By Vic Cox

PacifiCare HMO members at UC may need to make new arrangements for their medical insurance in 2008 since their plan is being discontinued and a substitute offered, the UC Office of the President has announced. Similarly, the Definity Health HRA-PPO (Health Reimbursement Account-Preferred Provider Organization) will no longer be a local option next year.

These changes will affect more than 1,200 employees at UC Santa Barbara, estimates Laura Morgan, campus health care facilitator.

However, Health Net HMO will become the default plan for those PacifiCare members who do not take action during open enrollment, which runs from Nov. 1-27 this year. Likewise, UC will introduce CIGNA Choice Fund PPO to replace Definity, which was offered only at UCSB and UC San Francisco as pilot programs.

UCSB’s 900 PacifiCare members may think that finding a new primary care provider will be difficult, says Morgan. “But that is not likely to be a problem in Santa Barbara,” she adds. Health Net’s benefits and providers are “virtually the same as PacifiCare” in California.

In fact, Health Net has provider groups in Santa Maria, Ventura/Oxnard, and the Ojai Valley as well as two in Santa Barbara. Former PacifiCare members will have to confirm their physician preference by selecting them again during open enrollment. If an automatic assignment of a new doctor is not to an employee’s liking, it can be changed during the month of January, Morgan points out.

In addition, Health Net’s cost to employees in all four salary bands will decrease slightly in 2008. For example, those earning $45,000 or less will see their part of the monthly premium drop between $3.78 and $11.16, depending on how many family members are covered. For those earning up to $89,000, the cuts range from $2.53 to $7.65, according to figures provided by the Human Resources Benefits Office.

United Behavioral Health’s network has been selected as UC’s new mental health provider for all non-Medicare plans except Core. Kaiser members may select UBH or Kaiser clinicians. This may mean a change in service providers for some, but employees may ask for additional time to find a UBH provider. UBH will also cover co-pays for the first three in-network visits. For more details, go to <http://atyourservice.ucop.edu/briefing/2007_sep/ ubh_benefits.html>.

With all the changes in store it may help to check out UCOP’s open enrollment Web site <http://atyourservice.ucop.edu> or go to some of the presentations organized by UCSB Benefits Office. Beginning on Oct. 29 in SAASB 3101, staff will present open enrollment highlights during the noon hour.

Other workshops include noontime medical plan comparison sessions on Nov. 9 and Nov. 19, and a session on Nov. 13 at 1:30 p.m. on the CIGNA Choice Fund. All will be held in SAASB 3101.

A free Open Enrollment Fair is planned for Nov. 2 between noon and 3 p.m. in Corwin Pavilion, highlighted by talks by representatives of Health Net, UBH, and CIGNA Choice Fund. Other representatives and benefits staff will answer questions about dental, vision, and legal plans as well as the flexible spending accounts offered by SHPS.