EMPLOYEE MEDICAL PLANS

Health Net Blue and Gold HMO

This plan is an HMO (Health Maintenance Organization). You choose a primary care physician (PCP) who coordinates your care and refers you to specialists within your designated medical group.  The plan covers only the cost of services authorized by your PCP.  You pay a small copayment for prescription drugs and some services. HMOs provide coverage for services outside of your medical group only in cases of emergency.

Plan Highlights

• Has a custom network of providers created exclusively for UC, including
• All UC Medical Centers and medical groups
• 16 of the 20 largest provider groups serving current UC Health Net members
• Lower premiums than the standard Health Net HMO

Plan changes for 2013:

The following medical groups and hospitals have been added to the Health Net Blue & Gold network:

• Affinity Medical Group – Eden/San Leandro (Alameda County)
• ARTA Health Network (Orange County)
• Memorial Care Medical Group (Orange County)
• Premier Physicians Network (Los Angeles County)
• Physicians Medical Group of San Jose (Santa Clara County)
• Vantage Medical Group (San Diego County)

The following medical groups have been removed from the Health Net Blue & Gold network:

• Brown and Toland (San Francisco County)
  • Information for current Brown & Toland group members
• Monarch (Orange County)
  • Information for current Monarch medical group members

Copayments are increasing:

• Office visits: $20
• Urgent care: $20
• Outpatient surgery at hospital ambulatory surgery centers: $100
• Emergency room visits: $75
• Brand name prescription drugs: $25
• Non-formulary prescription drugs: $40

The copayment for smoking cessation drugs is now $0

In-network women’s preventive services offered at no charge

 

2013 Health Net Blue & Gold HMO Plan Costs
Pay Band (per annum)		Self	Self + Child	Self + Adult	Family
Under $50,000	Employee Cost	$25.26	$45.47	$101.25	$121.45
	UC Contribution	558.21	1,004.78	1,124.04	1,570.61
$50,001 - $98,000	Employee Cost	$61.31	$110.36	$183.55	$232.59
	UC Contribution	522.16	939.89	1,041.74	1,459.47
$98,001 to $147,000	Employee Cost	$98.31	$176.96	$257.31	$335.95
	UC Contribution	485.16	873.29	967.98	1,356.11
$147,001 and above	Employee Cost	$136.62	$245.92	$333.73	$443.02
	UC Contribution	446.85	804.33	891.56	1,249.04