 20 years of UCRP service credit • See Retiree Medical Plan Costs on UCnet http://ucnet.universityofcalifornia.edu/compensation-and-benefits/health-plans/medical/retiree-plan-costs.html

  27. Maximum UC Contribution – Rate Chart • All family members in Medicare • One or more are not in Medicare • Non-Medicare Plans • All family members under 65 • Non-Medicare Age 65 and Over • UC Retiree did not coordinate with Social Security when employed • No one in family eligible for Medicare • Rates are same as employees in salary band 2

  28. Medicare Part B Reimbursement • If your UC medical plan premium is zero, you may receive a full or partial "reimbursement" of your Medicare Part B premium – example: $0.00 $44.49 > added to UC pension • The amount of the reimbursement depends on the premium UC is charged by the insurance carrier for your plan

  29. Graduated Eligibility – Group 2 • Hired on/after 1/1/90 (UCRP entry/reentry date) with less than 20 years of UCRP service credit • UC contributes 50% of the maximum contribution at 10 years of service credit • UC contribution increases 5% per year of service credit • “Age + service credit = 75” -- 50% of max • Find rate on UCnetusing “Medical Plan Chooser”

  30. Graduated Eligibility – Example • Service credit = 15 years • UC pays 75% of “Maximum UC Contribution” $436 Maximum UC Contribution (single/non-MC) $327 75% of Maximum UC Contribution $611 Gross premium (single/HN Blue & Gold) - $327 75% of Maximum UC Contribution $284 = Monthly premium paid by retiree

  31. https://uc2014.chooser2.pbgh.org

  32. Graduated Eligibility – Group 3 • Hired on/after 7/1/2013 • Also current employees not grandfathered • UC Contribution calculated using age and service credit; • 100% at age 65 w/ 20 years of service credit • Graduated eligibility chart is posted on Future of UCRP website – see Fast Facts

  33. Monthly Premiums • Medicare Part B • $104.90 – standard rate in 2014 • Deducted from Social Security check or you pay directly • UC Medical and Dental • Deducted from UC pension check • Part B Reimbursement added to check • UC Retiree Vision – paid to VSP

  34. “Income Related Adjustment” • Medicare Part B and D premiums may be higher for retirees with incomes over: • $85,000 – single • $170,000 – married

  35. What is Medicare? • Federal program that provides health insurance to: • People 65 or older • People with disabilities • Covers most medical services • Does not pay total cost of care • Foundation for all UC Medicare plans

  36. Medicare Eligibility • Your own work history • Work history of spouse or ex-spouse • Contact Social Security to clarify your eligibility

  37. In-patient hospital Home health care Skilled nursing facility Hospice care Office visits Lab tests Physical therapy Medical equipment Some preventive care Three Parts of Medicare Part B - Medical Part A - Hospital Part D – Prescription Drugs

  38. Medicare Premiums in 2013 • Medicare Part A – No monthly premium • Medicare Part B - $104.90 per month • May cost more for retirees with higher incomes • Deducted from Social Security check or you pay directly • Medicare Part D – No monthly premium • May cost more for retirees with higher incomes

  39. When to enroll in Medicare? • Employees • Eligible at retirement • Eligible after retirement

  40. Employees • Do not enroll in Medicare Part B or D • Spouse enrolled in your UC employeemedical plan does not need to enroll * • “Special enrollment period” when UC employee retires • You may enroll in Part A when first eligible at age 65 – not required * • See special considerations

  41. Employees – Special Considerations • Domestic partners should consult Social Security about when to apply for Medicare • Blue Shield Health Savings Plan members may NOT be enrolled in Medicare A, B or D • IRS does not allow Medicare recipients to make contributions to a Health Savings Account (HSA) • Delay enrollment in Medicare until retirement • Please note: If you are drawing a Social Security Pension, you will be automatically enrolled in Part A at age 65

  42. Eligible at Retirement • You and your family members who are eligible for Medicare must enroll in Parts A & B • Go to Social Security office one month before UC employee retires • Complete UC forms to enroll in UC plan • You may also receive a follow-up “Coordination of Benefits” form from Medicare

  43. Eligible after Retirement • You and your family members who are eligible for Medicare must enroll for Parts A & B • Go to Social Security office or www.ssa.gov about three months beforeturning 65 OR • If receiving a Social Security pension, you will get a Medicare card in the mail • UCOP will mail UC enrollment forms to you and family member

  44. You assign your Medicare to the insurance plan • Cannot use Medicare outside the plan HMO Advantage • Health Net Seniority Plus • Kaiser Senior Advantage • Medicare is primary payer • Blue Shield is secondary Blue Shield PPO High Option Supplement Coordination with Medicare

  45. Blue Shield PPO High Option Supplement • Any Medicare physician Choice of Physician • You select PCP • PCP coordinates care • PCP refers to specialists • Specialists limited to physicians in medical group HMO Advantage • Health Net Seniority Plus • Kaiser Senior Advantage • Sansum Clinic is only HNSP provider in Santa Barbara • Change to Sansum PCP • Change to Blue Shield plan

  46. HMOs have copays for care Health Net Seniority Plus Kaiser Senior Advantage

  47. Blue Shield - Deductibles • Deductibles paid by Blue Shield • Medicare Part A (Hospital) = $1216 • Medicare Part B (Medical) = $147 • Deductible paid by you • Plan deductible for services not covered by Medicare (e.g. acupuncture, hearing aids) • Blue Shield PPO = $100 per individual/year • High Option = $50 per individual/year

  48. Blue Shield – Office Visit Example Medicare Allowable = $150