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Our first open enrollment announcement brings good news about premium costs and the option to keep your current plan — including Western Health Advantage, or WHA — if it’s working well for you. 

Although 69���� Health has ended its ownership and commercial network participation in the Sacramento-based WHA health maintenance organization, UC and WHA have come to a special arrangement for UC employees. Through this arrangement, WHA members can continue to see their 69���� Health PCPs or select new 69���� Health PCPs, other employees can switch to WHA and new employees can sign up for WHA.

There is one change in WHA coverage:  Members will no longer have access to the plan’s Advantage Referral program, under which members can self-refer to specialists within the WHA network. Instead, starting in 2018, your PCP will refer you to appropriate providers if you require specialty care. 

Open enrollment booklets are due to arrive at home addresses next week. UC Human Resources advises: As soon as your booklet arrives, take time to review your choices so you’ll have the right benefits for you and your family in 2018.

“We are pleased that we have been able to keep premium costs exceptionally low for the overwhelming majority of our people,” said Dwaine B. Duckett, vice president of systemwide HR. “Employees still have an array of choices of high value, high quality plans at low rates — allowing them to improve or maintain their health and the health of their families.”

Highlights for 2018

• Continued low costs — Most faculty and staff will see medical plan premium increases of less than $10 a month across all salary and coverage levels. Premium increases for UC Care will be a bit higher, ranging from $17 to $53 a month. UC will continue to adjust premiums by pay level to ensure costs are distributed fairly, and to offer dental and vision plans for you and your family at no cost to faculty and staff. 
• Explore UC’s diverse options or stay in current plan — UC will continue to offer the same choice of quality medical plans next year. Health care needs can change over time, so take a moment to review UC’s full range of plan choices to make sure you have the best fit for you and your family.

Change in Rx benefits administrators

For 2018, Anthem Blue Cross will replace OptumRx in administering pharmacy benefits for all of UC’s preferred provider organization (PPO) medical plans. Anthem currently administers medical and behavioral health benefits for UC’s PPO plans, and will continue in that role in 2018. This change will affect faculty, staff and retirees enrolled in the following PPO plans: Core, UC Care, UC Health Savings Plan, UC High Option Supplement to Medicare, and UC Medicare PPO with Rx. UC is working to minimize disruption for members, but you should expect changes to the formulary, to processes and to pharmacy, mail order and specialty networks.

Ways to manage your costs

You don’t have to sacrifice the quality of your care to keep your costs down. Here are a few suggestions:

• If your medical need is not an emergency, save time and money by skipping the emergency room and getting the care you need from your plan’s advice nurse, telemedicine provider or urgent care center.
• Consider enrolling in UC’s Flexible Spending Account (FSA) or Health Savings Plan with a Health Savings Account to lower your tax bill, by paying for health care costs with pretax dollars.
• To help you make informed health care choices, take advantage of tools like Castlight (available with UC’s PPO plans) to compare doctors and medical services for cost, quality and convenience.

Benefits to help you stay well

Seeing your doctor regularly for check-ups helps you prevent problems later on, and check-ups (and other preventive care) are free with every UC plan. You should also check your plan’s website for information about free wellness and health management tools. For example, your plan may offer fitness and nutrition classes, health coaching programs, discounts on gym memberships, and apps or online tools to help you manage your care.