Open enrollment news is coming early this year:
- Employees who belong to Western Health Advantage HMO (health maintenance organization) learned Monday (Aug. 26) that the university will drop WHA as a medical plan option next year.
- As a comparable alternative, the university will offer its existing UC Blue & Gold HMO (administered by Health Net) at rates that will come down to be among the lowest of all of UC’s medical plan options. UC Blue & Gold’s provider network includes UC Davis Health and UC Davis Medical Group, as well as Hill Physicians, Mercy Medical Group, Meritage, Woodland Clinic and St. Joseph Health.
- Existing members of UC Blue & Gold HMO will also benefit from the cost reduction.
- All other employees can switch to UC Blue & Gold HMO during open enrollment, so they can also benefit from the cost reduction.
UC Blue & Gold and Western Health Advantage HMOs have nearly matching medical provider networks. So, if you move from WHA to UC Blue & Gold, you should be able to keep your providers with uninterrupted access — only your insurance card will change. See the FAQ below for exceptions.
The switch will be automatic, unless you choose one of UC’s other health plan options during open enrollment, Oct. 31-Nov. 26. WHA members to whom this applies include employees, retirees and their eligible dependents.
When open enrollment begins, you will see yourself enrolled in UC Blue & Gold HMO by default, in the online system. If you take no action by the open enrollment deadline, your switch to UC Blue & Gold will take effect Jan. 1. Or, you can choose a different plan — so long as you act before the open enrollment deadline.
The reason for the change
“UC Davis wants employees and their families to have access to the best care, the most innovative technology, and the best expert clinicians through the most affordable, cost-effective health plans,” reads an FAQ posted on a website dedicated to the transition from WHA.
“By making this change, we can bring down premiums and health care costs for our employees, while also ensuring more of our employees have access to the high quality of care provided by UC Davis Health or other providers in the UC Blue & Gold HMO network.”
UC Davis will subsidize UC Blue & Gold’s reduced premiums for employees for the next five years “to help grow the (plan’s) insurance pool and reduce the cost of health care for our employees,” the FAQ states. “Unfortunately, it is not possible to subsidize retiree premiums.”
The annual open enrollment booklet — with complete information, including monthly premiums — will arrive by mail at home addresses toward the end of October (open enrollment will open Thursday, Oct. 31, and close Tuesday, Nov. 26, two days before Thanksgiving. Information also will be posted to UCnet as open enrollment approaches.
Important notes for this year’s open enrollment:
- UCPath — Access to the open enrollment website will be through UCPath, which goes live Sept. 27 at UC Davis, UC Davis Health and Davis-based UC Agriculture and Natural Resources. More information on UCPath at UC Davis.
- Duo — To use UCPath, you must be signed up for Duo multifactor authentication. See “How to Move to Duo.” Need help with Duo? IT Express consultants are attending all Davis campus UCPath town halls in August and September. The consultants will answer questions about Duo and/or help people enroll on the spot. The town hall schedule continues today (Aug. 27) to Wednesday, Sept. 25, with one town hall held weekly. See the schedule here.
More from the FAQ
- Who will be affected by this transition?
- All UC Davis employees, retirees and their dependents. Note: Medical and veterinary residents and students will continue their WHA enrollment until their coverage year ends in June 2020.
- Will I still be able to see my current primary care physician and specialists?
- WHA and UC Blue & Gold have nearly matching provider networks, so there should be uninterrupted access to your current care team. The exception to this is that NorthBay Healthcare may not be available, and the network through which you access mental health services may be slightly different than the current provider network. The vast majority of WHA enrollees will keep the same doctors they had with WHA.
- I heard that NorthBay Health was not part of the UC Blue & Gold HMO network. What if my physician is part of NorthBay?
- The UC Office of the President has asked Health Net (which administers UC Blue & Gold HMO) to engage in contract talks with NorthBay Healthcare. We are hopeful they will join the UC Blue & Gold provider network so that our members who use NorthBay Healthcare will see no changes in their providers. Most, if not all, NorthBay providers are network providers under UC’s PPO health insurance plans through Anthem Blue Cross.
- What medical groups are available under the UC Blue & Gold plan?
- Locally, the UC Davis Medical Group, Hill Physicians, Mercy Medical Group, Meritage, Woodland Clinic and St. Joseph Health are offered. Many other groups are available in other parts of urban California.
- What about behavioral health?
- For members moving from WHA to UC Blue & Gold HMO, your behavioral health network will change from Optum Behavioral Health to Health Net’s MHN. UC Blue & Gold went through the same transition in January 2019 with little impact to members, after Health Net contracted with additional providers or made arrangements with others to continue their relationships with members. Overall, members experienced very little disruption through the transition. During open enrollment, employees who receive behavioral health services should check to make sure their providers are available, since UC Blue & Gold HMO behavioral health services are provided by MHN, not Optum.
- If I’m in WHA now, will my premiums go up?
- Historically, employee contributions have risen a little each year and that may still be the case. However, because UC Davis will provide a subsidy to the employee portion of the health care premium, your premium costs will be no higher than other UC HMO premiums. Retiree premiums cannot be subsidized, which will result in premium increases as they transition to UC Blue & Gold HMO.
- Why should I choose UC Blue & Gold?
- This plan gives you access to the nationally-recognized experts and specialists here at UC Davis Health. We would like our best doctors taking care of our employees and making sure they stay healthy and have access to the best health care available.
- Will employees enrolled in other HMOs be affected by this transition?