UCSB Human Resources, Benefits

1. Blue Shield Health Savings Plan UCSB Human Resources, Benefits This presentation is intended for communication purposes only.Please see the At Your Service website (http://atyourservice.ucop.edu) and plan documents for complete information. 1 11/2013

2. Blue Shield Health Savings Plan Combines high deductible PPO with account to pay out-of-pocket expenses + Medical Coverage Blue Shield PPO Health Savings Account HealthEquity

3. Preventive Care • Preventive care is covered at 100% with Blue Shield PPO providers • Preventive care includes: • Annual well visit and labs • Well woman visits and labs • Preventive screening tests • Immunizations • See list of preventive services on http://www.blueshieldca.com/uc

4. Blue Shield PPO • 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 a Blue Shield PPO provider • “Out-of-pocket Maximum” limits your financial liability

5. Residence, Networks & Travel • The employee must live in US • 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

6. Blue Shield PPO - Plan Design

7. Deductible, Coinsurance, OOPM Individual (Single) Preferred Providers You can use the UC Contribution to the Health Savings Account to pay part of the deductible.

8. Deductible, Coinsurance, OOPM Family (2 or more)Preferred Providers The full family deductible must be met before plan shares costs You can use the UC Contribution to the Health Savings Account to pay part of the deductible.

9. Allowed Amount – In Network PPO plans negotiate “allowed” rates to process claims.

10. Allowed Amount – Out of Network PPO plans assign “allowed” rates to process claims.

11. Medical Claims, EOBs & Bills Provider sends billThe bill should match the EOB. It should reflect the in-network discount and any payments received from health plan. You receive services You pay nothing at the time of service for in-network care Provider sends claimfor services to Blue Shield • You pay provider • Pay with HSA funds • or • Pay with other funds Blue Shield sends EOB Explanation of Benefits (EOB) outlines allowed charges, deductible and co-insurance. “This is not a bill”.

12. Prescription Drugs • There is no separate drug plan with copays • Drug expenses are applied to the plan in the same way as medical expenses • You pay full cost of medication until you satisfy the deductible • After deductible, you pay 20% at preferred pharmacies

13. Pharmacy Claims You go to the pharmacy Give pharmacist your Blue Shield ID card so they can apply the Blue Shield Rx discount Pay with your HSA debit card or Pay with personal funds and later go to your HealthEquity account online and reimburse yourself(if you have money in the account)

14. Learn more about PPO Costs Fair Health Consumer http://www.fairhealthconsumer.org/ Health Care Blue Book https://www.healthcarebluebook.com/ Good Rx • http://www.goodrx.com • Estimate cost of drugs

15. Find costs on Blue Shield Website After your enrollment is complete and you are in the Blue Shield membership system, you will have access to additional tools. http://www.blueshieldca.com/uc • Treatment Cost Estimator Tool • Drug costs, information and claim summary

17. Health Saving Account • High deductible medical plan paired with a Health Savings Account + Blue Shield PPO Health Savings Account • The Health Savings Account is a separate account that can be used to pay medical and other health expenses.

18. Why is HSA better? • You keep the money even if you change jobs or insurance plans • You can make contributions at any time • It has triple tax advantage • No Federal taxes on contributions • No taxes when funds are used • No taxes on earnings • HSA funds rollover from year to year; no use it or lose it as with Health FSA

19. Annual Contributions by UC & Employee • UC Contribution (1/1/14) • $500 individual • $1000 family • You can contribute up to (optional): • Single-coverage: $2,800 • Family-coverage: $5,550 • Catch-up contribution, age 55+: $1,000 Tip: Contribute the money you would have put in your Health FSA. UC Contribution is prorated for plans that start after January 1

20. Who is eligible for HSA? To own an HSA you need to: • Be covered ONLY by an HSA-qualified health plan • Other health coverage may disqualify you, including Health FSA, Medicare or traditional health plan • Not be claimed as a dependent on someone else’s tax return

21. Whose expenses can be paid with HSA? • The money in your HSA can be used to pay for qualified medical expenses of any family member who qualifies as a dependent on your tax return. • The family member does not have to be enrolled in this plan

22. Use the HSA to pay for… • Deductible • Coinsurance • Any IRS Publication 502 Expenses, including: • Medical • Dental • Vision • Prescription drug • Long Term Care insurance premiums • See Health Equity website for more information

23. Your Responsibility • Follow HSA eligibility rules • Contribute only the amount allowed by IRS • Use HSA funds for eligible expenses • Keep itemized receipts as tax documents

24. How does HSA work? • UC makes annual contribution for plans that start on January 1. • You may contribute through payroll deduction or make post-tax contributions to HealthEquity • Use a HSA debit card to pay for health expenses • Use HealthEquity website to pay medical and other health claims • Invest HSA dollars when account balance reaches $2000 – no fees to invest

25. HSA vs FSA • The HSA is NOTlike the Health FSA where you have access to the entire annual contribution starting on January 1 • The HSA is like a checking account – the money must be in the account before you can spend it • You make monthly contributions through payroll deduction, you can change the contribution amount during the year • You can make one time contributions through Health Equity

26. www.healthequity.com/ed/uc Register as new member on this site.

27. www.blueshieldca.com/uc Register as new member on this site.

28. Health Equity Member Portal

29. Claim Summary Screen • View claim detail • Choose action to be taken • Pay provider • Reimburse themselves • Close expense • Pay from HSA account or external checking/savings account • Schedule payment

30. Member Resources • Welcome Kit - to get you started • Debit card loaded with UC Contribution • Online resources • Treatment cost estimator tool • Drug costs, information and claim summary • Use smart phone browser to access mobile website

32. Optum(formerly United Behavioral Health) • Optumcoordinates behavioral health care for all medical plans (except CORE) • psychiatrist • psychologist • therapist • substance abuse treatment • No referral required from physician • Call Optum to notify prior to first visit

33. Behavioral/Mental Health • Medical and behavioral health deductibles and OOPM cross accumulate. • See the Optum Evidence of Coverage for complete details.

34. For more information HealthEquityMember Services is available every hour of every day Call the Blue Shield/UC dedicated line 1.855.201.8375 say “Health Savings Account” www.healthequity.com/ed/ucwww.blueshieldca.com/uc