Participation Terms and Conditions

Your Social Security number will be requested only when needed by benefit plan administration for financial reporting or to verify your identity, in compliance with state and federal law.

As a participant in UC-sponsored plans, you agree to the following terms and conditions:

1. Most of the medical plans that UC offers [including the medical portion of Blue Cross PLUS and Blue Cross PPO (offered by Blue Cross of California)^®, Health Net, Western Health Advantage, and CIGNA Choice Fund], Core (offered by BC Life and Health Insurance Company), High Option Supplement to Medicare (offered by BC Life and Health Insurance Company), and Kaiser Permanente require resolution of medical malpractice and other disputes through binding arbitration. When you enroll in these plans, you agree that any dispute between you (and/or your enrolled family members) and the medical plan must be submitted to binding arbitration. You agree to waive your right to a jury or court trial to resolve these disputes. For more information about each plan's arbitration provision, please see the appropriate plan booklet or call the plan.
2. By making an election with your written or electronic signature, you are authorizing the University to take deductions from your earnings (employees)/monthly Retirement Plan income (retirees) to cover your monthly costs, if any, for the plans you have chosen for yourself and your eligible family members.
3. You acknowledge and accept all terms and conditions of the UC-sponsored plans in which you are enrolled as stated in the plan booklets and UC's Group Insurance Regulations.
4. If you enroll family members, the University and/or carrier may require proof of eligibility. Marriage or birth certificates, adoption papers, tax records, and the like may be requested. You agree to provide such documentation upon request.
5. If you enroll your eligible domestic partner and/or your partner's eligible child(ren) or grandchild(ren), or if you enroll or have enrolled your natural or adopted child who is not claimed as your tax dependent, you acknowledge that the UC/employer contribution for their medical and/or dental and/or vision coverage may be reported as income to you, subject to FICA (Social Security and Medicare) and federal and California state income tax withholding.
6. If you specifically ask UC representatives to intercede on your behalf with your insurance plan, University representatives will request minimum necessary health information required to assist you with your problem. If more protected health information is needed to solve your problem, in compliance with state privacy laws and federal laws, including HIPAA (Health Insurance Portability and Accountability Act of 1996), you may be required to sign an authorization allowing UC to provide the insurance plan with relevant personal health information or authorizing the insurance plan to release such information to the University representative.
7. Actions you take during Open Enrollment will be effective the following January 1, unless otherwise stated.
8. You certify that all enrolled family members are eligible for coverage based on the definitions and rules specified in the UC publications, Group Insurance Eligibility Factsheet for Employees and Eligible Family Members and Group Insurance Eligibility Factsheet for Retirees and Eligible Family Members. You agree that you will de-enroll them within 31 days if they lose eligibility. You further certify that all the information you provide is true to the best of your knowledge, under penalty of perjury.
9. Making false statements about satisfying eligibility criteria, failing to notify the University of loss of eligibility within 31 days of such loss, or failing to provide documentation when requested will lead to de-enrollment of the family members and possible legal action. In addition, employees/retirees may be subject to disciplinary action (e.g., loss of health benefits for up to 12 months) and will be responsible
   for any employer contributions to and benefits paid by the plan for the ineligible coverage.