Frequently Asked Questions (FAQs)

Do I have to do anything during Open Enrollment?

Yes, read the Retiree Open Enrollment booklet and New Dimensions. However, if you are satisfied with your current elections, no action is required and coverage just continues in the new year with any applicable rate changes. Keep in mind that some years have major changes, including the addition and/or elimination of whole plan, which are described in the Open Enrollment materials, which may require a choice on your part.

What is the difference between a plan and a provider?

A plan is an insurance plan. Expenses are paid for according to plan design, described in the annually issued plan booklet. Plan design can change from year to year (for example the deductible amount, percentage of cost covered by the plan, services/treatments excluded and included under coverage, etc.). Changes in plan design for the following year are announced during Open Enrollment.

A provider is a care provider, such as a doctor, hospital or other out-patient facility, who may or may not accept specific plans.

Medicare Part D

Part D is the designation given a Medicare drug plan (just as Part A designates hospitalization benefits, Part B designates medical services and Part C designates a Medicare Advantage plan). Medicare recipients must have a Part D plan. When a retiree continues with UC Medicare health plans, Part D is included and does not need to be enrolled separatedly as you might have to with other non-UC Medicare plans.

PPO without Rx

The UC Medicare PPO plan without Rx (Rx = prescription drug plan) was originally implemented for UC retirees that also had military TriCare for Life because Medicare does not allow a person to have two Medicare Rx plans. After a few years the plan was made available to all UC retirees and it allows a UC retiree to have a UC Medicare medical plan and go out and purchase a non-UC Medicare Rx plan. Whether this is a good idea depends on whether a person has other coverage, coverage needs for family members and/or the cost of purchasing a Part D plan. Keep in mind, that having the UC Medicare PPO without Rx plan alone is not complete coverage. To be enrolled properly in Medicare, you must also have a Medicare Part D plan. UC retirees enrolled in PPO without Rx are expected to obtain and maintain Rx coverage outside of UC that meets Medicare Part D specifications or be subject to Part D late enrollment penalty. The UC requires proof of alternative RX enrollment in order to enroll in the PPO without Rx plan.

Part B reimbursement

Retirees may see information in the Open Enrollment rate information, or possibly on their pension statements, labeled Part B Reimbursement. This figure represents a payment from UC (added to your pension check) because the health plan they are enrolled in costs UC less than the maximum amount the UC is willing to pay for the plan. For example, if the UC is willing to pay $100/month towards a health plan and that health plan actually costs $90/month, then the UC will take that $10 amount and return it to the member, labeled as a Part B reimbursement. It is called a Part B Reimbursement because all Medicare enrollees have to pay a monthly Part B premium and the Part B reimbursement can be seen to help offset the costs retirees must pay for Part B. The amount can vary from year-to-year and, in fact, can be zero--it all depends on the monthly costs for the Medicare plan chosen.

ID Cards

If the Open Enrollment material informs you that your plan will be issuing new ID cards or if you change plans, you can expect to receive those ID cards in late December or early January. If you do not receive a new card by the 2nd week of January, you should call the plan's Customer Service number. Medical plan ID cards are not issued by UC.

Changes to your contact information

If you have made any changes to your personal contact information (address, phone number, etc.), you need to inform the UC Retirement Administration Service Center (RASC). You may also review and update your contact information online through the UCRAYS portal.

RASC will send new contact information to your enrolled plans (medical, dental and legal). If you have Fidelity accounts or VSP Vision coverage, you need to contact those offices separately.

Changes to your beneficiaries

You can make changes to your beneficiary designations at any time by going online to your UCRAYS account. Beneficiary changes for Fidelity accounts must be done through the Fidelity website.

Create an online profile with medical and dental plans

Retirees are encouraged to create online profiles with their medical and dental plans. With an online profile members can:

• Obtain ID cards.
• Review enrollment and effective dates of coverage.
• Find in-network providers & hosptials.
• Review past claims & expenses.
• Find details about your coverage, including, for example, discounts for wellness programs.
• Receive emails from your plan about your coverage (UC does NOT share your email information with plans; only you can do this).
• Each adult member of a plan can have their own confidential online profile and access.

Review your UC pension income statements

It is always a good idea to check your pension statements on a monthly basis to make sure there are no errors, and if there is an error it can be corrected quickly. In particular, you should check your January pension check to make sure any Open Enrollment changes are correct. To check your pension statements, visit UCRAYS.

Abbreviations found on UC pension income statements

Medicare coverage only vs Medicare/UC coverage

Retirees do not need to continue with UC medical coverage. If a retiree is eligible for Medicare, the person can certainly choose to be covered by Medicare alone through what is referred to as Original Medicare. However, Original Medicare alone is usually not considered sufficient and that is why there are so many Medicare supplement plans available in the marketplace. For one, Medicare Parts A & B do not provide prescription drug coverage and so a person would at least need to purchase a Part D plan. UC retiree medical plans provide Part D coverage, (with the exception of Medicare PPO without Rx). Original Medicare alone has a number co-pays or co-insurance for many procedures as well as limits to the number of hospitalization days, etc. Most retirees will certainly look into buying a supplemental plan or an Advantage plan to cover almost up to 100% of their medical costs---UC plans can be considered just another option in the marketplace.

Everyone will need to do their own evaluation of the marketplace but UC plans probably offer more personalized service and comparable or better coverage (of course, the question of cost will be affected by one's Graduated Eligibility percentage). Should a retiree eligible for UC coverage wish to forgo it, they should call RASC to "suspend" their coverage--rather than to "drop" their coverage. By "suspending" the coverage, the retiree retains the ability to return to UC coverage during Open Enrollment or if they should suffer a loss of their current coverage.

Medicare Publications

https://www.medicare.gov/publications/