Plan changes for 2012

Below is a summary of changes to the benefits described in the most recent booklet (or Evidence of Coverage) for your plan. The most recent versions are available online or you can request a copy from the plan carrier.

Medical Plans

Anthem Blue Cross PPO

• Retail generic prescription drug copay reduced from $15 to $10.
• Specialty medications covered only if dispensed by Precision Rx Specialty Solutions.

Anthem Blue Cross PLUS

• Retail generic prescription drug copay reduced from $15 to $10.
• Specialty medications covered only if dispensed by Precision Rx Specialty Solutions.
• Out-of-network behavioral health benefits added.

CIGNA Choice Fund

• Online physician visits added, with members paying 20 percent of visit cost.
• Out-of-network behavioral health benefits added.

Health Net

• Generic prescription drug copay reduced from $10 to $5 (retail) and $20 to $10 (mail order).

Kaiser Permanente-CA

• Generic prescription drug copay reduced from $10 to $5 (retail) and $20 to $10 (mail order).
• Prescription drugs at plan pharmacy limited to a 30-day supply.
• Prescription drug copays for mail order changed to $10 for generic and $40 for brand-name, up to a 100-day supply.

Western Health Advantage

• Generic prescription drug copay reduced from $10 to $5 (retail) and $20 to $10 (mail order).
• The copay for Urgent Care at any network provider is $15.

United Behavioral Health

The Mental Health Parity Act, signed into law in 2008 and effective January 1, 2012, requires employers to offer a level of mental health benefits at least equal to other medical benefits offered. To comply with the law, UC is enhancing mental health benefits, including adding out-of-network services to Anthem Blue cross PLUS and CIGNA Choice Fund.

Other plan changes include:

• Limits on in-patient treatment days are being removed from all plans.
• Penalties for non-compliance with substance abuse treatment no longer apply.
• Notification penalties will be consistent with medical-plan penalties; for example, if an Anthem Blue Cross PLUS member uses in-network services without preauthorization, the claim will be paid at the out-of-network level.

Dental Plans

DeltaCare® USA

• Tobacco counseling for the control and prevention of oral disease is being added at no cost to the member.
• Coverage for additional fixed prosthodontics (bridge-related) procedures has been added:
  • Pontic – indirect resin based composite $50
  • Pontic – titanium $150
  • Crown – indirect resin based composite $50
  • Crown – titanium $150

ARAG Legal Plan

There are no plan or rate changes for 2012.

During Open Enrollment, all UC employees may download a copy of a living will and health care power of attorney for free. Read more.

Vision Service Plan

• The discount on additional pairs of prescription and non-prescription glasses, including sunglasses, when purchased the same day as the member’s eye exam from the same VSP doctor who provided the exam is increasing from 20% to 30%.  Members will still receive 20% discount for unlimited additional pairs of glasses if purchased through any VSP doctor within 12 months of the last covered eye exam.
• A Diabetic Eye Care Program, which provides medical eye care services specifically targeted to member with Type 1 diabetes, is being added.

Supplemental Disability

Rates are increasing for 2012. More Information is available here.