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PPOs for Employees and Retirees Not on Medicare

UC Care
Health Savings Plan
CORE
5

PPOs FOR RETIREES
ON MEDICARE

5

UC BLUE & GOLD
HMO

5

PPOs for Employees and Retirees Not on Medicare

5

PPOs FOR RETIREES
ON MEDICARE

5

UC BLUE & GOLD
HMO

5

OPEN ENROLLMENT ON DEMAND

OPEN ENROLLMENT IS OCTOBER 27 – NOVEMBER 19

OPEN ENROLLMENT ON DEMAND

OPEN ENROLLMENT IS OCTOBER 27 – NOVEMBER 19

OPEN ENROLLMENT ON DEMAND

OPEN ENROLLMENT IS OCTOBER 27 – NOVEMBER 19

OPEN ENROLLMENT ON DEMAND

OPEN ENROLLMENT IS OCTOBER 27 – NOVEMBER 19

what's new for 2023

UC PPO Plan changes

PPOs FOR EMPLOYEES AND NON-MEDICARE RETIREES

PPOs FOR RETIREES ON MEDICARE

UC BLUE & GOLD
HMO

Navigating Benefits is Easier With Accolade

PPOs FOR EMPLOYEES AND NON-MEDICARE RETIREES

IT’S YOUR TIME TO CHOOSE

UC Open Enrollment starts Thursday, October 28, at 8 a.m. PT and ends Friday, November 19, at 5 p.m. PT.

Note that the Open Enrollment end date is different from prior years.

what’s new for 2023

Find out what’s new and changing for 2023.

What to Do

Consider your choices and keep these tasks in mind as you enroll.

get help

Connect with resources to help you choose a medical plan.

What You Need to Know

There are no changes to the plans’ copay or coinsurance structure or to what the medical plans cover.

However, you should take note of other important changes that affect all plans.

What You Need to Know

There are no changes to the plans’ copay or coinsurance structure or to what the medical plans cover.

However, you should take note of other important changes that affect all plans.

What You Need to Know

There are no changes to the plans’ copay or coinsurance structure or to what the medical plans cover.

However, you should take note of other important changes that affect all plans. All changes are effective January 1, 2023.

What You Need to Know

There are no changes to the plans’ copay or coinsurance structure or to what the medical plans cover.

However, you should take note of other important changes that affect all plans.

What You Need to Know

There are no changes to the plans’ copay or coinsurance structure or to what the medical plans cover.

However, you should take note of other important changes that affect all plans. All changes are effective January 1, 2023.

what’s new for 2023

Find out what’s new and changing for 2023.

What to Do

Consider your choices and keep these tasks in mind as you enroll.

get help

Connect with resources to help you choose a medical plan.

what’s new for 2023

Find out what’s new and changing for 2023.

What to Do

Consider your choices and keep these tasks in mind as you enroll.

get help

Connect with resources to help you choose a medical plan.

Findhelp.org

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New ID Cards

To reflect the added benefit of Accolade to the UC PPO plans, you ‘ll receive a new ID card from Anthem (one card for each covered family member) in late December reflecting the addition of Accolade to your PPO plan benefits. Your new card will also include Accolade’s contact information, so you’ll always have it handy. Use your new ID card for all medical and pharmacy services beginning January 1, 2023.

Current Name New Name
UC Care UC Care + Accolade
UC Health Savings Plan (HSP) Health Savings Plan (HSP) + Accolade
CORE CORE + Accolade

Accolade helps you get the most out of your PPO plan benefits by connecting you to valuable health programs that make it easier to manage your healthcare. Health Assistants can answer your questions about finding quality care, understanding health plan coverage and costs, making sense of medical bills and more. Call or message a nurse to discuss symptoms, learn about a condition and explore treatment options.* Getting support from an Accolade Health Assistant or nurse is provided at no cost to you.

PlushCare is Accolade’s virtual care service. See and speak with a board-certified doctor from your phone, tablet or computer – day or night. They can help with urgent medical issues, ongoing and chronic conditions, mental health, preventive care, prescriptions and more. You can also see the same PlushCare doctor for all your virtual visits.

2nd.MD is Accolade’s expert medical opinion service. Get a second opinion from a leading specialist at no cost so that you feel confident about a new diagnosis, surgery, treatment plan or medication.

BENEFITS GUIDANCE

Accolade helps you get the most out of your PPO plan benefits by connecting you to valuable health programs that make it easier to manage your healthcare. Health Assistants can answer your questions about finding quality care, understanding health plan coverage and costs, making sense of medical bills and more. Call or message a nurse to discuss symptoms, learn about a condition and explore treatment options.* Getting support from an Accolade Health Assistant or nurse is provided at no cost to you.

VIRTUAL CARE

PlushCare is Accolade’s virtual care service. See and speak with a board-certified doctor from your phone, tablet or computer – day or night. They can help with urgent medical issues, ongoing and chronic conditions, mental health, preventive care, prescriptions and more. You can also see the same PlushCare doctor for all your virtual visits.

EXPERT MEDICAL OPINION

2nd.MD is Accolade’s expert medical opinion service. Get a second opinion from a leading specialist at no cost so that you feel confident about a new diagnosis, surgery, treatment plan or medication.

Introducing Accolade

Accolade doesn’t change your benefits; it makes them better.

Healthcare and benefits can be confusing. That’s why we’re partnering with Accolade to provide personalized health and benefits help for PPO plan members. Accolade offers an exceptional level of support that provides you with convenient and high-quality health care that can save you money and improve outcomes.

Accolade is offered exclusively to PPO plan members.

Just Ask Accolade

With Accolade, you get a single resource for all your health benefits needs — a care team that takes the hassle out of benefits for you and your covered family members. Accolade’s services are included in your PPO plan benefit at no cost to you. Your Accolade care team:

  • Takes the time to listen to your specific needs
  • Connects you to benefits that will be most valuable for you
  • Makes healthcare easier with both in-person and virtual care options
  • Understands your health plan coverage and can help you avoid unexpected costs

Beginning in 2023, Accolade will be your first point of contact for help with health benefits questions, big or small. Your experience with Accolade is completely confidential and takes the hassle out of benefits for you and your covered family members. You can ask your Health Assistant questions like:

  • Is this procedure covered by my health insurance? How much will I pay if I get the procedure?
  • Why does my medication cost this much? Is there a more affordable alternative?
  • Can you help me find a doctor based on my needs and preferences?
  • Where is the nearest urgent care facility?
  • Can you help me schedule and prepare for my next doctor’s visit?
  • Can I get a second opinion on a diagnosis and care plan I recently received?
  • Can you help me understand the information on my claim or Explanation of Benefits (EOB) from my last doctor visit?

 

Accolade is offered exclusively to PPO plan members.

One and Done.

With Accolade, you get a single resource for all your health benefits needs — a care team that takes the hassle out of benefits for you and your covered family members — at no additional cost. Your care team:

  • Takes the time to listen to your specific needs
  • Connects you to benefits that will be most valuable for you
  • Makes healthcare easier with both in-person and virtual care options
  • Understands your health plan coverage and can help you avoid unexpected costs

Beginning in 2023, Accolade will be your single point of contact for help with health benefits questions, big or small. Accolade is completely confidential! You can ask your Health Assistant and nurse questions like:

  • What benefits are available to me?
  • Is this procedure covered by my health insurance?
  • If there’s a more affordable option for my medication?
  • When you I make changes to your health plan?
  • Can you help me find a great doctor?
  • Where is the nearest urgent care facility?
  • Can you help me schedule and prepare for my next doctor’s visit?
  • Can I get a second opinion from a leading specialist?

Benefits Guidance: Accolade helps you get the most out of your PPO plan benefits by connecting you to valuable health programs that make it easier to manage your healthcare. Health Assistants can answer your questions about finding quality care, understanding health plan coverage and costs, making sense of medical bills and more. Call or message a nurse to discuss symptoms, learn about a condition and explore treatment options.* Getting support from an Accolade Health Assistant or nurse is provided at no cost to you.

Virtual Care: PlushCare is Accolade’s virtual care service. See and speak with a board-certified doctor from your phone, tablet or computer – day or night. They can help with urgent medical issues, ongoing and chronic conditions, mental health, preventive care, prescriptions and more. You can also see the same PlushCare doctor for all your virtual visits.

Expert Medical Opinion: 2nd.MD is Accolade’s expert medical opinion service. Get a second opinion from a leading specialist at no cost so that you feel confident about a new diagnosis, surgery, treatment plan or medication.

* Accolade and its affiliates (“Accolade”) are not an emergency medical service. Accolade provides a personalized healthcare information service to support you to better understand and utilize your benefits, receive information from expert medical resources, and facilitate your access to medical care from various healthcare professionals, including virtual medical care services. Virtual medical care services offered by Accolade are provided through independent professional medical practices, including under the PlushCare brand, to which Accolade provides various platform and related services. 

Compare Plans

View a side-by-side comparison of the plans


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Introducing Accolade

Accolade doesn’t change your benefits; it makes them better.

Healthcare and benefits can be confusing. That’s why we’re partnering with Accolade to provide personalized health and benefits help for PPO plan members. Accolade offers an exceptional level of support that provides you with convenient and high-quality health care that can save you money and improve outcomes.

Accolade is offered exclusively to PPO plan members.

One and Done.

With Accolade, you get a single resource for all your health benefits needs — a care team that takes the hassle out of benefits for you and your covered family members — at no additional cost. Your care team:

  • Takes the time to listen to your specific needs
  • Connects you to benefits that will be most valuable for you
  • Makes healthcare easier with both in-person and virtual care options
  • Understands your health plan coverage and can help you avoid unexpected costs

Beginning in 2023, Accolade will be your single point of contact for help with health benefits questions, big or small. Accolade is completely confidential! You can ask your Health Assistant and nurse questions like:

 

  • What benefits are available to me?
  • Is this procedure covered by my health insurance?
  • If there’s a more affordable option for my medication?
  • When you I make changes to your health plan?
  • Can you help me find a great doctor?
  • Where is the nearest urgent care facility?
  • Can you help me schedule and prepare for my next doctor’s visit?
  • Can I get a second opinion from a leading specialist
BENEFITS GUIDANCE

Accolade helps you get the most out of your PPO plan benefits by connecting you to valuable health programs that make it easier to manage your healthcare. Health Assistants can answer your questions about finding quality care, understanding health plan coverage and costs, making sense of medical bills and more. Call or message a nurse to discuss symptoms, learn about a condition and explore treatment options.* Getting support from an Accolade Health Assistant or nurse is provided at no cost to you.

VIRTUAL CARE

PlushCare is Accolade’s virtual care service. See and speak with a board-certified doctor from your phone, tablet or computer – day or night. They can help with urgent medical issues, ongoing and chronic conditions, mental health, preventive care, prescriptions and more. You can also see the same PlushCare doctor for all your virtual visits.

EXPERT MEDICAL OPINION

2nd.MD is Accolade’s expert medical opinion service. Get a second opinion from a leading specialist at no cost so that you feel confident about a new diagnosis, surgery, treatment plan or medication.

* Accolade and its affiliates (“Accolade”) are not an emergency medical service. Accolade provides a personalized healthcare information service to support you to better understand and utilize your benefits, receive information from expert medical resources, and facilitate your access to medical care from various healthcare professionals, including virtual medical care services. Virtual medical care services offered by Accolade are provided through independent professional medical practices, including under the PlushCare brand, to which Accolade provides various platform and related services. 

Introducing Accolade

Accolade doesn’t change your benefits; it makes them better.

Healthcare and benefits can be confusing. That’s why we’re partnering with Accolade to provide personalized health and benefits help for PPO plan members. Accolade offers an exceptional level of support that provides you with convenient and high-quality health care that can save you money and improve outcomes.

Accolade is offered exclusively to PPO plan members.

One and Done.

With Accolade, you get a single resource for all your health benefits needs — a care team that takes the hassle out of benefits for you and your covered family members — at no additional cost. Your care team:

  • Takes the time to listen to your specific needs
  • Connects you to benefits that will be most valuable for you
  • Makes healthcare easier with both in-person and virtual care options
  • Understands your health plan coverage and can help you avoid unexpected costs

Beginning in 2023, Accolade will be your single point of contact for help with health benefits questions, big or small. Accolade is completely confidential! You can ask your Health Assistant and nurse questions like:

  • What benefits are available to me?
  • Is this procedure covered by my health insurance?
  • If there’s a more affordable option for my medication?
  • When you I make changes to your health plan?
  • Can you help me find a great doctor?
  • Where is the nearest urgent care facility?
  • Can you help me schedule and prepare for my next doctor’s visit?
  • Can I get a second opinion from a leading specialist
BENEFITS GUIDANCE

Accolade helps you get the most out of your PPO plan benefits by connecting you to valuable health programs that make it easier to manage your healthcare. Health Assistants can answer your questions about finding quality care, understanding health plan coverage and costs, making sense of medical bills and more. Call or message a nurse to discuss symptoms, learn about a condition and explore treatment options.* Getting support from an Accolade Health Assistant or nurse is provided at no cost to you.

VIRTUAL CARE

PlushCare is Accolade’s virtual care service. See and speak with a board-certified doctor from your phone, tablet or computer – day or night. They can help with urgent medical issues, ongoing and chronic conditions, mental health, preventive care, prescriptions and more. You can also see the same PlushCare doctor for all your virtual visits.

EXPERT MEDICAL OPINION

2nd.MD is Accolade’s expert medical opinion service. Get a second opinion from a leading specialist at no cost so that you feel confident about a new diagnosis, surgery, treatment plan or medication.

* Accolade and its affiliates (“Accolade”) are not an emergency medical service. Accolade provides a personalized healthcare information service to support you to better understand and utilize your benefits, receive information from expert medical resources, and facilitate your access to medical care from various healthcare professionals, including virtual medical care services. Virtual medical care services offered by Accolade are provided through independent professional medical practices, including under the PlushCare brand, to which Accolade provides various platform and related services. 

WHY CHOOSE UC HEALTH?

EXPERIENCE A HIGHER LEVEL OF CARE

From primary care to treatment for the rarest conditions, the UC Health clinical teams use their collective experience, knowledge and cutting-edge research to provide the most effective care. The UC PPO plans provide in-network access to all six of UC’s renowned academic health centers. Choosing a UC PPO plan means in-network access to the highest-quality care at any UC health center, rated among the best in the state and the nation.

WHY CHOOSE UC HEALTH?

EXPERIENCE A HIGHER LEVEL OF CARE

From primary care to treatment for the rarest conditions, the UC Health clinical teams use their collective experience, knowledge and cutting-edge research to provide the most effective care. The UC PPO plans provide in-network access to all six of UC’s renowned academic health centers. Choosing a UC PPO plan means in-network access to the highest-quality care at any UC health center, rated among the best in the state and the nation.

WHY CHOOSE UC HEALTH?

EXPERIENCE A HIGHER LEVEL OF CARE

From primary care to treatment for the rarest conditions, the UC Health clinical teams use their collective experience, knowledge and cutting-edge research to provide the most effective care. The UC PPO plans provide in-network access to all six of UC’s renowned academic health centers. Choosing a UC PPO plan means in-network access to the highest-quality care at any UC health center, rated among the best in the state and the nation.

WHY CHOOSE UC HEALTH?

EXPERIENCE A HIGHER LEVEL OF CARE

From primary care to treatment for the rarest conditions, the UC Health clinical teams use their collective experience, knowledge and cutting-edge research to provide the most effective care. The UC PPO plans provide in-network access to all six of UC’s renowned academic health centers. Choosing a UC PPO plan means in-network access to the highest-quality care at any UC health center, rated among the best in the state and the nation.

NEW PHARMACY BENEFIT MANAGER

Navitus Health Solutions (Navitus)

Navitus Health Solutions (Navitus) is replacing Anthem IngenioRx as the administrator of the UC PPO plans prescription drug benefit. As the new pharmacy benefit manager, Navitus will set clinical policy and guidelines for medications and will process pharmacy-related claims.

After a thorough review process, a committee representing faculty, staff and retirees determined that Navitus would offer significant advantages as the pharmacy benefit manager, helping ensure employees and their families receive the highest levels of service at the most competitive prices for needed medications.

CONTINUED FOCUS ON SERVICE AND CONVENIENCE

Navitus offers members convenient and familiar options for filling prescription drugs, including UC pharmacies, a large retail network, mail order delivery, and access to specialty medications.

Navitus will also provide robust support to help you better understand and manage your prescription drug benefit, including 24/7 Customer Care, a member-focused website, and a mobile app for easy access to all your prescription medication information.

  • 24/7 Customer Care. Beginning October 1, Navitus Customer Care can answer your pharmacy benefit questions, advise you about taking your medications correctly, and help you get additional care if needed. Their toll-free number is (855) 673-6504 and they are available 24 hours a day, 7 days a week, except on Thanksgiving and Christmas Day. TTY users can call 711.
  • Online tools to make the most of your prescription benefit, including a pharmacy locator, cost compare tool, and educational resources to help you manage your health.
  • Navitus+ app. Access your benefits, locate a nearby pharmacy, view and manage your medications, and more. (Note: Pharmacy information will not be displayed on the Anthem Sydney Health app after December 31, 2021.)

Learn more about what’s covered, your costs, and find in-network pharmacies near you.

COSTS AND FORMULARY CHANGES

There are no changes to the prescription drug copay (for the UC Care plan) or coinsurance amounts (for the UC Health Savings Plan and CORE plan). However, every prescription benefit manager uses its own formulary, which is a list of drugs that are covered by the plan. While the Anthem IngenioRx and Navitus formularies are similar, there are some differences, which could affect your individual medication costs. You can review the Navitus formulary to confirm how your existing medications are covered.

UC Care Members: Navitus may classify drugs differently, which could affect your out-of-pocket costs. For example, both the Anthem and Navitus formularies feature four tiers of medications (including generic, preferred, non-preferred brand-name drugs, and specialty medications). However, the drugs that are included on the Navitus 4-tier formulary differ from those included on the Anthem 4-tier formulary. This means that you might pay more, or less, for your prescriptions than you do today.

But don’t worry. In most cases, if you are taking a drug that will not be covered or will be in a higher tier under the Navitus formulary, Navitus will contact you in December to explain your options. (It is possible that you will not be contacted if you begin a new drug late in the year.)

FILLING PRESCRIPTIONS

Navitus offers members convenient and familiar options for filling prescription drugs, including:

  • Retail network. A large national network including chains such as Costco, CVS, Walgreens, Walmart, and Safeway/Vons, as well as many independent pharmacies and walk-up pharmacies located within the University of California (UC) Health Medical Centers. View Navitus participating pharmacies. Find a pharmacy.
  • Mail order. Costco Pharmacy will fulfill mail order prescriptions beginning January 1, 2022. Remember that you can have a 90-day supply of eligible medications mailed to you at 2x the 30-day-supply copay (instead of 3x the 30-day-supply copay if you fill prescriptions at retail pharmacies). You don’t have to be a Costco member to use the mail order pharmacy, but you will have to register with the Costco mail order pharmacy after January 1, 2022.
  • Specialty pharmacy. Lumicera Health Services will fill specialty medication prescriptions beginning January 1, 2022. Specialty medications treat certain chronic illnesses or complex diseases such as rheumatoid arthritis, multiple sclerosis, cancer and hepatitis C. You will also be able to obtain many specialty medications through select UC Health Medical Center pharmacies.
TRANSFERRING PRESCRIPTIONS

Mail order: Most open mail order prescriptions will be automatically transferred to the Navitus mail service vendor, Costco. You don’t have to be a Costco member to use the mail service pharmacy. However, you will need to set up an account with the Costco Mail Order Pharmacy and set up your profile, including noting any medication allergies.

TIPS for
TRANSITION

Get a refill for your daily medications. Refill current medications to last through the holidays and new year.

Check the Navitus formulary and drug costs. Review the Navitus formulary to confirm the status of your current medications. You can use the Navitus Cost Compare tool to view 2022 prescription costs.

Find an in-network pharmacy near you. View the Navitus network.

TAX-SAVING OPPORTUNITIES

Save More in Your Health Savings Accoun

Health Savings Account contribution limits for 2022 are increasing $50 for self-only coverage — from $3,600 to $3,650 — and $100 for family coverage — from $7,200 to $7,300. Employees age 55 and older can save an additional $1,000 a year.

The Health Savings Account is available only to UC Health Savings Plan members.

Accolade helps you get the most out of your PPO plan by connecting you to providers and valuable health programs that make it easier to manage your healthcare. Health Assistants can answer your questions about finding quality care, understanding health plan coverage and costs, making sense of medical bills and more. Call or message a nurse to discuss symptoms, learn about a condition and explore treatment options.* Getting support from an Accolade Health Assistant or nurse is provided at no cost to you.

PlushCare is Accolade’s virtual care service. See and speak with a board-certified doctor or therapist from your phone, tablet or computer – day or night. They can help with urgent medical issues, ongoing and chronic conditions, mental health, preventive care, prescriptions and more. PlushCare doctors can also be assigned as your primary care physician so that you see the same doctor for each virtual visit — making it easier to manage ongoing conditions and creating a trusting relationship with a doctor and care team who are easy to reach.

2nd.MD is Accolade’s expert medical opinion service. Get a second opinion from a leading specialist at no cost so that you feel confident about a new diagnosis, surgery, treatment plan or medication.

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New ID Cards

To reflect the added benefit of Accolade to the UC PPO plans, we’re renaming the plans:

Current Name: UC Care
New Name: UC Care + Accolade

Current Name : UC Health Savings Plan (HSP)
New Name: Health Savings Plan (HSP) + Accolade

Current Name: CORE
New Name: CORE + Accolade

In late December, you’ll receive a new ID card from Anthem (one card for each covered family member) reflecting the new plan names. Your new card will also include Accolade’s contact information, so you’ll always have it handy. Use your new ID card for all medical and pharmacy services beginning January 1, 2023.

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