2024

A Complete Guide

to Your UC Health

and Welfare Benefits

MEDICAL, DENTAL, VISION, LIFE AND MORE

GETTING HELP

MEDICAL PLANS

CORE, UC Care, UC Health Savings Plan uchealthplans.com

• Accolade (Health Care Advocate): 866‑406‑1182

or member.accolade.com

• Anthem Blue Cross (Medical): anthem.com/ca

• Navitus Health Solutions (Pharmacy): 833‑837‑4308

Kaiser HMO (Kaiser Permanente—California,

Optum Behavioral Health)

• Kaiser: 800‑324‑9208 select.kp.org/university-of-california

• Optum: 888‑440‑8225 liveandworkwell.com (access code:

UC Blue & Gold HMO (Health Net, MHN Behavioral Health)

• Health Net: 800‑539‑4072 healthnet.com/uc

• Health Net Behavioral Health: 800‑663‑9355

Delta Dental PPO (Delta Dental)

866‑240‑8344 vsp.com

Accident, Critical Illness, Hospital Indemnity, Life, Accidental

Death & Dismemberment (Prudential)

855‑483‑1438

Business Travel Accident

Disability—Basic, Voluntary Short-Term,

800‑838‑4461 (claims) mylincolnportal.com

of life for people throughout California and around the world.

Our health and welfare benets program provides both choice and

value to meet the needs of our diverse workforce.

We know that making benets choices can be a bit overwhelming.

So we have tools and information to help you make the right choices

for you and your family.

UCnet (ucnet.universityofcalifornia.edu) oers additional tools and

information, along with ongoing updates about your benets. Visit

UCnet whenever you have questions about your benets or want to

make changes. You can also call your local Benets Oce or any of

the plans. You’ll nd their contact information on the insert at the

front of this booklet.

The information in this booklet reects the terms of the benet plans as in eect Jan. 1, 2024. Please note that this is a summary of your benets only; additional

requirements, limitations and exclusions may apply. Refer to applicable plan documents and regulations for details. The applicable policy issued by the carrier and the

University of California Group Insurance Regulations and other applicable UC policies will take precedence if there is a dierence between the provisions therein and those

of this document.

..................................................................................................... 19

Dental Plans

Vision Plan

Accident, Critical Illness and Hospital Indemnity

Disability Insurance

acquired by the University and/or they may have opted to remain in a previous

public retirement plan at the time of UC employment.

2

only and that your employment is intended to continue for more than a year.

3

participation in the Retirement Choice Program after working 750 hours in an

eligible position within a 12-month period.

4

You may enroll your eligible children up to age 26 in the same

plans as those in which you enroll. A disabled child may be

covered past age 26, if the disability is veried by the carrier or a

physician. You may also enroll your legal ward up to age 18 in the

same plan(s) as those in which you enroll. The Family Member

Eligibility chart on pages 13 and 14 gives the eligibility criteria

for children, stepchildren, grandchildren, disabled children and

legal wards. You may enroll your eligible domestic partner’s child

or grandchild, even if you do not enroll your partner.

In order to be eligible for UC-sponsored coverage, your

Overage disabled children must be claimed as a tax dependent

by either you or your spouse/domestic partner. If overage

disabled children are not claimed as a dependent for income tax

purposes, the overage disabled child must be eligible for Social

Security income or Supplemental Security Income (SSI) as a

disabled person or work in supported employment which may

oset the Social Security or SSI.

Your children (or legal ward) are eligible for only the plans for

which you are eligible and in which you have enrolled (See

“Benets Overview,” pages 10–12).

plan’s upper age limit, the child will remain covered pending the

plan’s determination. The plan may periodically request proof

of continued disability, but not more than once a year after the

initial certication. Disabled children approved for continued

coverage are eligible to participate in university-sponsored

medical, dental, vision, accident, critical illness, hospital

indemnity, legal, dependent life and AD&D plans for faculty and

sta. If enrollment is transferred from one UC plan to another, a

new application for continued coverage is not required; however,

the new plan may require proof of continued disability, but not

had continuous group health coverage since age 26. The plan will

later enrollment. UC and the plans reserve the right to collect

must provide documentation specied by the University

verifying that the individual(s) you have enrolled meet the

eligibility requirements outlined above. The plan may also

require documentation verifying eligibility status. In addition,

the University and/or the plan reserve the right to periodically

request documentation to verify the continued eligibility of

enrolled family members.

UnifyHR, which administers the family member eligibility

verication process, will send you a packet of materials to help

you complete the verication process. If you fail to provide the

enrollment of ineligible individuals.

WHEN COVERAGE BEGINS

The following eective dates apply provided the appropriate

enrollment transaction (electronic or paper form) has been

completed within the applicable enrollment period.

• If you enroll during a Period of Initial Eligibility (PIE), coverage

• If you enroll during Open Enrollment, the eective date of

rst day you have a new family member — such as a spouse,

domestic partner, newborn or newly adopted child. However,

if you request to change to a dierent medical plan at the time

you add a new family member, coverage under the new plan is

eective the rst of the following month for all family members.

5

over a 12‑month, standard measurement

enroll yourself and your eligible family members when you rst

example, the day you are hired into a position that makes you

eligible for benets. It ends 31 days later.

You should enroll online and complete the transaction by the

last day of the applicable PIE. Paper enrollment forms are

available and need to be received at the location noted on the

form by the last day of the applicable PIE. (If the last day falls

on a weekend or holiday, the PIE is extended to the following

work day.)

You may enroll your eligible family members during the 31-day

PIE that begins on the rst day the family member meets all

• For a newborn child, on the child’s date of birth

When you have a new family member, such as a spouse, domestic

partner, newborn or newly adopted child, you may enroll yourself,

the new family member and any other eligible family members not

already enrolled in your UC-sponsored health plans. Other plans

have dierent rules; see the plan-specic sections in this guide

for details.

If you are enrolled in a UC-sponsored medical plan, you may

transfer to a dierent plan. (This change to a new medical plan

may also enroll in or increase your Legal insurance, Accident,

You have 31 days from the date your new family member becomes

eligible to enroll the new member or to make any permitted plan

changes (for example, 31 days from the day you marry or your

child is born). You must enroll family members in your UCPath

account; enrollment is not automatic.

You will be required to complete the Family Member Eligibility

Verication process after enrolling the new family member. If

you do not respond by the given deadline, your new family

member may be disenrolled from the plans.

WHEN YOU LOSE OTHER COVERAGE

If you decline UC-sponsored coverage because you and/or your

family members are covered elsewhere, and you later lose the

other coverage, you may be eligible to enroll yourself and/or

your eligible family members in a UC-sponsored plan. The same

is true if you are enrolled in another employer-sponsored plan

• Coverage under another health plan for you and/or your

Who pays the premium: You and UC, for most plans

Medical coverage is one of the most important benets that

UC oers you and your eligible family members, and UC makes

medical coverage as accessible and aordable as possible.

UC oers a range of high-quality medical plans with

comprehensive coverage so you can choose the coverage that

best meets your needs.

You should carefully evaluate your family circumstances and plan

costs before selecting medical plan coverage. If you need more

information about a specic medical plan, you’ll nd telephone

ELIGIBILITY

The medical plans you’re eligible for are based on whether your

overall benets package is Full, Mid-Level or Core.

If you are eligible for coverage, you must take action to enroll.

You may enroll in certain medical plans only if you meet the

plan’s geographic service area criteria.

If you or a covered family member is enrolled in Medicare,

you are not eligible for the UC Health Savings Plan due to IRS

rules that do not allow Medicare members to make or receive

contributions to a Health Savings Account.

vary from those posted or printed. If you are represented by a

UC Care

CORE This plan has no monthly employee premium, but has a higher deductible. You can choose any doctor, hospital,

health care expenses with pretax contributions from you and

With the HSA, administered by HealthEquity, you can use the

funds at any time for qualied medical expenses or save them for

future health care needs. Your HSA account balance rolls over

annually; you keep the balance in the account, even if you don’t

use it or leave UC. You can use your HSA funds for qualifying

medical expenses without paying any federal taxes — whether you

pay with your HSA debit card or you pay out-of-pocket and le a

claim directly with HealthEquity to get reimbursed. You earn

interest on your account, and can invest any funds in excess of

contributions. UC contributes up to $500 for individual coverage

and up to $1,000 for all other coverage levels, depending on the

eective date of your HSP coverage. You can also contribute with

pretax payroll deductions, subject to payroll deadlines. You are

responsible for making sure the combined HSA contributions are

within the IRS limits. Individuals age 55 and older can make an

additional “catch-up” contribution of $1,000. You can make the

additional contribution through your UCPath account. If you

enroll in the UC Health Savings Plan anytime after January,

UC’s contribution to your HSA will be prorated for the

covered family members cannot enroll in UC’s or in any

general-purpose Health Flexible Spending Account.

• Programs and support from UC’s benets providers

• Preventive exams and screenings through UC’s health plans

• Disease management programs oered by UC’s medical plans

Participation in on‑site campus and health system wellness

programs varies by location; contact your location’s wellness

coordinator for details.

For more information, visit the UC Living Well website

as the PCP for your child(ren). If you use your work address to

qualify for a plan, you must pick PCPs in the service area of your

If you or your eligible family members do not select a PCP, your

medical plan will assign one to you. You may change your PCP at

any time by calling the plan directly.

If you want to receive care from a particular doctor, you should

call the plan or check the plan’s online doctor directory to conrm

that the doctor is in their network and accepting new patients.

costs.

• Want broad access to providers

• Are able to risk incurring greater out-of-pocket

costs

• Want tax-free savings for current and future health

• Want direct access to many providers without need

for referrals (includes UC Health providers)

$ Lowest costs in relation to all plans $$ Mid-range of costs in relation to all plans $$$ Highest costs in relation to all plans